Body Dysmorphic Disorder (BDD) is ‘a psychiatric illness in which patients become obsessively preoccupied with perceived flaws in their appearance’ (Luciano 2002: p175). Martin & Costello (2008) view it is a severe dislike and concern about some slight or imagined aspect of their appearance, that causes them significant emotional distress and difficulties. Cash (2008) maintains that sufferers have ‘a grossly distorted view of what they look like’ and Phillips (2005) coins BDD as ‘the disorder of imagined ugliness’ (p5).
Body Dysmorphic Disorder is classified as a somatoform disorder because the primary focus is a psychological preoccupation with a somatic issue. (Barlow & Durand: 2005) Thompson (2000) explains that the term that preceded Body Dysmorphic Disorder was ‘dysmorphophobia’ which was used by Morselli in 1886 (Morselli, 1886) which literally meant a ‘fear of ugliness’. In 1903, Janet’s description referred to an ‘obsession with shame of the body’; for decades BDD was thought to represent a ‘psychotic delusional state’ (Barlow & Durand: 2005, p183). The first English language paper on dysmorphophobia was not published until 1970 (Hay: 1970) focusing on the fear of other people’s reactions to the imagined flaw in appearance. BDD gained official status in 1987 when it was first published in the DSM-III-R
Jim was convinced that everyone, even his good friends, was staring at a part of his body that he himself found absolutely grotesque. He reported that strangers would never mention his deformity and his friends felt too sorry for him to mention it. Jim thought his head was square! Jim could not imagine people getting past the fact that his head was square. To hide his condition as well as he could, Jim wore soft floppy hats and was most comfortable in winter, when he could all but completely cover his head with a large stocking cap. To us, Jim looked perfectly normal. (Barlow & Durand: 2005)
In the article ‘Body Dysmorphic Disorder in men, psychiatric treatments are usually effective’, Katharine Phillips notes that BDD is an underrecognised yet relatively common and severe psychiatric disorder. Many doctors…do not recognize the condition as yet and simply see it as low self-esteem’ (Paterson: 2008, p51) Claiborn & Pedrick (2002) focus their attention on the two predominant features of BDD; the preoccupation with the [imagined] defect and the actions taken to reduce the feelings of distress.
How do I know if I have Body Dysmorphic Disorder?...
TABLE OF CONTENTS
1. What is Body Dysmorphic Disorder?
2. How do I know if I have Body Dysmorphic Disorder?
3. Different forms of Body Dysmorphic Disorder…
3.1 Muscle Dysmorphia
3.2 BDD by proxy
4. Obsessions and BDD
5. Compulsions and BDD
6. Cases of males with BDD – examples
7. Causes of BDD
8. BDD and gender – a male slant
9. How does BDD affect the male sufferer?
10. Treatment options for BDD sufferers…
10.1 Medication
10.2 Cognitive-Behavioural Therapy
10.3 Cosmetic treatments
11. BDD and other disorders…
11.1 Obsessive-Compulsive Disorder
11.2 Depression
11.3 Eating Disorders
11.4 Social Phobia
12. Family assistance for the sufferer
13. Where to get help for the sufferer
13.1 Organizations
13.2 Books and Websites for further reading
14. References
15. APPENDICES
15.1 Appendix A – Definition of BDD (DSM-IV)
15.2 Appendix B – Do I Have BDD? (Anna Paterson)
15.3 Appendix C - Location of imagined defects in 30 patients with BDD
15.4 Appendix D - Have I got BDD? (Veale, Willson & Clarke)
15.5 Appendix E - Clues to the Adonis Complex in Boys (Pope et al.)
15.6 Appendix F - Common Compulsive Behaviours (Rituals) in BDD (Phillips)
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