Three beautiful women, three stories of self-loathing that’ll break your heart . . .
What would you change about your appearance? a tuck here, a lift there — perhaps a smaller nose or fewer wrinkles — we all see imperfections when we look in the mirror.
But when Liane Piper looks at her reflection, she sees a monster so ugly that she is convinced her face is hideously deformed.
‘I put so much effort into trying to look nice and I never do,’ she says, tears springing to her eyes. ‘I look fat and ugly. I shouldn’t be allowed outside with all those normal faces.
‘Mine is deformed. Sometimes I just want to scratch it off.’
Liane is, objectively speaking, a beautiful young woman. alabaster skin, piercing blue-green eyes and supermodel-sharp cheekbones — she has the sort of looks that others can only dream of. But 29-yearold Liane can’t see that at all.
She suffers from body dysmorphic disorder (BDD), a crippling mental condition which causes sufferers to become obsessed with perceived defects or flaws in their appearance. Every day, she spends hours — it’s such an engrained habit she can’t tell me exactly how many — obsessively analysing her facial features and using heavy make-up to camouflage the parts she doesn’t like.
But hers are not the self-indulgent neuroses of an average 20something. Far from it.
So debilitating is Liane’s condition that she rarely leaves her house in South-West London, except to go to work at a nearby depot for a builders’ merchants, where colleagues are aware of her condition.
the prospect of socialising fills her with terror. On holiday, she has to cover her arms and legs with baggy clothing, fearing others would be ‘disgusted’ by the sight of her skin.
‘I find it really difficult to cope with the way I look,’ she explains. ‘Every time I’m out in public I feel like people are staring at me and talking about me.
‘It’s like my brain is working overtime, telling me things that are wrong with me. there isn’t time to think about anything else.’
Body dysmorphia also takes a heavy toll on Liane’s relationship with her boyfriend of four years, Mitch, as her fears make it difficult to have a normal physical life together.
Liane says the thought of Mitch, a personal trainer, seeing her body makes her feel ‘physically sick’.
‘at first I would make sure that whenever I saw him I had loads of make-up on,’ she explains. ‘When we got more serious and he started staying over, that’s when he saw who I really was.
‘In my head I know he must be attracted to me but I don’t see how he could be. I repulse myself. there is always the fear, even now, that he’s going to wake up and go, “What have I done?” ’
their sex life, she admits, has been non- existent for the past two years, driving a wedge between them.
Body dysmorphic disorder is surprisingly common, affecting one in 50 people in this country.
Yet it often goes undiagnosed, untreated and can be cruelly underestimated by family, friends and even medical professionals.
Liane bravely features with other women suffering from the debilitating disorder in a new BBC documentary, Ugly Me: My Life With Body Dysmorphia, which aims to raise awareness of this extraordinary, yet relatively still little-known, condition.
Body dysmorphia has been recognised since the 19th century, and its name derives from the Greek word for ‘misshapenness’ or ‘ugliness’.
Over the years, several famous people have been diagnosed with the condition — including the painter andy War hol, author Sylvia Plath and musician Michael Jackson.
But only 5 per cent of sufferers get help from mental health services and there is, to date, only one specialist treatment centre in the UK — at the Maudsley hospital in South London.
‘It is certainly very misunderstood,’ explains Professor David Veale, a consultant psychiatrist there and one of the world’s leading experts in the disorder.
‘the definition of body dysmorphic disorder is a preoccupation with perceived defects. It’s very distressing and can interfere with sufferers’ lives in various ways.
‘Like most emotional disorders, there are a number of personality traits that make you more vulnerable. there are things that have a strong inherited component — whether you’re a perfectionist or you’ve just got a very anxious temperament.
‘It may also be triggered by early experiences in one’s childhood: being teased or humiliated about some aspects of your appearance. You begin to think of yourself as being something “different”, and you start to protect yourself.’
the condition can take hold at any stage of a person’s life — and, like eating disorders and other obsessive- compulsive traits — affects men as well as women.
For Minnie Iris, 50, a childhood marred by bullying led to body dysmorphia being diagnosed when she was 38, though she suspects it started around the age of 11.
‘I was born in India and my parents moved here when I was six,’ she explains. ‘I felt like an outsider. at school I remember-sitting in a circle in a classroom and a little boy whispered in my ear, “You’re so ugly, no one will ever marry you.” ’
at secondary school, one of few asian students, Minnie was subjected to cruel racist taunts.
‘I had inherited this prominent, hooked nose from my grandfather and it gave the bullies something to latch on to,’ she explains.
‘I would walk past and they would chant, “Witch, with a big long nose.” It reinforced my belief that I was ugly, that I wasn’t good enough.
‘I became obsessed with my nose and also with the lines around my neck. I would spend hours in front of the mirror inspecting them, feeling afraid and anxious.’
at 18, Minnie, who lives in Surrey, had cosmetic surgery to change the size and shape of her nose. But her obsession simply shifted to other parts of her body.
Still, she was able to lead a relatively normal life until her mother died in 2005, when she gave up her job as an art curator to take care of her mother’s affairs and found herself spiralling downwards. ‘My hair started to thin and I developed dark circles under my eyes,’ she recalls.
‘‘It was a normal part of grief and ageing but it was really frightening for me. It felt like my life depended on my appearance.
‘I had to avoid mirrors because I was so horrified by my reflection. Being out of the house became incredibly distressing — I had to keep my head down in supermarkets, even on trains where there are reflective surfaces.
