What is BDD?

Body dysmorphic disorder (BDD) is a preoccupation with one’s appearance having a perceived defect that others do not notice or do not believe to have great importance. These symptoms also must cause significant impact or handicap to life to meet the criteria for diagnosis.

What may cause distress to those suffering with BDD is that when they seek validation and reassurance that others see what they do, this is not confirmed. The degree of insight that patients have into this being a psychological issue rather than an appearance one is varied. Even so, it is important to remember all severities of BDD are treatable. You can receive help from an online CBT Psychotherapist by making contact here

BDD Because I’m Ugly

Do most people have a concern about their appearance?

It is true that if you ask any individual if they have a concern about a part of their appearance, they will name something. But the diagnosis of BDD is different, there is a significant amount of distress attached to the way they feel about their appearance. Alongside distress is the handicap in at least one area of the individual’s life.

An example of this is that someone with BDD may only enter social situations whilst trying to hide/camouflage a perceived defect, this may include wearing certain clothing/hats or brushing hair a particular way. Other common unhelpful coping behaviours include using makeup or changing their posture. There is a significant amount of time thinking about how others may negatively judge them. Another common aspect of BDD is asking themselves unanswerable questions such as “why was I born with this nose”, “if only my stomach was flatter”.

There is a lot of misconception regarding BDD, many may worry they are seen as vain, or may draw attention to an area they do not want to be shown. It is generally recognised that BDD is a hidden disorder due to very high levels of shame. Surveys have shown that BDD to be about 2% of the population but could be higher. BDD is equally common in men and women.

If you wish to receive evidence based psychological support from an accredited body dysmorphia therapist, please get in contact

What are the symptoms of BDD?

Body Dysmorphia Therapist London, UK

Individuals may wonder what the signs and symptoms of Body Dysmorphic Disorder are.

Most of those suffering with BDD are concerned with multiple defects on their face, nose, hair, skin, eyes, chin, lips, and overall body shape and/or build. BDD when specific areas of concern are related to the face, may also be known as facial dysmorphia. Perfectionism is common in BDD and a concern with symmetry or that a part is too big or small, or out of proportion is also frequently reported. Any part or parts may be involved, including genitalia or breasts. There may also be a general feeling of ‘ugliness’ rather than an actual specific area of concern. Therapy utilising both CBT and CFT approaches assists with showing individuals on how to deal and manage facial dysmorphia and BDD.

BDD usually develops in adolescence, a time when people are generally most sensitive about their appearance. However, many sufferers leave it for years before seeking help. When they do seek help through mental health professionals, they often present with other symptoms such as depression, social anxiety or obsessive-compulsive disorder (OCD) and do not reveal their real concerns. Patients may have suffered trauma in childhood including being treated differently and bullied. Individuals may also have received praise for how they look, making the individual’s identity built solely on their appearance.

Do I have BDD- online test

Click here to access a commonly used symptomatic questionnaire used in treatment by professionals.

What causes BDD?

The generally accepted explanations are biological and psychological. The biological facial dysmorphia explanation accepts an emphasis on genetic predisposition to BDD, certain stressors, such as abuse or bullying also encourage a development of the disorder.

The psychological explanation emphasises a person’s low-selfesteem in relation to body image. They may judge themselves solely on this and not see themselves having an identity outside of their appearance. These individuals may fear that they are worthless or will be teased or rejected due to appearance. There may be evidence of a ‘ghost from the past’ where they have been humiliated and shamed. In relation to perfectionism shame occurs that their appearance is not an impossible ideal.

How to treat BDD?

NICE guidelines on BDD recommend Cognitive Behavioural Therapy (CBT). This form of therapy is based on a structured programme which focuses on challenging the way individuals think and act. Skills taught include mirror retraining, attention training and Compassion Focused Therapy (CFT) techniques. Value driven goals are created, and fears are confronted using Exposure Response Prevention (ERP).


Evidence Based treatment with a Cognitive Behavioural Therapist in London online or in-person home visits.

If you feel that you, a friend or relative would like help to overcome body dysmorphic disorder or facial dysmorphia, then please get in touch via email:info@homebasedtalkingtherapy.com

Websites and additional information

The National Institute of Clinical care and Excellence guidelines on BDD can be downloaded here.

The BDD Foundation is a charity for people with BDD and their carers.

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