Allyson Gale
Area Co-ordinator, The Pituitary Foundation

Allyson Gale is a pituitary patient and also a life coach, often working with people to improve their confidence and self-image. Allyson opened the workshop by asking what self-image meant to a pituitary patient. Many patients mentioned the loss of confidence, weight gain, feeling self-conscious, paranoid, putting themselves down and not being able to accept the change. Some said they do not look in mirrors or avoid cameras as they "see the disease in the image".

The workshop provided an opportunity for patients to express their feelings about their image and allowed Allyson and other patients to explain what has helped them and how to be more positive about your image. It was a very honest, frank and open workshop, and some of the comments included:

• I avoid doing things - I do not want to go out and get dressed up.
• My mother had perfect children and I am glad she can't see me now, as I feel deformed.
• I am angry and cannot accept the way I changed.
• I avoid children as they can be very cruel and make jokes.
• I am filled with self-hatred and when I receive a compliment, I think there is a hidden agenda.
• People do not understand pituitary conditions so have little sympathy for my feelings.
• I am prone to depression and anxiety.

Self-image issues do not change over night but Allyson and other members of the workshop advised taking positive steps, such as:

• Focus on your good points and try and change your perception of yourself, e.g. I have a lovely smile, a sense of humour etc.
• Take the focus off you - how do you make others feel about themselves?
• Go to your local support group, as other pituitary patients will understand your feelings. Start there and get support and then you can deal with work colleagues etc.
• Remember, at least a part of the person you feel you used to be is still there - your image is the only thing that has changed.
• Try to keep your sense of humour.
• Admit and accept the changes. Don't hide away behind baggy T-shirts or dark colours but equally, don't try to squeeze into smaller sizes. Buy nice tailored clothes instead, see a colour/image consultant, ask for help in shops or take a trusted friend.
• Remember that your friends and family are still there to support you.
• Try self-help books, Cognitive Behavioural Therapy (CBT) or life coaching.
• Talk to yourself in a positive way. Face the mirror (slowly at first) and tell yourself that you are a terrific or gorgeous person. If you don't believe it at first, practise believing it a little more each day.
• Changing your beliefs about yourself will change the way you feel, which in turn will change the image you project and therefore the way people respond to you.
• When people respond well towards you it reinforces your positive beliefs.
• Remember that, although your life may be different now, there may be a positive side to the changes.

One lady said that her self-esteem was very poor and she had visited her doctor who suggested CBT at her local hospital. CBT is a treatment often used to combat anxiety disorders, depression and other forms of psychological disorders. It involves recognising distorted thinking and learning to replace it with more realistic substitute ideas. She was eventually included in a 6-week CBT programme. She explained how useful it was but it finished too quickly and her psychologist advised her to do a longer CBT course. However, this was not possible through the NHS and she was advised to do an evening class on self-esteem and assertiveness. Many of the principles taught reinforced what she learnt in the CBT group.