How the Way We Look Affects the Way We Feel
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Carla Pappas was 13 years old, waiting in line at her school's cafeteria when she first came to believe she had a big nose. I was with one of my good friends and in front of us there was this boy and he turned around sharply and looked at me and he said, get your big nose out of here. And I looked at my friend and I asked her, do I have a big nose? And she said, well, yeah, kind of. Carla Pappas.

Carla quickly became obsessed. She started scrutinizing herself in the mirror and decided her friend and that kid in the lunchroom were right. Her nose was huge, hideous even. Now, Carla had what some people call a hooked or Greek nose, a high bridge that curved slightly outward.

It wasn't hideous at all. She now calls it a nose of character. But at that age, all she could see was what was wrong with it. She felt it was especially obvious from the side. When I started driving, so when I was age 17, when I would stop at traffic lights, I would make sure that I turned my head away from anyone if they were next to me in the car.

So they couldn't see my profile. And these were strangers. You know, I was even worried about what strangers thought about my nose. Or if someone was taking pictures, she would always make sure to be facing toward them so they didn't catch her profile. When she met new people, she became convinced they were staring at and judging her nose.

It didn't help that around that time, the early 2000s, plastic surgery makeover shows like The Swan were really popular. Teen, Amy came to us saying that she felt like a loser. Contestants who hated the way they looked would get all kinds of different procedures. And then there was a big reveal. Well, I know you can't wait to see her, neither can I. Here she is, the brand new Amy Williams.

Oh, you look hot. Thank you. Shows like these got a lot of criticism for perpetuating unrealistic beauty ideals, but all Carla saw was the transformation and the hope they represented. I would wish that, you know, I could get on one of those shows because I want to change my face, because when I change my face, my nose, then I'll be happy. Then I'll be beautiful. Think about the most recent time you looked at yourself in the mirror.

Did you like what you saw? Did you notice something positive? Like, I look nice in this sweater. Or my hair looks good today. Or did you hate your reflection? Immediately focusing on negative things only. That's what I end up doing. Like, oh, look at those bags under my eyes. Or I've gained even more weight.

When we don't like our appearance or we're hypercritical, it really does a number on our self-confidence, mood, and well-being. On this episode, the connection between appearance and mental health. ♪

To get started, let's hear more about Carla Papa's story. She started to hate her nose as a young teen, and she became convinced that the only answer to all of her troubles was plastic surgery. Liz Tang has more.

Carla's opportunity for a new face finally arrived when she was 21. That's when she met another young woman who'd recently gotten a nose job. Carla asked the woman for the surgeon's name and within a few weeks was sitting in his office for an initial consultation.

There, the surgeon showed Carla what her new nose would look like. And what the surgeon did right there in front of me was Photoshop my nose. So shaved off the parts that he would be taking off during the surgery. And so I saw it all happen right there so easily with a little bit of Photoshop magic.

And he said, this is what we'll do. This is what we'll make you look like. And I was so impressed and I couldn't wait to get it done. Carla's memories of the rest of the visit are a little fuzzy.

She knows the doctor went over some info about the risks and recovery, but his tone was easy breezy. There's an X percent chance that such and such could happen. But if it does, we'll just bring you back for a revision. No big deal. But of course, a 21 year old who's just really excited to get their nose changed because this is going to change their life and make them finally beautiful.

skims over that as well and doesn't think too much, doesn't think that could happen to me. So Carla scheduled her rhinoplasty, put down her deposit, and two months later was back in the surgeon's office ready for the procedure that would usher in her beautiful new life.

She had no doubts about her decision until just before the procedure. And I was waiting in the room and the surgeon came in and he was describing again what we're going to be doing today. And then, you know what he said? He was like, oh, would you like your breasts done as well?

