i have been debating with myself whether to post this, and since this thread came up again, i'll go ahead. the first part is clinical. the second half is personal. sorry - it is LONG...

Does anyone know anything about Body Dysmorphic Disorder (BDD)?
I just heard of it recently and looked it up and it sure sounds like me. And probly applies to many others here too.
There are lots more details available – but I’ll quote the parts that got my attention:

Common symptoms of BDD include:
• Obsessive thoughts about (a) perceived appearance defect(s).
• Obsessive and compulsive behaviors related to (a) perceived appearance defect(s) (see section below).
• Major depressive disorder symptoms.
• Delusional thoughts and beliefs related to (a) perceived appearance defect(s).
• Social and family withdrawal, social phobia, loneliness and self-imposed social isolation.
• Suicidal ideation.
• Anxiety; possible panic attacks.
• Chronic low self-esteem.
• Feeling self-conscious in social environments; thinking that others notice and mock their perceived defect(s).
• Strong feelings of shame.
• Avoidant personality: avoiding leaving the home or only leaving the home at certain times.
• Dependent personality: dependence on others, such as a partner, friend or family.
• Inability to work or an inability to focus at work due to preoccupation with appearance.
• Problems initiating and maintaining relationships (both intimate relationships and friendships).
• Alcohol and/or drug abuse (often an attempt to self-medicate).
• Repetitive behavior (such as constantly (and heavily) applying make-up; regularly checking appearance in mirrors; see section below for more associated behavior).
• Seeing slightly varying image of self upon each instance of observing a mirror or reflective surface.
• Perfectionism (undergoing cosmetic surgery and behaviors such as excessive moisturizing and exercising with the aim to achieve an ideal body type and reduce anxiety).
• Note: any kind of body modification may change one's appearance. There are many types of body modification that do not include surgery/cosmetic surgery. Body modification (or related behavior) may seem compulsive, repetitive, or focused on one or more areas or features that the individual perceives to be defective.

Compulsive behaviors
Common compulsive behaviors associated with BDD include:
• Compulsive mirror checking, glancing in reflective doors, windows and other reflective surfaces.
• Alternatively, inability to look at one's own reflection or photographs of oneself; also, removal of mirrors from the home.
• Attempting to camouflage the imagined defect: for example, using cosmetic camouflage, wearing baggy clothing, maintaining specific body posture or wearing hats.
• Use of distraction techniques to divert attention away from the person's perceived defect, e.g. wearing extravagant clothing or excessive jewelry.
• Excessive grooming behaviors: skin-picking, combing hair, plucking eyebrows, shaving, etc.
• Compulsive skin-touching, especially to measure or feel the perceived defect.
• Unmotivated hostility toward people, especially those of the opposite sex (or same sex if homosexual).
• Seeking reassurance from loved ones.
• Excessive dieting or exercising, working on outside appearance.
• Self-harm.
• Comparing appearance/body parts with that/those of others, or obsessive viewing of favorite celebrities or models whom the person suffering from BDD wishes to resemble.
• Compulsive information-seeking: reading books, newspaper articles and websites that relate to the person's perceived defect, e.g. losing hair or being overweight.
• Obsession with plastic surgery or dermatological procedures, often with little satisfactory results (in the perception of the patient). In extreme cases, patients have attempted to perform plastic surgery on themselves, including liposuction and various implants, with disastrous results.
• Excessive enema use (if obesity is the concern).

* * *

Teasing or criticism
It has been suggested that teasing or criticism regarding appearance could play a contributory role in the onset of BDD. While it is unlikely that teasing causes BDD, likewise, extreme levels of childhood abuse, bullying and psychological torture are often rationalized and dismissed as "teasing," sometimes leading to traumatic stress in vulnerable persons. Around 60% of people with BDD report frequent or chronic childhood teasing.

Parenting style
Similarly to teasing, parenting style may contribute to BDD onset; for example, parents who either place excessive emphasis on aesthetic appearance, or disregard it altogether, may act as a trigger in the genetically predisposed.

