Symptoms

Mirror Gazing

Mirror Gazing is the most common behaviour related to BDD.

Veale and Riley (2001) suggest the motivations for mirror gazing are:

• Hope that they will look different
• Desire to know exactly how they look
• Reassurance that efforts to camouflage have worked
• Belief that they will feel worse if they resist

Commonly sufferer's experience anxiety before looking in the mirror.  When they do look they often feel disgust at their image, resulting in a depressive mood.

The time spent in front of a mirror varies.  Prolonged sessions may result in a trance like state during which time is lost and the sufferer has no recollection of it passing.

After looking in the mirror sufferer's often feel anger or/and guilt.  This may be due to the time wasted or their efforts to look better failing or making them look worse.

Do's and Don'ts of mirror use (Veale 2001)

Do:

• Use mirrors at a slight distance
• Use mirrors large enough to show most of the body
• Focus attention on the reflection rather than how you feel
• Use a mirror only for a set purpose (e.g. shaving, putting on make-up) and limited period of time
• Use a variety of different mirrors and lights rather than sticking to the one that you ‘trust'

Do not:

• Use mirrors that magnify
• Use ambiguous reflections (e.g. windows, the back of compact discs)
• Use a mirror when you feel depressed
  

Research has suggested that 87% of people with BDD repeatedly check their appearance in mirrors or reflective surfaces (Phillips).


Compulsive Skin Picking (CSP)

Also known as neurotic excoriation, dermatillomania, pathological skin picking.

Compulsive skin picking is the repetitive picking at ones own skin resulting in actual bodily damage, lesions and scarring, and can be a symptom of BDD. Compulsive skin picking in itself does not indicate a diagnosis of BDD, however if the motivation to pick the skin is to improve the appearance eg. flattening bumps so the skin feels smooth or trying to remove imperfections, then the likelihood is that BDD is present.

Compulsive Skin Picking is common in Body Dysmorphic Disorder amongst sufferers with a preoccupation with their skin. The anxiety experienced as a result of the sufferer thinking his/her skin is wrong/bad/disgusting can result in an episode of skin picking, which they hope will make them look better.  Individuals with BDD and Compulsive Skin Picking can become locked into a cycle.

 

As well as fingernails, implements such as pins, tweezers, knives and razors may be used.  Sufferers are left with wounds and scarring which results in the need to camouflage their appearance even more, and in some cases to take time out of school/work. The physical damage can be extensive and require medical intervention.  In one case a woman exposed her carotid artery after an episode of picking at the skin on her neck.

Research has suggested that up to 38% of people with BDD pick their skin to improve it's appearance (Phillips).