What is Body Dysmorphic Disorder?
Body Dysmorphic Disorder (BDD) is a psychiatric disorder characterized by a preoccupation with one or more aspect of one’s appearance, leading to the belief that this aspect of one’s own appearance renders themselves ugly, abnormal, deformed, or disfigured in some way. In response to the distress experienced, individuals with BDD engage in repetitive behaviors such as those that seek to inspect, hide, fix, or seek reassurance about their appearance. These rituals may involve observable behaviors such as mirror checking, excessive grooming, pinching the skin, or changing clothes; or, the rituals may involve mental acts such as comparing one’s appearance to that of others. This preoccupation is often consuming to the individual, dominating their thoughts and causing distress or impairment in daily functioning.
Treatment for Body Dysmorphic Disorder
Evidence-based treatments for BDD include psychotherapy, medication, or both. Cognitive Behavioral Therapy (CBT) for BDD is considered the standard of care in evidence-based psychological treatment for BDD. In CBT for BDD, the therapist works with the individual to examine and challenge the unhelpful and/or inaccurate thoughts related to their appearance and replace these thoughts with more accurate, more adaptive, more flexible thoughts.
Attention is paid to teaching the individual coping strategies to decrease avoidance behaviors so that they may learn to more fully engage in valued areas of their lives. They are then challenged to expose themselves, in a gradual manner, to situations that evoke their unhelpful thoughts while they refrain from the patterned repetitive behaviors.
In addition, because individuals with BDD tend to miss the “big picture,” instead over-focusing on small aspects of their appearance, CBT teaches them to view themselves more holistically and non-judgmentally while looking in a mirror, rather than over-focusing on any perceived flaws. Medications, specifically serotonin reuptake inhibitors (SRIs), can also be effective for those who struggle with BDD in improving their quality of life.