Body Dysmorphia: Ugliness in the Eyes of the Beholder


This one’s for planet earth. If you prefer to listen, here’s the podcast version of this post:

We all have an internal self-portrait and that is created by the way we feel about who we are. There are SOOOOO many factors that control how we feel about ourselves and what we perceive as our flaws. And that’s why body dysmorphia is such a big problem: it looks and acts like “normal” self-image concerns. It walks and talks like vanity.  And, yet, it destroys the average person’s happiness in so many ways across a lifetime, unchecked. Your self-image is a distorted hallucination – one heavily affected by your fears, vulnerabilities, your brain chemicals, and the way you integrate information from the world around you. AND when it comes to how you view your flaws, it has no connection to how the world views you or your actual physical appearance. That’s one reason this is such a powerful and rising problem: it’s a kind of suffering that’s veiled as “normal” because it affects successful, healthy people. An every-growing percentage of the population is dissatisfied with some or many traits of their physical appearance. When everyone you know obeys the same standard and marketing and media reinforce the irrational bar – how would you ever know there was another option?

I have been trying to write this for almost a year now, because when I started it I realized it’s impossible to give someone solutions if you’re still battling the issues. As a part of my research process, I decided to drop any and all obsessive habits related to scrutinizing my looks. To cease any self-criticism – any measuring or quantifying or worry around physical appearance. As you probably know, it’s pretty much impossible to “finish” that process. Especially if you think of yourself as a participant in pop culture. But it can become a work in progress goal – a process - that gets easier and easier, and a problem that’s less powerful.

I can tell you that since beginning this process, I can see myself a lot more clearly, and as a result I am happier and more relaxed.  I save a lot more time: I don’t waste time measuring things or quantifying my value or what my appearance compares to related to others. I get to choose to skip all the feeling bad about what I’m not. I get to make bad skin and bad hair days and bikini diets not relevant to me. Not because it’s not berating my eyeballs, constantly. Because, I made that decision. Now it’s about staying the course. It’s a constant practice to honor that decision and it all comes down to the initial awareness. That this focus is a problem – and I want none of it. That there is another option: to make your happiness and well being as a holistic person your focus. To make enjoying your life and all the important moments, your goal. Once you make that your dream, achieving it requires staying consistent through the ups and downs that are your fears and emotions.

So yeah, I am walking you through this topic well aware that it’s really fucking hard. It’s a problem that’s extremely powerful because it’s so intertwined with our emotions. So my hope is that me telling you this will help you feel empowered and we can all fight it together. Let’s change the world one healthy attitude at a time.

You might be wondering – what does a person look like with body dysmorphia, when compared with someone who DOESN’T obsess with their physical appearance? They look the same. A person can be physically “perfect” or emaciated or overweight – they can be anything. There is no norm in appearance. The difference lies in happiness. In inner harmony. You can tell a sufferer by their identity and focus. It’s a disease of perception that infects your personal enjoyment. So in short, a person with body dysmorphia looks like everyone else but they live inside a hallucination that shows them nothing but flaws.

This affliction makes me enraged and filled with sadness – because it robs people of their spirit! Of their truest gifts. And occupies brilliant and amazing people for a lifetime – wasting their time and happiness being a slave to a mirror.  I am doing this because I know, one day we are all going to be old and wrinkled and we’ll have to let go of this physical form. And I believe – I – and you, should be able – should be capable of appreciating that time, in your physical form – without suffering and self-harm.

So if you suffer pain and terror and obsession with something about your physical appearance - the kind of obsession that robs you of enjoyment and participation in some of your life’s greater moments – this is for you. Because you don’t have to feel bad at your own hand. That’s not real beauty and it’s definitely not helping you become happier OR more beautiful.

There are three parts: the what, why and how – the tools!

Part 1: The What

Body dysmorphic disorder is the diagnostic term for a specific level of obsession – when you can't stop thinking about one or more perceived flaws – and the badness of the flaws aren’t seen by others outside of you. The form that your particular insecurity might come in could be anything – none is more logical or valid. There are many toxic beliefs that are extremely common and some that tend to exist within particular cultures, but they run the gamut as far as topic.

