Mark Twain once wrote, “Age is an issue of mind over matter. If you don’t mind, it doesn’t matter.”

I like that. But get real. In a culture preoccupied with youth and beauty, why has there been a 114 percent increase in the number of cosmetic surgeries performed since 1997?

How do women escape the judgment conferred on them every time they open a magazine, get online, or turns on the tube? How does she silence the menacing messages she sends herself when a new gray hair is found, or her crow’s feet grow an inch longer?

Very deliberately and carefully say Vivian Diller, Ph.D and Jill Muir-Sukenick, Ph.D, both professional models turned psychologists, in their new book, “Face It: What Women Really Feel as Their Looks Change.” The authors propose a six-step process to deal with this kind of anxiety that is prevalent but not often discussed among middle-aged women.

Step one: Confront our changing looks. Diller and Muir-Sukenick call them “uh oh” moments: when you notice your first wrinkles, smile lines, graying and thinning hair, darkening circles below the eyes, varicose veins, brown spots on hands and face, loss of muscle tone, hanging skin on arms or neck, and hot flashes. I’ve experienced many “uh oh” moments recently, but the one that comes to mind is last summer, when a friend of mine said to me about another friend, “She’s our age … you know, late 40s.” I was, at that time, late 30s and stopped by the drug store to pick up some moisturizing cream, which I have used a total of two times.

Step two: Identify our masks.

Not the ones we are supposed to be wearing at night to stay wrinkled-free and pretty. Diller and Muir-Sukenick mean the ways we hide from or avoid our fears by layers of protection that, in reality, make us look ridiculous. Like, for example, deciding to wear our daughters’ clothes to work–in order to prove to ourselves that we, too, can wear a size six, and that our body looks like an 18-year-old’s. That kind of denial covers up the shame, embarrassment, and anxiety we feel as we age. But the problem with wearing masks? Say Diller and Muir-Sukenick: “Clinging to an illusion of physical youth often leads to reliance on the approval of others to validate that illusion. Women’s sense of beauty is then too dependent on external sources, rather than an internal experience.”

Step three: Listen to our inner dialogues.

We give ourselves so many memos throughout the day that it is difficult to keep track. One day I did, and realize I had delivered over 5,000 nasty grams to myself in one 24-hour period. Just as a mask covers up our insecurity, our internal dialogue exposes it. It’s an ongoing conversation within us that we are, most of the time, oblivious to. But the rest of the body hears the dialog and registers the message: You’re old, fat, ugly, and useless. So we have to pay attention to these blabbers and catch them after they hurl a bunch of toxic stuff into our nervous system. One way that I like to turn out the toxic talk is by envisioning that I am having a conversation with a friend instead. I would never insult her that way. So I should honor the same manners with myself.

Step four: Go back in time.

Here comes the part where you get to blame your mother. Not really. But it helpful to know where your self-image is coming from, because only then can we redesign it based on what we know about ourselves. Write Diller and Muir-Sukenick: “As adults, our psychological reservoirs are ours to fill….Instead of feeling a loss of control as we get older, we in fact have increased opportunities to fill our reservoir with responses that can now come from our own selves and from people we choose to have in our lives.”

Step five: Consider our adolescence.

No! You might say. I buried those scars long ago. For Pete’s sake, leave them alone! At least that’s how I feel. Because I was an ugly 8th-grader with bad acne and a popular twin sister invited to all the parties. But I do think this is an important step, because, as the authors suggest, there are parallels between gray-hair anxiety and the awkwardness we went through as adolescents. In addition to my unpopular, acne-ridden self, I forgot that it was at this point that my dad left my mom, who was about 40 then, and married a woman who was 17 years his junior. No wonder why I’m a tad shaky about turning 40.

Step six: Get a face lift.

Kidding! It’s actually to let go. To mourn the youthful part of ourselves that is embedded into our memories. Viewing the aging process this way is helpful for me–because instead panicking and coloring every gray hair, I can look at the silver dandruff as an invitation to a new wiser, mature, but just as fun self.

Several of the women quoted by Diller and Muir-Sukenick said that they associated beauty with the time that they were most happiest–and that wasn’t necessarily their younger years. I can relate to that because I am much more gentle with myself now, know myself much better, and can be a friend to myself in ways that wouldn’t have made sense in my 20s.

In her book, “Motherless Daughters,” Hope Edelman writes, “Loss is our legacy. Insight is our gift. Memory is our guide.” It’s a bout coming up with a new meaning of beauty, a new definition of “youthful,” one that, perhaps, doesn’t require a plastic surgeon, but just a lot of raw and candid self-exploration and acceptance.