Body dysmorphic disorder (BDD)

There is a high degree of anxiety about the imagined bodily defect and the perception of oneself by other people. You may have noticed that your quality of life is affected by your worries, you struggle to meet deadlines due to excessive time spent worrying about your appearance or you feel depressed and that is to do with your looks. You might be trapped by excessively high standards and skewed self-image, which often results in depression or avoidance. Body dysmorphia is typically recognized by the frequent seeking for services of plastic surgent, day-long beauty regimes, preoccupation with the mirror and minor blemishes or seeking reassurance from others. Most of people affected by BDD share particular maintaining behaviours:

91% – Camouflaging imagined flaw with body positioning, assuming a particular posture, wearing clothes, makeup, hair or hat designed to hide the flaw.

88% – Comparing body part with that of others and scrutinizing the appearance of others. Checking own appearance in mirrors and other reflecting surfaces.

72% – Seeking surgery, dermatological or other cosmetic treatment.

52% – Touching the perceived defect.

Other rituals include dieting, excessive grooming and hair removal, frequent changing clothes, skin picking, mirror avoidance, excessive tanning, excessive exercise. All of the above are proven to maintain BDD.

Your psychotherapist will help you to identify your unique maintaining factors and develop strategies for reducing such habits. With the help of cognitive behavioural therapy, you will learn to set goals and strategies to successfully change these habits. You will gradually learn to tolerate your distress and your perceived flaws as well as learn to devise experiments to find out whether your assumptions about perception of other people are correct. Together with your therapist you will reduce avoidance of public places, overestimation of the attractiveness of others, challenge any perfectionistic beliefs and concerns about social acceptance and attractiveness. In therapy, you will practice skills necessary for reduction of anxiety associated with your body.

There are, however, deeper reasons for self-objectification, for example, low self-esteem, excessive criticism in early life, childhood abuse and neglect, low parental warmth, learned overemphasis on appearance, past trauma or doubts about own lovability. You will be invited to reflect on attractiveness and its connection (or lack of it) with happiness and self-worth. With the help of psychoanalytic psychotherapy, you will be guided to explore deep origins of your problem and learn other conscious ways to cope with BDD root cause. Your therapist will assess whether there are any co-occurrent mental health difficulties such as anxiety or depression and assist you in learning to cope with your feelings and emotions more effectively.

Latest research suggests that the more committed to therapy you are, the faster you will feel liberated from BDD. If you feel doubts about your recovery but have nothing to lose, give yourself a wholehearted chance and fully engage in working through exposure exercises. You may find that temporary discomfort will lead to permanent comfort as you recover from your symptoms. Your psychotherapist will be your trusted guide along the way to your recovery and if you have truly made up your mind about freeing yourself of BDD then it is only matter of time when you become so.

Some thoughts from past patients to current patients:

  • Be angry at the disorder, not yourself.
  • Allow, just allow, that your thoughts might be wrong. Remember that BDD is a disorder of thinking, not appearance.
  • Your old strategies focused on hiding or changing your appearance have not worked.
  • Stop the self-hatred and self-criticism. You are struggling with a disorder; treat yourself well.
  • It is the inside – how you feel and how you think – that needs attention, not the outside.
  • Comparing yourself to others is a waste of time. It is not a competition; it is about enjoying life.
  • Do not isolate yourself.
  • Pay attention to things you enjoy. Pay attention to your life, not your face, skin, hair, etc.
  • Give yourself credit for even the smallest effort.
  • It is a progression. Listen, learn, and change your life.