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COPING WITH INSOMNIA: THE SIGNS OF GEOPATHIC STRESS
According to Dr Kenyon* and other experts like Rolf Gordon of the Dulwich Health Society (who believes his son would not have died of cancer if he had known about geopathic stress) these are some of the symptoms: insomnia, teeth-grinding, cramp, feeling cold in bed, sleep walking, restless sleep, depression on waking, exhaustion, and rheumatic aches and pains. There may obviously be other causes for all of these, but you might consider the presence of geopathic stress if:
You are not responding to treatments like homoeopathy and acupuncture.
Your cat regularly seeks out a specific spot to lie on. Most plants and animals will not thrive in geopathically stressed areas; for some curious reason they are favoured by ants, wasps, beetles, termites and cats (many young cats concurrently fall ill with leukaemia).
A sensitive person feels there is a bad atmosphere in the room.
A baby healthy at birth becomes weak within a few days for no other apparent reason.
A baby or small child sleeps restlessly and/or regularly moves to one side or the bottom of his or her bed or cot in an attempt to escape the harmful radiation.
An older child wets the bed, or suffers from nightmares.
*46/169/2*

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HOW DO I KNOW IF I HAVE BDD?”I HATE EVERYTHING ABOUT MY LOOKS!”
A common misconception about BDD is that it has to involve one, or just a few, specific body areas. But some people dislike so many areas that they hate most of their body. One man intensely disliked and was preoccupied with 33 “abnormal” body areas! Other people dislike so many body parts that they don’t break down their concern into individual areas. They say things like, “My entire body is ugly,” or “I hate everything about how I look.”
Some people, however, discuss their appearance concerns in more general terms because they’re too embarrassed to reveal and discuss the specific areas they dislike. Or they’re afraid that describing the problem more specifically will draw more attention to it. After all, it’s much easier to say, “There’s something wrong with how I look” than “I think my penis is too small.” As one woman said, “I told my doctor about my aging fears, but not about the wrinkles or hair. It’s easier to talk in generalities.”
The first two times I saw Larry, he told me, “I just don’t like my face; I don’t like how it looks. It feels different from everyone else’s.” “Is there anything in particular that you don’t like?” I asked him. “No, nothing specific?I just don’t like it,” he replied. It wasn’t until the third time I saw him that he felt comfortable enough to reveal the specifics: that his nose was too wide, his forehead too small, and his eyes too beady. “I was much too embarrassed to tell you these things before,” he said. “I feel ashamed.”
*46/204/8*

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RELAXATION TECHNIQUES, BIOFEEDBACK FOR STRESS BREAKDOWN TREATMENT: POSSIBILITY TO FURTHER STRESS BREAKDOWN
Some of the relaxation exercise and biofeedback methods have as an underlying theory that feelings of tension under stress are a sign that the sufferer is physically unfit. The inference is that stress should not cause anxiety symptoms in a person whose body is physically fit from regular exercise, and who has his feelings under control.
I reject this concept. It must always be remembered that anxiety response to stress is a normal alarm mechanism. Abnormal physiological states can lead to anxiety symptoms when the person is trying to deal with what might be otherwise a normal stress load. I fear that some people giving advice about stress management seem to believe that anxiety under excess stress can be reduced by their methods.
The promise of some relaxation techniques and biofeedback methods, that they can dismantle the alarm reaction which warns us when we begin to overload the nervous system, seems at best ineffective, and at the worst, possibly harmful.
I believe that abuse and disrespect for ourselves is part of the human condition, and I tend to view the proposed use of techniques which would free us from the penalty of overloading our nervous systems, as just another example of the human behaviour which tends to make us vulnerable to stress breakdown in the first place. The promise that modern biofeedback methods are able to combat stress, in my view, just leads people to think they can cheat the system, and get more and more work out of their over-stressed nervous systems without paying any price. In fact, attitudes such as these are the classical preconditions for progressing from stage one stress breakdown to stage two and stage three. I tend to see therefore, some of these stress management programmes as potentially capable of producing serious stress breakdown, if they are used in ignorance of the real function of the anxiety response as a warning signal of overload.
*46/129/5*

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Other names: Neoral, Sandimmune

