the line between emotion and physical is not understood and may never be that's why there are so many scam artists .
It's a vicious cycle the medical doctor sends us to "mental" doctors who send us to physical doctors --bla bla bla

Is all of this about trauma ? is it just drama ? I think it's somewhere in both places and they over lap -the drama part is the unreal
reality that we need for our mystiques so we won't bore people when they actually get bored with the mystique crap instead of us as naked apes. what was I mumbling about ? oh yeah OCD and BDD we are all crazy and function to certain degrees , some people think they aren't crazy and they're the crazy ones . Your friend will be okay and so will you and I because in the immortal words of B.B.King Nobody loves me but my momma and she could be jiving me too .

He's been trying to date girls recently and faces nothing but rejection. He thinks this is further confirmation of his ugliness but I keep trying to tell him that the real reason is that he's a ball of neuroticism, awkwardness and desperation. No girl is going to want to go out with that, and it has nothing to do with your looks. But he won't listen and is unwilling to fix these other, IMO more important issues. He claims he comes across as perfectly normal, and uses his years of experience as a bank teller to claim that he knows how to interact with people. I know the kind of guy he is though, he's probably crafting a "normal" image that he wears in public and on dates "he's even admitted as much". I'm sorry but girls are going to see through that, it's going to seem robotic an awkward, and I really think he needs to fix these other issues. He's talked about feeling suicidal in the past as well. I have to in the past so I don't know how serious he really is, but I wouldn't put it past him.

Then I got married and I didn't give a shit anymore because my husband isn't perfect either. This person is looking at microscopic things. You assume everyone can see all your black heads or hairs in the wrong places. It can make you crawl up the wall thinking that people notice your lazy eyelid or even the hair up your nose. I think women go through this more often than men because of all those stupid magazines with photoshopped/air-brushed women who don't have pores.

This isn't about his appearance in the long run, it's about the power and control of your life and the misdirection of how your appearance is what affects these things. Control over his charisma, power to make friends and influence people. The very strong need to be accepted by everyone. If you're isolated from others, this pops out even more dramatically because no one is reinforcing any idea that you look good...It's vanity flipped inside-out.

He isn't living in an environment that is conducive to positive self esteem as from what I understand his mother actually actively makes fun of him. I don't doubt this from some of the family interactions I've seen. He needs to get out of his house, as do I, but I don't think he sees the importance in it.