Your Relationship with Your Body and Body Dysmorphic Disorder
We all have days when we don’t feel fully at home in our bodies. Societal beauty standards, pressure from the media, and advertisements from the fitness and beauty industries can all work against our self-confidence at times. The most intense manifestation of negative body perception is called Body Dysmorphic Disorder, or BDD. No matter how we feel about our bodies, we can improve that relationship. It is possible to recover from BDD.
Body Dysmorphic Disorder, previously known as Body Dysmorphia, is a chronic mental health disorder that can be diagnosed by a medical professional. People with BDD have an obsessive preoccupation with “flaws” in their physical appearance—characteristics that are mostly unnoticeable or completely insignificant for others.
Does this sound familiar? Do you constantly worry about your appearance? Everyone does this to a certain extent. However, some of us—as many as 1 in 50 according to some estimates—spend a disproportionately large amount of time worrying about how they look.
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If every time you see yourself in the mirror or in a photo, you immediately look for that one aspect of your body you can’t stand—the shape of your nose, your double chin, your hair or your body hair, the shape of your breasts, the general shape and size of your body, or anything else, this may potentially be a sign of Body Dysmorphic Disorder. BDD affects both women and men in roughly equal proportions and is more commonly found among teenagers and young adults, although it is possible that people in other age groups are underdiagnosed and suffer with the disorder in silence.
People with BDD spend hours obsessing over their appearance and trying to improve it. They compare their bodies to images they see on social media, turn to others for reassurance, and in some cases spend a great deal of money on beauty procedures or plastic surgery in the hope that this will “fix” them. Some BDD sufferers are forever examining themselves in the mirror while others go to great lengths to avoid mirrors and photographs altogether. They become slaves to obsessive, repetitive behaviours linked to appearance (such as excessive grooming or masking the body part they can’t bear others to see) and often experience strong intrusive thoughts related to how they look and how they imagine others perceive them. BDD is not commonplace insecurity, this is negative obsession that causes significant stress and mental turmoil, saps well-being, and interferes with the ability to live a healthy life.
A person suffering from BDD might refuse to attend a social event for fear of being ridiculed for their appearance; a small imperfection is seen as a “serious defect” and taken for proof that their whole body is “ugly” and “unworthy”. A common characteristic of Body Dysmorphic Disorder is the constant fear of outside judgment and the simultaneous need for outside validation.
People with BDD are convinced that others judge them harshly for minor “flaws” in their appearance and this becomes a source of near-constant stress.
Where does it come from?
As with most psychological disorders, Body Dysmorphic Disorder can arise for a variety of reasons; there often is a combination of environmental (e.g., previous experience with bullying), psychological (e.g., negative self-image, low self-esteem), and biological (e.g., genetic predisposition) factors in the background.
Personal or family history of obsessive-compulsive disorder, depression, anxiety and other mental health disorders as well as personality traits such as perfectionism can contribute to the development of BDD. Bullying and peer pressure to look a certain way are often contributing factors.
If the BDD obsession is connected with body weight, the sufferer also has an increased risk for developing an eating disorder as these also tend to be linked with a similar predisposition toward anxiety, negative self-image, and perfectionism. However, with BDD there is usually a specific body part the sufferer finds especially unappealing.
How is BDD treated?
The good news is that BDD can be successfully treated with the help of mental health professionals. However, it is common for people who suffer from BDD to avoid seeking help, either because they don’t fully recognize their own obsessive tendencies, or because they fear further ridicule for bringing up such a seemingly “insignificant” issue.
Any problem that causes stress and reduces the quality of your life is significant. You deserve to get help, no matter the issue.
It is important to realize that mental health disorders such as BDD usually arise together with other conditions such as anxiety, depression, OCD, or PTSD. A licenced therapist can help you address any underlying issues and help you work toward overall health.
BDD is a chronic condition. This means it will take time and most likely a combination of treatments and lifestyle changes, and maybe even several different therapists to treat it effectively. Don’t despair if it doesn’t go away right away. Be patient with yourself and work proactively to improve.
One of the most popular methods of treating BDD is Cognitive Behavioural Therapy (CBT). Licenced CBT therapists work with their patients to identify negative thought patterns and irrational behaviours and then create practical solutions for replacing these thought patterns with beneficial ones in every-day life. CBT doesn’t necessarily address the causes of old psycho-emotional wounds, but it provides realistic tools that help you cope with, and even overcome, the restraints a disorder has placed on your life.
For more serious cases of BDD, medication can be helpful. Underlying depression and anxiety can be treated with antidepressants, and SSRIs (selective serotonin reuptake inhibitors) are often helpful for treating obsessive behaviours and relieving intrusive thoughts. SSRIs allow the serotonin your body produces naturally to remain in circulation longer as conditions such as depression and BDD are linked to lower levels of serotonin in the brain. SSRIs are generally very safe and have been shown to greatly alleviate the symptoms of disorders such as BDD and OCD.