HOW DO I KNOW IF I HAVE BDD? CONCERNS
While people with BDD are concerned with, on average, about five different body parts over time, some are preoccupied with virtually every body area. Sometimes concerns with different body areas are present simultaneously, and sometimes sequentially. I’ve identified three common patterns:
1. About 30% are concerned with one body part,.?or one set of body parts?over time. One man was concerned with his receding chin and never developed another concern. Another became concerned simultaneously with his “sunken” eyes and “swollen” nipples; he remained concerned only with these two things, without developing new concerns.
2. About 40% are concerned with one body part and then add new parts over time, with continuation of their previous concerns. At age 13, Ted worried that his ears stuck out, then at 18 he also became concerned with his crooked lip, and at age 25 he started to worry about a scar on his neck. At 25, he had all three concerns.
3. The third pattern is more complex, and occurs in about 30%. Over time, concerns with one or more body parts disappear and other concerns emerge. Jane, whom I described in chapter 3, fit this pattern. She first worried about her nose and then a scar on her lip. Later, she became preoccupied with her jaw, breasts, and buttocks, but stopped worrying about her buttocks. One concern can begin when another ends. One man stated after nose surgery that his nose looked more acceptable, but his “stomach took over for (his) nose.”
While some people with BDD want to be unusually attractive or look “perfect” overall, in my experience most don’t?they simply want to look normal. They might not mind looking like Elvis Presley or Marilyn Monroe, but this isn’t what they’re obsessed with. What they’re obsessed with is getting rid of the perceived defect and looking normal. They want to no longer look like the Elephant Man; they want to no longer stand out in a crowd. They say things like, “I don’t want to look tanned like George Hamilton; I just want to look not pale.” “Being average looking is okay. My goal is to be acceptable.” As one man said, “I don’t care whether I’m attractive. I just want to look normal. I wouldn’t mind looking like Beetle Bailey; I just don’t want things on my face.”
People with BDD describe their perceived appearance problem in various ways. They may say that the defect, or their appearance more generally, is ugly, unattractive or abnormal. Or they may say that it looks defective, flawed, wrong, odd, not right, or off. Some people use words like “deformed,” “monstrous” or “hideous.” They describe themselves as the Elephant Man or the wife of Frankenstein. One man said he looked like a cartoon character, and a woman said that she resembled a distorted figure from a Salvador Dali painting.
For simplicity’s sake, I’ll generally use the term “defect” or “flaw” to refer to these various appearance concerns. I’ll also use this term to refer to more than one concern and to more general excessive concerns with appearance that aren’t so easily pinpointed or confined to a specific body part or parts.
*44/204/8*

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TREATMENT OF STRESS BREAKDOWN: RELAXATION TECHNIQUES, BIOFEEDBACK
Much of the literature available on stress symptoms today seems to be concerned with managing the anxiety from a too-busy lifestyle, and often contains advice about relaxation techniques, physical exercise and biofeedback techniques to deal with muscle tension.
While I am in full agreement with people who point out how generally unfit and unhealthy we sedentary, city dwellers are, and how in need we are of more physical exercise, I do not agree with the notion that physical exercise, relaxation or biofeedback are of use in themselves as an answer to stage one stress breakdown.
Take biofeedback, for example. It has been shown that human beings, given appropriate feedback or information on the state of a body function normally controlled automatically, can work out ways of voluntarily controlling that function. Patients, for example, are wired up to an instrument which will make a sound or switch on a light if muscle tension is high. The patient works out some way of visualizing some peaceful scene, or emotionally letting go, and learns the subjective feel of how to voluntarily lower the muscle tension.
I believe that this technique is useful for those people who have become so used to feelings of muscle tension that they cannot operate at any lower level of activity. Such people, in my opinion, have basic problems with nervous system function and sometimes have what might be called minimal brain dysfunction.
In these biofeedback experiments, the subject is learning how to control certain body reactions by using the reticular activating system’s capacity for inhibiting the activity of cortical brain cells.
The imagery required in biofeedback, therefore, requires a normally functioning reticular activating system and a normal capacity for the cortical cells to respond. Therefore, in order for biofeedback to be of use, the person cannot be suffering from third stage stress symptoms.
Thus biofeedback and relaxation techniques (particularly those using techniques of self-hypnosis) can only be of use for stage one symptoms. However, I feel that it is not of much use overloading the nervous system, and then working out methods of reducing the discomfort from the alarm system activated by that overload.
I recognize that relaxation techniques are useful in treating the anxiety of stage one stress breakdown. But the relaxation techniques which to me appear to be useful for stage one stress symptoms seem to work because they force people under stress to take time out to stop doing what they were doing and concentrate on something totally different. The something totally different might be to spend time concentrating not on the report you are trying to write, but on certain aspects of your own body function.
I really think that almost any relaxation technique will work so long as it imposes a forced rest. Likewise, the physical exercise that takes the executive away from the desk or the telephone will be effective because it does that, not necessarily because of the exercise aspect.
*45/129/5*

