The Broken Mirror Understanding and Treating Body Dysmorphic Disorder

by Phillips, Katharine A.

• ISBN13: 9780195167191
• ISBN10: 0195167198
• Edition: 1st
• Format: Paperback
• Copyright: 2005-06-02
• Publisher: Oxford University Press
• More Book Details
• Purchase Benefits

Summary

Dr. Phillips draws on years of clinical practice, scientific research, and professional evaluations of over 700 patients to bring readers her expertise and experience with body dysmorphic disorder, or BDD.

Author Biography

Katharine A. Phillips is RI Director of the Body Dysmorphic Disorder and Body Image Program at Butler Hospital in Providence, Rhode Island, and Professor of Psychiatry and Human Behavior at Brown University School of Medicine.

Table of Contents

Acknowledgments	ix
Why I'm Updating This Book	xi
Why BDD Matters	3	(4)
Patients Speak	7	(14)
Jennifer's Story
Chris's, Keith's, and Andrew's Stories
BDD from the Past and Around the World
``No One Takes Me Seriously'': Letters from BDD Sufferers and Their Families
Hope for People with BDD
What Is Body Dysmorphic Disorder?	21	(16)
``My Problem Isn't Very Severe'': Do I Even Have Body Dysmorphic Disorder?
A Spectrum of Severity: From Mild to Life-Threatening
How Is BDD Defined?
``A Sign on the Road''
``My Biggest Wish Is to Be Invisible''
How Do I Know If I Have BDD?	37	(14)
BDD Is Common but Underdiagnosed
Why BDD Is Underdiagnosed
Screening Questions for BDD
Clues: Mirror Checking, Grooming, Skin Picking, and Others
Additional Clues: Depression, Social Anxiety, and Other Symptoms
How to Avoid Misdiagnosing BDD
BDD Comes in Many Forms	51	(18)
Overview of Body Parts and Behaviors
Which Body Parts Are Disliked?
``My Face Is Falling''
``I Hate Everything About My Looks!''
``I Look Like a Gorilla'' ``I'm Not Feminine Enough''
Fear of the Future: ``Soon I'll Be Totally Bald!''
``My Face Is Asymmetrical''
``I'm Not Big Enough''
``I Look Depressed''
``My Fingers Are Getting Shorter''
``I'm Afraid My Nose Will Break!''
``The Walking Concept Was Erased''
``I'm Shrinking Because I Have Cancer''
``My Daughter's Ugly!''
``I Feel More Air Where My Hair Used to Be''
``I'm Just One Big Pimple. . . .''
Painful Obessions	69	(14)
``I Can't Get It Out of My Mind''
``It's Like an Arrow through My Heart''
``Everyone Is Staring at Me!''
``Different Degrees of Certainty''
Mirror Checking, Grooming, Camouflaging, Dieting, and Other BDD Behaviors	83	(32)
``I Have This Ritual Every Morning''
Compulsive Behaviors: ``I Can't Resist''
The Mirror Trap
Grooming: Cutting, Combing, Teasing, Tweezing, and Washing
The Batman Mask and Other Forms of Camouflage
Buying Beauty Products and Clothes: ``I Have to Find Something That Works!''
Clothes Changing
Skin Picking: ``I Can't Stop Destroying My Looks''
Reassurance Seeking: ``Do I Look Okay?''
Comparing: ``She Looks Better Than I Do!''
Doctor Shopping: The Never-Ending Quest
Dieting
Weight Lifting, Aerobics, and Other Forms of Exercise
Tanning
Distraction Techniques
Measuring
Reading and Information Seeking
Touching
Other Behaviors: Handwashing, Praying, and Doorknob Touching
How BDD Affects Lives: Social Avoidance, Problems at Work, and Suicide	115	(26)
Ian's Experience: ``It's Ruined My Life''
Carl's Experience: ``I Pull Myself Together''
Social Consequences: ``I Stay Alone''
Effects on School and Work: ``I Haven't Met My Potential''
Other Problems: Shopping, Bright Lights, and Leisure Activities
Being Housebound
