Body Dysmorphic Disorder (BDD)

Body Dysmorphic Disorder is a mental health disorder characterised by the idea that aspects of one’s own body or appearance are severely flawed and that something significant needs to be done to either hide the flaws or to physically change them.

BDD tends to be classified in one of two types:

1. Where the bodily flaws or delusional and not physically real, and
2. In which the flaws are real wihin generally accepted norms.

Most sufferers perceive flaws in their hair, facial features or their skin.

Regardless of which type of body dysmorphic disorder is being experienced there is normally a high incidence of obsessive and intrusive thoughts about these flaws that lead to severe stress and anxiety and may make normal day-to-day functioning very difficult.

BDD affects males and females in roughly equal numbers but does tend to feature females more prominently in media stories about this problem.

Like many of the mental health disorders, body dysmorphic disorder has been categorised as being due to faulty underlying neurobiology however, despite years of biological research, no conclusive evidence for biological malfunction has been identified.

Body Dysmorphic Disorder Symptoms

The main symptoms associated with Body Dysmorphic Disorder frequently include:

• A severe dislike of some aspect of one’s appearance.
• Depression.
• Social anxiety and avoidance.
• Paranoia that others are referencing or pointing out the flaws.
• Frequent checking of one’s appearance.
• Constant seeking of external approval and validation.
• Skin picking or other attempts ot make physical changes to the flaws.
• Other OCD related thoughts or behaviours.
• Obsessive dieting or exercising.

BDD sufferers will often present for corrective cosmetic surgery and in those cases in which the flaws are largely delusional, no relief from the emotional distress is obtained often leading to a cycle in which more and more cosmetic modification is sought out.

Most cases of body dysmorphic disorder can be helped with psychotherapy, particularly CBT which directly addresses the distorted cognition associated with BDD.

Diagnosis of Body Dysmorphic Disorder

Technically, only a psychiatrist can diagnose a Body Dysmorphic Disorder, but in the UK general practitioners have tended to diagnose mental health problems by using the Diagnostic and Statistical Manual of Mental Disorders (DSM).

The DSM lists specific symptoms against a range of disorders and whenever a person meets this criteria, they are said to be suffering from that disorder.

Diagnostic procedures do NOT make use of medical testing (for example blood tests) in order to produce a diagnosis, but rather is an opinion based on the observation of certain behaviours in the person who is suffering.

Because of this lack of verifiable medical testing, diagnosis remains a controversial subject, particularly within the psychological (non-medical) community.

However, in the UK access to support services is often contingent on receiving a diagnosis, so in this sense, a formal diagnosis may be useful.

Counselling for Body Dysmorphic Disorder

We offer a number of different types of therapy and counselling for Body Dysmorphic Disorder and related problems.

Choosing the most suitable therapy depends on a number of different considerations including factors such as:

• How long you have had the problem.
• Your personal preferences.
• How your problem is affecting you today.

You can read more about the different types of therapy for anxiety on the following links:

• Cognitive Behavioural Therapy for Body Dysmorphic Disorder
• The CORE programme for Body Dysmorphic Disorder
• Counselling for Body Dysmorphic Disorder

Although all therapies use slightly different approaches, the one thing they all have in common is the relationship that is formed between the client and therapist.

Research suggests that this therapy relationship may be the most important factor in achieving a good therapy outcome.