Body Dysmorphia — When the Mirror Lies

Body dysmorphic disorder (BDD) is a condition in which the person is preoccupied — sometimes obsessively — with a perceived flaw in their physical appearance. The flaw is either absent or minimal to outside observers. To the person experiencing it, it is consuming.

What BDD is not

It is not vanity. It is not excessive concern about appearance of the kind that the culture routinely encourages. It is a disorder of perception — one that causes significant distress, consumes large amounts of time, and interferes substantially with ordinary functioning.

The person with BDD is not choosing to focus on the perceived flaw. They cannot stop.

The preoccupation

People with BDD typically spend hours each day thinking about the perceived defect — checking it in mirrors, seeking reassurance from others, attempting to conceal or correct it. The reassurance never resolves the preoccupation. The mirror never shows what they are hoping to see.

“The person with body dysmorphia is not looking in the mirror and seeing what you see. They are looking in the mirror and seeing something that is, to them, completely real and completely catastrophic. The suffering is genuine, even when the perceived defect is not.” — Philippe Jacquet

Relationship to other conditions

BDD shares features with obsessive-compulsive disorder (OCD) — the intrusive thoughts, the compulsive checking behaviour, the temporary and incomplete relief that compulsions provide. It also overlaps with eating disorders, particularly in its relationship to body image and the belief that the physical self is fundamentally unacceptable.

Treatment

Effective treatment addresses both the specific preoccupation and the deeper beliefs about self-worth and acceptability that sustain it.

Book a consultation with Philippe Jacquet — psychotherapist and eating disorder specialist, London.