‘I was breathless and panicky almost all of the time. Eventually, the body dysmorphia became so all-consuming that the only thing I could think of doing was ending my life. that’s when I went to my GP and asked for help.’
Cognitive behavioural therapy, a type of psychotherapy which focuses on breaking negative thought patterns, is the most common — and most successful — way of treating the condition.
Practitioners often ask patients to carry out ‘exposure’ tasks, which involve putting themselves in situations that they might normally find stressful, such as posing for photographs or speaking to strangers.
One of the things sufferers find most difficult is forming — and maintaining — relationships, due to their extremely low self-esteem.
Minnie, married at 27, was with her husband for ten years, but says: ‘I chose someone I wasn’t attracted to, because I didn’t think I had the right to be with someone good-looking. they wouldn’t have been interested in me.
‘I managed to keep my condition under control during the marriage but it was always there, affecting every decision I made. I’ve been single since we parted.’ heartbreakingly, though she longed to be a mother, she admits her condition stopped her from having children.
‘I wasn’t able to express it at the time,’ she says.
‘But I always felt that I couldn’t have children because the child would be so ugly that it would be totally unacceptable.
‘If I gave birth to anything, that child would be a hideous monster. It wasn’t fair to bring it into the world.’
For parents of those suffering from body dysmorphia, daily life can be agonising.
Liane’s mum Lisa, 52, describes how her once-confident daughter became racked by self-doubt.
‘She was a perfect child — as good as gold,’ Lisa says. ‘She
‘Sometimes I just want to scratch my face off’
‘I took 200 selfies a day to check how I looked’
wasn’t self-conscious at all. Then when she got to 14, she started distancing herself from me. It began after we went on holiday that year.
‘ She started wearing lots of make-up and fake tan, and I just thought that was part of growing up. I had no idea it would turn into this.
‘It’s such a waste of her life. I want her to go back to being my daughter.’
Photographs from Liane’s teenage years show a smiling, carefree young woman. But she can’t bear to look at pictures of her younger self. ‘I remember that holiday — it was the first time I thought I was really ugly,’ she says.
‘There was a kids’ club and all the girls there were wearing makeup and the boys were interested in them. But I was a tomboy and I felt like nobody wanted to talk to me. It was horrible.’
Such innocuous childhood events can, Professor Veale says, have devastating consequences when a person is predisposed to obsessive, self-critical thoughts.
‘ It’s not something you can reverse — it just takes time to redevelop new ways of thinking,’ he explains.
‘Someone with body dysmorphic disorder will have 90 per cent attention on themselves and maybe 10 per cent on the world around them.
‘We have to help people get out of their own heads and focus on what’s happening elsewhere.’
In a society which places so much emphasis on appearance, such advice is not easy to follow.
The internet, particularly social media, plays a pernicious role in exacerbating the symptoms, with sufferers bombarded by perfect, Photoshopped images and airbrushed celebrities — and cases have become more prevalent as a result.
Tragically, suicide among people with body dysmorphia is 30 times the national average.
Sufferers can go to extreme and shocking lengths to change their appearance: one cut the ends off her fingers, another took a hammer to his face.
Alanah Bagwell, 22, a student from Henley-on-Thames in Oxfordshire, is so tormented by body dysmorphia that she has tried to take her own life three times.
Her last attempt, four years ago, led to her being hospitalised for three days.
‘There was this voice inside my head telling me to self-harm and kill myself, that I was disgusting and I deserved to die,’ she says.
‘ Body dysmorphia made me believe that I was a bad person, a bad friend, a bad daughter.
‘It went deeper than my appearance worries. I dropped out of school when I was 14 and barely left the house for five years.
‘I stayed in bed, sleeping, crying and thinking over and over how ugly and disgusting and worthless I was.’
At one of her lowest points, Alanah found herself compulsively taking ‘selfies’ — up to 200 a day — so she could scrutinise her appearance. ‘People might look at those pictures and see a vain, pouting teenager, but that was the only way I could let the world see me,’ she explains.
‘‘I’d spend four hours applying make-up and then obsessively compare myself to others. It took over my life.’
Ironically, it was online that she first came across body dysmorphic disorder — leading to her diagnosis and eventual expert help.
‘One day I Googled, “I’m so ugly that I want to die.” Up came these websites about body dysmorphia — and I thought, that’s me. I couldn’t believe other people felt the same way.’
Eight years later, Alanah is – at long last – on the path to recovery. Despite missing most of her GCSE and A-level years, she was able to take her exams belatedly at sixthform college — and is now a second-year psychology student in London.
Minnie, too, is moving on with her life and has become a trustee of the BDD Foundation, a charity raising awareness of the disorder, where she leads support groups for other sufferers.
She still hopes to find a healthy, loving relationship.
Others have a long road ahead. Liane has already had cosmetic surgery to alter her appearance and is, she admits, thinking about having more.
‘I struggle with looking into the future,’ she says. ‘Sometimes I get scared about what I see. In an ideal world, I wouldn’t be anxiety-ridden.
‘But realistically the only way I can see myself being happy is if I change the way I look.
‘I would love to be able to look in the mirror and smile, like a normal person. All I can do is take it one day at a time.’
Ugly Me: My life With Body Dysmorphia is available from 10am on June 6 on BBC Three. Visit bbc.co.uk/iplayer/live/bbcthree
One sufferer cut off the ends of her fingers