Extreme Body Dysmorphia – Crippling Anxiety

Abstract:

This is a case of a woman of 22 who believes she is a gift to mankind from God.  

Fear of aging. Restlessness. Anxiety with her body. ‘Beauty panic attacks’.

In love with her beauty. In love with the millions of UTube, TikTok, and Twitter fans who adore her.

Occupation: Daily blogger on online media channels.

Background; Australian; Mother Spanish; Father Egyptian[1]. Very religious Catholic upbringing.  Attends mass twice a day.

 Case Notes:

First Appointment 10/02/2021[2].

D.O.B. 2003.

Referring Counsellor’s diagnosis: Anxiety Disorder.

Medical diagnosis: Extreme body dysmorphia. She was referred to me by a Somatic Psychotherapist to help her with her obsession with Botox. Her current ‘facial anxiety’ is crippling.

 Case Analysis: I used the following key points and headings in analyzing this case to arrive at the correct prescription of Olibanum sacrum[3].

1. Rubric-repertorisation
2. Theme
3. Striking, or Peculiar Signs and Symptoms; Organon 153
4. Materia Medica
5. How, Why, and When Causations – the ‘Never-well-since-event’.
6. Follow-up Consultations

Below is a transcript from the first consultation. In the text, I have highlighted recurring themes and recurring words.

Question: Your doctor and counsellor are concerned about your obsession with continual Botox injections. I am aware of course that your looks are your occupation and livelihood. I am not making a judgement call on TikTok, or YouTube. My concern is that you have had quite a few anxiety attacks about getting old.

Patient: I am having beauty panic attacks.

Question: What does that mean?

Patient: I am terrified of getting old and getting wrinkles. I want to have cosmetic surgery.

Question: Have you had cosmetic surgery before?

Patient: No.

Question: How is your anxiety affecting you?

Patient: I am beautiful. I am truly above everyone else. Everyone adores me. I thank God every day for my beauty. Everything I have, I have, because God endowed me. I am crippled with fear of losing it; I can already see wrinkles appearing on my face. I am having panic attacks; I can’t breathe. I start sweating. My heart is racing. I can feel my heart beating all the time. I have had everything checked, ECG’s, full body CT scans, MRI’s; everything; so my doctor sent me to you.

 Question: Do you remember when you started to worry about aging?

Patient: I was five years old; we went to visit my grandmother who was dying of liver cancer. I don’t think that my father should have taken me. She was so ugly. I said to God that I would remain pure. I don’t want to become a nun but I am going to live my life married to God. I am not going to get married and have sex. God heard me that day and blessed me with beauty. I go to mass twice a day and have given my soul to God. 

 

Causation: Delusion rubric: soul: exchanged; was: olib-sac. [1] 1.

1. Rubric-repertorisation

• Denial: Delusion rubric: queen, she is a: olib-sac.
• Delusion rubric: nun; she is a: olib-sac. [1] 1.
• Delusion rubric: God: communication with God; he is in: olib-sac.
• Delusion rubric: born into the world; he was newly: olib-sac.
• Delusion rubric: clothes: beautiful; clothes are: olib-sac.

2. Theme

Every patient will have recurring patterns or themes in their lives. The advantage in identifying and understanding the psychological processing that your patient is moving through is that it allows you to narrow the remedies being considered to the remedies listed in those particular rubric categories.

She is not abandoned, or forsaken by society. Olibanum sacrum have psychological ‘delusions of original sin’ in relation to only one sin: that their soul was exchanged for the ability to be in communication with God.

God is synonymous with power and beauty – Delusion rubric: she is a queen. God is also synonymous with religious power and religious responsibility – Delusion rubric: she is a nun.

The action of the simillimum will slowly unravel the psychodynamic need to create and maintain their illusions and delusions. The action of the simillimum will slowly heal their traumatized psyche. The action of the simillimum will also slowly unravel their need to create and maintain their numerous psychosomatic neuroses.

