Body Dysmorphia (BDD) Workbook
Name the feature, map the rituals, drop one safety behavior
Body Dysmorphic Disorder is maintained by a loop: a perceived flaw, ritualized checking or fixing, brief relief, and a return of the distress — usually worse. CBT for BDD targets the loop, not the appearance.
The feature(s) I'm preoccupied with
Skin, hair, nose, body shape, symmetry, muscle, genitals — name it plainly. Naming the obsession is not the same as agreeing with it.
Safety behaviors I use
Mirror checking, comparing, camouflaging (makeup, hats, clothing), grooming rituals, reassurance seeking, photo editing, skin picking, cosmetic consults, avoiding mirrors / cameras / sunlight.
What I avoid because of this feature
Social events, dating, photos, work meetings, intimacy, leaving the house unless "fixed," specific lighting / angles.
Cognitive distortions running underneath
All-or-nothing ("I'm hideous"), mind reading ("everyone is staring"), emotional reasoning ("it feels ugly therefore it is"), fortune telling ("they'll reject me"), magnification of the feature, comparison.
One ritual I'll drop this week — and what I'll do instead
The ritual
The replacement (delay, redirect, value-aligned action)
One avoided situation I'll re-enter
Pick something small enough to do this week. Predicted distress (0–10), actual distress at peak, actual distress 30 minutes later.