The term ‘dysmorphophobia’ comes from the greek meaning ‘ugliness of face’. It was introduced in 1886 by Morselli and is defined as the feeling of being ugly and/or having a physical defect, despite a normal appearance. It is thought to be associated with feelings of shame.
‘Body Dysmorphic Disorder’ (BDD) was first recorded in psychological texts in 1987, and is characterised by an intense pre-occupation with an imagined or real defect of physical appearance. In the majority of cases the focus is on a minor defect, but the concern eventually leads to social and occupational difficulties that can be extremely distressing.
Although almost any area of the body can be the focus for BDD, the common areas of anxiety are the face and hair. Unlike people with eating disorders BDD sufferers don’t have a distorted body image as a whole. The anxiety is associated with repetitive and intrusive thoughts about the perceived defect, and most BDD sufferers will perform regular checking rituals such as looking in the mirror or picking at the skin. This behaviour resembles obsessive-compulsive disorder.
How is BDD treated? There are a number of treatments including counselling and certain serotonin reuptake inhibitor drugs. However, studies have found that some sufferers also have cosmetic surgery. Unfortunately the same studies show that the temporary happiness and relief is replaced by the symptoms of BDD moving to another part of the body, or the sufferer feeling that the surgery was not successful. In some cases there is a real danger that cosmetic procedures will become part of the ritualistic behaviour.