According to one book it’s, “An obsessive fear of a deformity.” When a perceived flaw is an obsession that gets in the way you complete your “role” or takes up your mental focus for 1 or more hours a day. So in other words – severe obsession that interferes with your functioning in life.

Many who suffer text-book BD get endless plastic surgery – and it’s never enough. Many can’t leave their home because they suffer severe anxiety around others due to their perceived deformity – it’s all they think about, to a debilitating degree. This belief is so powerful, those who do continue to attend their job can get stuck in a bathroom mirror trying to fix or cover the flaw they feel everyone in the world is gawking at. In other words – it’s powerful.

There are all sorts of lines drawn in the medical books as to what constitutes a “real” disorder – basically how damaged your functioning is or how truly miserable you make yourself. In this podcast, I’m using the term of “body dysmorphia” as a catchall term for a painful and disruptive obsession with our physical flaws, though that’s not the technical definition. There are levels of severity that one needs to be “officially diagnosed” with BD. A psychologist would call me out on the use of the term– but in my opinion, it’s all a vast area of grey – with terms that are meant to judge how “normal” a person’s suffering is. When it comes to weight and dieting – obsessive and dysfunctional behaviors are either categorized as Anorexia or Almost Anorexia, or just plain old disordered eating / “Ed” for short. In my opinion, the lines between all of these disorders (body dysmorphia, eating disorders and almost-anorexia) are arbitrary when it comes to who is affected and how they are affected and there is a ton of overlap - so I am choosing to address them as a one big ugly topic – because a vast majority of us suffer a version of all of them at once. Suffering is suffering and whether or not your range is “normal” you deserve to heal and find relief. 

What I am addressing is a disabling kind of focus that affects the way you live your life. It’s the kind of pain that can occupy your soul for the majority of your life- in ways you might not even recognize as tragic until it is much too late, and you are finally forced to let go. 

BD is your insecurities on crack: like you’re hallucinating a horror movie that is shaped as yourself. And you feel everything in life – no matter how wonderful, as filtered through them.  It’s the pain that prevents you from attending an important function because your skin broke out. Or causes you to believe a spouse left you because you looked too old.  Or when seeing a family photo, causes you to see “when I was 8 lbs overweight.” It’s a pain that robs millions of time and money – pushing them to pay for surgery and products that burn and sting – and they never feel like they’re enough. It’s the pain that makes many feel so disgusted with their body, they cannot tolerate intimacy with a person they love, who loves them and the way they look.

And if you’re suffering, you likely know it hurts and you wish it would stop, but you probably don’t think there’s a solution other than YOU changing. That’s what sucks most. And why I fucking HATE THIS FUCKER. This perception is a blindness that pits you against yourself.  It robs and destroys lifetimes that SHOULD be happy and carefree and confident. It takes health and turns it to imbalance and sickness. And it likely affects the majority of the population! So fuck you body dysmorphia! I fucking hate you.

So who am I talking to? Everyone who suffers. Boys. Girls. Men. Women. No matter the degree.  Maybe your affliction isn’t clinical or described by the DSM – maybe it looks just like the average person – BUT if you are one of those out there who feels their physical body is the measure of how well they’re doing in this world, and that causes you to suffer as a pervasive state in your life – YOU can and should halt this fucker dead in its tracks. You are MORE that this piece of shit disorder. 

Part 2: The Why

Because this is a distortion related to how you FEEL that then dictates how you see yourself, it’s a potent problem in how it guides your lifetime. It can change how your day is going or become the reason you believe you can’t ever wear shorts for your entire life!  There are quite a few causes being currently studied but I am going to list the majority of the sufferers who have been the subjects of research, so check yourself against the list and know it’s not your fault. BD is the result of a “complex interaction between genetic and environmental factors” – basically it’s not ONE of the below, it’s likely a few.  You have to have the type of brain and personality traits that set you up to be sensitive to specific environmental factors. The brain structures of body dysmorphia sufferers share a lot with depression, OCD and anxiety.

This is to give you your light bulb on the causes, but if you are suffering greatly I highly recommend you look further into yourself with a therapist. At the very least, become aware of the problem that exists so that you might be able to help yourself when you are experiencing effects that are not rational.