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COPING WITH INSOMNIA: GEOPATHIC STRESS
I used to think that ley lines, the lines of electromagnetic energy running through the earth, were of strictly academic or hippy interest ? until I experienced for myself the effects of sleeping over a stressed energy line.
Energy radiated upward from the earth is normally positive, but it can be distorted by underground water currents, mineral deposits, electric pylons and geological fractures, which cause the earth’s electrical fields to radiate at unnaturally high frequencies. These distortions, called geopathic stress, can cause severe problems to anyone living, and particularly sleeping, over them.
The effects of geopathic stress include insomnia, depression, stress, respiratory problems and depletion of the immune system. It has been found to have a strong relationship with the development of cancer and other serious illnesses like Multiple Sclerosis: sometimes you come across a house in which whoever lives there develops a serious illness. Geopathic stress can also be the reason why some people never feel really well, while others don’t recover from illness, whatever treatments they try.
In West Germany the problem is considered important enough for the government to have funded in 1987 a 400,000 DM research project to investigate the claim that cancer can be caused or exacerbated by living in an area of geopathic stress. And according to research in both Germany and Britain, there appears to be an important link between geopathic stress and cot death, the theory being that it weakens babies by affecting their immune system.
Geopathic stress may not actually cause cancer, depression and so on; what it appears to do is to trigger an illness towards which the person is already prone, or to magnify minor feelings of anxiety or depression. In my own case it is possible that the stress was caused by a re-routing of local water pipes, since I slept in the same room for many years before developing the symptoms of geopathic stress. I was recovering extremely slowly from a back problem, and at the same time found myself waking in the morning with extremely unpleasant and powerful sensations of anxiety, depression, and general horribleness. I had no way of knowing that what was probably a mild attack of self-doubt had been magnified a hundredfold, and began to wonder whether I was a candidate for psychiatry.
The cause was eventually pinpointed by a homoeopathic doctor whose wife confirmed the presence of geopathic stress through dowsing ? for which I am eternally grateful. What was really convincing was that once the stress had been dealt with, I returned within a day or two, (and with enormous relief) to a normal state of mind. The experience has convinced me that geopathic stress is a very real and serious factor in our health, particularly in view of its possible connection with cot death.
It is hard to say how widespread this problem is. Dr Julian Kenyon, Director of the Centre for the Study of Complementary Medicine in Southampton, originally trained in orthodox medicine and now specializing in acupuncture, homoeopathy and research into the human energy fields, told me that geopathic stress is common enough to be considered seriously in insomniacs who don’t respond to the normal methods.
Using a Vegatest (a diagnostic machine used by some doctors and natural practitioners) he finds that about 15-20 per cent of his patients suffer from geopathic stress; as he says, they are a highly selective population, but could still represent quite a lot of people.
The presence of geopathic stress is obviously of great importance to our physical and emotional health, and that of babies and children. How can you tell it’s there?
*45/169/2*

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COPING WITH INSOMNIA: A HEALTHY ENVIRONMENT
As has already been mentioned, your bedroom should be associated with sleep, and not with other activities. It should also be warm and welcoming, with a peaceful and healthy atmosphere; some bedrooms, as will be seen the next section, can actually damage your health.
Colours
Colours have an influence not only on our visual sense but on our nervous system; they radiate at different wavelengths, some of which are stimulating, and some calming. Calming colours for bedrooms are soft blues and greens, pastel pinks and peaches; neutral colours like beige and cream are also appropriate. Avoid vivid colours, particularly in a child’s bedroom, where they might seem cheerful but can be over-stimulating.
The bed
Your bed should obviously be comfortable, ideally with a firm but not over-hard mattress. People’s tastes in mattresses vary, and if you’re happy with a squashy one, that’s fine. But soft mattresses are not good for your back in the long run.
It’s best to sleep with a single pillow, which keeps your neck at a natural angle. A stiff neck is often greatly improved when two or three pillows are replaced with a single one. (It’s been suggested, incidentally, that if you sleep badly in strange houses, taking a familiar pillow with you will provide the link with home that will allow sleep to come.) Some people find hop- or herb-filled pillows help them to sleep; you can get them at herbalists like Culpeper’s. Sniff before buying to make sure you like the smell.
Fresh, clean air
Fresh air is important, provided it doesn’t make the room too cold. If you don’t like sleeping with an open window, consider getting an ioniser. Ionisers replace in the atmosphere negative ions, electrically charged molecules which are found in abundance in mountain air and around waterfalls, and which keep the air healthy and clean.
Crystals
Crystals are getting very popular these days as aids to healing, meditation, and clearing the atmosphere. Rose quartz and amethyst are both suitable stones for sleep; keep one by your bedside. When you buy a crystal, it should be thoroughly cleansed before you use it, since crystals absorb energies from the atmosphere around them. Soak it for several hours in a bowl of salt water, rinse it under the cold tap, don’t wipe it with a cloth but place it to dry on a sunny window sill.
*43/169/2*

