Dr. Deb’s Mental Health Vitamin: Body dysmorphic disorder

September 12, 2018 / by / 0 Comment
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Dr. Deb Wade

By Dr. Deb Wade
GCU Vice President, Counseling and Psychological Services

I believe it is human nature to have that one imperfection that we wish we could change – it may be eyes that are too close together, a large nose, a crooked tooth, too curly hair/too straight hair, a flabby tummy. Mostly, these are just annoyances and frustrations that we rarely give consistent or constant thought.

But there is that segment of the population that tends to obsess over these imperfections to the degree that it is a fixation that interrupts the natural flow of life. I am talking about a mental health condition known as “body dysmorphic disorder” – BDD.

Those who suffer from BDD often spend huge amounts of time and energy focusing on, analyzing and attempting to change the body feature that bothers them. Additionally, they may spend many dollars on plastic surgery in an attempt to rectify the problem yet are mostly dissatisfied with the results – only tending to reinforce the disgust with self.

Those with BDD are impacted in nearly every area of their lives.

They tend to isolate from social events in the belief that others also are disgusted with their perceived imperfection. They also tend to ruminate on ways to cover up, erase or seek validation about their imperfection (which they don’t believe anyway) — and/or they tend to either avoid mirrors altogether or spend exorbitant amounts of time in front of the mirror.

Sadly, this condition can become so severe that one who suffers from it might even consider suicide as a means to escape the pain.

The paradox of this condition is that the perceived flaw is usually fabricated or, if present, hardly noticeable to others. The one afflicted will spend inordinate amounts of time checking on the perceived flaw, will often isolate or “hide” from others because of the flaw and will plan life around the flaw, which almost always leads to social anxiety and/or isolation.

It is a debilitating condition, and it seems to control the thoughts, actions and reactions of the one who deals with it. The obsession over the perceived flaw often will lead to ritualistic behaviors (often like one who has Obsessive-Compulsive Disorder), and they can become so pervasive that life functioning is greatly impaired.

Where does this come from? There are many theories: Genes and the environment are probable causes. One’s risk of having and failing to cope with BDD are greatly enhanced, also, if there is a biological relative who deals with it; if there was a negative experience in childhood that greatly impacted them (such as bullying, teasing); if there is underlying poor self-esteem; or if there has been a great emphasis to be “pretty,” to “stand out” or to be “handsome.”

If you or a loved one suffers with this condition, what is the action plan? Therapy is a MUST – it helps to unlock and recognize irrational and illogical thinking patterns and, ultimately, to replace the negative self-evaluation with a positive one, based on facts.

For example, “I have come to realize that genetically, I am prone to have many moles on my skin; however, I have come to recognize them as beauty marks and can learn to be OK with them.” 

Another kind of therapy – exposure therapy – is just as the name implies. One is encouraged to go out in public with the perceived flaw exposed. When there is no negative reaction from the general public, this is to be repeated consistently so that the one suffering can begin to realize that the flaw is more in their own mind than in the eye of the public.

In addition, exposure therapy encourages one to stop seeking approval from outside and, instead, begin to be OK with self from the inside. Another goal is to stop the frequent “checking” and “covering up” – rather, to learn to live freely without having to constantly engage in those behaviors.

Freedom can come with therapy. If you are suffering from BDD, please know that this is not a life sentence. There is relief, there is release and there is rejoicing that can come with healing.


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