3. Striking, or Peculiar Signs and Symptoms; Organon 153

In unraveling the significant events in the lives of your patients, and repertorising each poignant emotional event, the simillimum will be evident in every case once you identify the disproportionate interpretation of the patient’s life.

Pathology has its foundation in delusional disturbance. This is acknowledged in the modalities of psychiatry and homoeopathy. Psychological insight comes from understanding the Delusion rubrics which are peculiar to a remedy profile.

The Delusion rubric: sees diabolical faces around him; can be interpreted in two ways. If you analyze that the patient feels persecuted by people then they would have many abandonment and persecution rubrics. This woman believes the people are looking at her because she is beautiful and ugly. Her occupation is an online professional Utube sensation.

• Delusion rubric: watched, she is being: olib-sac. [This rubric (in relation to Olibanum sacrum) can pertain to persecutory fears or the desire to be admired and be allocated into ‘delusions of grandeur’.]
• Delusion rubric: dirty: he is: olib-sac. [Olibanum sacrum get depressed if they are not dressed magnificently.]
• Delusion rubric: old: feels old: olib-sac.

 

4. Materia Medica

Olibanum sacrum is a homoeopathic remedy derived from frankincense. Olibanum sacrum have exchanged their soul for beauty – Delusion rubric: soul was exchanged. Olibanum sacrum are the only remedy listed in the Mind rubric: sensation of beauty of the soul, beautiful things.

Olibanum sacrum need to communicate with God to allay their guilt for needing position and power and beauty. Olibanum sacrum is the only remedy listed in the Mind rubrics: desire for seduction, and imaginary love for a person. Olibanum sacrum are in love with God.

Olibanum sacrum have the theme that they are a gift from God and a gift to God.

Olibanum sacrum have the Delusion rubric: he was newly born into the world. Olibanum sacrum perceive that they are pure [she is a nun] and as yet untouched by the world.

They feel responsible for any lack of harmony and they believe they are dutifully bound to bring harmony and peace to man. Olibanum sacrum are the only remedy listed in the Delusion rubric: restlessness with anxiety. Olibanum sacrum are also the only remedy listed in the Mind rubric: anger about disorder.

Communication with God brings peace, order and a heightened awareness of meditative beauty which they crave. Olibanum sacrum have psychological ‘delusions of original sin’ in relation to only one sin: that their soul was exchanged for the ability to be in communication with God. God is synonymous with power and beauty – Delusion rubric: she is a queen. God is also synonymous with religious power and religious responsibility – Delusion rubric: she is a nun.

When Olibanum sacrum are ill and dying they are fearful that they will not find peace and beauty in death. They fear being trapped [she is a prisoner] and divided between heaven and earth.

• Denial: Delusion rubric: God: communication with God; he is in: olib-sac. Delusion rubric: queen, she is a: olib-sac. Delusion rubric: religious: olib-sac. Delusion rubric: nun; she is a: olib-sac. [1] 1. Delusion rubric: cathedral; he is in a: olib-sac. [1] 1. Delusion rubric: apparition; he would see an: olib-sac. Delusion rubric: flying: church; in the: olib-sac. [1] 1. Delusion rubric: convent, she will have to go to a: olib-sac. Delusion rubric: born into the world; he was newly: olib-sac. Delusion rubric: clothes: beautiful; clothes are: olib-sac. Delusion rubric: apparition; he would see an: olib-sac. [1] 2. [brom] Delusion rubric: visions, has: grandeur, of magnificent: olib-sac.
• Forsaken: Delusion rubric: misunderstood; she is: olib-sac. Delusion rubric: watched, she is being: olib-sac. [This rubric (in relation to Olibanum sacrum) can pertain to persecutory fears or the desire to be admired and be allocated into ‘delusions of grandeur’.]
• Causation: Delusion rubric: soul: exchanged; was: olib-sac. [1] 1.
• Depression: Delusion rubric: danger, impression of: olib-sac. Delusion rubric: prisoner; she is: olib-sac.
  Delusion rubric: restlessness with anxiety: olib-sac. [1] 1. Delusion rubric: drugged; as if: olib-sac. Delusion rubric: dirty: he is: olib-sac. [Olibanum sacrum get depressed if they are not dressed magnificently.]
• Resignation: Delusion rubric: dissolving, she is: olib-sac. Delusion rubric: body: divided, is: olib-sac. Delusion rubric: body: lighter than air; body is: olib-sac. Delusion rubric: old: feels old: olib-sac.

