Acne-related Cognitive Distortions as One of the Psychological Effects of Acne
I am very introverted, so it’s hard to get my yes for an invitation.
On top of that, dealing with acne for more than a decade has made me avoid social situations even more (aside from the fact that I don’t have “extrovert energy” and I am sickly).
So, when I was invited to a party and I said yes, that was very un-Lara of me.
My colleague had been so persistent in getting me out of my cave. He is an extrovert willing to adopt an introvert like me.
To get myself excited (since parties don’t inherently thrill me), I went shopping for an outfit to wear that day.
The goods were delivered, and I believed there was no turning back.
But all the hype I built up for myself deflated when one day I looked in the mirror and saw this:
This happened around the time I was making good progress managing my brother’s acne and mine as well.
I was sorely disappointed to wake up with breakouts as it made all my progress seem insignificant—I broke out just two days before the party.
Although I only had two pus-filled acne lesions, it was enough reason for me to decide not to go.
Clearly, I was dealing with the psychological effects of acne.
What are Cognitive Distortions?
I believe that if you had been there with me at that moment, you would have convinced me that I could still go to the party. It was two days away anyway!
You might have suggested that I carefully pop and drain my zits and put pimple patches on them.
But I have to tell you, no amount of pep talk could have cheered me up or made me see the situation from a different perspective.
My body had a physical reaction: I was almost shivering. It was as if my brain perceived a threat, triggering a flight response.
My past experiences with people who sometimes out of naïveté or insensitivity made comments about my skin had left me crippling in fear.
Their comments disturbed me because even after repeatedly comforting myself that nothing was wrong with my skin and no one would notice, my self-reassurances failed to match my reality.
Therefore, I behaved according to the negative thinking pattern I had habitually built over the years: Whenever I had acne, people would always make offhanded remarks about my skin.
I protected myself by constructing this narrative in my mind. It’s better not to expose myself when I’m at my most vulnerable.
For me, it wasn’t just a possibility; it was the truth, the overall pattern.
And I didn’t even dare to question my belief.
This is what’s problematic with cognitive distortions—they are often automatic and habitual.
Cognitive distortions are thought patterns that skew perceptions of reality, leading to exaggerated negative interpretations of events or situations.
And when these thoughts are never challenged and examined, they only contribute to emotional distress and dysfunctional behavior.
Acne and mental health was difficult for me to navigate because I didn’t even realize my mind was showing me inaccurate perceptions of reality.
Types of Cognitive Distortions (with Acne-related Examples)
Cognitive distortions can become our default coping mechanisms.
Although our thoughts could be partially true in some situations, it doesn’t mean we have to allow them to stay in our minds and act on them.
In my case, I convinced myself that skipping the party was essential for safeguarding my mental health. This was my way on how to mentally deal with acne.
However, repeatedly reinforcing this belief was not a healthy way of coping with acne.
It was a bad choice.
Life should make me mentally resilient, adaptable, and flexible, but I chose to be mentally rigid because whenever I perceived a threat, I instinctively retreated.
Instead of considering that this time might be different or embracing the potential for unexpected joys and friendships, I withdrew into my room.
It’s important to name and recognize our cognitive distortions, so we can cope with acne and improve our resilience and well-being.
Here’s a list of acne-related cognitive distortions we may be prone to believing (and they can overlap):
1. Overgeneralization
We make sweeping (i.e. always, never), negative judgments based on isolated experiences and turn them into an overall pattern.
- “No matter how I try to make myself look presentable, someone will always comment on my skin.”
- “I always look bad in photos because of my acne.”
- “Acne has ruined every social event I’ve attended.”
- “I’m hesitant to share God’s Word with others because my acne will distract them from the message.”
2. Mental Filters
We focus exclusively on the negative aspects while ignoring the positive ones. This shapes how we view ourselves and our experiences.
- “No matter how much my skin improves, I’m still left with dark spots and scars.”
- “I achieved a personal milestone today, but all I can think about is how my acne makes me look unattractive.”
- “I don’t think I am fearfully and wonderfully made.”
- “Acne is ruining my life.”
3. Discounting the Positive
We dismiss positive feedback or experiences and downplay our achievements.