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Other names: Endep

WHY BDD IS UNDERDIAGNOSED: NOSE CONCERS AND OTHER SYMPTOMS
Nose concerns are also very common. About 60% of people with nose concerns worry that their nose is too large. More than a quarter worry it’s bumpy or misshapen. Less commonly?sometimes after nose surgery?they think it’s too small. One woman thought her nose was “bumpy and swollen”; a middle-aged man thought his was “puffy.” People with nose concerns are especially likely to have surgery?often repeated surgeries. One woman I treated first thought her nose was too large, and then, after surgery, felt it was too small. A college student first believed his nose was too long, but then, after surgery, thought his nostrils were too wide.
I once had an interesting conversation with a psychiatrist from Japan who was familiar with BDD. He was surprised to learn that I’d found that people in the U.S. usually worry that the nose is too large; in his experience, in Japan the concern is often that the nose is too small. In addition, he said that concerns with hair loss are uncommon in Japan. These observations raise the interesting question of whether cultural factors may influence the exact worry that people have.
BDD can also involve larger body areas. Many men are preoccupied with their overall body build, thinking they look too small or inadequately muscular. This form of BDD is called “muscle dvsmorphia.” Thev may wear many layers of clothing to enhance their size, excessively lift weights, or use potentially dangerous anabolic steroids to bulk up. Others?often women?are concerned that they’re too large or overweight. Of the people in my studies, 22% were excessively concerned with their weight.
*43/204/8*

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TREATMENT OF STRESS BREAKDOWN: TIME OUT
When we have to deal with unremitting stress and suffer anxiety symptoms as a result, we can prevent further stress breakdown by taking little holidays. I think it is better in the long run for an over-worked person with a responsible job to take the occasional day off work when feeling over-stressed. Even if at the time the person knows he or she really isn’t sick enough to warrant a day off, occasional time off may prevent a breakdown which could well result in weeks or months away from work. Sensible people in business know that occasional time off may be necessary to keep an employee working at full capacity.
The office worker should, if possible, get away from the job during the lunch hour and do something different. Sometimes that little break can be very helpful. A sleep during the lunch hour is even better, if it is possible.
Whatever one’s religious beliefs, at least one day off work each week, a day of total rest, is essential to good mental health.
It is always a good idea for a person with a demanding job to do something at weekends that doesn’t resemble his or her work. The intellectual ought to do something requiring physical exercise; the manual worker might do something which is intellectually stimulating.
*44/129/5*

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TREATMENT OF STRESS BREAKDOWN: STRESS WE CANNOT AVOID
We come now to the people who are suffering from stage one stress breakdown symptoms as a result of stress that they cannot possibly avoid. In this category I place the people whose occupations require them to accept long periods of stress when they may also be short of sleep and malnourished. Soldiers come into this category; so do the families caring for severely handicapped relatives and some mothers of newborn babies, if they are denied help from others. My advice to people suffering from stress-breakdown symptoms from unavoidable stress is:
– Are you really sure you can’t get any help at all? Are you really a coper who thinks it is a sign of weakness to ask for help?
– If you cannot avoid stress symptoms, at least don’t mistake them for symptoms of illness, and don’t make any wrong assumptions about the origins of your symptoms. For example, if you are bursting into tears at the thought of having to psych yourself up to do the shopping on your own, don’t load yourself up with guilt for being lazy.
– If you can’t avoid the big problems, at least get rid of as many of your other little problems as you can. It’s like jettisoning extra baggage to lighten the load if the ship is in danger of sinking. So if you can’t look after your sick baby and the other children as well, and keep the house clean, let as many non-essentials go as you can.
? Get as much sleep as possible, even if it’s just ‘forty winks’ now and then during the day. Don’t skip meals, and don’t do anything like deciding now is the time to go on a crash diet to lose weight. Don’t drink alcohol or ask the doctor for sedative drugs. Cut down on your tea and coffee intake.
– Decide to take a holiday when the stress is over, and do it. The holiday might be going to bed for a few days, or going away to recuperate and be pampered.
*43/129/5*

