The morning of the shoot I'd scheduled myself I nearly canceled. It was two weeks after a 17-day trip across Italy, six days after coming down with a persistent cold that caused me to lose my voice, and three days after Thanksgiving. In my head, it made sense to postpone. "I shouldn't expose other people to whatever I have," I told myself, "I'm not as prepared as I'd hope I'd be following my vacation." But in reality, I wanted to call it off because I was nervous about seeing myself in the camera.

Here's some background: I wrote a book, a 13-year project that covered my life and the decisions I made during my 7-year struggle with an eating disorder. I revealed the ways I physically and psychologically hurt myself through odd daily rituals, hours standing in front of mirrors criticizing myself and bizarre food choices, and how it influenced my first experience with love. I didn't know what I was writing when I began the project, and couldn't have guessed what it would become. But through writing my book, I found that my identity had space to exist outside of my disease.

I liked the girl portrayed in the book. I understood her thoughts and feelings. I forgave her bad choices. Although, I've come to accept the person I revealed through words, I still struggle to accept that same person when captured in an image.

The picture I see in my mind is built on fear.

After earning my degree at university, something that took six years and five schools across three countries, I agreed to let my mom purchase my graduation portraits only after she promised never to hang them on a wall. When I agreed to act as a bridesmaid at a close friend's wedding, I asked her to exclude me from the photos. At work, I yelled at a coworker for taking my picture without permission. She thought my outfit complemented the floral arrangement on our desk; she knew nothing about my past, yet I scolded her.

I thought that by avoiding pictures I could manage my problem. But it doesn't work. Social media aside, capturing moments through photographs is an important part of life and my negative relationship with my image was not isolated to my own experience. But affected the experience of people around me.

But how do I change it?

I first considered physical changes. Could I be in better shape? No. I am very fit. I could change my hair, but my hair isn't the problem. It's my nose. Specifically, it's my nose and the empty expression behind my eyes.

I thought about fixing my nose for a long time but didn't go in for a consultation until 2021. My mom and I sat on a bench in an examination room waiting to speak to a plastic surgeon. Mom was there for moral support. She had a nose job when she was younger. Although, she did not believe I needed one, she sympathized with my wishes.

"I want to start by acknowledging that I have body dysmorphia," I told the doctor when he arrived. "I know, my situation is complicated but I am not looking for a big change. I just don't want to continue to feel this way." His blank look caused my voice to quiver, "I don't want to be crying on my wedding day because I can't stand the way I look."

"I'm going to stop you," the surgeon said, raising his hand. His tone was gentle. "I hear you, and I recognize this is a real problem for you and that it seems to hold a lot of power over your life. I agree, your feelings should improve."

"But," he added, dropping my file on the counter to his left, "I have to turn you away. To perform such a procedure on someone who has been clinically diagnosed with body dysmorphia would be malpractice. I am very sorry, but I must turn you down."

In the car, I cried. My mom tried to console me, saying, "You know, I don't agree you need a nose job, but if you want a second opinion, we'll find someone else."

"No!" I shouted without hesitation, "I don't want to see anyone else. Now, I wouldn't trust anyone else."

That doctor was right to turn me away. If my tattoos taught me anything it's that I am not someone who should make permanent alterations to her body. I have severe body dysmorphia. If I had surgery, there is no guarantee I would have liked the result any better than what I have now. Still, I cried. Even though I wasn't confident the change would make me feel better, it was the fastest way to find out. When I left the doctor's office, I was back to square one.

What changed? It hadn't always been like this. In high school, I was engaged in photos, I was even told, "You should model," a sentiment that consoled my own feelings, which tended to disagree. But then there was a moment in my 20s when I came to relate to the camera as cementing my greatest fear, "you're ugly and I'll show it."

I needed to find another way to resolve my insecurity, a task that was becoming more difficult over time. I had come to understand my life as if through understanding I could stop hurting, but the pains don't disappear; they change. The issue was not how I feel in my skin; it was how it was captured in a still. The solution felt obvious. If I was to like the way I looked behind a lens, I had to stand in front of it. To see pieces of myself that were hurting or weren't flattering and find new ways of seeing it.

"There is no way of knowing," I remember the doctor saying, "if what you would receive would make you feel any better than what you have. I have given patients exactly what they want, when the surgery went seamlessly, and they will come to me months later dissatisfied. Then they ask for something else. Changing your nose won't guarantee you greater peace."

I will never know what I would have felt after a nose job, but I am aware of the looks I have now. I did not choose my appearance. But I can choose every image created from it.