Question 1: I was never good-looking In the past, I had many relationships, good, bad and indifferent. Then I didn’t. Part of that was me wanting to take some time after a bad breakup. But in trying to get back on that horse, nothing materialised. I’ve joined groups, I’ve gone out, I’ve engaged in activities that I enjoy, I’ve involved myself in my communities. I am friendly and approachable. I’m bright, well-educated, well-read, well-travelled. I have good self-esteem, a positive outlook and I’m told I’m very easy to talk to. These are things that people who know me well say about me.
But it’s now been 20 years since I’ve had a relationship. Trusted loved ones assure me I’m not doing anything wrong. The reason must be that I am unattractive and ugly. I was never a good-looking man, but I had youth on my side back then.
Philippa’s answer When we want to make sense of something, we invent a story to try to help us understand, and you’ve made up the “ugly” story. Even if you were not conventional-looking, people who don’t fit in with the popular idea of good-looking do pair up. Most people these days use internet dating; you don’t mention this, but I assume you’ve tried it. The way to approach it is to not ask whether this person is “the one”, but just to enjoy the dates.
There is a slight chance, but I can’t possibly know just by an email, that you may be under- or over-adapting to other people. Under adaption may mean you are very logical, sensible and a little rigid in habits, and don’t automatically read people easily, which means it takes longer for other people to feel that you “get” them and they may find it hard to realise where you’re coming from, too. Over adaption is when you try to please others so much that the essential you gets lost, so there’s no one there for them to have a relationship with.
Drop the “ugly” story. It does you no good. Love yourself, love your body, treat yourself well and you will appreciate yourself more – and it will show. You have loved ones, so you are lovable. If you want a partner I feel pretty certain there will be someone who wants you.
With a psychotherapist who practises relationally, you can learn to identify how you may have lost trust in humanity after your last relationship went wrong and how you may be pushing people away rather than attracting them, and then develop new ideas and thinking patterns about relationships.
Question 2: Should I have surgery? I am a 68-year-old retired teacher/lecturer married for 39 years with a (mostly) lovely family. But my viciously rational mind now knows that my face has been badly eroding my wellbeing for years.
I’ve had a variety of other mental health panic-points, all attached to the way society reacts to my face. I’m reaching breaking point and my ability to shrug off the constant look of repulsion on faces of predominantly male strangers is dying. Should I have surgery in the hope that it will enable me to become more accepted, or just become more depressed and distressed and isolated? The description ugly really does exist and it belongs to me.
Philippa’s answer Quite often, it’s easier to blame our bodies or a part of the body for our psychic state. It’s easier to think that if only our nose was smaller or our chins were fewer, we’d be more acceptable. Therefore, we attack that part of the body as if our body wasn’t us. But we are our bodies.
I’m also worrying that you are searching other people’s faces for revulsion – that you are looking for it. If you are, this will affect your expression. Sometimes cosmetic plastic surgery is trying to solve a mental problem with physical means. General anaesthesia is not risk-free and unless it was necessary for my physical health, I would avoid it at all costs.
The trouble with being clever, and I expect you are, is that you can use that cleverness to persuade yourself that you are physically defective. But, if you knew that plastic surgery was 100% the right thing to do, I don’t think you would have written to me.
The risk with trying to solve a mental problem with surgery is that after it’s done you may still be unsatisfied because the underlying self-rejection has not been dealt with.
I’d recommend psychoanalysis or psychotherapy first. Don’t choose a practitioner who argues with you about whether you are ugly or not, but one who wants to find out what problem you are putting on to your looks, and how this started. Interview a few. If this leads nowhere and you feel certain surgery is a way forward then speak to some established, respected, surgeons who seem honest and realistic.
Philippa Perry’s The Book You Want Everyone You Love* To Read *(and maybe a few you don’t) is published by Cornerstone at £18.99. Buy it for £16.14 at guardianbookshop.com
Every week Philippa Perry addresses a personal problem sent in by a reader. If you would like advice from Philippa, please send your problem to askphilippa@guardian.co.uk. Submissions are subject to our terms and conditions
