Anxiety and mood
Body dysmorphia
Body-image disturbance and the compulsions built around it: mirrors, comparisons, reassurance-seeking, and avoidance.
How I see this presentation
Body dysmorphic disorder (BDD) is a clinical area I trained in during my time at the Maudsley NHS eating-disorders unit. The presentation is most often invisible to anyone outside it: rituals around mirrors, photographs, comparisons, reassurance-seeking, and avoidance of social situations. The thing you see in the mirror that no one else seems to notice can become the organising fact of a day. People typically arrive having lived with it privately for years.
How I tend to work with it
The evidence-based lead for BDD is Cognitive Behavioural Therapy with exposure and response prevention (ERP), adapted to body-image disturbance. The early work is formulation: mapping how the appearance preoccupations and the rituals are maintaining each other for you. The exposure work is then introduced collaboratively, with hierarchies agreed in advance and paced as the work progresses.
What a course might look like
Sessions are 50 minutes, online, typically weekly. A defined course often falls between twelve and twenty sessions, though this is not a fixed rule.
Next step
If what you have read here fits what you are experiencing, please get in touch.
When you're ready
Book your first session with Henry.
You don't need to know what you want from therapy before you book. The first session is for getting that clear.