Cognitive Behavioral Therapy for Body Dysmorphic Disorder
Body dysmorphic disorder (BDD) is characterized by an excessive preoccupation with a perceived defect(s) or flaw(s) that is not observable or appears slight to others. BDD is a severe and common disorder associated with high levels of functional impairment and high rates of suicidality. Cognitive behavioral therapy (CBT) is the most studied and empirically supported psychosocial intervention for BDD. CBT for BDD consists of psychoeducation about BDD, cognitive restructuring of maladaptive appearance related thoughts, and exposure and response and ritual prevention for feared and avoided situations. Additional therapeutic techniques include mindfulness/perceptual retraining and motivational interviewing. Flexible modules aimed at addressing common co occurring concerns in BDD (e.g. skin picking/hair plucking, depression, surgery seeking) allow clinicians to further individualize the treatment. This chapter outlines the cognitive behavioral model and therapy of BDD and illustrates use of the treatment using a case example.