Dysmorphophobia

I decided to dedicate this short article to dysmorphophobia because I think that our contemporary life and society, both imbued with narcissism, often tend to make us underestimate this type of problem, which is increasingly frequent.

A problematic or, more often, a pathological relationship with one’s corporeity must be identified promptly, especially among the very young and, where possible, it must be treated in the best way and the treatment should be tailored to our patient’s needs.

Dysmorphophobia: definitions

Dysmorphophobia (or body dysmorphic disorder) is an excessive concern about one’s physical appearance.
An individual perceive a specific physical aspect as unpleasant or very disturbing: sometimes they are small defects – almost imperceptible – in other cases the “ugliness” is rather a subjective perception of the patient than real problem confirmed by other people.

The so-called physical “defect” (which can, at times, simply be a peculiar characteristic of the subject and not a defect tout court) causes intense discomfort to those who suffer from it, leads the person to experience shame, annoyance and limits his or her social and working life (or school life, if they are very young people).

Trend

This discomfort in the relationship with oneself has a chronic trend and does not fade spontaneously: not even the intervention of aesthetic medicine or cosmetic surgery seems to give relief to people who suffer from it.

The illusion lies in the belief that, by changing something “outside”, you can obtain a benefit in terms of mood, serenity and an improvement in the relationship you have with yourself.

Usually, however, the relief is only apparent and short-lived: it has as much life as the fluttering of a butterfly’s wings.
After that, the individual finds himself dissatisfied, perhaps on other fronts and tends to perceive a sense of incompleteness which can once again lead to an attempt at “formal” rather than “substantial” modification of his own Self.

Despite the reassurances that these people often receive from those around them or perhaps even from specialists in the field, the rejection of some parts of their body does not tend to decrease and continues to “damn” those who encounter it and experience it first-hand.

A constant and devastating brooding

Usually, those who suffer from this problem experience the issue of the “physical defect” as the main question, in their lives: they think about it every day, for most of the day, perhaps imagining possible ways out or various panaceas.

All this brooding distracts the individual from the present and makes him/her absorbed and absorbed in himself/herself, as if there was almost nothing else to think about and reflect on. It is difficult, in these cases, to be able to fully dedicate yourself to reflecting on something else.

The age of onset is between 15 and 20 years old, a very delicate phase, full of many changes, in which each individual must deal with the physical and psychological transformations that one usually undergoes when going through adolescence.

Body districts

The parts of the body most affected by this type of discomfort are the nose, lips, hair, eyes, skin, teeth.

In any case, any part of the body can be involved.

Comorbidities

Dysmorphophobia is often associated with some disorders, mainly depressive disorders (especially major depressive disorder), vigorexia, narcissistic personality disorder (or typical traits of narcissistic personality) and anxiety disorders.

If perception goes beyond reality and is characterized by bizarreness, we are instead faced with a separation from reality.

In this case, w have to deal with a delusional disorder or a delirium which in any case refers to a severe psychopathological condition: psychosis.

Our current society

Today’s society, steeped in narcissism to the core, imposes a pressing comparison with the themes of power, success, wealth, beauty: not only does it promote this kind of ideals, but it spreads an apparent aspect of “normality”.

Even if they do not meet all the criteria that allow us to accurately diagnose this specific psychological discomfort, very often people show that they have an excessively critical view towards their physical appearance.

This can also be an alarming fact because it is a sign of an internal conflict, sometimes very intense and, moreover, very disabling.

The so-called “normality”

We “must” be beautiful and attractive: if this were not the case, it seems “normal” to have to achieve that prototype of “beauty” at all costs – which is a very subjective concept… Investment of money, unrealistic fantasies of achieving a coveted and lasting happiness, these disguises and make-up only highlight how uncomfortable the subject is with himself/herself.

Anyone who doesn’t like themselves must “change”. And the almost seem to be entitled to a sort of imaginary compensation.

In many cases the use of unnecessary cosmetic surgery is seen as “loving oneself” or, worse, wanting to improve one’s self-esteem: as if self-love had to do with mere appearance and not with the essence. of what we are.

Quick and personal thoughts

More than twenty years ago I was diagnosed with a deviation of the nasal septum with hypertrophy of the turbinates: septoplasty surgery was the unanimous advice of the specialists.

I visited the surgeon who would operate on me, who took the opportunity to invite me to change the appearance of my nose: eliminate the hump, narrow the nostrils.

In fact, up until that moment, I had never liked my nose very much and I thought that I could also include that “aesthetic” operation, also because it would be covered by insurance.

In my early twenties I was in psychotherapy and I spoke to my ex-therapist about my intention: to get a nose job.
A few words from the doctor were enough to invite me to reflect on the decision, and I chose to keep the nose I had – and still have: in the end I no longer found it unpleasant, on the contrary.

I thought that with that little hump he had more personality than many anonymous noses.
A “different” nose, I thought with the help of my therapist, can change the balance of a face, it can even transform it greatly: what if once changed I didn’t like it?

Today I think I have risked to face with a “danger”: the danger of no longer being myself and liking myself less, the danger of looking in the mirror and always thinking about that nose that wasn’t mine. The possibility of not recognizing me and my face as Giorgia’s traits.

When I warned the surgeon that I would keep the nose I was born with and to which I was used to, however, he was upset. He had done the math without the innkeeper.

A gaze toward our inner world

I recommend, before resorting and chasing a change “outside of ourselves”, to try to consult a mental health specialist (psychologist, psychotherapist, psychiatrist), to understand together whether what we don’t appreciate about ourselves is really something to get rid of or whether , however, cannot become our strong point, a trait that distinguishes us from the crowd, an element of originality that only we possess (or that we share with some family members).

We are all “different”, even homozygotic twins, upon closer inspection, stand out, and diversity is something that unites us to each other: why should we all look like copies of the same mold?

Let’s try to find the courage to show ourselves for what we are, for the ideas we express and for the wounds that we inevitably carry with us: accepting ourselves for what we are and loving ourselves as we are: that’s the key to access acceptance and, therefore, to greater serenity with ourselves and with others.

Article written by Dr. Giorgia Aloisio, psychologist and psychotherapist (Rome).

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