Denis Asselin is walking.
By the end of a two-month journey from his hometown in Pennsylvania to six states in the Northeast corridor, he will have walked 500 miles.
He has stopped to speak to hundreds of mental health professionals who will hear the most important lesson the teacher from Cheyney, Pa., has ever learned. It's the lesson a father learns when his grown son kills himself.
"Talk to your patients' families," said Asselin, speaking to a group at the Mount Sinai School of Medicine in Manhattan, sporting shorts and a walking stick. "You may see them for an hour but we live with them the rest of the time."
It's 'about moving forward'
The walk is a kind of pilgrimage for his son, Nathaniel, who killed himself at the age of 24. His goal is to reach mental health professionals, some of whom treated his son, and talk to them about the syndrome that ultimately drove his son to suicide last year.
"Walking is a metaphor for life," said Asselin, who walked the length of Long Island from Great Neck -- where he had consulted a top doctor on his son's condition -- to Orient Point, only occasionally using public transportation and rides from friends.
"Walking is about moving forward, about the possibilities. In life, we don't choose what happens but we do have a choice about how we handle it," he said.
Nathaniel suffered from body dysmorphic disorder (BDD). The condition is defined by a preoccupation with what the patient sees as a physical flaw that is either minor or nonexistent, such as bumps on the skin or misshapen ears.
Those who suffer from it try to camouflage their perceived flaws to avoid feelings of anxiety, depression, distress and disgust, said Fugen Neziroglu, director and co-founder of the Bio-Behavioral Institute in Great Neck, which specializes in BDD and obsessive-compulsive disorder.
"Coping with a child with BDD is very hard," said Neziroglu, who consulted with Nathaniel and his family. "Families initially have a hard time distinguishing between normal body concerns during adolescence from that of BDD. Later on, when they realize the severity of the condition, they often have to cajole the person into therapy because the sufferer sees nothing wrong or does not believe a therapist can help. They often seek plastic surgery or dermatological interventions."
Struggles at home
Asselin still recalls how he and his wife, Judy, stood outside the bathroom coaxing Nathaniel to open the door. They knew how painful it was for the boy to stare at himself in the mirror and compulsively focus on imperfections. They kept rolls of brown paper and masking tape on hand to cover mirrors.
For Nathaniel, the first signs of a problem emerged when he was 11. He started running and did not know how to stop. He'd come home after whipping around the school track or the neighborhood and turn around and head out the door to do it again, and again.
Then he lost weight, leading to his first hospitalization at Kids Peace in Allentown, Pa., one of the many places Nathaniel stopped along the way.
A therapist treating him for OCD mentioned the diagnostic possibility of BDD. The Asselins had never heard of it, but virtually every symptom of BDD was on Nathaniel's checklist. He had a hard time being in public. He was a perfectionist. He was preoccupied with his face in the mirror.
According to Dr. Katharine Phillips, director of the Body Dysmorphic Disorder Program at Rhode Island Hospital in Providence, the most common age of BDD onset is 13. She said in an email that "it is typically a severe disorder that usually causes substantial emotional distress and difficulties with day-to-day functioning. Suicidal thoughts and behaviors are common."
Nathaniel's parents sought out the top experts in the field for their son. By 2009, he'd been hospitalized several times and the family drove to Great Neck to consult with Neziroglu. His parents decided to hospitalize him at McLean Hospital in Massachusetts in January 2010. A few days into a 10-day stay, Nathaniel ran away, later calling his father, who brought him back home.
He tried to kill himself but failed. Then, in April of last year, he ended his life.
Since then, Asselin has been trying to turn his grief into something positive. He took inspiration from Buddhist teacher Thich Nhat Hanh, who once told someone mourning her son's death that the way to recover was to walk. "Putting one foot in front of the other has given me the power to respond the way I want to," Asselin said. "Moving forward."