Body Dysmorphia Takes Son's Life; Propels Grieving Dad to Walk

May 30, 2012— -- From the age of 11, Nathaniel Asselin struggled with body dysmorphia -- a cruel disorder that made him magnify every imperfection he imagined on his face.

The "fiercely intelligent" boy with a keen sense of humor agonized over gelling his hair the right way or staying in shape, but mostly about his skin.

"A shaving nick or a small blemish, or even just a bump under the skin would keep him in front of the mirror for hours, applying small pieces of Band aid to cover up the marks," said his mother, Judy Asselin, a middle school teacher from Pennsylvania.

"The irony, of course," she said, "was that he had a beautiful complexion."

In his teens, Nathaniel's social sphere grew smaller. Dating was "an impossibility," according to his mother. And when he mustered the courage to leave the house, he thought people were looking at him because of his "wrong" appearance.

But after numerous hospitalizations and failed treatments, Nathaniel took his own life somewhere near the family's home in Cheyney, Pa., at the age of 24.

He told his parents throughout the "roller coaster" of his life: "I can't do this anymore," and "I can't wake up in my bed in the morning and do this all over again."

His father, Denis Asselin, a retired French teacher, said they felt "helpless."

Now, his grieving father has embarked on a 525-mile trek on foot to Boston -- "Walking With Nathaniel" -- stopping at hospitals and clinics that were part of his son's painful journey.

As for healing, Asselin, 64, said that if he "puts one foot head of the other" he might get there.

"It was a metaphorically powerful symbol for me -- how to move forward after the most tragic experience," he said.

Nathaniel had body dismorphic disorder (BDD) -- often called "broken mirror syndrome" -- a form of obsessive compulsive disorder that may affect as many as 1 in 100 people, according to the International OCD Foundation.

The disorder commonly starts in adolescence when children begin to compare themselves to their peers. The obsessions can consume a person's thoughts, harming every aspect of their life.

"They focus on a part of the body -- the nose is too big or the skin is not smooth enough or the hair is not thick enough," said the foundation's executive director Dr. Jeff Szymanski. "For men, you have a group who feel like they are too thin ... the gym rats."

Those with BDD can fixate on their appearance, mirror checking and covering up with hats, scarves or make-up. Some turn to frequent and excessive plastic surgery.

"It goes beyond a preoccupation and the mind can't let go of the obsessions," he said.

They are at 45 times greater risk for suicide than the general population. And because those with BDD don't recognize they have a problem, therapies are often ineffective.

"You have to look at their belief system and get insight in there and go the distance," he said.

Szymanski praised Denis Asselin, who has already raised $15,000 for research, who has turned "adversity to advocacy," a theme of the foundation.

Asselin left Pennsylvania on April 24 and by June 7, he will arrive in Boston, the home of McLean and Massachusetts General hospitals, in clinics where Nathaniel sought treatment.

Nathaniel began to experience OCD compulsions in the fifth grade. A healthy interest in running became an obsession and his weight dropped. By high school, he was spending hours in front of the mirror.

A therapist suggested Nathaniel had BDD. School and the pressures that accompanied test taking were stressful for Nathaniel.

"It was as if the patterns he followed were all dictated by the disorder," said Judy Asselin. "He never felt he could launch a career, as he couldn't go to college. He was brilliant and could have taken anything if he had not had the disorder."

Nathaniel yearned to be an emergency medical technician, "to be a hero, a rescuer," but getting the certification in a timed manner was "unbearable" to him, she said.

Instead, he volunteered to be an ambulance rider, and coached track and worked part-time at Westfield School, where Judy Asselin is a middle school teacher.

"He was a pied piper," said his father. "Kids just loved him and they never knew about his struggle because he never complained."

But Nathaniel's obsessions continued to get worse and medications came with side effects. He was eventually hospitalized at McLean, but ran away, refusing treatment.

Suicide Moves Father to Take Pilgrimage

Nathaniel died on April 15, 2011, just two weeks before his sister Carrie's graduation from college. She had signed up for a walk along Spain's ancient pilgrimage route, Camino de Santiago, but in her grief, Carrie told her parents she couldn't do it alone.

So, they offered to walk the second leg with her. That was when Denis Asselin got the "Camino fever" and an urge to keep walking to ease the pain.

"It is powerful -- just the feet hitting the ground," he said. "It's a conduit for some of the pain and sorrow deep inside. And you are moving, not sedentary. It's like a cleansing that's happening -- and you are doing something."

After the trip, Denis Asselin thought about crossing the Pyrenees, but later it "seemed a little contrived -- a little artificial."

"The ancient Pilgrims walked out the front door where their journey began," he said. "And then the trajectory came to me."

Asselin got the unwavering support of his family and the OCD Foundation. After four preliminary walks to places where Nathaniel had found joy in his short life, he headed north. Next week, he will cross the final finish line at a rally at Christopher Columbus Park on the waterfront in Boston.

The journey has been hard on his feet, but good for his heart.

"My motivation is that if every day five people learn what BDD is about, it will be well worth it," said Asselin.

As for Judy Asselin, she has derived courage and strength from his walk and intends to join him next week with their daughter.

All, are healing in their own way.

"Nathaniel was the center of our orbit for so long that having him gone throws us all out of whack; but then, so did his disorder," she said.

"He was a gem of a human being, but watching him suffer became less and less tolerable," Judy Asselin said of her son. "My challenge will be learning to accept the injustice of his suffering and death. It just isn't fair ...

"Finding the cause and better treatment seems to be the only path to that goal."