Most clients with Body Dysmorphic Disorder who come to therapy believe to some degree that the issues that they are

facing are related to how they their appearance.. One of the things that can help them have more insight in to their

situations is having them look at their bio-psycho-social history.

 One thing that is common in people with Body Dysmorphic Disorder is lack of self-esteem and self-love. When I ask clients

about their upbringing,they often say that their parents were either permissive or uninvolved. Some tell me that their parents

were too protective of them and  did not let them experience things that they needed to.  I saw example of these parents

when I worked for as a clinician in a school.

One parent that I recall, often cooked lunch for her son who was in first grade. She will bring his son’s lunch to school for

him every day.  When her son was playing with other kids in the school yard,  she often watched him carefully so that he

won’t fall down and hurt himself.  One time when I was in the school yard, his son fell down and started crying. Her mom

went and grabbed him and he was crying for more than 20 minutes. Afterwards, her mother told the school staff that she

was taking him home.Even though we did not agree with what she was doing, she took her son home anyway.

You can see how this style of parenting can have a negative affect on the child’s self-esteem.

 With people  with BDD, sometimes the parents are just uninvolved. uninvolved parents can also be neglectful. Sometimes

these parents are dealing with their own emotional issues or substance abuse issue that can cause them to be

neglectful. When parents are uninvolved, children struggle with self-esteem issues. They tend to perform poorly in school.

They also exhibit frequent behavior problems and rank low in happiness.


So some say that we do not pick our parents. So, How can this help people who have BDD?  Some client’s who have BDD

have little insight into their situation. Some do not even believe that they have BDD and are sure that their appearance is

what is causing them  feel this way. This is the main reason they seek many seek cosmetic surgery.

I believe that when doing therapy with people who have BDD it is very important that they become aware of all these factors

that can contribute client’s BDD. Many people with BDD see what their mind wants them to see when they look in the

mirror. Looking in the mirror confirm their false belief.  Once the clients understand all these factors that can contributed to

them having BDD, and start accepting that they way they look is not the source of their problem, that is when the real

progress can be made.