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HOW DO I KNOW IF I HAVE BDD? HAIR CONCERNS
Hair concerns are also very common. The most common worries focus on hair loss, thinning, or balding (a concern of one third of people who dislike their hair) and excessive facial or body hair (also present in one third of people with hair concerns). But hair obsessions may focus on virtually any aspect of the hair: it’s too curly, too straight, too full, not full enough, uneven, messy, or
dirty. James, a teacher, thought his hair “never looked right.” He feared that it was thinning and that other people laughed at him because he was going bald.
Each day he applied hair potions that cost him hundreds of dollars a month. Although his friends said his hair looked fine, he was so upset over it that he bought a thousand-dollar hairpiece. But this didn’t help. As he stated, “I was never satisfied; I still battled myself and wanted to get rid of it.” In fact, James was so unhappy with his hairpiece that he destroyed it in a fit of rage.
While men are more likely than women to worry about thinning hair,
women have this concern as well. One woman said her mother had very thin
hair, and she feared she would eventually look even worse than her mother,
becoming completely bald. It was hard to come in to see me because she feared
she became “balder and balder” with each visit.
Getting a haircut is usually a very distressing?even traumatic?event for people with hair concerns. “I’m terrified of getting my hair cut,” Jon told me. “Getting the right haircut is crucial. There’s very little stability in my life because of the BDD. How I feel and function depends on how I happen to look and the quality of my haircut.”
Hair concerns may also involve other body hair. Men may be preoccupied with supposedly uneven, light, or heavy beard growth. Men or women may think they have too much or too little body hair. Marie, an attractive 24-year-old nursing student, worried that she had “excessive” and “dark” hair on her nose and arms. She thought about her hair nearly “all day every day,” and she repeatedly looked at her arms, tweezed her hair at work, and, using special lights, checked her facial hair in mirrors for an hour a day. She tried to hide her hair with makeup, had electrolysis, wore long sleeves in the summer, and covered her face with her hands. Marie described her preoccupation as “severely upsetting,” saying that she felt “masculine” and “like a freak” whom no one would ever love.
*42/204/8*

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INSOMNIA: NATURAL THERAPIES FOR CHILDREN
As I’ve already mentioned, natural remedies can often soothe an upset child. To help a child get off to sleep herbal drinks and baths can be very soothing; so can massaging a baby’s or child’s feet. Babies and children also respond very well to Bach Flower Remedies; a few drops of Rescue Remedy or Rock Rose are ideal for a child awoken by a nightmare.
It’s possible that allergies are over-diagnosed by some over-enthusiastic natural practitioners. You should be cautious of following very extreme diets in young children. But allergies do occur, very often to cow’s milk, as well as to other allergens like food additives. Symptoms include constant upset stomachs, eczema, asthma, hyperactivity, and unexplained misery. If you suspect an allergy, seek advice from a well-qualified homoeopath, naturopath or medical herbalist. Allergic reactions can also sometimes respond to treatments other than diet, such as cranial osteopathy or acupuncture. If you are breast-feeding, check your own diet: a breast-feeding mother who drinks a great deal of tea or coffee will be passing the caffeine on to her baby.
Sometimes babies or toddlers are fractious because they are in physical discomfort; the cause is not always evident to GPs, but it may be something that can be put right relatively easily by an alternative practitioner, a homoeopath or cranial osteopath for instance.
If a baby is ailing or miserable for no evident reason, do ensure that the cot is not in a geopathically stressed area.
Manipulative techniques
Some osteopaths and chiropractors have a particular interest in treating children and quite small babies; manipulative treatments have cured cases of bed-wetting (when caused by a spinal maladjustment) and even allergies and colic.
Sometimes the actual birth causes a slight maladjustment in the bones of the skull, creating physical discomfort which leads to apparently inexplicable crying. This can be put right very easily by cranial osteopathy. You may even be able to correct it yourself. The test is to take the baby’s feet and bring them up over its head: most babies enjoy this and often laugh. If your baby doesn’t find it amusing, there could be something awry. The surprisingly simple remedy is to hold the infant upside down by its feet, and swing it, very gently, for a minute or two; again, most babies enjoy this. Since the bones of a baby’s skull are quite mobile, the weight of its head is often enough to settle them into their normal position. If this doesn’t work, however, do seek professional advice.
Homoeopathy
Children seem naturally to want to be in balance, says a homoeopath. Their systems are quite sensitive and any trauma ? mental, physical, emotional or dietary ? can knock them slightly out of kilter. Very often a homoeopath can restore the balance by administering a single remedy.
Vaccination can produce after-effects in children more often than is generally realized. These can take the form of eczema, rashes, or chronic catarrhal coughs. Homoeopathy can clear these up, as well as many childhood infections which, if treated with antibiotics, tend to recur time and again. Since homoeopathy affects the mental and emotional levels, it can also help with night-time fears, nightmares and so on.
Other natural treatments particularly suited to children include medical herbalism, the Metamorphic Technique and spiritual healing.
*42/169/2*

