Vitiligo, Self-Image, and Inner Healing

It’s surprising how often, and how natural, it is to judge oneself. Have you ever asked yourself “what was I thinking?” or thought to yourself “that was stupid” when doing something? That was your internal voice judging you. In some people that internal voice can be too critical and harsh, leading to low self-esteem. In others, it may be so weak that they don’t notice when they are mean or insensitive to others.

Listening to your internal voice and judgments of yourself is the first step to changing your self-image and esteem. Being aware of self-criticisms (or lack of criticisms) can help you determine your current self-image and decide if it needs to be improved and how.

One way to gain a better understanding of your current self-image is to imagine your reaction to certain situations. For example, if you start a beautiful morning thinking, “I can’t wait to get outside and do things!” instead of chiding yourself for not getting out of bed, “don’t be such a lazy slob; start moving”, you are exhibiting a more positive internal voice.

But sometimes it’s hard not to listen to an internal voice, even when that voice is critical. Sometimes a person passes internal judgments to protect him or herself from potentially awkward or uncomfortable situations. For example, telling yourself you aren’t able to do something or convincing yourself that others won’t like you is a way of avoiding potential failure or rejection. Because of this, people often put up with internal criticisms, even though they lead to low self-esteem.

But it is possible to protect yourself without limiting yourself. For example, you could place less importance on other’s opinions of you (“so what if they don’t like me?”), or emphasize the positive (“at least I wasn’t afraid to try”), or you can practice silencing your internal voice or correct it when it exaggerates your negative traits. It’s important that when you make internal judgments you also listen to the more rational part of yourself that can adjust for any unreasonable criticism.

Reminding yourself of your positive qualities is one of the fastest ways to improve and maintain a positive self-image. This worksheet is intended to help.

Use the following list as a guide, or write your own list. What are you good at? What qualities do you have that make you feel good about yourself? What are positive things people have said about you? Print this worksheet, and circle or highlight the words that describe you.

Put this list someplace where you can see it and remind yourself regularly of all your good qualities.

I AM …

• Adaptable
• Adventurous
• Affectionate
• Ambitious
• Artistic
• Assertive
• Broad-minded
• Capable
• Caring
• Charming
• Cheerful
• Clear-headed
• Clever
• Compassionate
• Competent
• Confident
• Conscientious
• Considerate
• Courageous
• Creative
• Dependable
• Determined
• Devoted
• Dynamic
• Easy-going
• Efficient
• Energetic
• Enterprising
• Enthusiastic
• Fair
• Faithful
• Flexible
• Friendly
• Funny
• Generous
• Gentle
• Glad
• Good-natured
• Happy
• Helpful
• Honest
• Hopeful
• Idealistic
• Imaginative
• Independent
• Industrious
• Intelligent
• Inventive
• Kind
• Likable
• Logical
• Lovable
• Mature
• Merry
• Modest
• Natural
• Neat
• Non-judgmental
• Nurturing
• Open-minded
• Optimistic
• Organized
• Original
• Outgoing
• Patient
• Peaceful
• Persevering
• Persistent
• Pleasant
• Polite
• Positive
• Practical
• Precise
• Progressive
• Punctual
• Rational
• Realistic
• Reasonable
• Reflective
• Relaxed
• Reliable
• Resourceful
• Responsible
• Robust
• Sexy
• Sincere
• Sociable
• Spontaneous
• Spunky
• Stable
• Strong
• Tactful
• Talented
• Tenacious
• Thorough
• Tolerant
• Trusting
• Trustworthy
• Truthful
• Understanding
• Unique
• Versatile
• Warm
• Witty
• Zany

Why not take a few minutes now to write your own description and include some of the nice things people have said about you.

The best way to improve your self-image is through practice. Below are a number of experiences you may have that require you to question your self-image. Try practicing your responses to the situations below. You may want to ask a relative, friend, or advisor, whom you feel has a positive self-image and confidence in you, to listen to your responses and offer advice.

Scenario 1. Your friend has invited you to a party, which you’d really like to attend. Unfortunately you have nothing new to wear and you haven’t got the money to buy a new outfit. Which of the following would you do:

A. Turn down the invitation.
B. Go, but know everyone realizes you couldn’t afford a new outfit.
C. Think of some way to modify an old outfit and go.
D. Realize that you were invited, not your clothes, and go.

