Body Dysmorphic Disorder

Overview

BDD sits in the OCD spectrum. Treatment is ERP-style — exposure to feared appearance situations + response prevention of mirror-checking, comparing, reassurance-seeking, and grooming rituals. High suicide risk; screen carefully.

First-line treatments

• ERP — Exposure and Response Prevention (for OCD)

  Modified ERP for BDD — drop checking, comparing, camouflaging, reassurance-seeking.

• CBT — Cognitive Behavioral Therapy

  Cognitive work on attentional bias and overvalued beliefs about appearance.

Also consider

• ACT

  Acceptance + values to reduce avoidance and ritualized appearance focus.

• CFT

  Addresses underlying shame and self-attack.

Cautions

• Cosmetic procedures rarely help and often worsen BDD — discourage and address the urge directly.
• Suicide risk in BDD is among the highest of any psychiatric disorder — assess at every session.

Related tools

• Assessments

Related worksheets

• The OCD Cycle
• ERP Exposure Ladder
• Sitting with the Urge
• Inner Critic Dialogue
• Shame Resilience Map