BDD Therapy: Advocating for Change
Guest Post By BDD Therapist Jem Gunn
Body Dysmorphic Disorder (BDD) is a silent thief.
BDD steals time, relationships, and joy. It whispers that you are defective, unworthy, and grotesque. BDD isolates people, convincing them that if they could just fix their appearance, life would finally begin.
I know this thief intimately. I am a BDD Clinical Supervisor, Integrative Psychotherapist, and a person with BDD who has walked this path myself.
For decades, I was trapped in the relentless loop of self-scrutiny, ritualistic checking, comparison, and avoidance. BDD dictated my existence, where I went, and who was allowed to see me. It took years to understand that my appearance was never the problem. The real problem stemmed from the deep emotional wounds that shaped my beliefs about myself.
Today, as a professional speaker and advocate, I work tirelessly to shift the conversation around BDD. I help sufferers and clinicians understand that BDD is more than a preoccupation with appearance. It is a disorder deeply rooted in trauma, rejection, and unmet emotional needs. My mission is to raise awareness about BDD and to champion more integrative, compassionate, and effective approaches to treatment.
BDD: Dispelling the Myths
One of the most damaging misconceptions about BDD is that it’s about vanity or low self-esteem. It is neither. BDD is an obsessive-compulsive disorder that hijacks the mind, distorting perception, and driving compulsive behaviours. The media often portrays BDD as an extreme form of insecurity but the reality is much darker. The distress is all-consuming. The self-hatred is profound, and in severe cases, the disorder can be life-threatening.
For me, BDD started in adolescence, but the seeds were planted long before. I was raised in an environment where my appearance was constantly scrutinized. I was humiliated and criticized for my looks. As a result, my mind internalized the belief that I was fundamentally flawed. The constant criticism led me to the unshakable feeling that my self-worth was conditional on how I looked.
BDD: A Life Under the Microscope
By my teenage years, I was already deeply entrenched in disordered behaviours. I avoided social events and was obsessed with social comparison, reassurance seeking, mirror checking, and calorie restriction. My thoughts revolved around the ‘defects’ I saw in myself. I feared that others would see what I saw: someone who was ugly and unworthy of love.
BDD is not just a disorder of perception. BDD is a disorder of existence. I wasn’t just afraid of looking unattractive. I was afraid of being unacceptable, of being rejected. Every reflection, every photograph, every social interaction felt like a test I was destined to fail. And fail I did, in my own mind, over and over again.
Healing: The Journey Back to Myself
It took me years to unravel the roots of my BDD. Therapy, particularly Transactional Analysis (TA) psychotherapy, helped me understand my mind’s unconscious scripts. The ‘Be Strong’ driver, ingrained from childhood, kept me locked in silence, unwilling to reach out for help.
The British stoicism I was raised with told me to endure, not to complain. The institutional upbringing before ‘mental health’ was an accepted concept meant that my struggles were ignored, dismissed as ‘hypochondria’ or ‘attention-seeking.’
But as I worked through my trauma, I began to see that my self-loathing was never really about my appearance. It was about the deeper wounds of abandonment, of feeling unseen, and being unwanted. BDD was simply the manifestation of that pain.
Beyond CBT: A More Holistic Approach to BDD Treatment
The current treatment model for BDD, primarily rooted in Cognitive Behavioural Therapy (CBT), is helpful, but it is not enough. CBT targets the symptoms: the obsessive thoughts and the compulsive behaviours. However, it often fails to address the underlying trauma that fuels BDD in the first place.
I integrate Transactional Analysis and Coaching, alongside CBT, to create a more comprehensive treatment approach. I developed the BDD D.E.F.E.N.C.E. Strategy™, an integrative model that goes beyond symptom management and delves into the emotional, relational, and neurobiological aspects of BDD. My approach acknowledges that BDD is not simply an issue of body image. BDD stems from deep-seated emotional pain that requires a more nuanced and compassionate approach.
Advocating for Change: Why I Speak Out
BDD remains one of the most misunderstood and underdiagnosed mental health conditions. Too often, sufferers are dismissed, misdiagnosed, or told they are just insecure. Even among mental health professionals, there is a gap in understanding BDD’s complexity.
This is why I advocate. This is why I speak out. I am committed to raising awareness and changing the narrative around BDD. I want clinicians to be better equipped to recognize and treat BDD. I want sufferers to know they are not alone, that their pain is real, and that recovery is possible.
A Message to Those Struggling with BDD
If you are reading this and you are in the depths of BDD, please know this: You are not broken. You do not need to ‘fix’ yourself to be worthy of love and belonging. The lies that BDD tells you are not truths. You are not alone in this, and there is hope.
Recovery is not linear, and it is not easy, but it is possible. It requires courage, support, and the willingness to challenge the deeply ingrained beliefs that keep you trapped. It requires a shift from ‘fixing’ to healing, from shame to self-compassion.
I am here to provide a safe space for healing and to push for better treatment and understanding of BDD. If you are a clinician, I urge you to educate yourself beyond the basics of CBT. If you are a sufferer, I urge you to reach out, to find the support you deserve.
BDD stole years of my life, but I refuse to let it steal my voice. And neither should you. For therapy, professional training, or media inquiries, please visit my website. Let’s disrupt the perception together.