- “My friend complimented my makeup, but she’s just being polite. She doesn’t actually think I look good.”
- “My skin looks good today, but it doesn’t count because I know it won’t last.”
4. Jumping to Conclusions
A. Predictive Thinking
We expect or predict negative outcomes based on little to no evidence.
- “I’m already dreading the family reunion next month because I’m sure everyone will be asking about my acne and offering unsolicited advice on how to fix it.”
- ” I’ll never find love because no one could be attracted to someone with skin as bad as mine.”
B. Mind-reading
We make assumptions about others’ thoughts or intentions even without sufficient evidence.
- “I’m sure my date canceled on me because he’s embarrassed to be seen with someone with bad skin.”
- “God must be punishing me with acne.”
5. Emotional Reasoning
We believe something is true because we feel it to be true.
- “My acne is disgusting. I am disgusting.”
- “I just want to end my life. Nothing I’ve tried to clear my acne worked. I am hopeless. There’s nothing more to life for me.”
- “I can’t go out without makeup. I can’t help but feel disgusted and ashamed of myself.”
6. Black and White Thinking
We perceive situations, events, or ourselves in extremes, without acknowledging shades of gray or nuance. This all-or-nothing thinking can lead us to see our skin as either perfect or completely flawed.
- “When I don’t have breakouts, I feel confident and attractive, but if I have them, I feel ugly and unworthy.”
- “I’m failing as a Christian because I can’t seem to find joy and contentment despite my acne.”
- “If I had stronger faith, God would heal me from this acne.”
- “I’d be happier only if my skin is clear.”
7. Personalization and Blame
We blame ourselves for external events that went wrong, even if the factors may be beyond our control.
- “I’m so frustrated that I can’t control my skin. I’ve spent so much money, but nothing works.”
- “It’s my fault people comment on my acne—I couldn’t clear it.”
8. Catastrophizing
We expect the worst possible outcome and exaggerate the significance of negative events.
- “I’ll never fit in or be accepted by others.”
- “I’ll never succeed in life with acne holding me back.”
- “I’ll never be able to face anyone with my skin looking like this.”
9. Labeling
We assign broad, often negative, labels to ourselves and others.
- “I am a vain, worldly Christian for even trying to clear my skin.”
- “The world’s so harsh with me. No one understands my pain.”
(Note: This list is adapted from an article from simplypsychology.org. )
Most of the statements I included for each cognitive distortion were exactly the thoughts I had for almost a decade.
They stemmed from bad theology, poor self-image, and social and cultural influences.
Fixing Acne-related Cognitive Distortions with Biblical Self-Counseling
Fixing my cognitive distortions only started when I became aware of the lies that I believed.
Being aware of them empowered me to examine and challenge them…and ultimately bring my thoughts captive to obey Christ (2 Cor. 10:5).
Whenever we take our thoughts to the Word of God and filter them through its truths, we engage in what is called biblical self-counseling.
I may sound like I’m overspiritualizing acne, but that’s not the direction I’m taking.
Rather, I’m acknowledging the profoundly practical impact of aligning my thoughts with biblical truths as my acne and mental health support.
A. Removing the Barriers First
Dealing with acne was my bridge to the gospel, but it also became a barrier to my spiritual growth.
Before discussing biblical self-counseling, I need to clear the air first.
I was exposed to Christian clichés and teachings that were either too oversimplified or dogmatic. They failed to communicate the richness of grace and truth in Jesus Christ.
The result: They only intensified my cognitive distortions.
Here are some things I highly encourage you to straighten out before you try biblical self-counseling.
1. Misconception about Sin and Suffering
- Barrier: Believing that acne is a punishment from God or directly linked to personal sin
- Biblical Perspective: Suffering and physical conditions are not always a direct result of personal sin (John 9:1-3)
2. Ignoring Physical Care and/or Medical Intervention
- Barrier: Neglecting proper skincare routine and medical advice due to overspiritualizing the condition
- Biblical Perspective: Recognize the body as a valuable gift from God and the importance of taking care of it (3 John 1:2)
3. Misunderstanding Healing
- Barrier: Believing that faith alone should heal all physical ailments
- Biblical Perspective: Recognize that while God can heal miraculously, he also works through natural means and medical interventions (1 Tim. 5:23)
4. Misconception about Faith and Healing
- Barrier: Believing that acne persists because of a lack of faith
- Biblical Perspective: Healing is not always immediate or directly correlated with the strength of one’s faith (2 Cor. 12:9-10)
Notice that they do not communicate biblical compassion and grace.