Low Self-Esteem, Depression, Anxiety, and Panic Attacks
Poor Quality of Life
Unnecessary Medical Evaluation and Treatment
Self-Surgery
Bodily Damage
Alcohol and Drug Use
Accidents
Violence and Illegal Activities
Hospitalization
The Cost of BDD
Suicide: The Most Devastating Consequence of All
Gender and BDD Across the Life Span	141	(16)
BDD and Gender
BDD Across the Life Span
BDD in Children and Adolescents
BDD in the Elderly
What Causes BDD? Clues to an Unsolved Puzzle	157	(30)
Patients' Perspectives
Theories About BDD's Cause
Genetic/Neurobiological Theories: Is BDD a Brain Disease?
Psychological Theories: Is BDD a Mind Disease?
Sociocultural Theories: Mega-Makeovers and Perfect Thighs
Triggers: Comments, Stress, and Other Possible Precipitants
What Doesn't Cause BDD
What Makes BDD Better or Worse
Concluding Thoughts
Aren't We All Concerned with How We Look? BDD, Body Image, and Normal Appearance Concerns	187	(16)
We'd All Like to Look Better
How to Differentiate BDD from Normal Appearance Concerns
What Is Body Image?
Body Image in BDD
Getting Better: A Treatment Guide	203	(12)
Patients' Responses to Treatment
Overcoming Barriers to Treatment: The Critical First Steps to Success
Key Points About Recommended Treatments
How to Successfully Treat BDD with Medication	215	(34)
Serotonin Reuptake Inhibitors (SRIs): First-Line Medications for BDD
What's the Evidence That SRIs Work?
What Gets Better with an SRI?
How to Treat BDD with an SRI
What if an SRI Doesn't Work Well Enough?
Medications That Don't Appear to Work for BDD
ECT, Neurosurgery, and Other Treatments
A Suggested Approach to Treating BDD with Medications: A Proposed Algorithm
Needed Treatment Research
Cognitive-Behavioral Therapy for BDD	249	(50)
An Overview of Cognitive-Behavioral Therapy (CBT)
More CBT Basics
What's the Evidence That CBT Works?
What Gets Better with CBT?
Rationale for Using CBT for BDD
Doing CBT for BDD
What You Can Try if CBT Doesn't Work
Needed Therapy Research
Therapies That May Be Useful When Combined with an SRI or CBT
Treatments That Don't Work	299	(12)
Sophie's, Jack's, and Kate's Experience
How Many People Get Surgery, Dermatologic Treatment, and Other Nonpsychiatric Treatment for BDD?
Do These Treatments Work?
Other Ineffective Treatments for BDD
Anorexia Nervosa, Obsessive Compulsive Disorder, Koro, and Other Disorders---Are They Relatives of BDD?	311	(24)
BDD Symptom or Illness?
Obessive Compulsive Disorder: Obsessional Worries and Compulsive Behaviors
Social Phobia: Social Anxiety, Embarrassment, and Avoidance
Eating Disorders: Distorted Body Image and Problematic Eating Behavior
Depression
Hypochondriasis: Bodily Preoccupation and Illness Fears Schizophrenia
Olfactory Reference Syndrome: The Distress of Perceived Body Odor
Koro: Panic over Penile Shrinkage
The Delusional Variant of BDD
BDD and Personality
Concluding Thoughts
For Family Members and Friends	335	(18)
What You Can Do: An Overview
``The Selfish Disease'': A Husband's Perspective ``I Knew Something Was Wrong with My Daughter'': A Parent's Perspective
Suggested Guidelines for Family Members and Friends
Getting Help for BDD	353	(14)
Finding Treatment
Additional Reading on BDD
Concluding Thoughts
Appendixes	367	(26)
A. Demographic Characteristics of People with BDD
B. Brief Description of Selected Psychiatric Disorders
C. Instruments (Scales) for Assessing BDD
D. Co-occurrence of BDD and Other Disorders
Glossary	393	(8)
Index	401