Responses:
If you chose option A, you are not only punishing yourself by turning down a fun opportunity, but you are also placing too much emphasis on physical appearance and others’ perceptions of you. Remind yourself that a ‘sparkling’ personality can be far more attractive than a new outfit.
If you chose option B, you have decided to go but are setting yourself up to have a bad time. You’re also not giving others the benefit of the doubt – they may care more about how you behave than how you appear.
Option C is not a bad decision and shows a lot of ingenuity on your part. Congratulate yourself on being creative, but remind yourself that appearances (and others’ opinions) aren’t everything.
Option D indicates you have enough self-esteem to accept the invitation as an indication of your self worth.

Scenario 2. The boss asks you to organize a going-away luncheon. You’ve never done this before so:A. You tell your boss you can’t do it.
B. You ask you boss to pick someone else because you’ve never done this before.
C. You talk to someone who has done this before and get advice.

Responses:
If you chose option A, you’ve given up without even trying. Not only are you limiting yourself, but you are also limiting your opportunities. The more often you respond with a ‘no’, the less often you’ll be asked or offered special opportunities.
If you chose option B, you’ve provided an honest answer. This is good, but you’ve also foregone a chance to improve your relationship with your boss and his or her confidence in you. It’s fine to admit that you don’t have a specific skill, but you can make this admission positive by showing your boss you have initiative and are eager to learn. Instead of recommending someone else, you may want to say “I’ve never done this before, but I’d love to try and will read up on it and get advice from someone who has” or “I’m not sure I know how to do this, but would like to learn; maybe Mr. X (a coworker with more experience) and I can work on this together.”
Option C is another sensible approach. If, after getting the advice, you still think you can’t undertake the assignment, you at least can go back to your boss, showing him or her that you’ve made an effort to learn.

Scenario 3. Your class assignment from the night before is due, but you weren’t able to figure out some of the answers. You:A. Copy your neighbor’s work.
B. Skip class.
C. Don’t hand in the assignment.
D. Hand in what you have done with an explanation that, although you tried, you weren’t able to answer all of the questions and ask for an appointment so your teacher can help you.

Responses:
Neither A, B nor C are good reasons for not turning in your assignment. Worse, option A is cheating! If you chose any of the first three options, you have not focused on the real problem: you didn’t understand the assignment. This is no reflection on your capabilities. Everyone has difficulties at certain times or with certain subjects, but you are limiting yourself even more by not addressing the problem and learning how to handle it in the future.
Option D shows your teacher that you have made your best effort but still are having a problem. Most teachers will understand this. The purpose of class assignments is to ‘test’ your understanding of what you are learning before you are actually tested and your teacher is there to help. You may just need one-on-one time to ask questions that weren’t answered in class, or maybe you need to review the lesson again or walk through the exercises with your teacher.

Scenario 4. You are behind on bills so you decide to use a credit card to pay them. When you discover you’re still behind on bills the following month, you decide to use another credit card. Eventually you’re behind on all your bills and cards, so you:A. See if you can get another credit card.
B. Borrow money from family and friends.
C. Seek advise from a financial advisor or consumer group about how to create a budget, consolidate your debt, and pay it off.

Responses:
If you chose option A, you are just making your financial difficulties worse! Anyone can have financial problems, but “covering them up” by using credit cards with high interest rates is just going to make you deeper in debt. The first thing you should do is put yourself on a budget and pay off your credit cards. You may also need to get a loan or work out a payment plan with some of your creditors. Don’t be ashamed to admit that you need to work within a budget – this is far more financially responsible than pretending that you don’t. You’ll be surprised at how understanding and helpful many financial institutions and corporations can be: they’d rather work with you to get their money back than ‘punish’ you.
If you chose option B, you are admitting you need help, which is good, but be sure you don’t use this loan as a band-aid. You still need to address the cause (why you can’t pay your bills), not just the immediate problem. Again, you may need to put yourself on a budget and be sure that your budget includes setting aside money to pay back that loan (or for future emergencies.)
Option C is probably the best option. Although it may be difficult to admit to others (or yourself) that you need financial help, advice from experts can be invaluable. Even people who don’t have financial difficulties often seek expert advice on getting the most from their money. An honest and responsible approach can save your reputation and lead to well-earned esteem. It can also lead to a debt-free and even profitable future.