This is a tragedy when God is “merciful and gracious, slow to anger and abounding in steadfast love and faithfulness (Ps. 86:15).”
Removing these theological barriers opened me to the power of God’s Word to renew my mind.
B. Delighting in God’s Word
What was my error when I let my cognitive distortions rule me? I lived in fear despite God’s clear instruction not to.
For all who are led by the Spirit of God are sons of God. For you did not receive the spirit of slavery to fall back into fear, but you have received the Spirit of adoption as sons, by whom we cry, “Abba! Father!”
Romans 8:14-15
Instead, I hid in my room, bemoaning and sulking how life was so unfair, how God was so unfair.
Although it took me some time to rediscover the joy in God’s Word, the crucial point is that God’s grace has sustained me throughout.
Yet, there are mindset shifts necessary to find joy in God’s Word.
These are the lessons I’ve picked up along the journey that I wish to share with you, so you can overcome your cognitive distortions, not just concerning acne, but in in every aspect of life.
1. Reading the Bible must be like coming to the dinner table rather than shopping for groceries.
Grocery shopping is a chore while coming to the dinner table is an opportunity for intimacy.
We read the Bible to get to know God. Transformation of our thoughts only happens when we encounter God in his Word.
This is the most important principle of biblical self-counseling: Develop a real appetite and hunger for the word.
We won’t counsel ourselves with the Word of God if Christian sound bites and IG posts are what we rely on to nourish our souls.
Do whatever is in your power to get yourself in the word. This may mean experimentation.
In my case, I found that reading in the early morning doesn’t work for me because I tend to fall asleep again.
Update: I have decided to be more disciplined and consistent with my Bible reading by doing it first thing in the morning. This means going to bed early to avoid feeling sluggish. Besides experimentation, I recommend an honest assessment of one’s habits and life season.
I invested in an audio Bible app because my mind tends to drift when reading. Using both visual and auditory channels helps me concentrate better.
I also use a study Bible and a commentary app. A reading plan also keeps me on track.
Additionally, knowing the basic rules of hermeneutics, the methodology of interpreting Scriptures, opens up the door to a richer comprehension and application of God’s Word and prevents us from misinterpreting and twisting the Scriptures.
2. Reading the Bible must be like enjoying the feast and the host who provided it.
There is a me-centered approach to reading the Bible.
We come to the Word seeking answers to our questions and solutions to our problems.
You must be scratching your head right now, thinking if my title was just a clickbait.
“I thought this whole article was about solving my problem with acne-related cognitive distortions. Why are you switching gears, Lara?”
No, beloved. We can fix our acne-related cognitive distortions by reading God’s Word, but not through a me-centered approach.
We must not read the Bible anticipating answers and solutions.
We must read the Bible anticipating an encounter with God.
I have read articles advising reading the Bible in such a way you intentionally seek and study how God sees you. That is good advice, but it is not a God-focused approach.
I have realized in my journey to Christian maturity, that being rooted in my identity in Christ comes as a by-product of being in awe of God.
I’ve learned not to worry when a Bible passage in my reading plan doesn’t seem to address my current life situation.
Because learning about God’s nature and attributes is always relevant no matter the season and circumstance.
I sit at the feet of Jesus, learning about who He is and how He works.
I don’t want to read myself in the Bible because the purpose of the Bible is to reveal God to me and not the other way around.
We must read the Scriptures with a God-focused intent—beholding God.
And we all, with unveiled face, beholding the glory of the Lord, are being transformed into the same image from one degree of glory to another.
2 Corinthians 3:17-18
It is only through beholding God that we are being transformed in thoughts and actions.
3. Reading the Bible should not be like spitting out food that you don’t like.
We will be confronted with harsh truths about ourselves whenever we turn to God’s Word.
As someone who deals with acne, I am both a sufferer and a sinner.
