Dear Marni...

My family doesn’t want me to have cosmetic surgery...

I am a young woman who has been dreaming about having a particular cosmetic surgery procedure for as long as I can remember – even at the age of thirteen I recall begging my mother to let me have the surgery, although all I received was her adamant refusal! Six years have passed and I am finally in the position to be able to afford the surgery myself. I have always believed that everything else about me is attractive and I am totally comfortable with the rest of my body. The problem is that some of my family members are completely against my decision. I am shocked and upset by their total lack of support, although being an adult now I feel I have every right to go through with the surgery, regardless of what they think.

Marni writes: As there is no obvious separation between mind and body, it follows that modifying your exterior will also inevitably bring about changes relating to your inner world. It is possible therefore, to feel better about yourself as a whole if you alter an exterior bit that is either too large or too small for your liking. But exercise caution; if the change is not what you expected, if you suffer from low self esteem relating to other issues, or if you encounter post-surgical complications, you could find yourself deeply disappointed. Furthermore, becoming an adult doesn’t necessarily mean you should begin acting upon all of your previous juvenile desires. Adults, young and old, make plenty of decisions they come to regret later on, so passing that magic number will not provide you with immunity either. You now possess ultimate responsibility for yourself, your body and your choices. That being said, credit goes to you for choosing to discuss this topic openly, rather than just ploughing ahead with something as serious and potentially irreversible as surgery.

APPEARANCES
If you are as determined as you sound, a prudent task seems to be that of organising a chat with at least one additional surgeon and your GP. This will give you the opportunity to challenge your current subjective view. For example, if you do have a blatantly obvious reason for surgery it will only reassure you if others agree; just as you should be suitably concerned if everyone thinks you are barmy for showing them a ‘problem’ only you can see. A good surgeon is likely to be straightforward about whether the procedure will enhance your appearance or not, so ask for their opinion. Even so, you will have to accept bias as a limiting factor since we all have different ideas about what is attractive, normal, square, round, large or small.

Also, keep a trusted friend involved in the process. An outside opinion ensures that you have not developed a disproportionate view of the area you wish to change, as we are all susceptible to ‘obsessing’ about a particular body part. People with acutely distorted views of themselves such as body dysmorphic disorder can make drastic decisions they come to regret, or opt for surgery that leaves them feeling worse because it does not relieve the genuine source of the problem.

JUDGEMENTS
Which leads to the perplexing part of your issue - not knowing what you are hoping to change. For instance, when I imagined you were hoping to reduce your breast size, I felt an immediate sense of empathy, even compassion. Conversely, when I imagined you were pining for breast enlargement the notion triggered very different thoughts. These unsolicited judgements will arise naturally in all of us, including your family members, and are essential to consider. They provide you with valuable information and authentic concerns you should be aware of and thinking about. Your family are no doubt against you assuming the risk of surgery because of their love, concern and desire to protect you: risks are real and do exist. Their feelings probably seem somewhat contradictory to yours right now, as you want support and acceptance. However, taking the time and consideration to acknowledge their views may enable them to see you as a mature and responsible decision-maker.

GUILT
Finally, ask yourself whether you are struggling with familial disloyalty, or feeling a deeper twinge of existential guilt now that you are preparing to make permanent changes to your body. What sparked your initial longing for surgery at the age of thirteen? Are you completely convinced it is the right thing to do, or have you found yourself caught up in the act of exercising your adult authority? Sometimes we get so involved in the stubborn desire to ‘win’, we are surprised to realise that the content of what we were fighting about isn’t actually as important as the meaning of the conflict itself. Reflect upon these ideas as they are essential to pursue before your final incision, that is, decision is made.

Marni Eisenberg, MA, MBACP, UKCP, qualified existential psychotherapist and counsellor.

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