84 ALLURE MAY 20 19
derm will look at your acne, put you on
a treatment plan, ask about your sleep
patterns and any major life events or
stressors that could exacerbate skin
conditions like acne, teach you some
breathing exercises. “You would think
people go to a doctor’s office just to
have a diagnosis and get a treatment,”
says Weschler. “No. They also want to
be understood.”
That makes sense, but then
shouldn’t all doctors be
psych-certified?
Weschler laughs. “Right.” She
explains that doctors often spend a
marginal amount of time with
patients, which can create a lack of
empathy. Even though her practice is
more derm than psych, empathy
is extremely important. “We used to
have sort of a...not a joke, but you
know, it wasn’t a normal day if at least
one patient didn’t cry.”
At many points
during this
reporting
process, one question
keeps bouncing off the walls of my
brain: Are beautiful people more likely
to be happy?
I know that it shouldn’t be true,
that despite the fragrance ads and
the deluge of income bestowed
on our nation’s hottest people, mood
disorders do not discriminate. But
if a person is constantly exalted
for their appearance, would they have
higher self-esteem and therefore
an easier time dealing with anxiety
and depression?
James Murrough, a psychiatrist and
associate professor of psychiatry and
neuroscience at Mount Sinai Hospital
in New York City, does not seem to
think so. Self-esteem, he says, is not
clinically defined by any one aspect of
self-image; it’s a combination of many
things. (He believes most baseline
self-esteem levels develop in early
childhood through adolescence.)
But, he concedes, a negative physical
perception of self affects a not-
insignificant portion of depressive
patients—around 20 percent.
“Positive self-image has been
shown to be very important—a
protective or resilient factor against
stressors that may otherwise trigger
major depression or a clinical anxiety
disorder,” he says. “It doesn’t happen
overnight, but through positive self-
care, through healthy relationships,”
self-image can be improved.
Weeks later, my therapist tells
me the five aspects of self-care:
intellectual, physical, spiritual, social,
and emotional. He is not, personally,
a fan of the idea that doing a
face mask qualifies as an act of self-
preservation. But if treating your skin
brings you joy, excellent—that’s one-
fifth of the puzzle. The rest includes
things like gathering a support
system of loved ones, engaging with
a community of people like you—
that all amounts to what we consider
“positive self-care.”
There is also room for weird stress-
relief treatments. For example, on
my third visit, Rieder asks if I am open
to being hypnotized.
Hypnosis, according to Rieder, is
“a lost medical art”: the arcane magic
of suggestion. It replaces negative
stimuli with positive stimuli,
embedded into a calming meditative
practice. He mentions a video he’d
seen as a medical student of a
woman undergoing surgery without
anesthesia—her face registered the
amount of pain associated with
taking a warm bath. She had been
hypnotized to feel nothing.
Yes, I would be down to try this.
(I am a “great candidate for hypnosis,”
according to a sick burn by Rieder.)
With his instruction, I roll my eyes
back slowly while closing them. He
tells me to pretend there is a balloon
under my wrist, and I should let it rise
toward the ceiling. He tells me I am
floating. He asks me to project my
stresses and insecurities onto a blank
screen, then to part with them.
Next I am supposed to come back to
earth. Rieder writes directions—a
prescription for a hypnotic trance—so
I can do it before bed, or whenever
I’m feeling overwhelmed. (I will let you
know if it works as soon as I can get
through it without falling asleep.)
It is month four of Botox, and I am
gradually wresting back control of
my forehead, discovering that my brow
lines are exactly where I left them.
In the mirror, my cheeks are wind-
whipped and pink from the winter
weather; my eyes are soft and blue.
How do I look? I look fine. I feel better.
I still have no idea if crying at your
dermatologist’s office—or hypnosis
or Botox—is the key to happiness,
but man, was it nice to talk about it
for a few hours. For the first time
in a while, my heart swells with hope.
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