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HOW DO I KNOW IF I HAVE BDD? CONCERNS
While people with BDD are concerned with, on average, about five different body parts over time, some are preoccupied with virtually every body area. Sometimes concerns with different body areas are present simultaneously, and sometimes sequentially. I’ve identified three common patterns:
1. About 30% are concerned with one body part,.?or one set of body parts?over time. One man was concerned with his receding chin and never developed another concern. Another became concerned simultaneously with his “sunken” eyes and “swollen” nipples; he remained concerned only with these two things, without developing new concerns.
2. About 40% are concerned with one body part and then add new parts over time, with continuation of their previous concerns. At age 13, Ted worried that his ears stuck out, then at 18 he also became concerned with his crooked lip, and at age 25 he started to worry about a scar on his neck. At 25, he had all three concerns.
3. The third pattern is more complex, and occurs in about 30%. Over time, concerns with one or more body parts disappear and other concerns emerge. Jane, whom I described in chapter 3, fit this pattern. She first worried about her nose and then a scar on her lip. Later, she became preoccupied with her jaw, breasts, and buttocks, but stopped worrying about her buttocks. One concern can begin when another ends. One man stated after nose surgery that his nose looked more acceptable, but his “stomach took over for (his) nose.”
While some people with BDD want to be unusually attractive or look “perfect” overall, in my experience most don’t?they simply want to look normal. They might not mind looking like Elvis Presley or Marilyn Monroe, but this isn’t what they’re obsessed with. What they’re obsessed with is getting rid of the perceived defect and looking normal. They want to no longer look like the Elephant Man; they want to no longer stand out in a crowd. They say things like, “I don’t want to look tanned like George Hamilton; I just want to look not pale.” “Being average looking is okay. My goal is to be acceptable.” As one man said, “I don’t care whether I’m attractive. I just want to look normal. I wouldn’t mind looking like Beetle Bailey; I just don’t want things on my face.”
People with BDD describe their perceived appearance problem in various ways. They may say that the defect, or their appearance more generally, is ugly, unattractive or abnormal. Or they may say that it looks defective, flawed, wrong, odd, not right, or off. Some people use words like “deformed,” “monstrous” or “hideous.” They describe themselves as the Elephant Man or the wife of Frankenstein. One man said he looked like a cartoon character, and a woman said that she resembled a distorted figure from a Salvador Dali painting.
For simplicity’s sake, I’ll generally use the term “defect” or “flaw” to refer to these various appearance concerns. I’ll also use this term to refer to more than one concern and to more general excessive concerns with appearance that aren’t so easily pinpointed or confined to a specific body part or parts.
*44/204/8*

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