Scenario 5. A close relative is always criticizing your job, which you happen to enjoy and pays your bills, you:A. Get a new job that your relative approves of so that he will leave you alone.
B. Start to question if your job is right for you.
C. Repeatedly make excuses to your relative about why you’re keeping the job.
D. Ask your relative to explain why he hates your job and address his concerns. If the criticism continues, you ask him to keep it positive or withhold it altogether.

Responses:
If you chose option A, B, or C, you are placing too much emphasis on what your relative thinks is important, not what you think is important. If you are happy with your job, if your coworkers treat you well, and if your job meets your financial needs, you are already luckier than most! Don’t let groundless criticisms make you question your own judgment. If, on the other hand, a nagging voice in your head (not your relative’s), says that there is some truth to the criticism, you might want to ask yourself why you are staying with your job.
Option D shows self-confidence in your judgment and a willingness to defend it. It also shows a respect for others’ beliefs. By taking the time to listen to and address your relative’s criticisms, you are not only being open to new ideas but also showing him that you respect his beliefs. Taking the time to listen and respond may be enough to stop future criticisms. If it’s not, you have every right (and the confidence) to ask him to stop.

We often want to believe that shame is reserved for the unfortunate few who have survived terrible traumas, but this is not true. Shame is something we all experience. And, while it feels like shame hides in our darkest corners, it actually tends to lurk in all of the familiar places. After interviewing over 400 women across the US, I learned that there are twelve areas that are particularly vulnerable for women: appearance and body image, motherhood, family, parenting, money and work, mental and physical health (including addiction), aging, sex, religion, surviving trauma, speaking out and being labeled or stereotyped.

Interestingly, there are no absolutely universal shame triggers.

The issues and situations that I find shaming may not even come up on another woman’s radar. This is because the messages and expectations that drive shame come from a unique combination of places including our families of origin, our own beliefs, the media and our culture. One place where women find themselves surrounded by unattainable and conflicting expectations is body image.

While some of us might have quieted the tapes about “not being smart enough” or “not being good enough” — it seems that almost all women continue to wage battle with looking “beautiful, cool, sexy, stylish, young and thin enough.” With more than 90% of the participants experiencing shame about their bodies, body image is the one issue that comes closest to being a “universal trigger.” In fact, body shame is so powerful and often so deeply rooted in our psyches that it actually affects why and how we feel shame in many of the other categories, including sexuality, motherhood, parenting, health, aging and a woman’s ability to speak out with confidence.

Our body image is how we think and feel about our bodies. It is the mental picture we have of our physical bodies.

Unfortunately, our pictures, thoughts and feelings may have little to do with our actual appearance. It is our image of what our bodies are, often held up to our image of what they should be.

While we normally talk about body image as a general reflection of what we look like, we can’t ignore the specifics — the body parts that come together to create this image. If we work from the understanding that women most often experience shame when we become trapped in a web of layered, conflicting and competing expectations of who, what and how we should be, we can’t ignore that there are social-community expectations for every single, tiny part of us — literally from our heads to our toes. I’m going to list our body parts because I think they are important:

head, hair, neck, face, ears, skin, nose, eyes, lips, chin, teeth, shoulders, back, breasts, waist, hips, stomach, abdomen, buttocks, vulva, anus, arms, wrists, hands, fingers, fingernails, thighs, knees, calves, ankles, feet, toes, body hair, body fluids, pimples, scars, freckles, stretch marks and moles.

I bet if you look at each of these areas, you have specific body part images for each one — not to mention a mental list of what you’d like it to look like and what you’d hate to have a specific part look like.

When our very own bodies fill us with shame and feelings of worthlessness, we jeopardize the connection we have with ourselves (our authenticity) and the connection we have with the important people in our lives. Consider the woman who stays quiet in public out of the fear that her stained and crooked teeth will make people question the value of her contributions.

Or the women who told me that “the one thing she hates about being fat” is the constant pressure to be nice to people. She explained, “If you’re bitchy, they might make a cruel remark about your weight.” The research participants also spoke often about how body shame either kept them from enjoying sex or pushed them into having it when they didn’t really want to but were desperate for some type of physical validation of worthiness.

