Body Dysmorphic Disorder

What Is Body Dysmorphic Disorder?

Body dysmorphic disorder (BDD) is a mental health condition in which individuals have a preoccupation with one or more areas of their appearance they perceive as defective.

Those struggling with BDD spend a great deal of time camouflaging their appearance, avoiding the outside world, mentally reviewing, ruminating, and seeking reassurance due to high levels of anxiety and depression. BDD causes significant impairment within the individual as they search for any methods that offer relief.

BDD is often misdiagnosed and under-diagnosed as the cause and symptomatology behind it are still greatly misunderstood. The disorder has similarities to eating disorders and obsessive-compulsive disorder.

Common Symptoms Include:

Extreme preoccupation with a body part or aspect of appearance that to others seems minor or is not visible
Belief this defect makes them deformed and unattractive
Belief others are staring, paying attention, and thinking negatively about this body part or aspect of appearance
Like obsessive-compulsive behaviors, those who struggle with BDD engage in behaviors in an attempt to reduce distress (avoiding, checking, reassurance seeking, grooming, skin picking, hair pulling, seeking out cosmetic procedures, wearing makeup or clothes to camouflage perceived flaws, and many more.
Often these individuals do not leave their homes and are unable to attend school or work
ANY area of the body can be perceived as a defect, but primary areas include- the nose, ears, hairline, wrinkles, hair texture and appearance, skin and veins, breast size, muscle size, and genitalia

Treatment for Body Dysmorphic Disorder at CalmOCD:

Currently, evidence-based treatment for BDD includes medication and psychotherapy. At CalmOCD we offer a combination of approaches to help those suffering from BDD.

Cognitive Behavior Therapy:

CBT is a psychological treatment found to be effective in treating many mental health disorders, including body dysmorphic disorder. CBT for BDD begins with the therapist conducting an in-depth assessment and providing psychoeducation on BDD. Cognitive behavior therapy involves helping the individual identify their current cognitions and work through unhealthy thought patterns that are leading to avoidance and ritualistic behaviors. Through cognitive work the individual starts to understand their safety behaviors are not keeping them safe, they are instead creating a larger problem. The avoidant behaviors reduce painful feelings temporarily; however, they negatively reinforce the disorder and maintain their belief system and unhealthy coping skills.

Acceptance and Commitment Therapy:

ACT assists those with BDD in increasing psychological flexibility, helping patients enter the present moment in a meaningful way and either alter or continue a behavior while moving in connection to a person’s values. ACT helps to alter functions of private experiences that are keeping people entangled such as their thoughts, feelings, memories, or bodily reactions. ACT can be a very powerful tool for those suffering from BDD as it assists individuals suffering to develop a different relationship with their thoughts and feelings. Instead of engaging in avoidance and ritualistic behaviors when they feel emotions, they can embrace uncomfortable emotions and move in alignment with those things that are important to them. By choosing action, those suffering from BDD learn the behaviors keeping them ‘safe’ only lead to depression while the behaviors that move them closer to their values lead to freedom.

At CalmOCD, the therapist will work with the patient as a team to develop a deep understanding of their struggles and barriers preventing them from feeling better.

Mindfulness Based Therapy:

MBT assists those suffering from BDD by helping them practice being present without passing judgment. Those with BDD are constantly judging themselves and feel others are as well. Learning to incorporate noticing without judgment can serve as another tool for those struggling. Mindfulness-based interventions help BDD sufferers have internal experiences without viewing them as inherently wrong or bad.

Dialectical Behavioral Therapy:

DBT is a psychological treatment that is helpful for those suffering from BDD. The treatment focuses on distress tolerance, emotional regulation, interpersonal effectiveness, and mindfulness. The ‘dialectic’ in dialectical behavior therapy acknowledges life is complex and continuously aimed at balancing the existence of two opposites. First, acceptance of their experiences and behaviors as valid, and second, the ability to change and manage these emotions and behaviors.

Exposure and Ritual Prevention:

(E/RP) At CalmOCD, before implementing any exposure and ritual prevention, the therapist will build a strong foundation of skills with the models discussed above (Cognitive behavior therapy, Acceptance and Commitment Therapy, Mindfulness-Based Therapy, and Dialectical Behavioral Therapy). The therapist will help the client develop an understanding of all the behaviors that are reinforcing their fears. Examples include (excessive mirror use, avoidance behaviors, checking rituals, reassurance seeking, doctors’ appointments, and more). Once a full analysis is completed the therapist helps the client reduce these safety behaviors through exposure and ritual prevention. The goal of E/RP is to help patients practice tolerating distress and learn new information to help evaluate beliefs.

Perceptual Retraining:

Those struggling with BDD often have complex relationships with mirrors and reflective surfaces. Some individuals may spend too much time with mirrors while others may avoid mirrors. Those using mirrors most commonly focus on the area of concern and will zoom in closely to the mirror to magnify imperfections which tends to reinforce their belief system. During their time in front of the mirror, BDD sufferers tend to be extremely critical of themselves and may automatically start judging themselves. Perceptual retraining helps those with BDD engage in healthier interactions with mirrors. This may include a therapist helping guide the patient in describing their body without using judgmental language and more objectively. The therapist helps the patient refrain from their safety behaviors during this experience and assigns exposures for the client to do on their own. Through this training, the patient is encouraged to have experiences where they are present and focus on other areas in their environment as opposed to just their appearance.

Ready to Start Your Healing Journey?

If interested, please follow the steps below! Due to the high volume of inquiries please allow 48 hours for a response.


Submit an online inquiry


You will receive a response from CalmOCD within 48 hours and a 15 minute complimentary consultation will be scheduled

Intake Session

If CalmOCD seems to be a good fit based on your individual needs, an intake session will be scheduled.