5. How, Why, and When Causations – the ‘Never-well-since-event’

The ‘never-well-since-event’ has to involve childhood trauma if the patient is in internal battle with themselves. Until I discover the primary trauma in a patient’s life, I am never totally sure of a simillimum prescription. It is what I refer to as the ‘eye of the storm’. It occurs during a consultation when everything stops in the case-taking and you know you have arrived at the center of your patient’s internal storm.

 Question: Do you remember when you started to worry about aging?

Patient: I was five years old; we went to visit my grandmother who was dying of liver cancer. I don’t think that my father should have taken me. She was so ugly. I said to God that I would remain pure. I don’t want to become a nun but I am going to live my life married to God. I am not going to get married and have sex. God heard me that day and blessed me with beauty. I go to mass twice a day and have given my soul to God.  

• Causation: Delusion rubric: soul: exchanged; was: olib-sac. [1] 1.

NOTE: At five years of age it is meant to be the age when children are aware of themselves as an individual in the world. They also become aware of their family dynamics and their friends families.

Prescription: Dose and frequency is highly contentious amongst homoeopaths. I chose a low potency of 30, and low frequency of one dose every 3 days because of her crippling anxiety, and increasing neuroses. This prescription for unstable neuroses and dissociative disorders has always proved very successful in my practice. Obviously, I accept another practitioner might have chosen a higher dose.

Follow-up Consultations

First follow-up in person: May 2021[4].

There have been several short, follow-up Zoom consultations. These are the notes from these follow-ups:

She reports she is now aware of her neurotic obsessions with her constant need to post pictures of herself on UTube etc. She now posts only once a day; even though her fans beg her for more. She has enrolled to study to become a beautician. She wants to start her own business and her own cosmetic range.

A so called ‘cure’ in this patient has to be reflected in her ability to allow herself to have natural facial wrinkles. This woman is 22 years old! It is now January 2023 and the Botox injections have stopped. She is studying to become a beautician and will eventually do her own Botox injections for her clients; but she has conceded that she doesn’t need Botox yet!

Conclusion

After our first consultation I downloaded UTube and watched hours of posts from similar young women. Make-up tutorials. Shopping tutorials; it was seriously endless. The world she lives, and works in, is relentlessly obsessed with aging.

Bibliography

 Schroyens, Frederik. M.D. Synthesis. London, Homeopathic Book Publishers, 1997.

 [1] The reason I list ethnicity is to provide a context for her exotic beauty.

[2] Normally to protect the patient’s identity the date of appointments are not listed. The correct date has been changed to protect the patient’s identity. Given her online notoriety it is important to be careful to protect her.

[3] Frankincense is obtained from trees of the genus Boswellia sacra. Its aroma has traditionally been associated with religious rituals within the Jewish and Christian religions. Frankincense was one of four ‘sweet scents’ of the ceremonial incense in the Jewish religion. Frankincense is mentioned in the Pentateuch and formed part of the offering which was presented with the Shabbat bread on Sabbath. In the book of Exodus in the Old Testament it was an ingredient for incense. In the Gospel of Matthew, gold, frankincense and myrrh were among the gifts given to celebrate the birth of Jesus.

[4] The follow up ‘in-person’ consultation was 12 weeks later because Melbourne, Australia had several Covid related lockdowns and I was not allowed to consult. Eventually, I was able to get around the lockdown regulations as a counsellor. Homoeopaths and naturopaths were not allowed to consult. Melbourne had the longest lockdowns of anywhere in the world; 100 days!