There were also many women who talked about the shame of having their bodies betray them. These were women who spoke about physical illness, mental illness and infertility. We often conceptualize “body image” too narrowly — it’s about more than wanting to be thin and attractive. When we begin to blame and hate our bodies for failing to live up to our expectations, we start splitting ourselves in parts and move away from our wholeness.

We can’t talk about shame and body image without talking about the pregnant body. Has any body image been more exploited in the past few years? Don’t get me wrong. I’m all for exploring the wonders of the pregnant body and removing the stigma and shame of the pregnant belly. But let’s not replace that with one more airbrushed, computer-generated, shame-inducing image for women to not be able to live up to. Movie stars who gain fifteen pounds and have their stretch marks airbrushed for their “Look!

I’m human too!” portraits do not represent the realities that most of us face while pregnant.

Parenting is also a shame category affected by body image. As an admittedly vulnerable, imperfect parent, I’m not one to jump on the “blame parents for everything — especially the mothers”

bandwagon. Having said that, I will tell you what I found in my research. Shame creates shame. Parents have a tremendous amount of influence on their children’s body image development, and girls are still being shamed by their parents — primarily their mothers — about their weight.

When it comes to parenting and body image, I find that parents fall along a continuum. On one side of the continuum, there are parents who are keenly aware that they are the most influential role models in their children’s lives. They work diligently to model positive body image behaviors (self-acceptance, acceptance of others, no emphasis placed on the unattainable or ideal, focusing on health rather than weight, deconstructing media messages, etc.).

On the other side of the continuum are parents who love their children just as much as their counterparts, but are so determined to spare their daughters the pain of being overweight or unattractive (and their sons the pain of being weak) that they will do anything to steer their children toward achievement of the ideal — including belittling and shaming them. Many of these parents struggle with their own body images and process their shame by shaming.

Last, there are the folks in the middle, who really do nothing to counter the negative body-image issues but also don’t shame their children. Unfortunately, due to societal pressures and the media, most of these kids do not appear to develop strong shame resilience skills around body image. There just doesn’t appear to be any room for neutrality on this issue — you are either actively working to help your children develop a positive self-concept or, by default, you are sacrificing them to the

media- and society-driven expectations.

Power, Courage and Resilience

As you can see, what we think, hate, loathe and question about our bodies reaches much further and affects far more than our appearance alone. The long reach of body shame can impact how we live and love. If we are willing to examine the messages and practice empathy around body image and appearance, we can start to develop shame resilience. We can never become completely resistant to shame; however, we can develop the resilience we need to recognize shame, move through it constructively and grow from our experiences.

Across the interviews, women with high levels of shame resilience shared four things in common. I refer to these factors as the four elements of shame resilience. The four elements of shame resilience are the heart of my work. If we are going to confront the shame we feel about our bodies, it is imperative that we start by exploring our vulnerabilities. What is important to us? We must look at each body part and explore our expectations and the sources of these expectations. While it often painful to acknowledge our secret goals and expectations, it is the first step to building shame resilience. We have to know and explicitly identify what’s important and why. I believe there is even power in writing it down.

Next, we need to develop critical awareness about these expectations and their importance to us. One way to develop critical awareness is to run our expectations through a reality-check. I use this list of questions in my work:

Where do the expectations about my body come from?

How realistic are my expectations?

Can I be all these things all of the time?

Can all of these characteristics exist in one person?

Do the expectations conflict with each other?

Am I describing who I want to be or who others want me to be?

What are my fears?

We must also find the courage to share our stories and experiences. We must reach out to others and speak our shame. If we feed shame the secrecy and silence it craves — if we keep the struggles with our bodies buried inside — the shame will fester and grow. We must learn to reach out to one another with empathy and understanding. If, in a diverse sample of women ages

18 – 80, over 90% of the women struggled with body image, it is clear not one of us is alone. There is a tremendous amount of freedom that comes with identifying and naming common experiences and fears — this is the foundation of shame resilience.

About the author:

Brené Brown, Ph.D., L.M.S.W., is an educator, writer, and nationally renowned lecturer, as well as a member of the research faculty at the University of Houston Graduate College of Social Work, where she recently completed a six-year study of shame and its impact on women. She lives in Houston, Texas, with her husband and two children.