I was like mortified. It was maybe a moment where I could have, should have questioned, what am I doing here? And I think maybe I did. But because it was booked in, because I'd paid the $2,000 deposit, I kind of was like, no, I've got to go ahead with it. Like I've told everyone I'm doing this. I've got to go ahead with it. The rhinoplasty went smoothly and Carla went home to recover. She was able to get her

It was then that she realized that nose jobs are a bigger deal than she'd thought. Carla had what's called an open rhinoplasty. With those, the surgeon makes an incision near the base of the septum and essentially peels back the skin and soft tissue to expose the cartilage underneath. Then they can cut away slivers of cartilage from the tip of the nose or the bridge or file down the nose bone itself in order to remove a hump, for instance.

Once the internal structures are arranged and stitched together the way they want, they pull the skin back down and close the incision.

If you watch videos of it, it's pretty cool, but also pretty invasive. And even small missteps can lead to noses not looking the way the patient had hoped or even problems with breathing. As Carla discovered, recovery can also hurt a lot. Yes, so the recovery was way more painful than I thought it would be. She was pretty much bedridden those first few weeks.

She wasn't allowed to exercise for at least a month or two, as increased heart rate and blood pressure can cause bleeding and swelling that slows down the healing process. She had to avoid swimming, bending, pulling, pushing, sunlight, spicy foods, even blowing her nose. Still, Carla was happy with the results at first. ♪

But as the months went on, scar tissue began building up around her nose, underneath the skin. My nose got really wide. I look at it now and I joke around. I call it a Play-Doh nose because it looks like someone just put a bit of clay, a bit of Play-Doh on my face.

So it was six months after that where I realized like this is not what I wanted it to look like. Throughout the whole recovery process, Carla had been making monthly visits to her surgeon so he could check her progress and give her cortisone shots to reduce the swelling. The second time I went back to the surgeon, they like said, oh, you know, like maybe you'll need like a slight revision, a slight retweak. And in my head, I'm just thinking, you've got to be kidding me. I

I have to go through this all over again. Well, no, I have to, but I went through this. I put myself through this and now like this is the result that I have. This sucks.

It was wild. More pain, more time stuck in bed, more life she would miss out on. Worse, she was going to have to pay another $4,000 to get the revision done. On top of the $9,000 she'd already paid for her rhinoplasty. This is not super uncommon, by the way. Anywhere from 5 to 15 percent of patients opt for revisions. Many of them are not.

But as she contemplated her own, Carla became filled with anger and regret and shame. It felt like a little bit like, I guess, selfish. And what is the word? Vain, obviously. Like, yeah, all about my looks. And I started to kind of have that realization, you know, after the surgery in those earlier days. I chose to do this to myself.

And so I think it was that realisation as well, a bit of anger in there. And having a deep hate for yourself and what you look like, and that's what I felt for myself for so many years.

Ultimately, it took about two years for Carla to save up enough money to get the revision done. Two years of not being able to breathe through her nose because of the swelling and of a debilitating self-consciousness that was even worse than before. I felt, again, just so ugly. I felt disgusting. I felt like...

I hate myself. And to say that out loud is so sad to think that, you know, past me felt that.

These feelings, the regret, the anger, the fear and shame, are more common with plastic surgery than the reality shows and before and after pictures might have you believe. Psychologist David Sarwer knows this well. For the past 30 years, he's been leading a research program at Temple University in Philadelphia looking at emotional and mental health issues surrounding cosmetic surgeries.

And he says, while most patients end up happy with their results, some people do experience regret, even when nothing goes wrong.

This is especially true for rhinoplasties, which have one of the highest regret rates of all cosmetic procedures, around 10 to 15 percent. If you've spent 20 or 30 years living with your nose looking one way and suddenly it's now changed, that can really be unsettling for some people. But David says a lot of it also has to do with patients' unrealistic expectations.

I often think that almost all patients probably have some kind of daydream of how very different their lives may be after they undergo these procedures. People may imagine they'll get invited to more parties, that they'll get that promotion they wanted, that the one that got away will suddenly see them in a new light. But in reality, David says...

Our interpersonal relationships, whether in the workplace or our social relationships, are influenced by countless different factors and our appearance is only one of them. And so we may change that one little element of our physical appearance and that may lead people to look at our faces or our bodies slightly differently, but their total experience of us as a human being isn't going to necessarily change just because of that cosmetic procedure.

