The Body Dysmorphic Disorder

Simply defined, Body Dysmorphic Disorder, or BDD, refers to the clinically diagnosed condition of extreme dissatisfaction with one's physical appearance (Phillips 200). This extreme dissatisfaction can be compartmentalized into two separate independent components; There is a perceptual component which focuses on physical body width estimations, and a subjective attitudinal component which focuses on positive or negative thoughts about one's body image (Gardner 96). Mindfulness meditation exercises, acceptance training activities like positive mood induction, body scans, and perceptual retraining in particular, produce positive body satisfaction outcomes in those who suffer with BDD by producing higher levels of self-compassion in participants, relinquishing negative self-image thoughts, and promoting positive body image thoughts.

In acceptance training, participants are instructed to acknowledge their feelings without labeling them negatively (Taylor, Cooper 120). One way to engage in this process is through positive mood induction activities like autobiographical recall. In an autobiographical recall mood induction, participants are asked to recall a happy (positive mood induction) or sad (negative mood induction) scenario from their past. Participants who recall a happy event have an overall improved mood after the study, participants who recall a negative event however, experienced a drop in their overall mood (Drace, Desrichard, Shepperd, and Hoorens 300). For participants with Body Dysmorphic Disorder, positive mood induction leads to “a lesser number of disturbances in body size perception in the form of a tendency to overestimate their body size and significantly lesser dissatisfaction with their body size” (Cooper, 400). Conversely, for participants who did not previously suffer with Body Dysmorphic Disorder, after engaging in a negative mood induction, the participants tended not only to significantly overestimate their body size, but they also expressed a greater dissatisfaction with their body (Cooper, 400). These findings highlight the connection between mood and body size perception. After engaging in an activity that promotes a positive mood, participants with Body Dysmorphic Disorder felt happier, and therefore more content with their bodies at the present moment. Participants also more accurately estimated their true body widths after the positive induction (Cooper, 400). Simply by recalling a happy memory, individuals not only could begin to combat the attitudinal component, but also the perceptual component of body dysmorphic disorder.

Another acceptance training activity that promotes positive body image thoughts

is a body scan. During a body scan, participants are first instructed to relax their body and quiet their mind. They are then asked to bring their attention to a single body part and observe the sensations and emotions that body part emits without judgement. After several minutes of this observation, participants are told to release any tension, and accept any emotion that they may feel in the body part. They are then instructed to bring their attention and awareness to a different part of the body (De Urquiza, 125). After engaging in a body scan, Body Dysmorphic Disorder Participants reported improved moods and a higher level of body satisfaction (Atkinson & Wade, 20). These results can be partially attributed to the fact that by engaging in a body scan activity, participants are forced to go through a thought pattern different from what they normally experience. For a person with Body Dysmorphic Disorder, multiple or single perceived bodily flaws control their everyday thinking. They obsess over these flaws repetitively, for hours each day. In body scans however, participants are only allotted a certain amount of time to think about a certain body part and all the negative emotions that surround it before being forced to move on and draw their attention elsewhere. It is this process of recognizing the negative emotion, allowing it to have its place in the mind without judgement, and ultimately releasing it that provides relief in participants.

In an activity similar to the body scan, perceptual retraining, participants are again encouraged to recognize, accept, and ultimately release negative body cognitions. Individuals with Body Dysmorphic Disorder often have a negative relationship with mirrors or other reflective surfaces. They often switch between spending hours in front of the mirror, scrutinizing themselves, or actively trying to avoid seeing their reflections (Wilhelm, 625). In perceptual retraining, a therapist helps guides a patient through describing their entire body, head to toe, while standing a few feet in front of a mirror. The participant is instructed to describe themselves objectively instead of using judgemental language and to not zone in on, or touch disliked body parts. Without therapist intervention, individuals with BDD will get very close to the mirror, and only focus on the body parts of concern, magnifying their perceived imperfections, and maintaining their negative body image beliefs. Furthermore, individuals will tend to engage in emotionally charged and judgemental self-talk while looking at themselves. Therapist intervention however stops individuals from engaging in these harmful acts. They are guided away from the mirrors when they get too close, and are constantly encouraged to shift their attention between body parts. This activity allows individuals to address their distorted body image perceptions, and also helps them learn how to engage in healthy mirror-related behaviors (Wilhelm, 630).

While each has a different premise, the accepting nature of each of the aforementioned exercises is what ultimately makes them suitable treatments for those who suffer with Body Dysmorphic Disorder. It allows individuals to acknowledge, embrace, and better accept the discomfort of their disordered thinking. Instead of trying to challenge and correct dysfunctional thoughts, acceptance training teaches individuals to view these thoughts dispassionately. This is what allows the individual to place thoughts in their proper perspective: that they are just thoughts, not facts. In body scans and perceptual retraining, negative thoughts are allowed to enter the mind, but they are not given importance. Individuals are taught to accept their emotional distress, while simultaneously focusing on building new, positive, body image cognitions. It is the process of acknowledgement, acceptance, and ultimately fostering the ability to move past and create new thoughts that creates self-compassion in individuals with Body Dysmorphic Disorder. It is self-compassion that creates positive thoughts about one's appearance in the mind, which is something BDD individuals cannot experience without intervention. This introduction of self-compassionate thoughts, and the relinquishing of negative self-image thoughts that follows acceptance training is what makes it a positive treatment option for Body Dysmorphic Disorder individuals.

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