Body Dysmorphic disorder can be one of the most challenging problems to work on with clients due to the strength in which the client sees themselves in ways that are inconsistent with other’s reality.
For example when people suffering from body dysmorphic become triggered by their reflection in a mirror, they selectively attend to the areas of their concern. It is if they are zooming in on a telescope and blocking out almost everything else around them.
As they harshly criticize their body, feelings of depression and disgust emerge. A strong sense of anxiety builds as they ruminate over how horrible they look as compared to others. They often reinforce their evaluation of themselves as quite defective. In turn they engage behaviors designed (with good intentions) to cover up the so called “defects.” This could be their avoidance of events, engaging in surgery consultations, obsessing on what they are wearing, use of make-up, etc.
The problem with these “safety behaviors” is that the more they engage in this avoidance to “keep them safe,” the more unsafe they actually become because these avoidance behaviors and “safety measures” actually maintain these negative beliefs about themselves. The more mirror analyzing and the more negative evaluations. This negative pattern stops them from learning to test out these negative assumptions about themselves and build real coping to face the anxiety head-on.
Good Cognitive Behavioral Therapy treatment and perhaps even with the assistance of psychopharmacology (when needed) can often be most helpful to help them to methodically give up their avoidance and behaviors that they “think” keep them safe and instead learn tools for new healthy anti-avoiding behaviors, and new healthy beliefs about themselves but the way in which others and the world see them.
If you know someone or believe you may suffer from body dysmorphic disorder, contact us at the Cognitive Behavioral Therapy Institute of Southern California. We provide affordable and CBT.
Paul DePompo, PsyD, ABPP is board certified in cognitive behavioral therapy, a diplomate of the academy of cognitive behavioral therapy, and the director of the only Albert Ellis affiliated training center in California.