1. Neurochemical Abnormalities

To summarize: complicated brain chemicals gone awry. Loops of thinking that won’t stop when they’re meant to. In other words, a serotonin or dopamine disorder. There are lots of little chemical messengers in your brain that help you regulate mood, sleep, hunger, sex hormones, etc. and they are regulated by things like serotonin. So if they are off – you start to act weird and do things like obsess in a mirror. The reason this is a theory behind BD is that when you take something like LSD that messes with your serotonin, BD gets way worse.

2. Personality Traits

Specific kinds of personality traits increase your risk for BD. Common traits include perfectionism, shyness, sensitivity to criticism and rejection, and unusually high standards for oneself, introversion, socially avoidant, and low self-esteem. People that score high on the neuroticism scale are often sufferers of BD.

3. Maladaptive Body Image

When you can’t change your view of yourself despite changing your physical body. For example, if you lost 100 lbs. you might never feel like you lost the weight. Your emotions would be still tied to a person 100 lbs. heavier.

4. A history of teasing

It’s also often the catalyst for the particular flaw a person becomes obsessed with. A single painful emotional occurrence can legitimize a fear you have around a flaw – it can become the motivating reason you perceive behind everything negative in your life moving forward. No matter how random, a joke delivered from a child about your “weird elbows” can be life-cursingly powerful, creating a belief you hold throughout adulthood.


Trauma - including sexual trauma or abuse. Sexual trauma has a very strong tie to dislike of ones body. This one makes me the saddest.

6. Moving

Moving to a new place where you feel like an outsider. Feeling like you don’t fit in to this new place starts a focus on how you are different. When you have a desperate need to fit in, this becomes a label for your pain: I don’t look right. There’s a lot of trauma experienced when moving but when you feel physically different it adds power to the shock.

7. Parents

Parental expectations of perfectionism: If you had a parent who was preoccupied by your appearance and gave negative OR positive feedback for attractiveness. They call this “BD by proxy.” Also, if you felt unloved by a parent: Parents who were neglectful or who made you feel unloved. Kids externalize what must be wrong with them so that they might control the pain.

8. Mood disorders

BD often co-occurs with anxiety or depression. Sometimes it’s a symptom of the depression and sometimes it’s separate. A lot of people don’t get treated for because the depression is the more obvious problem. So if you suffer both, I recco you see a professional!

9. Industry

This one’s a biggie. Everything from film, TV, magazines, products, and even the news legitimizes the importance of “thinness and beauty.” The imagery and language of media highly endorses looking abnormally perfect. As a concept, physical perfection is constantly reinvented and therefore it’s an ever-expanding industry. Cosmetic surgery, diet products, cosmetics, hair products, skin treatments: new products are being invented everyday to solve for problems that are being invented everyday. Marketing creates the need for products. Entertainment confirms it. It’s a multibillion dollar industry that reaches more and more of the population, targeting wider audiences of men and women, and it’s reaching them younger and younger. I know! SO dire and scary. Which brings me to the most important part…


These are for moving in the right direction but if you’re suffering in a bad way, I recommend you go see a specialist. Don’t let this go unchecked. It’s your life, and time is precious! I want to help you to empower yourself to take on this mission so I am putting all the information and resources that I have on this subject at the end of this blog.

1. Awareness and a Desire to Change

This is step one. BD comes with an over-identification and focus on the external as a definition of you– and that over focusing is what robs you of your balance and any accurate perception. A loss of sense of yourself as a whole person is what creates the problem. Like, you suddenly are looking for flaws instead of living and thinking and laughing and dancing! So truly, this is the most important tool I have to give you. Awareness of the fact that you have a choice. You probably never considered you had one, but you do.  Become aware that you are a sufferer and CHOOSE to overcome this by beginning to fight in everyday. Once you begin with the awareness, work on separating from the problem, mentally - recalling you are not this voice.  This is the voice of a sickness that steals your life away. The key is to stay aware of the problem and separate from it, so that you can choose the correct patterns to follow in your life in spite of it. Helping yourself soothe in the individual moments and, even when it hurts and you’re afraid, going toward your truest, highest goal anyway.

