Body dysmorphic disorder – Wikipedia, the free encyclopedia
Obsessive thoughts and compulsion play a common role in day-to-day life. But for the obsessive-compulsive individual, obsessions have a persistent impairing capacity to hit panic buttons, bringing alarming thoughts to the forefront and demand for these thoughts to be considered as true. Obsessions that occupy the mind still leave some room to function with some measure of normalcy; however, certain obsessions such as imagined defects on the victim’s physical appearance demand attention and compulsive actions to be assuaged.
Because this disorder exploits the victim’s own concerns, it cripples her by essentially causing self-destruction. Fixed around an obsession, this condition often leaves the victim feeling out of control, causing the anxiety that earns BDD’s classification as an Anxiety Disorder. It could very well be classified as a type of Obsessive Compulsive Disorder.
Compulsions manifest as response to obsessions: a thought or often a simple sense that an act must be performed. Compulsions dehumanize a person due to the pointless repetition and humiliating characteristics they posses. Because of the physical time and space required to perform these compulsions, obsessive-compulsives have severely restricted lives. Their compulsions take away the time and energy to interact with the world outside. When a thought that begins as an expression of common sense, or merely on a curious whim takes on a pathological need to be fulfilled, the victim develops a sense of helplessness. She no longer functions to please herself, but to satisfy the thoughts that constantly harass, often to her own detriment. To the unsympathetic observer, it seems that only a weak pathetic vain self-absorbed shallow individual would fall prey to BDD.
To further the victim’s frustration, BDD behaves like a ghost, like a thief in the night that comes and goes as it pleases, in that its causes are elusive and indefinite. Mirror-checking compulsions seem to develop in response to particular parents. Obsessions with physical defects on the victim’s face and body also seem to develop from a sense of accountability, with the victim feeling as if her imagined defects are an inconvenience to society. To this day, the factors that make BDD so remain a mystery. The compulsive brain shows irregularities in serotonin levels that account for the high levels of anxiety, but factors that affect BDD go beyond the parameters of socio-cultural and biological factors.
Obsessions of body dysmorphia fall into two categories. First, there are obsessive thoughts that cannot be escaped or settled; second, obsessive thoughts that revolve around a specific fear which usually leads to a compulsion. This second kind of obsession appeals to a more pragmatic sense and ordinarily begins with a rational concern. It becomes compulsive and distressing when taken out of context.
Compulsions of BDD generally manifest as checking or in motion rituals: compulsive mirror checking, glancing in reflective surfaces; an inability to look at one’s own reflection or photographs of oneself; often the removal of mirrors from home; compulsive skin-touching to measure or feel the perceived defect; social withdrawal and co-morbid depression; obsessive viewing of celebrities or models the person suffering from BDD may wish to resemble; excessive grooming behaviors: combing hair, plucking, shaving, etc.
Motion rituals have no basis in reality; they are the hardest to explain. They involve a set of exaggerated physical motions that must be performed an nth number of times, or until the ritual has been performed “just right”.
When rituals such as the simple act of checking one’s reflection in a mirror grow to big extents, they require a certain precision and dedication to perform them until the victim feels “right” in her body. This sense of completion is vague and hard to define. For the ritual-compulsive, each simple act has a set of pre-requisites that must be met or a sickening sense of incompletion and lack of closure will plague her.
BDD then takes an almost schizophrenic quality. The victim is at war with herself, self-destructing. Trapped in her house, performing rituals that she cannot control and do not enjoy, the compulsive-dysmorphic suffers a duality that other people do not experience. Resenting thoughts of hatred towards her own face and her body, resenting her actions, and yet obliged to perform them, her own mind seems to have turned on her.