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TREATMENT OF STRESS BREAKDOWN: STOICISM VERSUS CHRISTIANITY IN VULNERABILITY TO OVERLOAD
The philosophy which demands that we be prepared for all eventualities well in advance so we can bear them with dignity and restraint is that of the ‘Stoic’ philosophers of the Roman Empire. This stoic philosophy, far from dying out with the ancient Romans, seems to be alive and well and flourishing as an integral part of modern Western culture. Large numbers of people seem to regard as culturally normal, a question such as:
‘What will I do next Thursday if nobody cooperates and everything goes wrong?’ The only answer I can reasonably give (and people literally do ask me questions such as this), is, ‘Panic, I suppose; perhaps burst into tears.’
The best-known spokesman for Stoic philosophy was Seneca, one-time tutor to the young Emperor Nero. Nero later forced Seneca to suicide. In his Letters From a Stoic, Seneca advises his friend:
Let the personality be made ready to face everything; let it be made to realize that it has come to terrain on which thunder and lightning play terrain on which
‘Grief and vengeful Care have set their couch,
And pallid Sickness dwells, and drear Old Age.’ This is the company in which you must live out your days. Escape them you cannot, scorn them you can. And scorn them you will, if by constant reflection you have anticipated future happenings . . . We must see to it that nothing takes us by surprise . . . this habit of continual reflection will ensure that no form of adversity finds you a complete beginner.
Christian philosophy, on the other hand, offers quite the opposite advice.
This is why I tell you: do not be worried about the food and drink you need to stay alive, or about clothes for your body After all, isn’t life worth more than food? And isn’t the body worth more than clothes? Look at the birds flying around: they do not plant seeds, gather a harvest, and put it in barns: your Father in heaven takes care of them! Aren’t you worth much more than birds? Which one of you can live a few more years by worrying about it? . . . Your Father in heaven knows that you need all these things. Instead, be concerned above everything else with his Kingdom and with what he requires, and he will provide you with all these other things. So do not worry about tomorrow; it will have enough worries of its own. There is no need to add to the troubles each day brings.
There are no prizes for guessing which of the two approaches would be better for preventing overload leading to stress breakdown. The problem, however, is the person caught in the middle, who perhaps is afraid to trust God enough to leave the future to him to worry about, but who believes enough in Christianity to be saddled with a list of do’s and don’ts which merely further overload the nervous system.
*42/129/5*

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HOW DO I KNOW IF I HAVE BDD?
Some people with BDD also have “subclinical” concerns with certain body areas; that is, in addition to the body parts they’re preoccupied with, they dislike others, but not to the point where they’re preoccupied with them or experience distress or impairment as a result. Heather, for example, disliked her “wide” nose and her weight, but her weight wasn’t a significant concern and didn’t preoccupy her. “It’s much less severe than my nose,” .she said. “I don’t like it, but it’s not really a problem.” In my research, I’ve made an effort to identify the body parts that are the focus of preoccupation, and have listed only excessive and problematic concerns in Table 5. If I had identified all the body parts which people had any dissatisfaction with whatsoever, the percentages for each body area would be much higher.
Some people with BDD think they sometimes look okay. As one woman said, “When my hair looks okay, I think I look attractive. But when it’s bad, which it often is, I think I’m really ugly.” People who are worried about minor acne may think they look fine when their skin is better?but when it’s “broken out,” it’s a disaster.
I’ve found that skin concerns are most frequent. Two thirds of people with skin concerns obsess about perceived acne or scarring, followed by concerns with marks (one third) and skin color (one quarter), typically thinking it’s too red or too white. But virtually any aspect of the skin can be disliked?facial pores that are considered unusually large, veins, capillaries, or other skin flaws. Some people think their skin is the wrong color?typically too red or too white. Others obsess about wrinkles, lines, sagging, shriveling, or stretch marks, which they may consider a sign of aging.
*41/204/8*

