Body Dysmorphic Disorder (BDD)

Below are the key characteristics of BDD, which affects around 1% of the population.

  • Criticising and worrying about the way part of your body looks (but not mainly about being thin enough or worrying about becoming fat)
  • Spending a lot of time (more than an hour) thinking about appearance every day.
  • Checking or ‘fixing’ appearance (e.g. checking in the mirror or other reflective surfaces, grooming activities, or skin picking).
  • Hiding, covering, or disguising a perceived flaw in appearance (e.g. with make-up, hats, bulky clothes, or body posture)
  • Comparing your appearance to that of other people.
  • Avoiding places, people, or activities because of your appearance concerns (e.g. bright lights, mirrors, dating, social situations, being seen close-up)
  • Appearance related critical thoughts that cause a lot of anxiety & shame.
  • Interference with work, school, family, socialising, or relationships because of your appearance concerns

CBT for BDD

Below are some of the distinctive features of CBT for BDD. It’s very important to have CBT that is specifically tailored to BDD for therapy to be effective. BDD can also be helped by high dose SSRI type anti-depressants, which can be combined with CBT.

The key is to understand what makes your BDD (preoccupation, distress, interference in your life) worse/better.
Try testing out treating your BDD ‘as if’ it’s a psychological problem for an extended period of time (e.g. 3 months) and avoid getting into debates as to whether you problem is BDD or your appearance.

Reducing & stopping rituals/safety behaviours e.g.

  • Checking
  • Reassurance seeking
  • Comparing
  • Camouflage
  • Approaching feared/avoided (often social) situations
  • Dealing with mirrors and photographs
  • Dealing critical thoughts, mind reading etc.
  • Learning to focus your attention into the outside world, here and now
  • Reclaiming your life from BDD

BDD isn’t always well understood, but it can certainly be overcome.

For more information please take a look at the BDD Foundation’s website:

http://bddfoundation.org/

You might also find the following books helpful:

Overcoming Body Image Problems

The Broken Mirror by Katherine Phillips