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Body Dysmorphia: more than just being self-conscious about your appearance

Body Dysmorphic Disorder (BDD) 

A lot of us have some insecurity about how our face or body look and have cringed at a photo of ourselves.  Maybe you’ve even said no to a few social invites, because you felt like you wouldn’t look good enough.  Body confidence is something that most of us could do with a bit more of!  If you find that there is a feature or part of your body that you dislike so much that you’re putting a lot of energy into trying to change it or hide it though, you might have body dysmorphic disorder (BDD).   


Understanding Body Dysmorphic disorder 

Body Dysmorphic disorder is a condition in which you become very focused on a part of your appearance that you dislike.  It might be your nose, your hair, or the shape of your face.  It might be redness that you can see on your skin, or spots.  To you, the flaw in how you look seems obvious, and you might have ideas that because of it you are ugly, or other people won’t want to spend time with you.  It can leave you feeling anxious, down, and alone.  If you do manage to talk to anyone about how you feel, you might notice that often other people don’t see the ‘flaw’ as being nearly as bad as you do.  They might even struggle to see it at all.   


Recognising symptoms of Body Dysmorphic disorder 

For most people, BDD starts before they are 18 years old.  Common symptoms of BDD include avoiding mirrors or checking your appearance in mirrors very often; trying to hide the part of your appearance that you don’t like with clothes or make up; excessive preoccupation with this body part so it dominates your thinking, and comparing how you look to other people.  Body dysmorphic disorder is different from eating disorders, where the main focus is on weight and body fat.   A lot of people with BDD think about cosmetic surgery to try and change the part of their appearance that is distressing them, but the research shows that a few months after surgery BDD usually comes back. 


How CBT can help 

Cognitive behavioural therapy has been shown to be the most effective type of therapy for adults and young people suffering with body dysmorphic disorder.  It focuses on identifying and challenging negative thoughts patterns and behaviours that are keeping BDD going.  CBT provides practical tools and techniques to change how you think, react, and cope with the impact of body dysmorphia. 

  • Identifying Thought Patterns: The first step in CBT is becoming aware of your thought patterns.  Pay attention to the thoughts you have when you are distressed about your appearance.  Are you making guesses about what other people think about you because of how you look?  Challenging these thoughts and replacing them with more realistic ones can help. 

  • Cognitive Restructuring:  Once you’ve identified negative thought patterns, it’s time to restructure them.  Start by questioning how you know the distressing thoughts that you have about how you look are true.  Are there any alternative explanations or ways of looking at it?  Gradually, you’ll train your mind to think more realistically about how you look and reduce your distress. 

  • Exposure Therapy: Exposure therapy is a key component of CBT for body dysmorphic disorder.  It involves gradually and safely exposing yourself to situations and places that might be avoiding because of how you feel about how you look.  This can be really different for each person with BDD.  It might be allowing yourself to leave the house without contouring your makeup, without shapewear, or being able to let someone take a photograph of you.  By confronting these triggers in a controlled and supportive environment, you can learn to reduce their power and reclaim a sense of safety and control. 

Seeking Support: Living with body dysmorphic disorder can feel overwhelming at times, and it's important to ask for support when you need it.  Reach out to friends, family, or a therapist who can provide a listening ear and professional guidance. Remember, seeking help is a sign of strength, and you don't have to face body dysmorphia alone. 

Taking the first step 

Recovering from body dysmorphia can be a difficult journey.  CBT provides practical tools and strategies to help you take control of your relationship with your appearance, so you can live the life that you want to live.  By identifying negative thought patterns, challenging them, gradually exposing yourself to fearful situations, developing coping strategies, and seeking support, you can gradually reduce your distress and regain a sense of well-being. 


Remember, body dysmorphic disorder is treatable, and you don't have to let it define your life. Through psychotherapy you take the first step towards reclaiming your peace of mind.  

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