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Body Dysmorphic Disorder

Posted Jan 07 2009 6:52pm

















I am back from my well rested vacation. Ready to go back to work, and back to blogging.

As I began catching up by reading my favorite blogs, I came across this one by Shrinkette. She blogged about how according to The New York Times, the average woman worries about her body every 15 minutes...more frequently than men think about sex. And that 29% of women worry about their size and shape every waking minute."

More and more, I have been seeing in my practice young girls AND young boys concerned about their face, their physical beauty and their body image. This trend has been well documented, and I won't go into it here, but how can we help these young minds from such unattainable perceptions when the culture we live in is selling perfection and beauty.

Digital retouching here and here give the illusion of perfection.

And even with research telling us that genes determine our body shape, many individuals cannot accept certain aspects of their body, or even perceive "flaws" that are not really there. These individuals can also see things so minute, that it compels them to fix it, hide it, or shun themselves from others as a result of it.

This intense set of symptoms is called Body Dysmorphic Disorder.

Body Dysmorphic Disorder (BDD) is a SEVERE preoccupation with an imagined physical defect in appearance OR a vastly exaggerated concern about a minimal defect. This preoccupation usually causes impairment in a person's life, interfering with schoolwork, occupation, social life and a sense of well being. Social isolation occurs, and the seeking of plastic surgery or dermotological interventions is frequently pursued.

A person with BDD will think and obsess about the flaw or defect for at least an hour per day. Many report being unable to pull themselves away from the mirror for hours, or have intrusive thoughts about their perceived "ugliness". Those with BDD are often concerned mostly with facial features, but any part of the body perceived as flawed - from hair, skin and nose to actual body parts - can be the focus.

BDD often begins in adolescence, becomes chronic and leads to a great deal of internal suffering in adulthood. A person with BDD will usually consult many dermatologists or plastic surgeons and undergo painful or risky procedures to try to change the perceived defect. The medical procedures rarely produce relief. In fact, they often lead to a worsening of symptoms. Individuals with BDD are never happy with the cosmetic surgery or the dermatological treatments, and continue to look to these interventions over and over again... and their negative body image escalates with each step.

Other behaviors that may be associated with BDD include:

*Frequent glancing in reflective surfaces

*Skin picking

*Avoiding mirrors

*Repeatedly measuring or palpating the flaw.

*Repeated requests for reassurance about the flaw.

*Elaborate grooming rituals.

*Camouflaging appearance.

* Repeated touching of the imagined or minimal flaw

* Avoiding social situations where "the defect" might be seen by others.

* Social anxiety being with others.


Secretive Aspects of Body Dysmorphic Disorder
Many individuals are extremely secretive about their negative body image and it's severe preoccupation and do not reveal the symptoms to others. In fact, many medical and health professionals are not aware that they may be treating a person who has BDD. Body Dysmorphic Disorder has psychological, genetic and psychiatric origins, and can be treated successfully. But individuals with BDD often see a dermatologist, plastic surgeon, or other medical doctor rather than a mental health expert.


Treatment for BDD
Psychotherapy and medication can help reduce the symptoms of Body Dysmorphic Disorder. Treatment will focus on learning how to reduce the circular thinking and rituals about body aspects and overall appearance. Learning to embrace and accept one's body will be a focal point.



References
Body Dysmorphic Disorder by Dr. Carol E. Watkins

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