AREN’T WE ALL CONCERNED WITH HOW WE LOOK? THE BURDEN, PAIN, AND ISOLATION OF ACTUAL DISFIGUREMENT
AREN’T WE ALL CONCERNED WITH HOW WE LOOK? THE BURDEN, PAIN, AND ISOLATION OF ACTUAL DISFIGUREMENTErving Goffman, other researchers, and authors such as Lucy Grealy have vividly and movingly described the burden, emotional pain, and social isolation of people with visible physical deformities. Such disfigurements may result from birth defects, illnesses, accidents, or other causes. I’ve been struck by how similar the experiences of many of these people are to those of people with BDD. This makes sense. Because people with BDD think—and may be completely convinced—that their defect looks unattractive, even grotesque, it’s not surprising that their experience might be similar to that of people with actual disfigurement. Indeed, some people with BDD describe themselves this way: “I’m the third ugliest person in the world,” “I look like a burn victim,” “I look like the Elephant Man.”Research suggests that people with facial disfigurements are very aware of their deformities and other people’s reaction to them. They feel stigmatized. They may assume that all of the behavior of others who interact with them is a reaction to their appearance. This awareness of being obviously deviant in a negative way profoundly shapes their self-concept and self-esteem, which may be quite low. The visibly damaged often feel a profound sense of shame and vulnerability to exposure, devaluation, and rejection. They may feel deeply defective and not quite human. These experiences are similar to those of many people with BDD.Disfigured people generally need more energy to prepare for going out in public and must cope with emotional hurdles in social situations in which the defect will be visible. When they do go out into the world, they may hide the defect by disguising it. They often try to fade into the background rather than stand out “deviantly” in the crowd. They struggle to maintain self-esteem and be accepted by others. McGregor describes one reaction to facial disfigurement as “social death”—that is, badly disfigured individuals may cut off their relationships with the world and go into a closet existence. People with BDD— especially more severe BDD—experience strikingly similar feelings, fears, behaviors, and isolation.*223\204\8*
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