In today’s world, where social media and constant connectivity often set unrealistic beauty standards, it’s not uncommon to feel dissatisfied with our appearance from time to time. Thanks to social media’s connectivity, the idea of having a dysmorphic view of yourself has also become more widely known.
However, some people experience an entirely different level of distress about aspects of their appearance. For these people, this dissatisfaction can become overwhelming and lead to significant distress and impairment in daily life. This is often due to a mental health condition known as Body Dysmorphic Disorder (BDD). While the more commonplace awareness of dysmorphia can help reduce some stigma around BDD, it can also lead to misunderstandings and misinformation.
What is Body Dysmorphic Disorder?
Body Dysmorphic Disorder is a mental health condition characterized by an obsessive focus on perceived flaws or defects in one’s appearance. These perceived imperfections are often minor or even invisible to others, but for those with BDD, they can cause significant distress and anxiety. The condition affects both men and women and can start in adolescence or adulthood. If you are just realizing that BDD is different from certain insecurities, you are not the only one. Body Dysmorphia is not to be confused with body dysphoria, disordered eating, or an eating disorder.
3 Things to Know About BDD
1) It is not about vanity:
Whether you have BDD or you know someone who does, it is important to understand that this is not a shallow, self-serving “quirk.” It is a disorder in the OCD spectrum where you are struggling with obsessive thoughts about a perceived defect that leads to endless compulsions. Individuals with BDD experience intrusive thoughts about perceived flaws in their appearance, leading to compulsive behaviors aimed at concealing or fixing these imagined imperfections. Those who have a history of perfectionism, negative life experiences, or another mental health condition are more likely to suffer from BDD, as opposed to those who look (or don’t look) a certain way.
If Body Dysmorphic Disorder was about vanity, then external fixes would solve the problem. Plastic surgery, new makeup, an updated wardrobe, or any other physical change could improve the way you feel. Because BDD is actually an intrusive, body-focused form of OCD, it’s not really about the physical at all. And it cannot be fixed with practical measures. While social media has helped certain aesthetic trends to be more widespread and talked about, BDD isn’t about peer pressure or a desire to emulate certain people. It may be helpful to take breaks from social media if certain creators or accounts trigger intrusive thoughts, but that is to help you take steps to address your mental health disorder, not because social media is the cause of it.
One of the signs and symptoms of OCD is a fixation on something that might seem inconsequential to the outside world. This can mean intrusive thoughts, feelings of paralysis until the issue is addressed, and impulses to adopt behavior to try to alleviate the distress caused by the obsession. BDD follows this format; it’s not about trying to look your best or “be the best-looking person.” It’s about trying to quiet the persistent worry. Some individuals are aware that their BDD is calling the shots when they perceive a certain flaw, whereas others truly believe that what they are seeing is real.
It may be difficult for those outside of BDD to understand that it is not an issue of vanity because mirror-checking, photo/selfie-taking, and seeking reassurance are all symptoms. To the outside world, a person may appear self-obsessed and self-congratulatory. Really, on the inside, that person is struggling very hard with thoughts and fears that will not leave them alone. They believe that they are ugly and most detest involving anyone else or letting anyone else know that they feel the need to reassure themselves. Many people who struggle with Body Dysmorphic Disorder feel shame and embarrassment around being perceived as vain, and it can lead to them delaying seeking help. This is why it is so essential that if you are struggling with BDD, you set aside any shame you feel and reach out to someone who can help you begin to work through the process. The last thing anyone needs, on top of intrusive and obsessive thoughts about their appearance, is to accuse themselves of having shallow priorities or to bully themselves about whether their struggles are “deserving” of a mental health intervention.
Acceptance and Commitment Therapy (ACT) focuses on tolerating symptoms as they come up; through mindfulness, you can learn to observe thoughts without judging or acting upon them. Accepting being harassed about a perceived flaw by your own mind is no small task. If it were easy to manage, it would be easy to stop. That is how you can know that your BDD is so much deeper than a surface-level desire to feel attractive or to be thought of as attractive by others.
2) It is not an eating disorder:
Disordered eating can come with a dysmorphic view of one’s body shape and/or size, and you may even hear commentary that anyone who has an eating disorder has body dysmorphia. Although BDD and eating disorders can share similar symptoms related to body image, they are distinct conditions. BDD is a subtype of OCD that focuses on specific perceived defects in appearance that can involve any body part while eating disorders primarily revolve around food intake and body weight. That being said, BDD can lead to an eating disorder if the area of fixation is one that is thought to be “adjustable” through dietary restrictions and/or exercise regimens. BDD and disordered eating also have ritualization, life intrusions, fear and anxiety, and negative social impacts in common. While there can be overlap in how each presents and some of the associated behaviors, BDD is not an eating disorder.
Understanding what you are dealing with and how it differs from disordered eating allows you to understand that while there may be some overlapping symptoms, they are not the same thing. Our patients who attend Body Dysmorphic Disorder therapy in Woodland Hills undergo specialized diagnosis of and treatment for BDD. It is important to have a mental health professional to guide you, as both BDD and eating disorders can occur at the same time, but each needs to be addressed in specific ways.
