Body Dysmorphia Worksheet

What is body dysmorphic disorder?

Sometimes, individuals are deeply troubled by their body image, leading to persistent worries that affect their overall well-being. This phenomenon is commonly referred to as body dysmorphic disorder (BDD). 

BDD is characterized by an individual's excessive preoccupation with imagined flaws in their physical appearance, even when those flaws may not be observable to others. This condition is officially recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), illustrating its significance in mental health (Nicewicz & Boutrouille, 2022).

Central to understanding BDD is body image, which encompasses one's perceptions, thoughts, and feelings about physical appearance. While having a positive body image is ideal, characterized by acceptance and appreciation of one's body, individuals with BDD struggle to achieve this state. Instead, they fixate on perceived imperfections, often experiencing intense distress and engaging in repetitive behaviors, such as excessive grooming or seeking reassurance, to alleviate their concerns.

A systematic review revealed that body dysmorphic disorder (BDD) affects approximately 2.2% of adolescents and is more prevalent among women than men across various settings. The presence of BDD among these demographics is common, particularly in psychiatric and cosmetic contexts where it often remains underrecognized (Veale et al., 2016).

Women are particularly vulnerable to developing BDD, as societal pressures often emphasize the importance of physical appearance. With the rise of social media usage, constant exposure to unrealistic beauty standards can fuel feelings of inadequacy and self-doubt, perpetuating a vicious cycle of negative self-perception.

What are the risk factors and symptoms of this disorder?

Understanding BDD and promoting strategies for improving body image can help support those affected by this challenging disorder.

The cause of Body Dysmorphic Disorder (BDD), which typically emerges in adolescence, remains unknown, affecting about 1% of the population equally across genders. Possible contributors include familial history of similar disorders, brain chemical imbalances, personality traits, and life experiences (John Hopkins Medicine, 2020).

BDD leads to repetitive behaviors aimed at concealing, inspecting, or seeking reassurance about disliked body parts, consuming certain hours daily and often challenging to control.

Typical behaviors include camouflaging, comparing features, mirror checking, excessive grooming, seeking reassurance, skin picking, clothes changing, tanning, excessive exercising, shopping for appearance-related items, seeking cosmetic procedures, and taking excessive selfies, especially prevalent among women and teens, with these behaviors often exacerbating rather than alleviating BDD symptoms (Phillips, 2014).

How is body dysmorphic disorder diagnosed and treated?

BDD diagnosis involves evaluating symptoms' impact on daily life, excessive concern over minor flaws, and ruling out other mental health conditions like OCD, social anxiety, depression, and eating disorders (John Hopkins Medicine, 2020).

Fortunately, there is hope for those struggling with body dysmorphic disorder (BDD), as effective treatments are available. Treatment primarily involves cognitive behavioral therapy (CBT) and serotonin reuptake inhibitor (SRI) medication (Veale & Singh, 2019). Here's an overview of each:

Serotonin Reuptake Inhibitor (SRI) medication

SRI medication encompasses all selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine, sertraline, paroxetine, citalopram, escitalopram, and fluvoxamine, along with clomipramine, a potent SRI belonging to the tricyclic antidepressant class. They have been found effective in reducing body dysmorphic disorder (BDD) symptoms.

Cognitive Behavioral Therapy (CBT)

CBT targets altering appearance perceptions, diminishing self-focused attention, and correcting maladaptive coping in body dysmorphic disorder (BDD), often using graded exposure and behavioral experiments to confront appearance-related fears over 16–24 sessions. It has demonstrated effectiveness in alleviating BDD symptoms, enhancing quality of life, and fostering insight, with motivational interviewing techniques employed when patients display resistance or lack of insight.

Breaking free from the grip of BDD requires a multifaceted approach. Cultivating a positive attitude towards oneself and adopting healthier perspectives on beauty are essential steps toward recovery. Moreover, addressing underlying psychological factors, such as low self-esteem or perfectionism, can help disrupt the cycle of self-objectification and promote self-acceptance.

What problems can this disorder lead to?

