Is it a disease that I can’t stop putting cream on my face? I am 32, male and I’ve always been suffering from insecurity even though I am not that ugly. I do not like the skin on my face. I feel good if I can put so much cream on it that when I touch my skin it feels even and smooth. Am I sick? Should I look for a psychologist?

An obsessive-compulsive disorder involves repetitive thoughts and behaviours. Within this category of mental health disorders there is one that specifically involves a focus on the body and is called body dysmorphic disorder. Body dysmorphic disorder occurs when a person can’t stop thinking about a problem, defect or flaw in their appearance. There are a number of psychological strategies that have been found to be helpful. The main therapy for body dysmorphic disorder is exposure and ritual prevention which involves the client developing a hierarchy of situations that make them anxious or which they avoid. They then slowly start to work towards exposing themselves to these situations. Alongside this they are given a range of skills to resist and reduce the obsessive behaviours and rituals. Cognitive behaviour therapy has good evidence with this disorder for both young people and adults. Acceptance and commitment therapy has also been found to be effective.

I’m struggling with the consequences of a childhood trauma. One of the things that makes every day difficult to get through is that I keep associating things that I really like as well as random things with what happened to me and more specifically to the person that did it. Help!

A trauma trigger is something that makes us more likely to remember a traumatic experience. To deal with trauma triggers it is important to have support and skills. Having people around you who know about what has happened and can be there with you if you do encounter a trigger is very helpful. They can talk you through other ways of looking at the trigger, help distract you or help you realise you can confront the trigger and cope with it. Having skills to remain physically calm such as breathing and progressive muscle relaxation can help you remain calm even when facing difficult triggers. Having cognitive skills to understand how your brain works, what your fears are and how you can deal with triggers is also important. Mindfulness training is a great way to learn more about how your brain works.