Cosmetic Procedures: Filling More than Lines and Wrinkles?


This is called a projection: we have a thought and imagine others have the same thought. We all project—it is just something our brains naturally do. Awareness helps undo projections since they are subjective perceptions and not objective truth—although they sure feel true.

“So I think what you are telling us is that the only thing we know for sure is that YOU are really struggling with getting older, changing, and being single right now. Thoughts?”

“I think you’re right.”

“You know and those are really big and hard issues. They are complicated for all of us and bring up many feelings and conflicts. Can we just take a breath and let that be for now without doing anything about it.”

I know we are not going to solve these issues in one session. In fact, they are not issues to solve. Jennifer is dealing with existential issues around aging and self-worth. We have to struggle over time to resolve these complex issues, not avoid them with a potentially harming quick fix.

I say to Jennifer, “If you go through with the injectables, you might be filling your wrinkle when it is really your confidence that needs some filling. Botox may be great but I don’t think it can do that. What do you think?”
“I never looked at it that way.”

Jennifer and I worked together for two years after that session. During that time, we came to understand how her childhood experiences had a direct effect on her feelings about herself. She came to understand how her mother’s excessive reliance on her beauty made Jennifer feel that is what mattered most.

Jennifer didn’t feel valued for her brain or her gentle and kind personality. Jennifer’s mother had cosmetic surgeries and Jennifer remembers her mom crying about aging.

I would bet that if Jennifer’s mother embraced aging, Jennifer would feel differently. If Jennifer’s mother and father de-emphasized looks and emphasized character, Jennifer would feel more confident now. If Jennifer grew up in a home where the family valued one’s unique “imperfections” and “how there is beauty in the humanity of how we age naturally,” I imagine Jennifer would feel quite differently.

The point here is that the feelings we have about our looks are not objective, they are subliminally taught to us by our family’s values, our culture and the myriad of advertisements for cosmetic procedures and anti-aging products.
These influences put our securities into us and cause us to feel shame, both consciously and unconsciously, for what we look like. The truth is we all just look like the humans we are. We are all in this aging thing together. No one is spared. And THAT is truly beautiful.

Patient details have been changed to protect confidentiality


Fosha, D. (2000). The Transforming Power of Affect. New York: Basic Books.

Fosha, D., Siegel, D., Solomon, M. (2009). The Healing Power of Emotion: Affective Neuroscience, Development & Clinical Practice. New York: W.W. Norton and Company.

Nathanson, D. (1992) Shame and Pride: Affect, Sex, and the Birth of the Self. New York: W.W. Norton and Company.

Kaufman, G. (1996). The Psychology of Shame. New York: Springer Publishing Company.


Botox injection photo available from Shutterstock

Cosmetic Procedures: Filling More than Lines and Wrinkles?

Hilary Jacobs Hendel, LCSW

Hilary Jacobs Hendel, LCSW, takes the complex world of emotions and makes them easy to understand for all. She is author of the award-winning self-help book, “It’s Not Always Depression: Working the Change Triangle to Listen to the Body, Discover Core Emotions, and Connect to Your Authentic Self” (Random House & Penguin UK, 2018). She is a certified psychoanalyst and AEDP psychotherapist and supervisor. Hilary’s blog on emotions and how to use them for wellbeing is read worldwide. For more FREE resources on emotions and emotional health, visit:


APA Reference
Jacobs Hendel, H. (2015). Cosmetic Procedures: Filling More than Lines and Wrinkles?. Psych Central. Retrieved on February 22, 2020, from


Scientifically Reviewed
Last updated: 16 Dec 2015
Last reviewed: By John M. Grohol, Psy.D. on 16 Dec 2015
Published on All rights reserved.