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.