Dear Not Really Here,
Thank you for your question. It sounds like you’ve been struggling to navigate through some difficult feelings and experiences, and I appreciate you reaching out for help. Interestingly, the way your question is phrased, you’ve coined a term that technically doesn’t exist in the mental health field, at least according to the DSM V: body dysphoria. We have “gender dysphoria,” and “body dysmorphic disorder.” We also have folks describe a more generalized feeling of dysphoria, not specifically connected to the body. But since you name body dysphoria specifically, and since I don’t believe that the DSM is the Holy Bible of mental health, let’s go with your version instead!
You say that some of your dysphoria is related to gender and some of it is not, so I’m going to assume that you are not, in fact, talking about body dysmorphic disorder. Rather it seems that you’re referencing a more general sense of feeling disconnected from and uncomfortable in your body, during sex but also while navigating the social and relational dynamics involved in dating. This is actually a more common experience than you might think. As you mention in your letter, it can occur for many people who experience gender dysphoria, but it can also be something that people experience as a result of trauma (sexual or otherwise), shame associated with religious or cultural beliefs about sex, beliefs we internalized about our bodies or our desirability (from our parents, our peers, or the media), internalized homophobia or transphobia…the list goes on. Even if we do not consciously believe these things to be true, our subconscious has a way of letting those beliefs sneak in when it sees an opening, and often that opening comes when we are at our most vulnerable–physically or emotionally. Engaging in sexual activity and dating creates the perfect opportunity for that vulnerability.
So your question is, how do you navigate the times when you feel that dysphoria?
You’re actually doing the first part already, which is to be aware of what is happening. Now, being aware of dysphoria when you’re not in a dysphoric state might be easier, but the fact that you know this is something you experience means that you’re already developing the first step that you’ll need to address this.
Your letter doesn’t mention whether your dysphoria includes feelings of dissociation, but I’m going to assume that it does. For this reason, the next thing I’ll recommend is s-l-o-w d-o-w-n. And I mean, WAY down. This will be a principle to keep in mind through all aspects of dating, sex and relationships. When you meet someone new, take your time getting to know them. Spend time with them in places that make you feel safe and comfortable. Maybe that’s outside, sitting on a park bench, or taking a walk. Or maybe it’s in a crowded cafe with lots of people around. What’s important is that it’s a place where you feel safe and comfortable. Do that as often as you need to while you’re getting to know this new person.
As the relationship progresses, keep those same principles in mind–slow and safe. You need time to build trust with the person you’re getting to know, but you also need time to build trust with yourself in this new relationship. This part is also key. Building trust with yourself means taking the time to check in with how you’re feeling, in your mind but also in your body, during the various stages of dating and relationship building.
Then the challenge is to make sure that your body, and your nervous system, know that you are safe. And, it might sound silly, but you might have to remind your body and nervous system about this. Staying connected to your body is key, and that becomes increasingly difficult to do as the dysphoric feelings ramp up. This is where slowing down becomes even more important. If you can recognize when you’re starting to feel uncomfortable, or disconnected, or even just…weird, use that as a signal to stop, or go slower. Focus on your breathing, or on something tactile. Find a way to ground yourself, literally and metaphorically. Notice your feet on the floor, sit with your back against something solid. Let your eyes wander until they focus on something that draws your attention in a neutral or positive way. Let your mind conjure an image that feels calming. Then let yourself notice how your body responds to that. Give your nervous system some space to integrate that new feeling. Remember that our bodies prefer to feel regulated rather than dysregulated. But when we are used to existing in a dysregulated state, we often need time and space to learn how to get back to a state of equilibrium.
Engaging in physical touch, alone or with someone else, can be a helpful way to learn how to navigate dysphoria. Keep in mind that I am not talking about masturbation (which is also great, but that’s for a different day!) If you’re with someone else, using the principles of slow and safe, agree on some boundaries for how you will engage with each other physically. Decide where you’ll sit, or lie down. Decide how clothed or unclothed you’ll be. Then start with a part of your body that you feel good, or neutral, about. It should be a place that you can reach on your own (so, not your back). It can be your knee, or your forearm, or your cheek. My point is, pick something that feels, you guessed it…safe. Then allow yourself to give that part of your body some attention. Maybe gently caress it, or kiss it, or lightly tickle it. Be playful, or erotic, or even silly. Decide what feels good for you. The important thing is to first engage in self-touch, and have your partner there, as close as you’re comfortable with, but just watching at first. Maybe touching you in some way, but not touching that same part of your body. See if you can be present with yourself while touching this part of your body that you feel good or neutral about. And see if you can let this other person witness you touching this part of your body in a playful, or erotic, or silly way. Do this for a short period of time at first, maybe 30 – 60 seconds, then pause. Breathe. Check in with yourself. Notice how you feel.
You can build on these types of exercises, bringing in your partner over time and in whatever ways you might like to, or not. The key points to remember are to ground yourself in what makes you feel safe and comfortable, to focus on areas that you feel good or neutral about, to go s-l-o-w, so that your nervous system has time to integrate what it’s experiencing, and to set boundaries for yourself and with whomever you’re dating.
Lastly I’ll say this, dysphoria of any kind can be a symptom of any number of other issues, so to the extent that it may be a “symptom” of something larger, I do suggest talking to a therapist who can help you understand the larger context of what you’re experiencing. Hopefully you can work through the dysphoria together, and perhaps figure out some other things along the way
Warmly,
A Queer Therapist