Healing

Very little about my life is much of a secret, which is the result of my work and my general disposition. I just never hold much back.

One of the things I’ve never, ever written about, though, are my scars. I mean visible scars, and there are a lot of them, scars on scars on scars, and fairly often open wounds and sometimes, some pretty bad infections. People notice the scars (I cover up the open wounds and infections), but they almost never say anything. I prefer that people say nothing, as it happens, happy to leave them to their own theories for as long as they care to wonder. I’m about as comfortable as I can be with the scars, to the point where I sometimes feel I should leave a note of explanation for the medical examiner for after I die, so no one thinks I was tortured.

The explanation is this: I have scars is because I pick at my skin.

For many years I thought I was pretty much alone in doing this, and living for more than 50 years with the problem hasn’t been a ton of fun. As a child, my parents asked the pediatrician for help, and he came up with a plan for me to drop by his office twice a week. There, I rolled down my knee socks, and if I’d been picking, which I always was, he’d tell me no one would ever love me, and other cruel things meant to dissuade me from my compulsive behavior. He later told my parents not to let me wear knee socks, thinking that if I couldn’t hide the problem, I’d stop picking. Other advice from him: Mittens taped at the base to my wrists every night. None of it worked, and I refused to put up with the mittens — they interfered with my other compulsion, which was reading.

Years later, when the pediatrician died, mom called to tell me, and I blurted out, “that fucking son of a bitch!” which sort of surprised us both. I’m pretty sure she thinks I made it all up, or at least exaggerated it, because everyone went to that pediatrician and she never heard anything bad about him from the other parents. But honestly, I can still hear that fucking son of bitch in my head, still see his exam rooms as right out of a Norman Rockwell illustration and if I think about it too long, I’ll start to cry.

Once I aged out of pediatric care, I tried various things to stop the urges. I’ve been on meds for it, tried behavioral modification, hypnosis, and even went to some bizarre clinic where they wired me up, directed me to touch a scab and then shocked the hell out of me.

Nothing worked.

With the dawn of the internet, I was surprised to find out that I wasn’t alone with this problem, which would have been nice to know a long time ago. Still, I figured it was incredibly rare, couldn’t be fixed and was best treated by long sleeves, pants or dark hose and cover make-up for what couldn’t be hidden by fabric. At some point I learned about “fish” antibiotics, and have long kept Cephalexin on hand for when infections got bad.

Shocked again, but a good kind

This morning, I was reading the New York Times and an article about my condition popped up on my tablet. I know it’s the very first such piece I have ever read about this in a mainstream publication, and I’m 61 years old and still read compulsively and pretty much non-stop.

Turns out, it’s more common than I could ever have imagined, and because of the stigma, it’s under-reported, which means it’s even more common. From the article, emphasis mine:

Habitual skin picking is formally called excoriation disorder (in the past, it was known as dermatillomania). It affects roughly 1.4 percent of the population, according to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (D.S.M.-5). (Some studies put the rate higher.) Hair pulling, or trichotillomania, occurs in about 0.5 to 2 percent of people, according to the same manual. The behaviors are classified in the chapter covering obsessive-compulsive and related disorders. This edition, published in 2013, was the first in which the American Psychiatric Association included detailed information about skin picking.

Because patients often work to hide evidence of the disorders, researchers and clinicians suspect that those rates represent an underreporting. But even at these levels, they add up to a more prevalent disorder than some others that tend to be more familiar, such as anorexia nervosa, which affects only 0.4 percent of young women, according to the D.S.M.-5.

I have read the article twice, checked back for the comments (Incredible! Courageous! Affirming!), and had a feeling of such relief that it’s as if a dam gave way. I still think my pediatrician is a fucking son of a bitch, and I doubt I will ever truly let that go.

But I decided after reading the article and the comments, that I don’t want to be secretive about this anymore. I’m still going to be covering up, mostly because I just don’t want to deal with other people asking what’s wrong with my skin, but the feeling of shame is suddenly, incredibly gone.

This is stunning to me.

I keep circling back to feeling such pride in the power of truth-telling, of journalism. Lindsay Gellman wrote an article, dozens of fellow sufferers told their stories in ways that resonated, and the world is a little better for a lot of people in one small way today.