Other life experiences
Many other life experiences may also act as triggers to BDD onset; for example, neglect, physical and/or sexual trauma, insecurity and rejection.

* * *
Certain personality traits may make someone more susceptible to developing BDD. Personality traits which have been proposed as contributing factors include:
• Perfectionism
• Introversion / shyness
• Neuroticism
• Sensitivity to rejection or criticism
• Unassertiveness
• Avoidant personality
• Schizoid personality
• Shyness
• Social phobia
• Social anxiety disorder

* * *

That was from the Wiki article. It puts things in convenient bullet lists so it’s easier to read. Other sites say very similar things.

Nearly every point sounds like me – except for the cosmetics, medical procedures/surgery and enemas (the last because it was part of my abuse.) as I read through the descriptions it made a lot of sense to me.

When I was under 5, I never gave a thought to my body. It was just there and everything was fine. I was not self-conscious or embarrassed or even aware of my appearance or differences from others, as far as I can remember. After mom married the step-dad, that all changed. He made me shower with him. I was starting to be aware of a contrast and comparison. Especially in the genital area. And that was all too obvious because his were right at my eye level in the shower so the differences were hard for me to avoid. We helped “wash” each other… and the differences became more obvious. I started to feel embarrassment when I was naked. I didn’t like to be seen.

When I had just turned 11, my best friend pressured me to show & tell and he brought another friend. We were all amazed at the differences. They were both small and smooth. I was already (as I now know) adult in size and every other detail. They touched me and I got aroused. That was even more incredible to them. I misunderstood their reaction. They were impressed and envious but I thought that they were the normal ones and that I must be a freak. The differences between us were so dramatic that I felt absolutely sick. I was sure that there must be something terribly wrong with me to be deformed in this way.

By the next day, everyone at school knew about me and I was repeatedly beleaguered by many others with requests and demands to show them, too. I pulled into my shell and tried to avoid these confrontations – but was periodically forced to comply. I became an instant celebrity. I felt like an absolute abomination – a little boy with “huge” s*x organs (only slightly above average for an adult man.) everyone wanted to see me at the max size and would make me show it. and all the attention became very arousing to me. I did not disappoint my eager audiences – though I tried my best to prevent erections.

From that point on, I worried about my disproportionate abnormality. I would try to hide it any way I could – tight underwear, long shirt tails, holding or carrying things in front of me. I worried so much about getting erections that I got them even more frequently because I was always thinking about it.

That was in the spring of my 5th grade. So – I am convinced that I have the biggest one in town – and am mortally humiliated by that. Then comes 6th grade. I have PE in a class with boys my age as well as some older ones. And one of them is older by far – has repeated at least one grade and is big for his age as well. So he must have been about 15 – and also an early bloomer – but he is big all over – a real muscle-man. I was forced to compare myself with him. And he is bigger soft than I am hard. And suddenly I feel tiny and insignificant again – like when I was first exposed to the step-dad.

Now I am incredibly confused. Am I a gigantic freak – or am I a miniscule freak? For some reason, my brain cannot conceive of the possibility that there is any middle ground.

Starting then, I have had a compulsion to compare myself with any other male that I can catch a glimpse of. And nothing seems to be able to reassure me that I am normal. I have researched all the studies and statistics. I have looked at thousands of photos – both clinical and p*rn. I have observed in real life whenever I had the chance (feels really creepy to confess that) – and nothing seems to let me stop worrying about it. I feel compelled to know if I am bigger or smaller than every other guy I see. And I flip back and forth between feeling too big and too small. Even though I know I am just fine – within the usually quoted normal figures – definitely not at one extreme or the other.

I wrote this a couple of months ago. Now I have made peace with myself. I am content just as I am.


Edited by traveler (12/03/12 07:08 PM)
As my life goes on I believe somehow something's changed
Something deep inside...
I've been searchin so long to find an answer
Now I know my life has meaning
Now I see myself as I am, feeling very free...
When my tears have come to an end I will understand
What I left behind: a part of me. Chicago