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by Dr. Ryan Kaplan

Often when people with BDD first come to see me for treatment, they describe their struggles with their appearance and how they hate what they see when they look in the mirror. They talk about feelings of disgust, anxiety, and shame about their appearance, and a deep desire to one day look in the mirror and see a reflection that inspires the opposite — beauty, euphoria, love.

In BDD, as with other obsessive-compulsive conditions, there are the thoughts, feelings, and perceptions, and then there are the behaviors. As most people with BDD would relate to, this deep desire to think about and perceive one’s body or appearance differently — to experience love for one’s body or appearance — often translates into coping rituals of checking; mirror-gazing; reassurance-seeking; self-comparisons; researching; undergoing cosmetic surgeries; applying and checking makeup; and other behaviors or activities that really characterize BDD. 

What’s more is that together, these very negative appearance-related thoughts, feelings, and perceptions and the BDD coping rituals make for a pretty difficult time. They can become all-consuming, taking up a lot of time and getting in the way of doing other things — things like socialising with friends; dating and pursuing romantic relationships; studying at school or university; getting a job or doing a job well; going to parties; engaging in hobbies, sports, and other activities; and lots more.

What I often hear from people with BDD at the start of treatment is that they would like to do all of those things, to enjoy life, but they feel unable to until and unless they can somehow either “fix” their appearance or see something very different when they look in the mirror. “Once I love how I look, then, and only then, can I start to do all the things I really want to do.”

People with BDD are often at war with their bodies, their appearances. And it’s not uncommon for a person with BDD to seek treatment with the goal of being able to “make love, not war” — to somehow feel love for their appearance so the war will finally end.

Don’t get me wrong, this is a fine goal to have. Why shouldn’t we want to love our appearance? In fact, with commitment to treatment, someone with BDD may get to a place of loving their body. This is not unheard of. But the truth is that, no matter the context, there is a lot of distance between war and love.

The late acclaimed Israeli author Amos Oz used to say that the mantra “make love, not war,” is a beautiful but often fanciful idea. It’s quite rare that two warring entities will go from animosity to amorousness just like that. “Make peace, not love,” he would say, is a much more realistic and pragmatic principle. Love might come later, but peace is a much more attainable first step.

I think this idea is really relevant for people with BDD. Making peace with one’s flaws, perceived or actual, doesn’t require love. It doesn’t even require “like”! One doesn’t have to love one’s appearance or even like it in order to make peace with it. But it does allow a shift of focus from one in which life can only start after the war is won, to one which is more about getting on with life, and focusing on other more important things, even though the hostile feelings towards one’s appearance might still be there.

If you are someone with BDD and are at war with your looks, I encourage you to seek out an experienced therapist with whom you can work to make peace, so that you can reclaim your life and start to enjoy things once again.

Dr. Ryan Kaplan is the director of Be Psychology & Mental Health and the Sydney Body Dysmorphic Disorder & Body Image Clinic in Sydney, Australia

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