It can also be helpful to talk to others going through a similar experience. Support groups for Body Dysmorphic Disorder are available in many places and online. Participating in a support group has many benefits: the group destigmatizes the experience, helps you to better understand your behaviours, and provides support and encouragement.
BDD is especially prevalent among teenagers and young adults. This is a serious disorder that can lead to serious consequences. Early intervention can be very effective in preventing the further development of more serious symptoms. If you notice signs of BDD in young people (or anyone, really) in your social circle don’t ignore them. Be considerate and offer friendly support but be prepared for your offer to be turned down. If you see someone who is really struggling, be a good listener and acknowledge and accept their feelings even if you don’t understand them. You can help them seek therapy or a support group and support them in their own self-care practices. Acknowledge small wins whenever you can and observe them to learn what triggers compulsive behaviours. “Hold space” for them when you can and offer practical support.
Be careful with your words and don't comment on specific body parts. While it might seem helpful to make light of what bothers someone else, this approach often backfires. Saying something like “Hey, don’t worry about that weird mole/belly roll/crooked nose so much” is asking a person who is unable (at least in the moment) to manage their anxiety about “that mole” to push down their fears and pretend it’s not a problem, plus it puts the body part in the spotlight, which is their biggest fear. Social pressure is one of the biggest contributors to body-image related mental disorders, so you don’t want to add to the pressure they are already feeling.
People who obsess over specific flaws often dream of plastic surgery. Modern plastic surgery has come a long way and can treat issues that would have been untreatable in the past, leaving almost no trace. A plastic surgeon can change the shape of a chin or a breast or a buttock, as well as remove marks left by diseases and medical surgeries with relative ease.
However, for those with BDD the core issue is not actually the “unsightly” body part—it is the negative obsession, the low self-esteem, the intrusive thoughts, and the many hours of stress that are lost to this disorder. Health professionals generally agree that plastic surgery is not an effective treatment for mental health issues and can lead to even greater complications for an obsessive psyche. Transforming the body is unlikely to magically cure damaged self-esteem and stop obsessive behaviour. A person suffering from BDD is more likely to keep looking for “flaws” that can be “corrected”.
I haven’t been diagnosed with BDD, but I can relate! What now?
If you haven’t been diagnosed with BDD but find that you have strong negative feelings about your appearance, here are a few things you can try to start healing your relationship with your body:
Find an online self-assessment for anxiety and begin addressing those symptoms.
Get enough sleep, eat healthy meals, go on walks regularly—all the good stuff!
Make sure your wardrobe, including your bra, is the right size for you. Even if the size on the tag is bigger or smaller than you’d like, well-fitting and comfortable clothing will instantly make you feel more at ease.
Drastically limit the time you spend on social media and the sites you visit online that may be negatively influencing how you feel about yourself.
Look up body positivity and body neutrality content online, sites dedicated to celebrating real bodies—stretchmarks, belly rolls, scars, and all!
Catch yourself noticing physical “flaws” in yourself and others. Consider why you feel this way and what that judgement means to you, where does it really come from.
Try thanking your body for everything it does for you every day for a week. You can start a journal to trace your thoughts.
Find some brief meditation or breathing techniques that appeal to you and practice them regularly for several weeks. Reflect on your experience. Perhaps this is something you would like to incorporate into your daily routine on a permanent basis.
Reach out to one or two people you feel you can really trust and ask them if you can share the negative feelings you’re experiencing. Anonymous mental health lines can also be immensely helpful. Simply to be heard and understood, to have our experience validated, is often the springboard we need to make a change.
The ugly roots of beauty standards
In the last few decades there has been a paradigm shift in many places around the world; we are becoming more understanding of each other. Each of us can do our part by practicing acceptance of the people around us, including ourselves. By doing so we are creating a better world for ourselves and for the generations to come.
Fear of the unfamiliar, hatred of what seems strange—a body type or skin colour that goes against the ruling notions in the society, a different set of abilities and disabilities—has no place among compassionate people in the 21st century. We can learn to defend ourselves against arbitrary standards that exist only to sell us products and ideas.
Cultivate compassion for yourself and be kind to others and you will attract those who do the same. Celebrate who you are. The beauty and the imperfections, the shadow and the light, there is no one else exactly like you and the world needs your contribution! Don’t be afraid to ask for help; all of us need help sometimes. We believe in you!
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Perrotta, G. (2020) “The Concept of Altered Perception in ‘Body Dysmorphic Disorder’: The Subtle Border Between the Abuse of Selfies in Social Networks and Cosmetic Surgery, Between Socially Accepted Dysfunctionality and the Pathological Condition, Journal of Neurology, Neurological Science and Disorders, 6(1): 001–007.
Ryding, F. C. & Kuss, D. J. (2020) “The Use of Social Networking Sites, Body Image Dissatisfaction, and Body Dysmorphic Disorder: A Systematic Review of Psychological Research”, Psychology of Popular Media, 9(4), 412–35.
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