Liz Atkin is 40 years old and only recently starting wearing T-shirts. The idea of showing her arms, and the scars on them, was frightening, shameful, hard to explain, and so much more. Since childhood, Liz has lived with a disorder called dermatillomania, a skin-picking disorder in the same family as obsessive compulsive disorder.
“It’s not about self harm,” she says. “It’s about trying to perfect the skin and make it smooth and make it feel and look perfect, but the process of it causes wounds and scars and marks, so it constantly perpetuates this cycle of wounds and scars.”
The disorder only affects about 1 to 5 percent of people, according to U.S. News and World Report, but women are more likely to seek treatment. For Liz, it developed as a way to rid her skin of imperfections but became something she was unconsciously doing.
“Sometimes I’d look down at my hands and I was picking all the way down to my knuckles, and on some fingers I didn’t have fingerprints because I was picking all of the skin off,” she says.
The disorder was easy to hide, too, as Liz would have a lie ready to explain any picks or scars. When she was 8 years old, she told a schoolmate’s parent it was chicken pox. When she was older, she avoided swimming parties, covered her face in foundation, and dressed in what she calls gothic clothing in order to keep her disorder a secret.
“I was adapting my behavior to fit this disorder around my life,” she says, explaining that the shame also comes from it being something that one theoretically should be able to stop. “There’s not a way to switch your fingers off, so what do you do if the tool you’re using to attack your body is attached to you?”
Liz saw her skin picking get worse than ever in 2013 when she went through a depressive breakdown that led her to take 10 months of sick leave. During that time, she took antidepressants and saw a therapist for cognitive behavioral therapy that helped her manage her anxiety, depression, and skin picking. But something else that worked as an antidote to her frustrating mental state was her work.
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As a visual artist in London, Liz had previously captured her disorder in artwork featured in the Museum of the Mind at the Bethlem Royal Hospital, England’s first mental health hospital, which features artwork specifically focused on mental health.
During her 10-month leave from working regularly, Liz received a call from the museum asking for a commissioned set of artwork explaining skin-picking disease. While she initially turned it down, feeling too unwell to deal with it, her therapist pushed her to try.
The commission, which featured images of Liz that she took herself mostly in a bathtub where she felt safe and comfortable, was so well received that she earned a solo exhibition in Los Angeles at the David Geffen School of Medicine at UCLA, where students and professors learned to look at the disorder through her artwork.
“It went from the very worst thing of my life to something that led me on a very different journey and I was able to translate this awful thing in my life with an image,” she says.
Now Liz is able to work as a freelance artist, teacher, and mental-health advocate. Here, she explains some of her pieces that best illustrate what it’s like to live with dermatillomania.
“This is what was in my head tumbling out to my skin. It’s the feeling of depression. Since skin picking is such a visual disorder, the gaze and the connection with the camera is so important. It’s a very visual and tactile disorder. In these images, having eyes closed was quite important because it felt very internal. I spent a lot of time writing in journals and books when I wasn’t well, just a tumble of thoughts. They weren’t very coherent, and repetition came up a lot. I wanted to capture this sort of cacophony of words.”
“This was about the ink engulfing me and trying to go between two worlds. I’m being submerged but pushing to get out of it. It’s ink and oil. I mixed the two together so you get a viscous kind of surface. None of these are Photoshopped or created on the computer. I’ve gotten good about washing the oil off—after a couple of showers it’s gone.”
“My chest has been a place I’ve picked for years and it’s fully healed now, but for a long time it was a very intimate private part of the body and I attacked it and my fingers over and over and over. So I started thinking: What would it be like to turn that into something beautiful and soft instead of being scabbed and scarred? I thought of it as a calm, soft moment and to rethink my skin as colorful and celebratory.”
“This is made of acrylic paint, which takes about 10 minutes to dry, so I peeled the entire piece off in one go. For a skin picker, that’s pretty cool. It felt like a collaboration with the disorder, and it would feel so wrong to make artwork without that being present because it’s part of me.”
“This is underwater, about that journey into the black liquid. Depression felt like it was changing me, and I was so worried I’d never get back to what I’d be before. It was like I had no control over the change. Water can drown you just as it can soothe you, so this is it drowning me, it’s removed anything I used to be, and I’m just this body that has to lie in the bath.”
“This white milk is a rethinking of the depression stuff because the skin picking is with me so [it’s] there in these colorful kind of touches, but the water is still and everything is calm. It feels like how I am today—that’s recovery. I have this disorder with me all the time, but I’m very at peace with it and I don’t try to switch it off or ignore it. As an artist, I’ve found a lot of value in these experiences. These sensations are not always an easy part of my life to struggle with, but they can be very useful if they’re channelled in the right way, which is what resilience is.”