Body Dysmorphic Disorder

Earlier Body Dysmorphic Disorder (BDD) was classified as a somatoform disorder in Diagnostic Statistical
Manual-4-TR as it involves preoccupation with certain aspects of the body. Later psychologists’
identified high similarities between OCD and BDD. Henceforth, it was moved from somatoform disorder
category to OCD and related disorders classification in Diagnostic Statistical Manual 5. In my experience,
people suffering with OCD usually show signs of Body Dysmorphic Disorder as well.

People with BDD are obsessed with some perceived or

imagined flaw in their appearance that may not be evident
or may appear slight to others. BDD over the course of
disorder, the individual starts to perform repetitive
behaviors (example, mirror checking, excessive grooming,
seeks reassurances from people around them).

Clients’ suffering from Body Dysmorphic Disorder focuses

on a particular part of their body. Research statistical data
has shown BDD clients expressing their defects; skin 73%,
nose 37%, hair 56%, eyes 20%, nipples/breast/chest 21%
and most common areas are stomach and face size or
shape. A lot of time client perceive all the part of the body
as “flaw”.

They usually perceive these body parts as a defect like, “my skin have blemishes” “my breasts are too
small” “My stomach is oddly big”. Consequently, to seek temporary relief from these thoughts they
repetitively check their mirror or seek reassurances from others. The preoccupation of such distressful
thoughts and repetitive behavior causes clinically significant amount of anxiety or impairment in social,
occupational and other important areas of functioning. In my experience, the most disturbing part about
this disorder is, sometimes after clients check their mirror seeking temporary relief instead, they end up
feeling worse about themselves and constantly bash oneself, “look how ugly I am” or “I look terrible
with those eyes”.

Treatment plan: -

Cognitive Behavioral Therapy (CBT), exposure and response approach has success ratio of 50%-85% with
BDD and OCD clients. CBT involves identifying and changing the distorted thought patterns and beliefs
during exposure to anxiety provoking situations (example, when wearing something that highlights your
defect instead of disguising it) and prevention of obvious response (looking in mirror over and over
again or seeking reassurances). Over the course of treatment, the client will learn to resist the BDD
thoughts and behavior. Psychiatric Medication would also be helpful depending on severity of the case.