And then there are unrealistic expectations about the results themselves. In an ideal world, David says, surgeons would take the time during initial consultations to get a full and accurate picture of what the patient is looking for and to explain what they're realistically able to deliver. They would also make sure that patients fully understand what they're getting themselves into when it comes to risks and recovery. Scott Hollis said,

Scott Hollenbeck is the president of the American Society of Plastic Surgeons. The healing process, for example, is unique to everybody's own body. Some people, for example, heal in a way that leads to tremendous scarring, and that would change the outcome of the procedure such that guaranteeing 100 percent satisfaction would be unrealistic and would almost be deceitful in some ways.

I think you have to notify patients that there are certain things that are a little bit out of everybody's control. Infection, for example, can occur. Another step that David and Scott both say should be happening, but often isn't, is screening patients for body dysmorphic disorder, a condition in which a person becomes obsessed with perceived physical flaws in such a way that it begins disrupting their everyday lives.

It's a condition that David says only affects around 2% of the population. But among patients who present for cosmetic surgery and dermatological treatments, most of the research done in the last 25 to 30 years suggests that it affects anywhere between 5 and 15% of patients.

Now, that might not seem like a lot, but when you think about the number of physicians who practice just cosmetic procedures in this day and age and may see 20 new patients in a week, that means they're seeing one or two patients a week who may have features of, if not this actual diagnosis. David says cosmetic procedures tend to make this disorder and all of its symptoms worse.

Carla's revision surgery went well. Her nose finally looked like the image her surgeon showed her on Photoshop. But now, more than a decade later, Carla still has regrets. She regrets the feelings that led her to getting the nose job in the first place. But she also regrets the feelings that led her to get the nose job in the first place.

In the years just after the rhinoplasty, Carla got really into yoga. And one of the mantras her instructor used was about acceptance. Acceptance of all that has been, acceptance of all that is, and acceptance of all that will be. And when I heard this for the first time, I realized, wow, like,

I don't accept myself just as I am. I'm always thinking that I need to change something. I'm always thinking, and this is a big one, that I need to lose weight, that I need to be thinner. And then I realised this was the same thing with my nose, that it needs to be smaller. I was always thinking, I need to take up less space in order to be accepted. And in my head, what I thought was that it was acceptance from others. But what it really was, was that I didn't accept myself anymore.

These days, Carla's pretty good about accepting herself as she is.

including the decisions she's made. However, if I could go back and change it, maybe I would. One big regret and one big thing that I think about now is, you know, I've just had a baby and he, I'm pretty sure, has my nose. Because if I look at me as a baby, it looks like the same nose. And I would call it the papa's nose because it's a very Greek nose. And

And this excites me that he has it, but it also makes me a little bit sad that I don't have it, that I, you know, I got rid of it. I got rid of a part of my history, a part of my family's history, a part of where I came from.

That story was reported by Liz Tung. We're talking about the connection between appearance and mental health. Coming up, serious skin conditions can make people isolate themselves. All of my friends were isolated.

Going out dancing and going to parties and being really social. And that's when my eczema was the most severe. So I feel like I missed out on a lot. A growing medical field recognizes the skin-mind connection. That's next on The Pulse.

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This is The Pulse. I'm Maiken Scott. We're talking about the connection between appearance and mental health. We instinctively know that there is a link between our skin and how we feel, and it's a two-way street. Our skin often bears the visible signs of what's going on inside. We tend to break out when we're stressed or not sleeping enough. And when we're dealing with a visible skin condition, it really affects our mood.

A growing field is recognizing the importance of this connection in hopes of offering people more holistic treatment. Alan Yu reports. Summer Forlenza has had eczema since she was a toddler. Her skin was very dry and would often be itchy, irritated and inflamed all over her body.