She is the author of I Thought It Was Just Me: Women Reclaiming Power and Courage in a Culture of Shame

Cognitive behavior therapy techniques can help you unlearn thought patterns that contribute to low self-esteem. See examples of thoughts that can erode self-esteem and learn healthy substitutes.

Low self-esteem can negatively affect virtually every part of your life, including your relationships, your job and your health. But you can raise your self-esteem to a healthy level, even if you’re an adult who’s been harboring a negative self-image since childhood.

Changing the way you think about yourself and your life is essential to boosting self-esteem. Cognitive behavior therapy (CBT) techniques are especially helpful in changing unhealthy thinking and behavior patterns. These techniques are based on the idea that your feelings and behavior result from how you think about yourself and your life. CBT techniques can help you recognize, challenge and ultimately replace negative thoughts or inaccurate beliefs with more positive, realistic ones.

These five steps toward healthy self-esteem are based on cognitive behavior therapy principles. As you go through these five steps, jotting down your thoughts, experiences and observations in a journal or daily record may help you use these steps more effectively.
Step 1: Identify troubling conditions or situations

Think about what conditions or situations about your life you find troubling and that seem to deflate your self-esteem. You may wish to change aspects of your personality or behavior, such as a fear of giving a business presentation, frequently becoming angry or always expecting the worst. You may be struggling with depression, a disability or a change in life circumstances, such as the death of a loved one, a lost promotion or children leaving home. Or you may wish to improve your relationship with another person, such as a spouse, family member or co-worker.
Step 2: Become aware of beliefs and thoughts

Once you’ve identified troubling conditions or situations, pay attention to your thoughts related to them. This includes your self-talk what you tell yourself as well as your interpretation of what a situation means and your beliefs about yourself, other people and events. Your thoughts and beliefs may be positive, negative or neutral. They may be rational based on reason or facts  or irrational  based on false ideas.
Step 3: Pinpoint negative or inaccurate thinking

Your beliefs and thoughts about a condition or situation affect your reaction to it. Inaccurate or negative thoughts and beliefs about something or someone can trigger unhealthy physical, emotional and behavioral responses, including:

* Physical responses, such as a stiff neck, sore back, racing heart, stomach problems, sweating or change in sleeping patterns.
* Emotional responses, such as difficulty concentrating or feeling depressed, angry, sad, nervous, guilty or worried.
* Behavioral responses, such as eating when not hungry, avoiding tasks, working more than usual, spending increased time alone, obsessing about a situation or blaming others for your problems.

Step 4: Challenge negative or inaccurate thinking

Your initial thoughts may not be the only possible way to view a situation. So test the accuracy of your thoughts. Ask yourself whether your view of a situation is consistent with facts and logic or whether there might be other explanations.

You may not easily recognize inaccuracies in your thinking. Most people have automatic, long-standing ways of thinking about their lives and themselves. These long-held thoughts and beliefs feel normal and factual to you, but many are simply opinions or perceptions.

These kinds of thought patterns tend to erode self-esteem:

* All-or-nothing thinking. You see things as either all good or all bad. For example, “If I don’t succeed in this job, I’m a total failure.”
* Mental filtering. You see only negatives and dwell on them, distorting your view of a person or situation or your entire life. For example, “I made a mistake on that report and now everyone will realize I’m a failure.”
* Converting positives into negatives. You reject your achievements and other positive experiences by insisting that they don’t count. For example, “My date only gave me that compliment because he knows how bad I feel.” “I only did well on that test because it was so easy.”
* Jumping to negative conclusions. You reach a negative conclusion when little or no evidence supports it. For example, “My friend hasn’t replied to my e-mail, so I must have done something to make her angry.”
* Mistaking feelings for facts. You confuse feelings or beliefs with facts. For example, “I feel like a failure, so I must be a failure.” No matter how strong a feeling is, it isn’t a fact.
* Self put-downs. You undervalue yourself, put yourself down or use self-deprecating humor. This can result from overreacting to a situation, such as making a mistake. For example, “I don’t deserve anything better.” “I’m weak, stupid or ugly.”

Step 5: Change your thoughts and beliefs

The final step is to replace the negative or inaccurate thinking you’ve identified with accurate thoughts and beliefs. This can enable you to find constructive ways to cope and give your self-esteem a boost.

This step can be difficult. Thoughts often occur spontaneously or automatically, without effort on your part. It can be hard to control or turn off your thoughts. Thoughts can be very powerful and aren’t always based on logic. It takes time and effort to learn how to recognize and replace distressing thoughts with accurate ones.

