“How can a therapist help with a physical problem? Why should I go to a mental health professional instead of a medical doctor or cosmetic surgeon?”
It may seem strange, but mental health professionals like therapists and psychiatrists are very helpful in dealing with the way you see yourself.
Your body image is the picture you have in your mind about the way you look. It includes your beliefs, thoughts, and assumptions about your appearance and develops and changes throughout your lifetime. Body image is complicated and can be influenced by many things. You may have noticed that the mental picture you hold of yourself can change with your moods and thoughts. For example, on days when you feel better you may think you look better; on the other hand, when you give less importance to the way you look, you may feel better. On days when you are feeling depressed or have more stress, you may judge your reflection in the mirror as more negative.
You probably have gone to dermatologists (to examine your skin) and perhaps even seen a cosmetic surgeon without much success. Research shows that most individuals with body dysmorphic disorder (BDD) have been seeing a dermatologist for almost 10 years before they finally visit a therapist. They do everything a dermatologist tells them to do only to find out it doesn’t help them feel or look any better. Many hope to get surgery, while others don’t see that as a possibility and still others wonder if that is their only choice. For those who have gone through surgery, they know that it has not helped them to feel any better. They have wasted money and hope for a better life only to find themselves in the same situation, if not worse. Most individuals with BDD seek treatment from other professionals before psychological or psychiatric therapy.
Both psychological and psychiatric treatment are very helpful in changing the way you think and feel about yourself, and the way you behave. They are helpful in changing the impression you have about your appearance. Both cognitive behavioral therapy (CBT) and medications specific for BDD can help.
Getting help does not mean accepting feeling bad about the way you look. It does not mean walking around feeling “awful” and “horrible” about yourself. It does not mean accepting viewing yourself as “ugly” or “unattractive.” Nor does it mean living a meaningless life. On the contrary, CBT helps you view your life and your appearance differently. It means empowering you to create a different life for yourself. It means helping you see and imagine a different way of living, achieving your goals, and living your life according to your values. Medications that are recommended for BDD can also help you view your appearance more accurately and improve your quality of life.
You may wonder, How can I ever achieve my goals if I look the way I do? CBT will help you to emphasize your goals and achieve them at school or work, or dating or playing an instrument. It does not matter what you want out of life — you will get closer to it with therapy. CBT will teach you to face your fears slowly, in a manner that you can handle. It will help you challenge your thoughts and get you to think more flexibly and adaptively.
Medications can also be helpful by helping you to help yourself. Medications make it easier to cope with life’s difficulties and help you handle what is being asked of you in CBT. Research shows that a combination of therapy and medications can be more beneficial than either alone.
Whatever it is you choose to do, CBT is a core part of achieving your goals.
by Fugen Neziroglu, PhD