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SOME COMMON SLEEPING PROBLEMS WITH CHILDREN
The screaming baby
A screaming baby can be exhausting for both parents and child. There may be a number of reasons for it, and it is a good idea to check that there is nothing physically wrong.
In the first few months a very common cause is colic. It is said that nothing can be done about this, and parents find themselves walking up and down during the night holding the baby until it quietens. However, colic can be helped by some natural medicines, as can other causes of screaming. (See the section of natural therapies towards the end of this chapter.) Gently stroking a small baby’s feet is also very soothing and calming.
The colicky stage is a risk area for establishing a pattern of ‘ baby cries ? mother comes running’. While it needs comforting at this time, once the colic is over is the time to get it into the habit of sleeping without expecting parents to be in constant attendance.
The overtired child
Some small children need more sleep than their parents realize; if your child is fractious, particularly at bedtime, it could be overtired. Remember, toddlers don’t know what the time is, and it’s up to you to tell them firmly that it’s bedtime.
Try putting the child to bed earlier; you will soon find out if they benefit from more sleep. But if you do experiment with different bedtimes, give the experiments time to work, so that the child has a chance to adapt to the new routine. A major cause of disturbed sleep patterns in children is inconsistency on the parents’ part.
The child who needs less sleep
As children get older, they are sometimes packed off to bed long before they’re ready for sleep, because the parents want the evening to themselves. It is confusing for them and their body clocks to be told it is time to sleep when they don’t feel sleepy, and they may raise strong objections.
It’s best to be honest with them about your own needs. Rather than engaging in a battle, let them play or read in bed until they are ready for sleep. (As a child sent to bed before I was sleepy, I used to read for hours under the bedclothes, to the detriment of my eyesight.) If you trust your child, he or she will go to sleep when they need to. They are less likely to if it becomes a major issue.
Demanding attention in the night
Some children have the parent-debilitating habit of waking in the night and demanding attention. This could be because bad habits have been set up in babyhood when an over-anxious mother has looked in at the slightest sound. Or it could be because they feel they’re not getting enough of her attention during the day. But so long as they are getting all the daytime love they need, they could be testing how far they have you on a string.
Providing there is nothing genuinely wrong with them, the standard advice is to leave them to cry, but many parents feel uncomfortable about this. There is a difference, however, in the sound of a child crying simply to get attention, and the cry of a child who is genuinely afraid or unhappy. It may be necessary to show the child you are there, but also let it know what your limits are, kindly but firmly. Leave the child with plenty of toys to play with if it does waken in the night. Again, you could create a system of rewards, or perhaps a star-chart, for undisturbed nights.
Sleepwalking
Sleepwalking is quite common in children and adolescents, and normally tails off in the late teens. It usually occurs in the deep stages of sleep and the child is not aware of it. It may be a sign of minor unresolved anxiety, but if it happens regularly there could be a deeper emotional cause. If occurrences coincide with particular incidents or some anxiety affecting the child or the whole family, the child may be in need of reassurance.
Otherwise, don’t worry the child by making too much of it. He or she will normally return to bed spontaneously; don’t waken them. But do make sure there’s no danger of the child falling out of windows or otherwise getting hurt.
Nightmares
Most small children go through a phase of having nightmares, usually around the ages of three or four, coinciding with a phase in their development when they are more anxious in general, and perhaps scared of the dark. If the child remembers the nightmare next day, he or she may perhaps be frightened of going to sleep.
Unless they occur very often, nightmares don’t necessarily mean that the child is emotionally disturbed; they can be triggered by a television programme or the sight of a fierce dog in the park, for instance. All the same, it’s important to respect the child’s fears, and listen to anything they want to tell you about their dream.
Make the child feel as secure as possible, and let them know that you are there if needed. They may like to have a nightlight; you can also appoint a favourite toy as a guardian. Some parents have helped children to lose their fear of nightmares by getting them to draw pictures of them and making a game of it ? for example, drawing a dream monster and then putting a red nose on it. If a child suffers regularly from nightmares, there may be some deeper cause, and you should talk to your GP about it.
Night terrors
Night terrors occur most often in small children, though adults can experience them too. When they happen the child suddenly sits up in bed, staring into space and screaming in apparent terror. Although these episodes can be very frightening for parents the child usually doesn’t remember them. They occur during the deep stages of sleep and are not related to dreams or nightmares. Stay with the child and comfort it until it falls asleep again.
Night terrors may be caused by the child going to bed feeling angry or distressed, and again, if they are frequent, the child may be reacting to some deeper worry or family problem about which it needs reassurance.
*41/169/2*

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Other names: Clomicalm

CHILDREN AS THE CAUSE OF INSOMNIA: ESTABLISHING A GOOD ROUTINE
Parents can be of tremendous help in laying down a good sleep pattern for their child in the future. A regular, consistent routine helps the child to understand that it is bedtime (small children aren’t aware of time), and should be established as early as possible.
Sometimes mothers and babies get off to a bad start when the baby falls asleep on the breast after feeding and learns to associate falling asleep with mother being there. As the child gets old enough to demand your presence, you can teach him or her firmly but lovingly to sleep alone. A firm tone of voice will help to get the message home. Make sure the child has comforting toys, and reassure it that you are around by looking in every now and again, but don’t let the habit of only sleeping with you there continue. Above all, be consistent, so that the child learns what to expect.
Bedtime should be a pleasant and enjoyable experience for both parent and child, accompanied by story-telling and plenty of cuddles. It’s a good idea for both parents to be involved, perhaps taking it in turns to put the child to bed, so that it doesn’t become dependent on the presence of just one of you. From the age of two, it’s possible to discuss with your child any problems in settling down or getting up in the night: you can set targets and have a reward system for an uninterrupted night. Try not to have a row with your child just before bedtime. And never send the child to bed as a punishment.
If your child consistently has trouble with getting to sleep, staying asleep or other disturbances, it’s useful to keep a sleep diary, as is suggested at sleep disorders clinics and described in My Child Won’t Sleep. In this you keep a note of what’s going on during the day, as well as the hours that the child sleeps, or fails to. You can then observe whether there is a pattern. Do regular nightmares occur, for instance, when father works late? Or is there some other disruption to the daily routine which might be causing anxiety to the child ? or yourself? Children very easily pick up when a parent is anxious or worried, and can develop all sorts of ideas about what might be going on, including believing that family problems are somehow all their fault.
*40/169/2*