Just a really extreme sensitivity to the environment. Cats, dust, any other animals, grass, flowers, sunshine, all of these things can trigger an eczema flare for me. With severe eczema, the skin can crack and start to ooze. And a ton of pain also. It became much more painful at that stage because it was kind of just...

covered in raw wounds all the time. Summer tried diets, baths, lotions, steroids, and other medications to get relief. But nothing seemed to work. When her skin itched at night, she struggled to fall asleep. She looked visibly different from all the other children at school. And as she got older, her skin condition made it hard for her to have much of a social life. In my early 20s, you know, all of my friends were

Going out dancing and going to parties and being really social and things like that. And that's when my eczema was the most severe. So kind of all of that fun, vibrant stage of life period was one that I feel like I missed out on a lot because...

You know, I was mostly just in the house. And it all took a toll on her mental health. The older I've gotten, the more my eczema shows up on my face. That's primarily where it happens now. And so it's very visible, or at least I feel that it is, you know. And so there's a lot of anxiety and sometimes a desire to kind of hide or isolate because of it. So it's like when I'm more stressed or anxious, I notice my skin flares more. And then also when my skin flares more, there's more depression and there's more anxiety that happens.

Summer started seeing a therapist in her 20s. She says it's been hard to find a mental health professional who understands how debilitating her skin condition can be.

Her dermatologists often did not have the time to talk about the mental health aspects of eczema during appointments. A lot of dermatologists are really, really, really busy. And so we have 15 minutes together. And the focus is, all right, how are your meds working? What can we do? Let's make sure we get these blood tests to make sure it's safe for you to keep taking these meds.

But over time, Summer came to realize that her treatment plan has to include her mental as well as physical health.

For example, accepting that she cannot control her eczema perfectly, no matter how hard she tries. I can take good care of my mental health, sleep really well, avoid allergens, take my meds, and I'm still going to have a flare. And the goal cannot be let me manage this so perfectly that I never have any pain or discomfort or itching. Salma is now a therapist herself.

She has spoken about the connection between eczema and her mental health in her work with the National Eczema Association. In surveys, patients have reported stress as a common trigger for eczema flare-ups. And in turn, those flare-ups then lead to anxiety and depression. More people are paying attention to the connection between dermatological conditions and mental health.

Psychologist Kristina Gorbatenko-Roth knows what it is like to have a visible condition that people stare at. She started losing her hair in her 20s due to a condition called alopecia areata. By her late 30s, she had lost all of her hair. Strangers, I would find them giving me the second look, you know, the second take, the double look, but not a good kind, the bad kind. Yeah.

I remember being stared at. I remember people coming up to me telling me that I'm going to beat the cancer that I have, you know, at the grocery store.

After Christina was first diagnosed and dealing with her condition, she talked to other alopecia patients who had trouble finding therapists to help them. Many of them have gone to see a mental health person. They have sought that out on their own. And they will say the person looked at them and said, you know, I don't really quite get it. It's just hair. What's the problem? Christina says the emotional impact of losing your hair is real.

Many of us will tell you that you feel extremely emotionally raw. You go into the dermatology office and you also have to take off your head covering or your baseball hat or your wig or whatever it is that you're doing. It's almost like a scab. Emotionally, it's like an emotional scab that you can walk around in your day and you try to protect it, but you go in there and it's like it doesn't have to be scratched very hard and you start...

to be pretty emotionally impacted by your skin condition. Christina says she did not expect her dermatologist to also be therapists, but she would have liked it if they could have maybe validated the emotional weight that losing her hair would have or offered referrals to people who could help.

She later discovered an organization called the Association of Psychoneurocutaneous Medicine of North America. It's a group of dermatologists, psychiatrists, and mental health professionals dedicated to understanding the skin and mind connection.

She went to one of their conferences and found her people. The doors not only have been opened, but there's a red carpet there and people are like, come on, come on through. She's now on the board of this organization. And so is psychiatrist Ladan Mostegimi, one of the pioneers in this field.

More than 20 years ago, at the University of Wisconsin-Madison, she convinced the departments of psychiatry and dermatology to open a clinic that specializes in treating the mental health concerns of people with skin conditions.

She says that opened up a whole new layer of care. For dermatologists, usually you see the affected areas of the skin, you give them a topical treatment, you see if the problem is acne, you treat acne. But she says, for instance, that people who suffer from acne are more likely to also have issues with anxiety and depression.