2. Ugly-Voice Translator

The voice of your ugly can be extremely convincing. It will sound just like you – or come from sources outside of you and they will constantly try to use rational, sound reasoning as a secret pathway toward disordered behaviors. And sometimes the voice is sooo veiled that it helps to give them a specific name assigned by their motives. So, imagine I am handing you a tiny chip to install in your mind via this blog – and this chip will give you an Ugly-Voice translators.  Right now you’ve got to set the preferences – so name the different sounding voices.

There are a few standard labels given to the voice of particular kinds of disorders: Ed is the name for eating disorder – the voice that tells you that you’re on your heavy side after eating a calorie high meal – and suggests you not eat for a day to even out. There’s also Social-Ed, which comes in the form of the fucked up cultural expectations and sickness spouted by the world around you.

Whatever it is, name your voice of ugly based on what it says. Learn to recognize it. Know that it lies. This self-blindness induced by emotional triggers never works in your favor.  It’s only creates a you that is unlovable and ugly. It’s showing you a false manifestation of your mental sickness: what you see is not real

Happily, I can tell you from personal experience that when you can see outside of your fucked up vision, as a more objective person – your looks and body become very “normal” and okay.  Any perceived changes are not so distracting or terrifying and they don’t wield the power to spank you.  Like, the terror piece has been taken out it.  You begin to understand that you look more like you do to other people who aren’t a victim to your brain. It’s like that experience of looking at an old photo of yourself and seeing that you were in fact much more beautiful than you felt– and realize how sad it is that you stole the moment from yourself.

You’ll find that once you begin to curb the obsessing by intentionally not making it your priority, you will see yourself objectively and then you can truly comprehend how awful the hallucinations were before.  How much time they stole from you and how much of a waste it really was. How stupid that it happens to us. Fuck it! Stupid shit! Fuck! THAT’s how mad it makes me!

3. Ugly Goggles

A key experience of BD is the hallucinations of something that doesn’t exist. It’s like the trigger moment when you hear your weight and suddenly you feel you look 60 lbs heavier. The same goes for exaggerations of flaws – your brain will cause you to perceive the flaws to be a million times worse.

Imagine it’s like your brain trigger has suddenly placed atop your eyes a pair of “ugly goggles” and you need to step away from the mirror and talk yourself down. Not real. Emotional blindness.

If you see a professional, some meds are known to help remove the ugly goggles permanently – like you stop hallucinating the physical flaw altogether.

4. Scare Away the Monsters

This is like the thing you do as a kid – when you’re afraid of something lurking in the dark. You talk really loud and calmly about how not-scared you are. And in turn, you calm yourself down. So in short, don’t isolate or hide your insecurities. Disarm them by owning them and talking about how you know you will overcome them. Joke about them. Over-share. Be social. Live your life and don’t let them rob you of your joyful experiences. Never let the problem silence you.

When you feel triggered and in pain, talk to yourself in the voice of sanity – and always be kind and supportive – tell yourself what is happening in calm rational voice.

5. Don’t pull the trigger!

Think of your trigger emotions like a loaded gun. And when you are scared, the instinct is to fire at something: your looks, your weight, something you’ve labeled as your pain. And yet, often the triggered emotions are mislabeled feelings that are OLD. They are coming from a different place inside. So before reacting to the trigger, stop and examine them and try to sense where it might be coming from. What age does it feel like? What voice is it speaking in?

Often the feelings we have tied to physical flaws or fatness are mislabeled emotions that we are unaware of. For example, with ED often its past emotional pain that is mislabeled as feeling fat, full, or empty. The emotion is much deeper.

Before reacting it also helps to soothe the emotion as a pure individual instance – so deep breathing exercises like book breathing or gimme-five breathing.

6. You-360

This is a journal entry. I want you to describe to yourself what you hope to be known for in your lifetime – what you would describe as your greatest assets as an individual.  Describe to yourself: who are you? What qualities do you have as a person? What are you really great at? What is your greatest dream? This should be what defines you as a thinking, breathing soul – and not something tied to your physical form.

This is the You that you are going to cater to moving forward. Not your physical. Everything you focus on should serve this whole person – and reward and protect them. That is your value. This statement is your focus when coming from a healthy vantage point.