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WHY BDD IS UNDERDIAGNOSED – ADDITIONAL CLUES: DEPRESSION, SOCIAL ANXIETY, AND OTHER SYMPTOMS – SOCIAL PHOBIA
Certain other disorders also commonly co-occur with BDD and may be a clue to its presence. One of these is social phobia (also known as social anxiety disorder), an excessive fear of social or performance situations due to a fear of doing something embarrassing or humiliating. Another is obsessive compulsive disorder (OCD), characterized by obsessions (intrusive, recurrent, unwanted thoughts that are difficult to dismiss despite their disturbing nature) and compulsions (repetitive behaviors that are intended to reduce the anxiety caused by obsessions). A high percentage of people with BDD have had problems with alcohol or drugs. The only study I know of that’s assessed how common BDD is in this group was the Minnesota inpatient study I mentioned earlier. This study found that a surorisinelv hieh percentage?26%?of inpatients with a substance ue disorder (drugs and alkohol) also had BDD.
So it’s important to ask people with these disorders whether they have symptoms of BDD. It’s important to inquire, because BDD sufferers may be too embarrassed and ashamed to volunteer their symptoms. In the depression study and the substance abuse study I just described, not a single person revealed his or her BDD symptoms to their doctor or therapist until specifically asked about them, reflecting BDD’s often secretive nature.
*40/204/8*

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TREATMENT OF STRESS BREAKDOWN: PREPARING FOR PROBLEMS IN ADVANCE
Many people overload themselves by trying to anticipate problems in advance. Their basic aim in doing this is usually to avoid being emotionally hurt or disappointed if plans don’t come out the way they want them to. Sometimes the people who habitually do this have deep fears and insecurity, perhaps arising from early childhood experiences. Being able to anticipate and deal with problems in advance, and thus guarantee the success of some proposed activity, enhances the person’s feelings of power over fate, or the forces of nature, or destiny, or whatever, and reduces feelings of personal vulnerability.
Of course, the difficulty with anticipating problems in advance is that while we can rehearse what we will do if some project goes awry, we can rarely anticipate the reactions of others.
Thus if the problems we anticipate are going to require the cooperation of others in order to solve them, our preparations in advance, on our own, are really a waste of energy. Sometimes we may try to hold other people to promises in advance that they will do exactly what we want when we want it, but this situation usually comes unstuck, because other people don’t like to be tied up in promises to us.
For example:
‘ Now George, I want you to promise me that when the plumber comes out to quote on the repairs, you will insist that he pay for the damage his truck caused to the front lawn. And don’t let him get away with any lame excuses!’
‘I want you to go up to the dress shop, describe the dress I’m making exactly, and buy a twelve inch zip fastener exactly the same colour. And don’t get the colour wrong!’
‘Get whatever meat looks good at the butcher’s, but don’t buy anything we won’t all like!’
‘Remember, when the visitors come, don’t start showing them around the house when it’s such a mess, even if they ask to see how the renovations are coming along!’
*41/129/5*

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TREATMENT OF STRESS BREAKDOWN: ANXIETY AND UNNECESSARY STRESSES
Treatment of stage one symptoms – anxiety
The most effective treatment for anxiety due to overload of the nervous system is not to overload the nervous system. The simple advice is: ‘Take it easy, don’t take on more responsibility than you can handle.’ This simple advice, however, is usually the most difficult to follow, because of three factors:
1. People are so adaptable that we tend to accept more and more load and responsibility up to a point where we begin to fail. We often simply don’t know how much is too much.
2. As much as we’d like to, we may not be able to avoid the stress and responsibilities which are thrust upon us.
3. We always experience some anxiety whenever we have to perform a new task which is unfamiliar to us. We recognize this as normal and accept that some anxiety is unavoidable in acquiring new skills. We therefore become used to ignoring anxiety and fail to notice when it is a signal of overload.
Identifying unnecessary stresses
The first thing to do to avoid needless stress is to identify the unnecessary loads we place on ourselves.
The most easily identifiable unnecessary stresses, I believe, are those we impose on ourselves by demanding guarantees of adequate performance. For example, a person undertaking a particular task, and who is concerned with getting ready in advance for the possibility of not being able to complete the task satisfactorily, has possibly quadrupled the load on the nervous system.
I commonly find that people suffering from stress-breakdown symptoms have often used up too much of their nervous system’s processing capacity by demanding from themselves answers to various unanswerable questions about the planned outcome of the tasks they face.
Had they concentrated on the task in hand, they would have perhaps been able to complete it without experiencing anxiety. The overload is often not from the task they have to do, but from trying to service all the unnecessary guarantees they have demanded from themselves. We often find ourselves demanding answers to unanswerable questions about our performance, such as:
– How can I be perfectly sure?
– How do I know I’ll be able to cope if…?
– What will they think if I fail?
– What will I do if…?
*40/129/5*