So a psychodermatologist would check for that as well. Psychodermatologists take care of both acne and mental health issues created by it. And this is the main difference in approach. The idea is that a patient would work with dermatologists as well as therapists and psychiatrists to get support for their mental and physical health.

Rick Freed, another leader in the field, also started his own clinic where he practices psychodermatology. 30 years ago, Rick had finished medical school and was training to become a psychiatrist. But after seeing a lot of his patients come in with skin conditions, he opted for dermatology instead. His fellow clinical psychologists did not understand this move.

He says, on the contrary, it makes sense to see the skin and brain as connected.

After all, when a baby develops in utero, there are three layers of development. One that leads to muscles, one that leads to intestines and lungs, and one that leads to the brain and skin. Rick likes to say that the brain and skin come from the same place. And if any dermatologist tells me they don't practice psychodermatology...

The field has definitely grown compared to the days when Rick and Laden set up their clinics. But there are still not enough providers to address demand, says Evan Reeder, a dermatologist and psychiatrist who runs his own practice in New York City.

He says one of the obstacles is just how busy dermatologists are. The workday of a dermatologist is very different than the workday of a psychiatrist. You know, we are often seeing four patients an hour. Some people see more than that. Psychiatrists may see two patients an hour, maybe see three patients an hour. And they have the luxury of time to be able to explore a lot of the topics that dermatologists don't have the luxury to do.

And Evans says that the lack of health insurance coverage is a larger structural hurdle. The way that doctors are reimbursed to be able to, you know, keep their lights on and pay for their electricity is by seeing patients in high volume.

That's why even though he can practice psychodermatology, most of his work nowadays is just medical and cosmetic dermatology. There may be more demand if there were more people that could practice in this arena while having a viable business model to keep their practices open.

Summer Forlanza has found medication that works well to treat her eczema and ways to manage the condition. But it is still something that she thinks about every day. And she says she hopes more people can understand how skin conditions can have a huge impact on the lives of patients. Everyone I know who has severe eczema has had experiences of people being confused about why they're missing school, why they're on disabilities.

why they're traveling to another country to try to get treatment, because I know a number of people have done that. There's such a misunderstanding of what eczema is, and people think of it as a small rash that you get for a little while while you're a kid. That story was reported by Alan Yu. This is The Pulse. I'm Maiken Scott. We're talking about the connection between appearance and mental health.

Recently, reporter Grant Hill deleted all of the social media apps from his phone. He felt like he had gotten addicted to them and spending so much time on Instagram and TikTok had made him feel bad about himself and his looks. So the apps were gone and suddenly he had a lot of extra time on his hands. And he found himself in front of the mirror a lot, scrutinizing his reflection.

He didn't like this new habit, so he decided to try something radical. Here's Grant.

Spending so much time on social media had left me feeling self-conscious about my appearance. For most of my life, I had consumed an endless feed of perfectly symmetrical successful people doing perfectly symmetrical successful people things. And then I would catch myself in the reflection of my dim phone screen, broad-faced with uneven eyes. I'd begun to hate myself, how I looked.

And I thought the solution was to go cold turkey on those apps, to break the doom loop. So now that I had finally done it, gone without social media, no attractive strangers, no filtered selfies, no unflattering snapshots taken and posted by friends, why was I constantly returning to the mirror?

Determined to get to the bottom of this strange new habit, I made a pact with myself to go one week without seeing my reflection, not in real life or online. I work from home, so it's not like I had anywhere to be.

So I grabbed some duct tape and an old tablecloth and covered my mirrors. And then I made some calls. First to Mark Pendergrist, a science writer and the author of Mirror Mirror, a history of the human love affair with reflection. I told Mark about my weird habit of staring at myself in the mirror and my plan to stop for a week.

He told me that what I was going to experience was the norm for most of human history. Mirrors were quite rare. You know, the first mirror was obviously a still body of water where people could look in and see themselves. It's not that people weren't trying. People made mirrors, but they were mostly using polished obsidian, a fairly rare naturally occurring black volcanic glass.

