Finding your confidence: exploring identity and acceptance – Q&A

Our finding your confidence: exploring identity and acceptance webinar can be watched here.

The answers below cover both questions asked on the night and those we didn’t have time to address. In some cases we have summarised the answer, so may differ slightly to the answer given.

Was your (Vikki) diagnosis and treatment as a child or as an adult, and were you able to access age-appropriate information and support for living with a visible difference afterwards?

Vikki was 34 when diagnosed, which is unusually young for head and neck cancer. She was never offered anything like Changing Faces, therapy, coaching, or wider support, and there was no real conversation about how her appearance changing might affect her. The focus was entirely on beating the cancer, with her appearance treated as collateral damage. Her husband was overlooked too. He could access Macmillan to talk about the cancer itself, but there was nowhere for him to talk about his wife’s changing appearance or how to handle other people’s reactions to it. It can sometimes be easier for the person with a visible difference to reach acceptance than for those close to them, similar to how parents watching their kids play sport can be more nervous than the kids are themselves. A lot of the anxiety of being out in public can come from worrying how friends or family will react to people staring, rather than the staring itself.

How do you get out of your own head and accept what people say they like about you, in a romantic setting?

This is something people navigate differently depending on their situation, whether that’s starting a new relationship with a visible difference, or already being in one and adjusting to a big change together. For Marc, developing a visible difference at 14, right in the middle of puberty, was particularly tough and affected those teenage years. It took a long time to be able to accept compliments, because it was easy to assume people were just saying something to be kind rather than meaning it. Ultimately, it came down to doing the inner work first, being able to accept yourself before being able to accept validation from other people. Vikki’s experience was a bit different. Growing up in the social media era, she hadn’t realised how much of her identity, and even her sense of career success, was tied up in being seen as good-looking. She knew her husband loved her, but it was easy to assume looks played a part in that. After her diagnosis, she felt like she’d become a burden to him, and the couple went through an awkward period where he felt unsure how to be intimate with her, worried about hurting her or not knowing what he was ‘allowed’ to do. Looking back, some of that distance came from her own defensiveness. When you don’t feel attractive, you put up walls, and other people pick up on that and pull back too.

How do you stop the ‘doom loop’ of going over and over a hurtful comment? And separately: living with a cleft lip, people often notice and touch their own upper lip when talking, how can this be dealt with without it feeling demoralising?

One approach is to lead with empathy rather than judgment, whether someone is being falsely nice or saying something hurtful. Any interaction is a bit of a window into who that person is, and when someone says something unkind, it usually says more about them than about the person on the receiving end. Choosing empathy over offence is what breaks the loop. Something like touching one’s own lip is often involuntary, coming from not knowing how to react rather than any unkindness, and leading with empathy takes the power out of moments like that. Vikki gets a similar reaction a lot, with people suddenly noticing and touching their own nose mid-conversation. She’s trained herself to find it funny rather than upsetting, treating it as though the other person had simply forgotten they have a nose. She finds that reframing it that way, rather than assuming malice, makes these moments much easier to shrug off. Her main tip for breaking the doom loop itself is to physically release the tension afterwards. Crying, dancing, shaking it out or whatever works. Early on, after being asked ‘what is that?’ by a stranger, and being called a ‘creature’ by someone else on a separate occasion, she found that walking away and having a proper cry in the car straight afterwards let her let it go completely. The idea is that when we feel threatened, the body produces a kind of ‘fight’ energy that has nowhere to go, because lashing out isn’t an option, so it needs another outlet, whether that’s crying, shaking, or dancing it off. Getting that energy out physically, rather than sitting with it, is what stops it turning into a spiral of rumination later that day.

With so much value placed on appearance through social media and celebrity culture, how do you protect your mental health from these standards? And separately: how do you deal with an unkind post or meme about you being shared and liked thousands of times, when the platform says it doesn’t breach their policies?

