Dysmorphophobia, i.e. the fear of ugliness. How to treat dysmorphophobia?

None of us are perfect. We have our own complexes and shortcomings that we would like to improve. Some try to change it and start exercising, others use the help of a plastic surgeon. There are also those who see even the slightest flaws as a huge problem that often deprives them of their will to live and closes them at home. The latter suffer from the so-called dysmorphophobia. What is this?

  1. Dysmorphophobia is a disorder in which there is an exaggerated preoccupation with non-existent or very slight body defects such as scarring or acne
  2. People with this disorder constantly search for new “flaws” that need improvement
  3. Before they go to the right specialist, they try to heal their complexes at a plastic surgeon or beautician

Kasia is 20 years old. Lives in Warsaw. Works in a call center. She is meticulous and hardworking. Friends see her as warm and friendly. And they unanimously admit that such a girl is wasted here because she has knowledge and talent and could go far in life. But Kasia doesn’t want another job. She also doesn’t want to go to college. It claims to have reached its peak.

She is one of those women who, while attractive, avoid men. Compliments seem to embarrass her. She is single. Social life is kept to a minimum. He likes spending his time at home with a book.

She is just like that

– As a child, she was also like that – remembers Kasia’s mother. “She has always had avoidant personality traits,” she adds. At least that was what the psychologist whom the girl found her way to as a teenager claimed. Parents were caring, you could even say overprotective. Kasia always believed that she did not meet their expectations.

Finally, after many sessions with a psychologist, Kasia was diagnosed with social phobia because the girl had problems with her peers and sometimes refused to go to school.

When asked about the reason, she finally admitted that she was ashamed to be among her peers. Reason? She felt worse.

The mother watched the increasing symptoms: first Kasia refused to wear skirts, then, even in summer, she walked all covered and made sure that no one saw even a fragment of her naked body.

In the end, she came to a psychiatrist who found out that Kasia was hiding an ugly body from those around her. Kasia claimed her skin was wrinkled, had nasty scabs, stains, and looked disgusting.

A specialist diagnosed a delusional disorder. He prescribed medications. He assured that there would be an improvement. But pharmacological treatment did not change Kasia’s attitude towards her body. After a few weeks, she stopped taking the medications. She felt even worse.

Finally, her mother took Kasia to a dermatologist so that he could objectively assess the condition of her skin. The specialist found only a few acne lesions. The girl did not believe it. She felt everyone was lying to her.

The mother, seeing that the drugs would not help her daughter, encouraged her to visit a beautician. Kasia agreed, though reluctantly. First, she went every two weeks, then every 7 days, until finally she could not imagine a day without body peeling and other treatments that were offered to her. One day, the beautician pointed out to her that she was coming too often. She claimed that there was no need to perform body treatments with this frequency. Kasia felt that no one understood her. She didn’t go there any more.

I don’t like my body

On the same day, she came to the aesthetic medicine clinic. There, she was offered a number of procedures, including laser therapy, mesotherapy, and hyaluronic acid treatments. Kasia kept saying that her skin is flabby and looks old. And she demanded more treatments. In the end, the dermatologist objected. He said she was young and pretty and “nothing else can improve her appearance.” Then Kasia found another office, and then another. Each time she told me how wrinkled her skin was and how terrible the changes she had on it. Again, she was entrusted with a series of treatments that Kasia meticulously undergoes. It lasted for several years.

When she was refused any surgery, Kasia claimed that her skin was disfigured and that the specialists were unwilling or unable to help her.

In the end, she decided that no matter what she did, she would remain ugly and repulsive. She shut herself up. No boyfriend, no friends either. She didn’t let anyone get close enough. He believes that people either take pity on her or laugh at her ugliness.

– One day Kasia was acting even stranger. She put on a cap and would not take it off, even at home, her mother recalls. The reason was, she claimed, her large and protruding ears.

Kasia cried for hours in front of the mirror and asked herself: “How did it happen that I had not seen it before?”.

Eventually, the girl went to a plastic surgeon and asked what she could do about it. But before the decision about the procedure was made, before Kasia did all the necessary tests, another problem appeared – teeth.

Kasia locked herself in the room. She didn’t want to talk to anyone. She cried that she had “horse teeth”, remembers her mother, who felt more and more helpless. She told her daughter many times that she was pretty, but that always ended in crying. – Kasia said that I was pity or mocking – complains mother.

Eventually, the mother, observing what was happening with her daughter, forced her to contact the psychiatrist again. This time there was no mention of social phobia or delusional disorders. The doctor looked at Kasia and said: You suffer from dysmorphophobia. And although Kasia expressed a strong belief that “she has a problem with her body, not with her head,” she agreed to another treatment, seeing no hope in him. A decision was made to hospitalize. During the 6 weeks of Kasia’s stay in the hospital, she was administered medications. Twice a week she had psychotherapy sessions. When the girl was released home, she felt quite well. She was in a better mood, she was calmer, she did not feel the need to constantly cover her whole body. However, she still found her ugly and repulsive and did not deserve love and happiness. The doctor decided that this belief should subside over time. Continuation of pharmacotherapy and further psychotherapy were recommended. Currently, Kasia is undergoing treatment. She is in good shape, but still feels unattractive.

What is dysmorphophobia?

Dysmorphophobia is a disorder in which there is an exaggerated preoccupation with a nonexistent or very slight body defect such as scarring or acne. Dysmorphophobia is also defined as fear of ugliness or beauty hypochondria. This problem affects 0,7-2 percent. of the population, most often adolescents and young adults. Patients are convinced that the deformities of the body are serious indeed, and their assessments and fears are justified. It takes them several hours a day to think about it (average 3–8) and is obsessive. A person with dysmorphophobia often cannot imagine a normal life and believes that he does not deserve anything good in life. People struggling with this disorder most often consider themselves extremely ugly, nasty, claim that the environment laughs at them or pities them. While their imaginary “defect” is unnoticeable to others.

People with dysmorphophobia often seek help from various specialists or undergo numerous beauty treatments. At the same time, they avoid their surroundings, have significantly reduced self-esteem, and often withdraw from various social roles. Dysmorphophobia can also be associated with depression and drug disorders. Well-chosen pharmacotherapy combined with psychotherapy is usually effective. The most difficult thing is to make a diagnosis, because patients can go from doctor to doctor for years. Usually, like Kasia, they hear that they suffer from social phobia or delusional disorders. The time to diagnosis by a physician is generally long, because the disorder has a clinical picture similar to that of many other disease entities.

When to suspect that you are affected by this problem?

  1. If you feel ugly, although the surroundings do not share your opinion. If you feel that others look at you with disgust, they cannot stand your appearance,
  2. If no doctor sees your defect,
  3. If treatments or other forms of improving the appearance are not effective,
  4. If you feel that you don’t deserve love and happiness because of a beauty defect,
  5. If you avoid contact with others because you feel that everyone sees your ugliness,
  6. If you look in the mirror for hours and try to hide your defect,
  7. If you neglect important aspects of everyday functioning because of your appearance.
  8. If you answered yes to the above questions, contact a psychologist or psychiatrist. Perhaps you also suffer from dysmorphophobia.

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