Those mirrors were dark and cloudy, but provided a truer image than the distorted view people could get from a pool of water. Mirror-making techniques using clear glass were perfected in Europe during the Renaissance. But Mark says it wasn't until the rise of industrially produced personal compact mirrors that

along with movies and makeup in the 1920s, that reflection reached true maximum scale. In department stores, all of the display windows would often have mirrors in them to attract people to look at them. Mirrors commanded attention, like a spotlight, and their ubiquity could easily lead to obsession. There are all kinds of studies that show that if you stare at yourself in a mirror for

For a long time, with the lights sort of down, people hallucinate and begin to see themselves distorted and in strange ways. And there are people who have to keep away from mirrors because they become absolutely obsessed with looking at themselves. I uncovered a story of somebody who couldn't have a toaster in their house because they kept looking at their reflection.

On that first day without my reflection, I did feel an absence. I brushed my teeth staring at a wall, noticing all the shiny trim around me, the metal sink, the shower head, the toilet paper holder, all the cleverly engineered angles that subtly reflected my own warped image back to myself, like an affirmation that I was indeed the center of my world.

And this was just my bathroom. As a psychologist, I spend actually a disproportionate amount of time probably thinking about mirrors. Sally Augustine is a psychologist who works with interior designers. I make recommendations that are neuroscience-informed. And much of her work involves something called biophilic design. Yes.

Using today's tools to replicate the sorts of conditions that were really positive for us when we were a young species. She says one reason our reflections are everywhere these days is because humans are hardwired to like shiny stuff.

That may be because in our earliest days as a species, we had really good associations to shiny things like a water hole seen from a distance. Well, that's a shiny surface, whatever. And so all of our early experiences seem to predispose us to thinking good things about mirrored surfaces. But not necessarily about what we see in them.

Sally says, take the whole Zoom face phenomenon that went down during the COVID lockdowns. We spend more time looking at ourselves. We notice things aren't really exactly as we wish. And we're more apt to have plastic surgery. We can also, when we're on a video call and looking at ourselves for long periods of time, that can start to make us a little tense sometimes.

and degrade our conversations. Mirrors make us feel self-conscious because they remind us that others are looking too. When we see ourselves in a mirror, we're actually more likely to behave in accordance with the social norms of our groups. So

Things like somebody who's putting together a recycling area in an office really should put a row of mirrors, reflective surfaces above the tops of all those barrels because if people could see themselves when they're standing there making recycling decisions, they'd be much more apt to be conscientious about doing things like separating what they want to recycle.

I wondered, without the crucible of social media, was I returning to mirrors for some kind of subconscious social guidance? Or was the mirror just an old analog source of that familiar feeling those high-tech apps gave me? One of not being good enough. Day two without my mirror came and went, and I did feel different.

Instead of instinctively seeking out those shiny surfaces, I avoided them at all costs. I wanted to forget what I looked like, truly, even if it was just for a day or two, as if I was camping and taking a vacation from myself. John Walters knows the feeling. He swore off mirrors in 1982, at least the normal kind of mirror.

He was 22 and feeling depressed, not happy with how he looked. He had spent a significant amount of time fiddling with his hair part, switching it from the left side to the right side, only to settle on keeping it right down the middle. But ultimately, it did not fix the emptiness he felt whenever he looked at himself. Then one day, at a house party, a little high and anxious in the bathroom, he was playing with the mirrored medicine cabinet to waste time.

He was tilting the mirrors back and forth and back and forth when suddenly, at just the right angle, he saw a different image of himself. I literally did a double take because I saw something in my eyes that I recognized. He had set up the mirrors in such a way that it did not flip his image like normal mirrors do. Instead, it was more like he was looking at himself through a window.

And he liked what he saw. I literally said, oh, there you are. Think about it this way. If you wear a shirt that says New Jersey on it, if you look at yourself in the mirror, those letters will be backwards. You won't be able to read it. But if your friend looks at you, they will see the words New Jersey on it.

John desperately wanted to recreate that experience he had in the bathroom. He spent 10 years trying to achieve what he had done using the medicine cabinet until finally he had a breakthrough with what he called a true mirror. Two glass mirrors angled seamlessly in a box that allows people to see themselves the way others do.