Not fitting a ‘typical’ appearance can be an opportunity to discover what actually makes you interesting. Even someone as famous for her looks as Marilyn Monroe probably wished people focused on other things about her, because in the end, no one remembers how someone looked. People are remembered for their kindness, intelligence, humour, and the difference they made. On the social media side, it helps to actively ‘train your algorithm’, not engaging with content that makes you feel worse, so that less of it gets served up, and to focus instead on what you do feel confident about, rather than pretending appearance doesn’t matter at all. On being mocked online specifically, if the worst thing someone can say about you is that you’ve ‘got a rubbish face’, you’re probably doing fine, though that doesn’t mean it doesn’t sting, or that you shouldn’t use the block and report tools available. It also takes real courage to put yourself out there online in the first place, especially with a visible difference, and that says a lot more about the person doing the mocking than about the person being targeted. More broadly, society has shifted from citizens to consumers, and a consumer economy relies on selling people things, which means appearance, fashion and image get constantly sold as things to strive for. Having a visible difference can, in a strange way, be an opportunity to opt out of those pressures and look for fulfilment elsewhere, through connection with other people and being a positive influence, which brings a deeper kind of confidence than external validation ever could.

What else can be done to raise awareness of visible difference?

One approach is putting yourself in spaces where visible difference isn’t usually seen, without making it the focus of the moment, for example, Vikki have a TEDx talk that wasn’t ‘about’ having a visible difference at all, just about being more than that. The goal is simply being allowed to exist as a person, without needing to explain or justify a visible difference every time. Sharing lived experience as evidence, not just as an inspirational story, is powerful, and there’s more that could be done within the NHS to support people going through similar experiences. That said, it’s worth sharing your story only once you’re coming from a stable, grounded place, rather than using it to seek external validation before you’ve done the internal work. Sharing from a place of genuine acceptance is what helps other people, and adds to your own personal growth too.

I struggle with a rare skin condition which flares/changes my appearance daily. How can I stay confident with an appearance that always looks different?

My (Vikki) appearance is eternally changing. Just when I get used to it, I have another surgery, and then my face is full of stitches, swelling, and discolouration. I had an infection after my last surgery, and my skin is still peeling from it. My face is still a bit swollen. It gets a bit paralysed after every surgery, then comes back. Then they do it again. So this is very relevant for me. I think confidence doesn’t have to mean feeling the same about yourself every day; that’s not realistic for any human being, let alone somebody with a visible difference. It’s something deeper. For me, de-centering my appearance in my confidence was a massive turning point. I’ve had to learn to build my sense of self on something bigger than what the mirror shows me that day. My value is my humour, my relationships, my ideas, my abilities, the way I make people feel, the things I’m building and contributing to the world. Those things are much more stable ground for my confidence. Regardless of how I look today, which is just the packaging, I’m a great person, and I’m allowed to take up space, to be seen, to participate, and to belong. If the confidence is inside, you can be so much more fluid about how you look.

How do you deal with a physical difference which you can feel on a sensory level – so it’s not just about external appearance?

My (Vikki) visible difference has lots of sensory things. I try to overcome them, to be honest. I couldn’t use my arm for a really long time after surgery, couldn’t hold a glass of water. I hit the gym and trained out of it, and even now, occasionally my daughter will go to hold my hand and she’ll touch my arm and I’m like ‘uurgh’. But it’s just part of my story, so I kind of minimise it. Some people just don’t like to be touched in certain places, and that’s OK. My nose feels very uncomfortable when my face moves, and it can bring feelings of self-consciousness. For some sensory things there may be treatment options that help. Equally, I know what it’s like to be trying every cream, lotion, tablet, potion, everything in the world and it not getting better. But my thought process was to ask myself: what is the actual impact, and how can I minimise this to make myself more comfortable? I have a very dry mouth, so I lick my lips a lot when I’m talking, and I’m very aware of that too. But I don’t really experience pain linked to my visible difference. In summary, for me it was about looking for mitigation first. Acknowledge the self-consciousness it gives you. And remind myself: I can feel this, but not everybody can. For me, the discomfort highlighted my visible difference to me but not to others. I know that may differ for other people.