Remembering positive aspects about appearance

Another techniquewhich can be useful in copingwith changes in your appearance is thinking of, and listing, positive aspects of your appearance. So much emphasis may have been placed on your skin condition that it becomes all that you see when you look in the mirror. You may ignore the fact that prior to the onset of the condition you liked certain things about the way you looked. You may find yourself focusing only on the skin disease and minimising the importance of other bodily features, or indeed the importance of your body as something more than just an aesthetic object. If this is the case, you need to try and ‘look past the skin disease’ and identify what parts of your appearance you are happy with. Doing this can help remind you that you are more than your skin problem and that your appearance may be attractive in other ways.
Graded exposure
The fear and apprehension that a person feels about themselves and others may dominate all aspects of their life. In the same way that a person with a phobiaabout snakes may avoid anything associated with the feared stimulus (e.g. zoos, television nature programmes, photographs that feature snakes), the same may apply to patients with skin disease. For example, they may cover their skin up with make-up or clothes that conceal the condition, avoid conversations about appearance or avoid activities where there is a possibility of other people noticing their condition. One way to help cope is to challenge your beliefs about the feared situation through graded exposure. This involves firstly establishing what the feared stimulus is and then constructing a hierarchy of situations that you avoid.The procedure generally involves the following:
(1) Establishing what the feared stimulus is, e.g. being seen in public without
camouflage make-up on to hide vitiligo lesions.
(2) Constructing a hierarchy of less feared situations that could lead up to this,(3) Rating the degree of difficulty that youwould experience in undertaking each
of the items on the list from 0 to 100, where 0 indicates ‘no difficulty’ and
100 indicates ‘the most difficult’, e.g.:
(4) Once you have rated the various activities or situations in order of difficulty,
put them into ascending order of least difficult to most difficult and then
attempt to undertake the least difficult activity on the list first.
(5) Once you have mastered coping with the least anxiety-provoking situation
and can do so comfortably, move up the list, doing the same with each
situation until you reach the most difficult task at the top of the list. By
doing this, you can address your negative or irrational thoughts, disproving
those beliefs that led to the avoidance of these different situations. Relaxation
training can be added to the exercise to help you to feel more emotionally
settled and comfortable while addressing each task.

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