BDD affects not only one's mental health but also one's overall functioning and quality of life. The relentless focus on appearance can impair social interactions, hinder professional aspirations, and strain personal relationships. Additionally, individuals with BDD may neglect their physical health, prioritizing cosmetic interventions over genuine well-being.

• Negative self-talk: This is associated with low self-esteem, and appearance concerns can perpetuate distorted perceptions of one's physical appearance, leading to feelings of inadequacy and self-doubt.
• Eating disorders: Body dysmorphia can contribute to the development of eating disorders as individuals may engage in unhealthy behaviors such as restrictive dieting or excessive exercise to alter their perceived flaws.
• Low self-esteem: Persistent negative thoughts and comparisons regarding one's appearance can significantly impact self-esteem, leading to feelings of worthlessness and dissatisfaction with oneself.
• Appearance concerns: Body dysmorphia can intensify preoccupation with one's physical appearance, causing distress and impairing daily functioning as individuals obsess over perceived flaws and strive for unattainable standards of beauty.

How does our Body Dysmorphia Worksheet template work?

Our Body Dysmorphia Worksheet template is designed to help individuals explore and address their feelings and perceptions about their body image in a structured and supportive manner. Here's how it works:

Step 1: Download the template

Download the body dysmorphia worksheet template from the link provided here.

Step 2: Understand the instructions

Take a moment to read and understand the instructions provided at the beginning of the worksheet. Familiarize yourself with the purpose and how to use it effectively.

Step 3: Fill in personal information

Complete the worksheet by filling in your personal information, including name, age, date, and therapist's name, to personalize the worksheet to your needs.

Step 4: Set goals for the session

Identify three specific goals you want to achieve during your therapy session, such as identifying triggers for negative body image or developing coping strategies.

Step 5: Answer the questions

Respond to each question honestly and thoughtfully, describing your perceptions and feelings regarding your body image and any related behaviors.

Step 6: Reflect on responses

Reflect on your answers and consider any patterns or insights regarding your body image concerns and their impact on your life.

Step 7: Discuss with a therapist

Bring the completed worksheet to your therapy session to discuss your responses with your therapist, who can provide guidance and support tailored to your needs.

Step 8: Implement strategies

Implement the strategies discussed with your therapist and practice self-care techniques to promote a healthier body image and overall well-being. Monitor your progress and adjust goals as needed during your journey towards positive body image and self-esteem.

What are the benefits of using our worksheet?

Using a worksheet to reflect and improve how one perceives one's body image can be beneficial. Here are five advantages of using our Body Dysmorphia Worksheet:

1. Improves body image: By systematically exploring thoughts and emotions related to body image, individuals can develop a more positive perception of themselves and their bodies.
2. Reduces self-objectification: Engaging in exercises designed to challenge negative predictions and assumptions about one's appearance can lead to reduced self-objectification and increased self-acceptance.
3. Provides a holistic approach: Our worksheet offers a holistic model for addressing body image concerns, considering physical, emotional, and psychological aspects to promote overall well-being.
4. Empowers young adult women: Explicitly tailored for young adult women, the worksheet serves as a valuable tool for self-reflection and personal growth, helping them navigate societal pressures and develop a healthy relationship with their bodies.

References

John Hopkins Medicine. (2020). Body Dysmorphic Disorder. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/body-dysmorphic-disorder

Nicewicz, H. R., & Boutrouille, J. F. (2022, September 28). Body Dysmorphic Disorder (BDD, Dysmorphobia, Dysmorphic Syndrome). PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK555901/

Phillips, K. A. (2014). Signs & symptoms of BDD - BDD. BDD. https://bdd.iocdf.org/professionals/signs-symptoms/

Veale, D., Gledhill, L. J., Christodoulou, P., & Hodsoll, J. (2016). Body dysmorphic disorder in different settings: A systematic review and estimated weighted prevalence. Body Image, 18(1), 168–186. https://doi.org/10.1016/j.bodyim.2016.07.003

Veale, D., & Singh, A. R. (2019). Understanding and treating Body Dysmorphic Disorder. Indian Journal of Psychiatry, 61(7), 131–135. https://doi.org/10.4103/psychiatry.indianjpsychiatry_528_18