Body Dysmorphic Disorder (BDD)

Many of us dislike or are insecure about certain parts of our appearances, perhaps a wide nose or a high forehead, but we wouldn’t think much about it all the time or spend hours trying to change it.

However, individuals who experience Body Dysmorphic Disorder (BDD) find it difficult to go a day without thinking about it and can spend too much time on the perceived flaw. This can affect their daily lives. BDD can result in individuals seeing themselves as deformed or ugly, but to others, these flaws are usually not as noticeable or severe as perceived. 

 

Signs and Symptoms

  • Preoccupation with perceived flaw(s)
  • Spending hours comparing one’s looks with others
  • Strong belief that flaws are very noticeable to others 
  • Frequently seeking reassurance from others
  • Repetitive behaviours to fix or hide flaws (e.g. frequent mirror checking, skin picking, self-surgery)
  • Little satisfaction from cosmetic procedures
  • Avoiding social situations to hide flaw(s)

 

Risk Factors

  • Family history of BDD and Obsessive-Compulsive Disorder (OCD) 
  • Aversive childhood experiences (e.g. Bullying, Sexual Assault, Passing Comments)
  • Perfectionist personality traits 
  • Societal beauty standards 
  • Other mental disorders (e.g. Anxiety or Depression)

It is also possible for a simple passing comment to develop into an obsession, or BDD. This can occur even if the comments were passed a long time ago. Some may try to fix their perceived flaws with cosmetic surgery, however, the results may be dissatisfactory, or one's attention could even shift to another feature.

BDD if left untreated may worsen and bring about more distress. Treatment for BDD is typically behavioural-based, to help individuals tolerate anxiety, change mindsets and shift attention away from the perceived flaw. Most individuals with BDD see themselves from the outside and therapy can help to tweak these perceived flaws and reduce unhelpful behaviours such as avoidance or excessive make-up to conceal the flaw.  

 

Treatment for BDD

Cognitive Behavioural Therapy (CBT) 

  • Manage symptoms by reframing thoughts and behaviour
  • Identify triggers and utilise Exposure and Response Prevention (ERP) approach
    • E.g. Someone who is preoccupied with perceived large acne may be put through a behavioural experiment with fake warts on her face and walk around. This can help counter their fear of people noticing and judging their flaws and change their mindset of avoidance. 
  • Using more helpful ways to cope (e.g. Healthy Lifestyle, Meditation) 

✽   Compassion Focused Therapy (CFT)

  • Encourages individuals to be compassionate towards themselves and other people
  • Using compassion focused imagery, mindfulness practices, and gratitude exercises

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