Are you obsessed and worried about certain parts of your body? Do you keep thinking about it, and believe there is something wrong with it? Do you spend a lot of time (hours) trying to fix it, hide it? Do you end up being depressed and anxious because of the way that body part looks and you can’t seem to get it good enough or feel better about it?
Has your normal functioning (work, school, social life) been affected due to this preoccupation?
Research indicates that Body Dysmorphic Disorder affects about 0.7 % to 2.4 % of the general population. However, the numbers may be higher if we consider individuals who seek dermatology care and plastic surgery. Most of the time people suffering from BDD do not consider it to be a psychological problem. They believe it’s a real physical concern and seek to repair their perceived flaw through different means other than psychotherapy.
“Every man dies. Not every man lives.”
Individuals who struggle with BDD experience shame, because they fear others may judge them as being vain, though they truly believe their body part is disgusting and awful. People experiencing BDD will obsess about their appearance between 1 hour to more than 8 hours a day. They wish they could get their thoughts about their “imperfection” out their mind, but they don’t seem to be able to; thus they begin to do behaviors (compulsions) to relieve their distress.
Common behaviors may include: camouflaging with clothing, makeup, their hand, hair, hat or their own posture. They constantly compare their own body part with that of others. They constantly check their appearance in mirrors and other reflecting surfaces. They seek surgery and dermatologic treatment. Their grooming may be excessive. For example, they spend hours combing their hair, applying makeup, shaving, removing hair, etc. They seek for reassurance or try to convince others that their perceived defect is in fact unattractive. They touch their perceived flaw body part constantly. They may continually change clothes, diet, pick their skin, or workout excessively.
When clients finally seek psychological treatment, they do so because of their depression and anxiety. Sometimes clinicians may miss the underlying problem when clients don’t talk about their obsession regarding the perceived flaw in their body.
“You can’t stop the waves, but you can learn to surf.”
What is the most effective treatment for BDD?
Research indicates that because this is a biological and behavioral problem, it’s best treated with medication and psychotherapy. Cognitive-Behavioral Therapy that includes Exposure and Response Prevention has been found to be the most effective way to treat this disorder. Research also indicates that Mindfulness meditation skills can make a positive difference in treatment as well.
What to expect in treatment?
- Full assessment
- Personal interview
- Questionnaires to measure clients’ level of anxiety and depression
- Questionnaires to confirm BDD and severity
- Psychoeducation throughout treatment
- ACT (Acceptance and Commitment Therapy)
- Learning to watch your thoughts
- Expansion – Learning to make room for your internal experiences such as thoughts, feelings, sensations, and urges
- Connecting to the present moment (Mindfulness training) – Learning to be here-and-now
- Recognizing the Wiser/Observer Self (the you who wants to live a better life)
- Values – Recognizing what really matters in your life
- Committed Action – Doing what it takes to live a valued-focus life and recognize BDD for what it is –not what matters!
- Cognitive-Behavioral Therapy skills will be taught, including helping clients to recognize thinking errors
- Exposure and response prevention program to help clients decrease/change rituals and compulsions
- Mirror retraining
- Mindfulness training
- Habit reversal training
- Relapse prevention Skills
- Other skills as needed depending on each case
If you are feeling depressed and anxious and your worries about a specific part of your body are consuming your life, maybe it’s time to consider psychotherapy. Talk to your loved ones so that they can help you with this decision.