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North London Stress Management Centre.
Tel: 020 8444 4871
Perhaps thankfully, few of us believe we are the embodiment of physical perfection. Most of us can identify flaws in our appearance and usually, we accept them. Saying this, it is perfectly reasonable to spend time staring into the mirror in contemplation of what could be improved, what could be larger or smaller or lighter or darker or thinner or fatter. For some people, however, this contemplation becomes an obsession that can rapidly deteriorate and ruin their lives.
Body Dysmorphic Disorder (BDD) is generally recognised as one of the most serious of psychological disorders with high rates of suicidal ideation and attempts in both adults and adolescents. Sufferers are usually preoccupied with one or more perceived defects in their physical appearance that are not observable or appear slight to others. Because of this, they usually perform repetitive behaviours (such as mirror checking, excessive grooming or reassurance seeking) and are constantly comparing their appearance with that of others, always from a negative viewpoint.
To help you ascertain whether your present condition reflects that of BDD, if you answer yes to any the following questions, it is likely that you are currently suffering from the disorder *:
Are you deeply concerned and preoccupied about the appearance of some part(s) of your body that you consider especially unattractive (examples of areas of concern include your skin, hair, the size or shape of your nose, mouth, jaw, lips, stomach, hips or defects of your hands, genitals, breasts or any other body part)?
Have your perceived defects caused you a lot of distress or pain?
Have they significantly interfered with your social life?
Have your defects significantly interfered with your job or your ability to function in a relationship?
Are there things you avoid because of your defects?
Have the lives or normal routines of your family or friends been affected by your appearance concerns?
Do you spend more than an hour a day thinking about your defects?
There are three principal insights relating to how BDD sufferers generally view their condition:
INSIGHT1: The individual recognises that the BDD beliefs are definitely or probably not true or that they may or may not be true.
INSIGHT2: The individual thinks the BDD beliefs are probably true.
INSIGHT3: The individual is completely convinced that the BDD beliefs are true.
BDD sufferers we see at our centre are fairly evenly split 50/50 between those who fall into the INSIGHT 1 and 2 categories. We have seen very few people who fall into INSIGHT3. Generally speaking, people in this category are far more likely to repeatedly seek the services of a cosmetic surgeon or a dermatologist than a practising therapist. Though there are overlapping issues that may contribute to the condition, it is thought (even more so than more common disorders) that environmental, genetic, or physiological factors and triggered events play a significant role in its development.
You may be depressed, suffer from anxiety and frequent panic attacks or have problems with drugs or alcohol as a result of BDD but you should not in any sense feel any shame or guilt or embarrassment. And you should not lose hope because the good news is that it can be successfully treated.
Our treatment programme:
We deploy techniques proven to be highly effective when dealing with BDD, including cognitive restructuring and ritual prevention, Psycho Cybernetics, Power of NOW exercises, Neuro-linguistic Programming, Gestalt psychology, CBT and, where appropriate, Emotional Freedom Techniques (EFT). If you are suffering from BDD and need help or information on our treatment programme, please feel free to contact us
Please note: if you are currently taking prescribed SRIs (Serotonin-reuptake inhibitors) you do not have to cease doing so to benefit from our programme. In fact, the immediate termination of any prescribed medication for BDD is dangerous and we will discuss this with you in some detail during the first session.
* adapted from the BDDQ designed by Dr Katharine A. Phillips and reproduced in her groundbreaking book
The Broken Mirror (Oxford University Press)