
posted 24th January 2023
We know that concerns about appearance in the adolescent population have escalated dramatically in the past few years. An Australian study of university students (Bartsch 2007) found that approximately 60% of those questioned were concerned about an aspect of their appearance and 2.3% of participants met the criteria for BDD. Fifteen years on, this seems like a conservative estimate. Not all people who are concerned about their appearance go on to develop BDD, but too many will do so. This vague statement reflects the lack of current statistical data and the difficulties researchers encounter due to people not reporting their BDD because of shame and misperceptions. Simply put, many people suffer in silence with life-impeding concerns about their appearance.
BDD is characterised by a debilitating preoccupation and distress over one's appearance and by time-consuming behaviours such as mirror gazing, comparing features to those of others, excessive camouflaging tactics to hide the defect, skin picking and reassurance seeking.
Body image concerns may be overlooked, misinterpreted and misunderstood and as a result, diagnosis can take a long time. Whilst BDD is left unidentified and untreated, it can become more entrenched and hence harder to overcome. Treatment options may be limited and finding and accessing support from those who understand and have relevant experience can be extremely challenging.
Our personal and professional experience has shown us that a compassionate consultation and early diagnosis, followed by the introduction of supportive measures gives the best chance of a positive outcome and eventual recovery. The route maps of how we can help are detailed here.
BDD impacts everyone in the family; as well as being overwhelming for the individual. At the Thorndon Centre, we recognise that the health, and well-being of family members of people who have BDD often suffer greatly. The dynamics between family members may involve behaviours that bring up shame, secrecy and sometimes blame. Getting to the heart of these patterns can make a huge difference in restoring well-being. We have lived experience of these dynamics and as a result, we know how important it is to compassionately support the whole family through the process of managing and overcoming the challenges BDD presents.
In most cases, a person who has BDD doesn't recognise that they have it; for them, the problem is the way they look; frequently there is some feature that causes them great distress. One characteristic of BDD is xxxx(denial say more here).
BDD is not to be confused with vanity, however, unfortunately, sometimes people misinterpret the person's behaviour, and this is deeply distressing for the sufferer. Our work with families can help to clarify and resolve such unhelpful misunderstandings.
The person with BDD becomes so troubled and preoccupied with their perceived defect that their life is overtaken by body image concerns and compulsive behaviours. Left undiagnosed and untreated it may become impossible to continue at school, college, or work. The person may withdraw from life, their relationships suffer and a destructive cycle gains power.
We aim to help to identify when a person is showing the first signs of body image disorders and to support the whole family to stop the escalation.
Some people get caught up in mirror gazing, this is where they are compelled to spend many hours a day checking their reflection and experiencing many extremely disturbing perceptions, thoughts and emotions. Some people avoid reflective surfaces at all costs because seeing their reflection is too troubling. People who suffer from BDD sometimes cover their bodies and try to conceal their perceived faults from others and in some cases from themselves.
It is obvious that the cost of not getting better is immense. Entrenched BDD is extremely difficult to treat and irregular or disjointed cycles of therapy can be counterproductive and reinforce a sense of hopelessness. Once the person has some insight into the way in which BDD works and some consistent support, there is every opportunity to take steps to recovery. It's often a long journey though and therefore finding a therapist who understands and who is committed to staying present and available, as long as necessary, is so important.
Our experience is that, with appropriate treatment and the right support structures in place for all involved, a positive long-term outcome can be realised.