He's been selling his true mirrors for three decades. To this very day, it's exactly the same. I mean, some people get it instantly and are just absolutely floored. And other people like, yeah, I don't know. What's the point? About 90 percent of people have that what's the point reaction, he says. But thanks to social media, his mirrors have started to go viral.

This is a true mirror. What does that mean? Two mirrors that meet at a 90 degree angle without a seam down the middle. It's amazing. Videos of influencers seeing themselves the way others see them in John's true mirrors have garnered millions of views.

But all the attention hasn't really translated to sales. John says most people don't want to see this side of themselves in the same way people hate the sound of their own voice. We're just much more familiar with the image we see in the mirror,

It's why phone cameras make your mirror image the default in selfie mode. TikTok has an inverted filter that you can actually film yourself without being reversed in selfie mode. And it's universally hated. Like, almost everyone hates the inverted filter.

John says we have become so accustomed to viewing ourselves and others through this mirror inversion that most now prefer to live in what he calls the uncanny valley of inversion. You know, if you look at the videos people make, they're all in selfie mode. You know, and you can tell because their expressions are not quite normal. You can read them, but there's a certain mirrorness to them that I can detect.

The backwards version only exists when you make eye contact in the mirror and of course now in selfie mode. But real life, you're not backwards. You know, no one's backwards except for you in a mirror.

By day three of my mirror cleanse, the tablecloth had started to slip down my bathroom wall. By day four, it had completely fallen off the mirror. For the rest of the week, I avoided the mirror the good old-fashioned way, by just not looking at it. I walked around consciously avoiding my reflection. And it felt good, like I was living by some ancient code. And then...

A package arrived in the mail. There is a label on it that warns that a delicate optical instrument is inside. Please handle carefully. It was from John. A true mirror. Something that would allow me to emerge from that uncanny valley of inversion and see the real me for the first time. A version I liked. Let's see. Okay. Um, I don't like it. Okay.

I definitely don't like it. It's disturbing. One thing I am kind of insecure about is the width of my face. And it's looking wider than usual, which I don't love. It's weird. I don't love it. I don't love it. I called my girlfriend into the room. Hey, Mary, you want to come look at yourself? No.

Yeah, I was telling the listener about my problem with my wide face. Your wide face? Oh, that you believe you have a wide face, yeah. And so here it's like inescapably wide. I'm just saying it's... So even the true mirror is not helping you see that you truly do not have a wide face.

Sometimes you don't need to go to the extremes to change how you feel about yourself. All you need is a little affirmation from a completely different angle to realize that others can see the best in you, even when you can't.

That story was reported by Grant Hill. You're listening to The Pulse. I'm Maiken Scott. You can find us wherever you get your podcasts. Coming up, when choices about appearance and style become much bigger than looks. I think there's a self-consciousness of saying to someone, this is who I am. These are the choices I make for my body. Are you present to be present with the choices I'm making for my body? That's next on The Pulse.

This is The Pulse. I'm Maiken Scott. We're talking about the connection between appearance and how we feel.

The things that really tend to bother people about their own looks often sound silly or minor to others. Like when your friend tells you how much they hate their hair and you reassure them it looks great and you mean it, really. But once you're obsessed over this one thing, it's hard to shake it. Nicole Curry has this unique tale of how an intimate detail became much bigger in the eye of the beholder.

Caroline Rothstein was 23 and waitressing in a sports bar in Atlanta. And on one night, a certain guest was desperate to get her attention.

He would say my name, Caroline, very directly, which felt very flirty. He was from out of town, there on business, and one thing led to another. And I said to him that I thought he was really cute, and he said back to me, really? Because I think you're gorgeous. He then said Caroline should call him after work.

And I'm feeling really good in my body. I'm feeling good and excited. And all this feels like important background to share. And so I go to his hotel and he asks if he can kiss me. Good consent game. And I say yes. And then he's like, let's get naked. And I was like, no, not yet. The two talked for a while. They laughed and the moment finally seemed right. And...

