Mental Wellness

By Dr. Rachel Lowinger

The story of Purim celebrates Esther’s revelation of her true identity in a hostile world. Esther is originally told by Mordechai to hide her Jewish identity–in other words to hide behind the mask of assimilation. At the appointed time, however, in order for Esther to fulfill her unique purpose in life, i.e., to save the Jewish people, she must, at great risk to herself, reveal her true origins. It is only through this courageous act of exposure that she can accomplish her life’s mission.

The theme of “revelation” is actually stated in the word Megillah, which contains the root letters of the verb to reveal. Drinking wine, another important aspect of Purim, is also known to cause people to reveal their true nature: “Nichnas yayin, yatsa sod.” It seems to me that one of the messages of the Megillah is that our ultimate goal should be to reveal our most essential self, such that we can live authentic and genuine lives.

Hiding behind a mask is not limited to a costume, nor is it limited to Purim. A “mask” can consist of a light veil of personality features (e.g., humor, a professional identity, etc.) that protects our inner feelings, delineates the limits of privacy, and creates a space for play and creativity. It can also be a rigid structure that one eventually experiences as stifling and alienating (e.g., secrecy in order to preserve a perfect image of one’s self). We may find ourselves compelled to hide behind masks in order to protect ourselves from emotional or physical harm. Such masks might feel essential to our well-being, yet ultimately failing to shed them can prevent us from fulfilling our own unique purpose in life.

There are many types of psychological and physical masks that people wear. In this article, I focus on concerns with body image and physical appearance and attempts to address these concerns through improvement and modification (masking) of the physical self. The most extreme example of preoccupation with imperfection of the body is a condition known as body dysmorphic disorder. BDD is characterized by a deep and persistent dissatisfaction with one’s appearance, usually with a specific feature such as one’s nose, hair, skin, etc. For a clinical diagnosis of BDD, a person must be overly concerned with a defect that others cannot perceive, and this preoccupation must lead to impairments in important areas of life, including work and social relationships. BDD is rare, affecting about 1% of the general population, though it is more common in students (2.3%—13%) and possibly in women (60/40 ratio). It is likely to be underdiagnosed because many sufferers do not reveal the nature of their problem, out of shame and embarrassment.

Pathology aside, we are all concerned with how we look, and many of us dislike aspects of our appearance. As with many other mental disorders, the difference between BDD and “normal” appearance concerns is one of degree. Still, even if one does not suffer from BDD, the potential for excessive and troubling anxiety about one’s appearance is real and common for many of us. When plagued by discomfort with one’s appearance, there are multiple behaviors we may resort to such as extreme dieting and exercising, endless shopping for “something that works,” seeking out cosmetic treatments, and even plastic surgery to fix a perceived defect. While none of these approaches are in and of themselves problematic, a reliance on them for one’s continued sense of well-being and self-esteem can be. These behaviors tread the boundary between healthy self-care and obsessive preoccupation, depending on the rigidity and frequency with which these efforts are undertaken. The line is crossed when people depend on the success of these efforts for their well-being and when these activities begins to interfere with other important aspects of a person’s life such as their family relationships, or productivity at school or at work.

Lauren is an example. She is a 17-year-old girl who was referred to treatment because of a relatively benign and curious dilemma she was having. Lauren was offered a desirable position as a lifeguard in a sleepaway camp. To her parents’ dismay, Lauren was first tentative, and later reluctant to accept the job. Worried, her parents suggested she go speak with a therapist. One day, overcome by emotion, Lauren burst into tears. This was followed by intense panic, when Lauren realized that her mascara was running and that she would most likely have to remove her makeup. At that point, Lauren confessed that she was entirely consumed by imperfections on her skin and felt she had to hide her hideous defects with meticulously applied makeup at all times. Lauren was terrified of being seen by anyone, including her therapist, stripped of her makeup mask.

Now her fear of the pool and public swimming with other girls made perfect sense. She could not tolerate the idea that friends and other girls might see her uncovered–the very slight (yet hideous in her mind) imperfections of her skin exposed for all to see. Lauren worked hard that year to build her inner resources and self-esteem, till she was able to evaluate her appearance more realistically. She was able, over time, to loosen the rigidity with which she applied makeup, although she reserved her best cosmetics for outings and special occasions. In Lauren’s case her concern about skin defects was clearly interfering with her ability to be herself and to fully engage with life.

Aside from missing out on good times and good friends, hiding behind a mask can give us the wrong impression that people will not accept us the way we are. This can be detrimental to our self-worth. If our efforts are centered on changing and “bettering” ourselves, we may never get to test the hypothesis that perhaps people would appreciate us just as much if we were to stop trying so hard. Here are some tips to make it easier to take your particular mask off before Purim even begins:

Much of our anxiety about appearances results from comparisons to others or to “ideal selves.” This can happen so ritually and subliminally in our mind that one might not even be aware of it. Clearly our entire being is unique and so complex that it cannot be reduced to a quantifiable measure that can be compared. Whenever you catch yourself comparing, redirect your thoughts to a different topic. Benign neglect of unwanted behaviors works not only with kids but with our own thoughts as well.

Fear of rejection and ridicule can fuel much self-inflicted pain. Even though at one point someone else may have made a hurtful remark, you are probably your own harshest and most hurtful critic. Begin practicing kindness toward yourself by easing up on the critical self-comments and you will find that many of those close to you are indifferent to your perceived defect and are supportive of you as a whole.

Nurture your natural talents and strengths. Whether you are a good artist, a pillar of chesed, or someone who can make others laugh, building your self-esteem is a lifelong task. It is much easier to cope with a less-than-perfect nose when you feel good about who you are in other meaningful ways.

Ultimately, our ability to reach our spiritual potential and connect with others is greatly impacted by our capacity to relinquish our masks and reach out to others in a genuine and open way. Revealing our essential self is the surest way to fulfill our unique purpose in life, and it is Esther’s legacy to us. v

Dr. Rachel Lowinger is a licensed clinical psychologist. She received her Ph.D. from Concordia University and has been a postdoctoral fellow at the William Alanson White Institute. She works in private practice in Lawrence and Manhattan, specializing in adults, emotional disorders, personality disorders, trauma, and women’s and young adults’ issues of identity. She can be reached at

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