These strategies may help you approach situations in a healthy way:

* Use hopeful statements. Be kind and encouraging to yourself. Pessimism can be a self-fulfilling prophecy. That is, if you think your presentation isn’t going to go well, you may indeed stumble through it. Try telling yourself things such as, “Even though it’s tough, I can handle this situation.”
* Forgive yourself. Everyone makes mistakes. Mistakes aren’t permanent reflections on you as a person. They are isolated moments in time. Tell yourself, I made a mistake but that doesn’t make me a bad person.”
* Avoid ‘should’ and ‘must’ statements. If you find that your thoughts are full of these words, you may be setting unreasonable demands on yourself” or others. Removing these words from your self-talk can give you and others more realistic expectations.
* Focus on the positive. Think about the good parts of your life. Ask yourself, “What other things have gone well recently?” “What personal skills do I have that have helped me cope with challenging situations in the past?”
* Relabel upsetting thoughts. Having negative thoughts doesn’t mean you must choose to react negatively. Instead, think of them as signals to use new, healthy thinking patterns. Ask yourself, “Which of my strengths can help me respond in a constructive way?” “What can I think and do to make this less stressful?”
* Encourage yourself. Give yourself credit for making positive changes. Treat yourself as well as you’d treat a loved one. Tell yourself, “I did a good job on the presentation. It may not have been perfect, but my colleagues said it was good.”

Achieving healthy self-esteem

With practice, these steps may come more easily to you. You’ll be better able to recognize the thoughts and beliefs that are contributing to your low self-esteem. Because self-esteem can fluctuate over time, you may want to revisit these steps, especially if you begin to feel down on yourself again. Keeping a journal or daily log can help you track trouble spots over time.

Achieving a balanced, accurate view of yourself and accepting your value as a human being may help you feel happier and more confident. And that may rub off on others, too, including your children, family or friends.

Living with vitiligo can be tough, so it’s no wonder that we spend a lot of time searching for a cure or a method to cover the white patches. However, neither one of these truly permanently deals with the deeper issue…our self-worth.

The terms self-worth and self-esteem are often used interchangeably, but I believe there is a significant difference between them.

Self-worth is having a proper sense of your true value as a person regardless of any external considerations or performance markers. Self-worth involves introspection and honest self-evaluation, as well as an understanding of the basic value of all life, and especially human life. Self-worth is always derived internally and is most concerned with the profundity of life and quality of character.

Self-esteem, on the other hand, is what we think of ourselves regardless of whether it’s true or not. More often than not, self-esteem does not involve any real introspection. It is largely driven by external and subconscious influences. It’s more often based on performance or appearance rather than character.

Self-worth is a much sturdier foundation to build our life upon than self-esteem. Self-worth is self-sustaining, while self-esteem can be easily damaged if we have little or no underlying sense of self-worth. Self-esteem is more vulnerable to false pride and vanity. It is less resilient to self-doubts and external attack because it shifts with both external influences and internal emotions and thoughts patterns.

Unfortunately, feeding our self-esteem is easier than developing our self-worth, and you know we humans like to take the path of least resistance. We usually opt for the quick fix instead of the long-term investment.

This is not to say that self-esteem is a bad thing. Positive self-esteem allows us to feel good about ourselves on a superficial level, and we live much of our day at that level. After all, we can’t walk around in deep thought and introspection all day long. But self-worth is ever present in our character, while self-esteem is dependent on many variables.

So how do we develop our self-worth? Self-worth is largely developed through honest introspection and an understanding of our spiritual nature, but there are several things we can become proactive at to boost both our self-worth and self-esteem. You’ve probably already tried a few: trying to think good thoughts, reading motivational materials, helping others…etc.

If you have found that these techniques didn’t have a deep, staying power on building your self-worth then you will want to try NLP, Neuro-linguistic Programming.

I will explain NLP in my blog tomorrow. The reason that I am so excited to share this method with you is two-fold: First, it will help build your self-worth so you will be able to live a full life by worrying less about how others view your vitiligo. And, since some doctors and scientists have theorized that vitiligo is stress related, using NLP to de-stress your life may be just the cure we are looking for…a way to reverse vitiligo from the inside out.