WHEN DOES CONCERN ABOUT APPEARANCE BECOME BDD?

Body Dysmorphic Disorder is also known as BDD.

BDD is when a person becomes extremely distressed and preoccupied with an aspect of their appearance that most other people would not dwell on.  Areas of concern include: nose, hair, eyes, chin, lips, build of body, appearing feminine or masculine, symmetry, being out of proportion and concern with genitals.  

Many people with BDD believe deep in their heart that their appearance is seriously defective.   Reassurance from other people rarely helps with distress or preoccupation.

People with BDD often make drastic changes to their life to avoid anything triggering worry about appearance.  For example, avoiding places, people, social situations, or objects. 

If avoidance is not possible then he or she may camouflage the body part that they are worried about.  For example, using excessive make-up, wearing particular clothes or maintaining certain body positions to reduce visibility of their feared body part.

Other common behaviours in BDD including repetitive checking of appearance, seeking reassurance, repeatedly feeling the body part, picking at skin to make it smooth and comparing themselves with other people.    

BDD usually begins in adolescence, but it can be helped as an adult by using cognitive behaviour therapy (CBT).  

CBT usually involves helping the individual to reduce their level of preoccupation about their appearance by examining the behaviours that accidentally maintain excessive preoccupation.  The goal of treatment is not to prove or disprove the existence of the 'defective physical feature', but to reduce pre-occupation with the feature so that the person can begin to take charge of their life.  

Individuals are encouraged to refocus their attention away from themselves and to give up comparing, checking, reassurance seeking and use of camouflage.  Other aspects of treatment may include visiting old upsetting memories in a specific therapeutic way so that they no longer have such an emotional hold on the person. 


Linda Atkinson

Clinical Psychologist and CBT Therapist