He looks at my shaven legs and notices that they're freshly shaven. And this made Caroline think about another part of her body. And I made a comment that I had not groomed myself in other places. Other places meaning the hair down there. But he said something about like,

Who cares? Pubic hair is beautiful. Like, I don't care. Like, that doesn't matter to me. You've probably figured out by now that Caroline's story isn't about sex or that one night stand. It was fun, but she never saw that guy again. Her story is actually about something that's even more taboo for public radio, pubic hair.

Because if you really think about it, this memorable conversation Caroline had with this guy sheds light on the fact that intimate grooming choices say something about ourselves that is much louder than the phrase, it's just hair. I think there's a self-consciousness of saying to someone, this is who I am. These are the choices I make for my body. Are you present to be present with the choices I'm making for my body? ♪

Thanks to pop culture, grooming pubic hair became visibly linked to how desirable or sexy a woman was. High-cut bikinis became popular in the 1980s. Then came the Brazilian wax craze. The bare look was everywhere, from magazine covers to the porn industry.

Even popular shows like Sex and the City amplified the beauty trend. "Jesus, honey, wax much?" "What? I didn't know I was gonna be wearing a bathing suit." "What are you talking about?" "I forgot to wax." "Since when? 1998?" Though not every woman felt pressured, like Caroline. Although she hadn't groomed before that one-night stand, she usually enjoyed the ritual.

It was nice to know, you know, every six weeks, every two months, every three months, I will go do this thing to take care of myself and lie down and someone will tend to a part of my body that, you know, is deeply personal and deeply intimate. But in 2013, after breaking up with a longtime partner, she changed her mind.

Caroline is a poet, artist, and activist. A lot of her work is about body positivity and self-love. I looked down and was like, I wish I had more pubic hair. I didn't get waxed for my ex, but I enjoyed being waxed the way I was while in that relationship. And I think after breaking up with my ex, I went on a deep, deep, deep

And so she decided to go longer in between waxes, checking on her hair every day. And it's not growing out. What she saw instead?

Large chunks of missing hair. And I'm like sitting there waiting for, you know, this big bush to grow back. I'm like wanting, you know, the quintessential 70s Debbie Does Dallas look. I'm like, I want so much hair to come back, but it's not growing. Weeks turned into months. And what did grow, to her surprise, was discomfort.

Caroline realized her previous years of waxing had damaged her hair follicles. And now she was really upset with herself. I absolutely regretted waxing in that way for all those years.

It made her really sad and a little self-conscious. I kept telling myself that everything would be better if I just had those extra square inches of hair sitting back on my lower torso. Like we tell ourselves, everything will be better if we meet the partner of our dreams or lose weight or get a new job. Everything will be better if...

And then she was hit with another emotion, guilt. Given the politics that I hold and the work that I make, there was some shame in like, ugh, I shouldn't be struggling with how I feel about this part of my body. I'm supposed to be the one who's out there facilitating workshops for everyone else on self-empowerment.

Years passed and it was obvious that the hair wasn't coming back. And for a while, it was hard to understand why she was experiencing this whirlwind of emotions and why she couldn't shake it.

But over time, Caroline finally remembered that the hair down there was not just hair. That what you choose to do with your pubic hair has been political since the beauty standards were introduced. Her grief was about the hair and the loss of choice. Choice is the greatest privilege of all. And when choice is out of our control, there's grieving and grief.

And then we have an opportunity to find a new choice. So when looking at my pubic hair and judging it, just instead meeting myself with curiosity, maybe touching that patch of skin with love instead of anger. So I've allowed my pubic hair to become, to feel empowered instead of me trying to control it.

That story was reported by Nicole Curry. I just want to lay it down and open up the deepness.

Thank you.

Our intern is Christina Brown. Charlie Kyer is our engineer. Our producers are Nicole Curry and Lindsay Lazarski. I'm Maiken Scott. Thank you for listening. This message comes from NPR sponsor Shopify. Start selling with Shopify today. Whether you're a garage entrepreneur or IPO ready, Shopify is the only tool you need to start, run, and grow your business without the struggle. Go to Shopify.com slash NPR.