Dr. Garcia Graullera is a prestigious psychologist from Madrid who directs the Center for Applied Scientific Psychology (PSICIA). She specializes in: anxiety, agoraphobia, social phobia, couple therapy and obsessive-compulsive disorder.
What is body dysmorphic disorder?
Body dysmorphic disorder, formerly called dysmorphophobia, consists of an exaggerated and obsessive preoccupation with an imaginary physical defect or one that is so slight and subtle that it is sometimes imperceptible to others. Normally the features that the person complains about or obsesses about are usually focused on the face, usually the eyes, mouth, nose, ears or facial features, such as asymmetries, spots, moles, wrinkles. Sometimes it is also focused on the hair, on the receding hairline, on incipient baldness; the person sees him/herself as ugly, defective and a kind of imaginary ugliness. The person lives with a lot of anguish, a lot of anxiety and their personal and social life is quite limited.
What are the most common symptoms or signs?
There are a series of very common symptoms and signs in people who have this disorder. One of them is negative self-talk. They talk with utter contempt about their physical appearance. They also spend many hours in front of the mirror analyzing their defect, their face, their face, sometimes they even have to measure daily if they have the spot that they can see themselves bigger or smaller. And they continually talk about it with their closest relatives. With strangers they try to dissimulate, but with their close environment it becomes monothematic. They also try to camouflage themselves a lot, with clothes, glasses, hats, makeup. They avoid situations where they have to expose themselves in public, such as swimming pools, beaches, gyms. They go a lot to dermatologists, to medical treatments, plastic surgeons and they are never satisfied, they always look bad and they can do whatever they want, but they are going to look worse and worse. In fact, there are already autonomous communities where psychological reports are being requested for adolescents before they undergo an intervention of this type.
What complications can this disorder have?
This disorder usually begins in adolescence and when the person comes for consultation usually already has several associated disorders. The most common are depression, anxiety, social phobia, abuse of alcohol and other substances to try to disinhibit themselves, and even suicidal thoughts.
What is the prognosis and the most effective treatment for this disorder?
As it is a disorder with little awareness of the disease, when the person comes for consultation there is usually a very significant deterioration. Here it is essential that the person goes to a specialist who is accustomed to treat this type of disorders. The therapy of choice is cognitive behavioral therapy, often combined with drugs such as antidepressants, serotonin reuptake inhibitors. In the treatment the patient will be taught to understand the disorder and its characteristics. To make a cognitive restructuring to have more adaptive cognitive thoughts and to expose gradually to situations that can generate anxiety. Here it is essential that the diagnosis and treatment be initiated as soon as possible. The earlier the diagnosis, the better the evolution and prognosis.