An eating disorder will typically impact consumption and/or eradication of sustenance for the express purpose of changing one’s body shape/size. Body Dysmorphic Disorder can include fixating on the texture of one’s skin, the size of one’s nose, characteristics of genitalia, one’s hair, and more. All of these are “issues” that are not at all impacted by weight. Yes, there can be issues with the size or shape of certain body parts with BDD, but it tends to be much more focused. An eating disorder will typically be about the body as a whole; some body dysmorphia can overlap when an eating disorder sufferer pays extra attention to certain areas on top of an overarching goal of transforming their entire body.
While BDD is not an eating disorder, similar disordered eating behaviors can show up with BDD, and similar pitfalls can and should be anticipated. For example, it is best to have a relapse plan in place. No matter how much progress you make in addressing the thoughts and behaviors related to Body Dysmorphic Disorder, there is always the possibility that an incident will cause a relapse. Eating disorders are much like this. In both cases, acceptance that relapse is possible is the place to begin. From there, an open dialogue with your therapist and conscientiousness on your part about checking in with yourself can allow you to explore what might trigger you. As with eating disorders, sometimes the stressor has nothing to do with appearance; it can be about moving, changing jobs, grief or loss, or interpersonal struggles. In cases of emotional triggers, those who suffer from an eating disorder might adopt restrictive behaviors as a way to reclaim a sense of control, even though their disorder is the driving force behind their actions. Those who have BDD, however, might be acutely aware of the feeling of being unable to control their obsessive and intrusive thoughts when under added stress.
3) You can’t just get over it or fix it with another surgery:
Cosmetic surgery is often ineffective for individuals with BDD, as the disorder’s root cause is a mental health issue, not a physical defect. Many people with BDD continue to fixate on perceived flaws even after surgical interventions. This is a serious mental health issue that can even lead to thoughts and behaviors related to suicide.
You may choose to attend in-person or online body dysmorphic disorder therapy in order to address the impact your BDD has on your life and take action toward alleviating your suffering.
Cognitive Behavior Therapy (CBT) helps you to address the intrusive thoughts, and rewrite the narrative that surrounds them. BDD can lead to isolation when you are afraid of being seen, or having trouble accepting others’ comfort or inability to see what is bothering you. The cognitive aspect of this therapy is about identifying the thoughts that are showing up for you, such as the assumptions you make about others and how they see you, or black-and-white thinking, such as the belief that one aspect of your appearance impacts everything about you. You might encounter these thoughts when you are looking at yourself, when you are experiencing depression and/or anxiety, or when you encounter something that you have to do, such as attend a public event.
Once you are relatively aware of the thoughts that are persisting and the narratives surrounding them, the next step is to unpack them with your therapist. Can you find evidence of your belief? If so, what is it; how true do you think it is? If not, how can you change your thoughts to be a more accurate reflection of your situation? What are you extrapolating from your thoughts that may not be serving you; do you believe that your life would be better if the thing you are worried about was magically fixed? Moreover, do you believe that your value would increase if that were to happen? This is the next step in cognitive therapy: addressing the beliefs we have about our value and worth that are related to the stories we tell ourselves about our appearance.
As a Body Dysmorphic Disorder counselor in Woodland Hills, I have seen the benefits of using Exposure and Response Prevention (ERP) therapy in the treatment of BDD. ERP allows you to encounter triggers and face situations that would normally struggle with intrusive thoughts about your appearance and develop and implement new behaviors to enact in response. This is also a process of determining what you are avoiding and the conditions around that avoidance. Where in the past you might have thought about something and not be able to relax until you checked in a mirror, ERP will teach you how to experience the thought without it causing you to follow your usual behavior pattern.
Exposure and Response Prevention therapy combines both real and imagined scenarios to help the patient come to terms with their mental illness and its resulting behaviors. Real examples of ERP might include going somewhere you know you will be seen without hiding or covering what you are worried about or imagining a scenario where you encounter someone or something that triggers your dysmorphic thoughts. Going out and experiencing these exposures can feel very high-stakes, so it is important to have a clear understanding of why the trigger is being confronted and how to manage discomfort, such as having a buddy to go with you and utilizing mindfulness to ground yourself if you begin to experience anxiety.
BDD is like any other mental illness: it is not the fault of the person who is struggling, but it comes with the burden of shame and fear of stigma, like the shame we see in our Woodland Hills Body Dysmorphic Disorder therapy sessions. If you feel this way, you aren’t the only person who has wrestled with the negative impact of BDD, and there are answers and supports available for you that have been tried and tested. The way your obsession with your appearance can take over your thoughts, your actions, your plans, and your hopes and goals is not to be understated. You deserve to get help in coping with BDD so that you can feel more confident, more focused, and more positive. The intrusiveness of this disorder can feel all-encompassing, but with the right therapies and practice, you can move forward.
Body Dysmorphic Disorder Therapy in Woodland Hills
BDD is a very debilitating mental health struggle where it feels like every minute of your day is consumed by intrusive, negative, repetitive thoughts about your appearance. It is also often a difficult one to get help for because when you suffer from Body Dysmorphia, your experience feels very real to you. When you work with a clinician who specializes in Body Dysmorphic Disorder, our treatment is tailored to track your thoughts and actions to understand how BDD shows up in your life. Once we build a good rapport, we will utilize Exposure and Response prevention along with mindfulness and CBT tools to change the way you relate to your body.Contact us today for your complimentary 20-minute phone consultation with our Admin Team today!