That’s the harsh truth.
God is compassionate towards my suffering. But at the same time, because of my sin nature, I can respond to my suffering in ways that hurt myself, others, and God.
I can harbor unforgiveness, resentment, and a desire for revenge against those who insensitively commented on my acne.
I can feel bitterness towards God for not giving me clear skin like other Christians.
I can choose to isolate myself from others and dwell in my grief and anger.
I can make the pursuit of clear skin an idol in my life.
I can even use my suffering as an excuse to act rudely to others.
And the list goes on.
Cognitive distortions can contribute to these ungodly responses to suffering.
Biblical self-counseling challenges cognitive distortions with God’s truth.
For the word of God is living and active, sharper than any two-edged sword, piercing to the division of soul and of spirit, of joints and of marrow, and discerning the thoughts and intentions of the heart. And no creature is hidden from His sight, but all are naked and exposed to the eyes of Him to whom we must give account.
Hebrews 4:12-13
This means the Word of God can make us uncomfortable, even offended.
But if we are going to continue reading the verses, we’ll see this:
Since then we have a great high priest who has passed through the heavens, Jesus, the Son of God, let us hold fast our confession. For we do not have a high priest who is unable to sympathize with our weaknesses, but one who in every respect has been tempted as we are, yet without sin. Let us then with confidence draw near to the throne of grace, that we may receive mercy and find grace to help in time of need.
Hebrews 4:14-16
This means that when we are convicted of our sins, we are not left to our own devices.
We draw near to the throne of grace—a throne of immeasurable kindness and favor that we never deserved in the first place.
There, Jesus meets us with compassion, sympathizing with our weaknesses.
If we continue reading further, we’ll find the Hall of Faith in Hebrews 11.
Here, we find weak people, like you and I, who have accomplished great things by faith.
Moving further into Hebrews 12, we learn that the reason we can live by faith is because Jesus is “the founder and perfecter of our faith, who for the joy that was set before him endured the cross, despising the shame, and is seated at the right hand of the throne of God” (Heb. 12:2).
This is the picture of ongoing repentance in a Christian’s life—recognizing the sin in our thoughts and actions, renouncing those sins, and running to God at His throne of grace.
This ongoing repentance facilitates the progressive work of sanctification.
Although being sanctified (being set apart for God) starts when trusting Jesus for salvation, sanctification is not a one and done deal. It is continuous for the goal of the Christian life can be summarized to this: becoming more like Christ (Rom. 8:29).
Remember when Jesus said this:
They are not of the world, just as I am not of the world. Sanctify them in the truth; Your word is truth.
John 17:16-17
Biblical self-counseling helps us to stay on the course of sanctification.
Biblical Self-Counseling is A Part of Discipleship
The gospel is so rich I would never have imagined it has application to my acne-related cognitive distortions! Who would have thought? All glory to the Father, Son, and Spirit!
As I mentioned, I struggled with distorted thinking for almost a decade.
I am not claiming I have fully overcome them, but one thing I am sure of—my Heavenly Father has continuously proven his word to be reviving the soul, rejoicing the heart, and enlightening the eyes (Ps. 19:7-8).
Consider biblical self-counseling an aspect of discipleship.
Instead of letting the voices of the world and our heads disciple us, we let God’s Word shape our thoughts and actions even in the midst of suffering.
Additional Resource
I highly recommend Three Trees as a biblical self-counseling model. (The downloadable PDF is from Christ Covenant Presbyterian Church.)
This is a God-focused, gospel-centered framework in helping us understand and address personal struggles from a biblical perspective.
It was developed by Dr. David Powlison, a prominent figure in the field of biblical counseling. Dr. Powlison was a counselor, teacher, and author affiliated with the Christian Counseling & Educational Foundation.
Note: Not being able to do biblical self-counseling is not a symptom of your lack of faith. Remember that Jesus treasures faith that is even as tiny as a mustard seed. If the emotional and psychological toll of acne is too heavy for you to handle, you don’t have to bear it alone. I highly encourage you to connect with biblical counselors. Aside from that, do not withdraw yourself from the community of believers. Participate in church life, and you will find people who will walk alongside you.