7. OCD Ugly

This means stop the rituals associated with your body dysmorphia. The compulsive obsessive checking and measuring behavior reinforces the obsession.  I know this is hard but you need to deliberately stop the behaviors you have around your perceived flaws. For example – to write this piece I threw away my scale. It was terrifying! I used to weigh myself pretty regularly. Once you get past the terror part – like omg I don’t know what I look like anymore – you begin to get a bit of clarity. I’m not going to lie it was really fucking hard and part of me wanted to run back to it – but I decided – for me, and you – that I was going to stop the measuring and instead just be whatever I am going to be based on my lifestyle.  

So if you want to help yourself undo this mental jail, you need to deliberately steer yourself away from all practices physical and mental and verbal that reinforce your negative measuring. That includes allowing yourself to mentally label experiences as bad or sinful instead of just enjoying them. What the hell is the good of a cookie if you’re going to allow yourself to beat yourself up about it all day? Let it go! Choose to let it go! Don’t stop until the voices subside. 

Redirect your energy toward something more important like how you’re going to get the promotion you’ve been wanting! Get out of your self-obsessed head and assume no truth lies there. Regardless of whether or not you feel you are up to par with an unrealistic cultural ideal, right now you are trapped in a form of perception that adds a thick layer of ugly. You cannot see or even appreciate your beauty.  You are seeing something much less beautiful than what exists in reality.

What if You Love to Groom Yourself?!

This is not at all about not loving your physical self. I am ALL ABOUT THAT. Joy up the wazoo. Savor every sensation! Care for thyself! Live to the max!

My point with all of this information is the pain and suffering is optional.  Living as a victim on an emotional rollercoaster – is not necessary to looking your best.  It all starts with awareness and then a goal you have for yourself and your life. I’m not talking you out of exercising or doing your hair or eating healthy so that you can be your best most beautiful self ever. I’m talking you out of the pain and obsession that causes the imbalance – that perpetuates problems and causes you to feel powerless. 

When you stop the obsession, you get clarity.  Once you have emotional balance and distance from this focus, physical self care and health is pretty straightforward. It’s all dictated by your holistic happiness as a human. Health and fitness comes automatically with the enjoyment of your life and your physical body. It’s inspired by you wanting to be healthy and happy and enjoy yourself.  It’s not the result of fear and penance or a backlash to the horror of a reflection.

If you want to dye your hair and get a tan and work out, go for it! It can be a passion and a lifestyle – something you love. I love exercise. It makes me feel amazing and like my truest self. I do it because I love how it makes me feel – I crave it for my happiness.  It’s for me, not to me. So this is really about checking where you’re coming from – being aware of what’s honest and good for you– and what’s fearful and hurting.  Making sure you’re coming from the right place, and that the place is self-love, enjoyment of your life – and happiness. Check your head. OFTEN.

In closing…

I know this process is really fucking hard! It’s hard by all measures! It’s like walking around in hell and everyone’s a demon and you are closing your eyes trying to find the door out of it. Keep grasping at the goal – there is a way out and once you find it – keep running with all your self-loving might! So you can share the path you took with others.

I challenge to choose YOU-360, over your body as the truest definition of who you are. I’m asking you to pursue a healthy, objective focus in your life that rewards your personality as a whole. Start by deciding you want that. Accept the fear of losing your obsession will happen intensely, causing you worse hallucinations and panic, and then it will subside.  Decide to step outside of the blindness and say– “I want my mental health and happiness.”

You can be everything you want to be and more but you must always come from self-love and tolerance. Commit to your own happiness and your right to enjoy every moment of your life.  Commit to honoring the wishes of your soul and lifetime in its entirety – while you’re on this planet. What do you want to do while you’re here?! The real goal is to rebuild your life from THAT foundation. Please love yourself as much as I love you, even though I don’t know you. Please want for yourself a life you enjoy as you are – which is what I want for you. I know you can obtain your balance again – and feel worthy and proud of the person you are now. I know you deserve love and affection as you are. From you!

Wouldn’t it be awesome if you had the ability to savor each moment – to not feel worthless or disgusting because of the random measure that happened to make you see someone ugly in the mirror. Well, you can. And you will. For the rest of your very long and happy life! So start now toward that goal. It all starts with a desire to change and then a commitment to making the steps necessary.

In truth… It’s when you’re laughing that you look the most beautiful. When you walk around with comfort in your skin that you look the most sexy. You look the most strong when you’re openly vulnerable. When you fully embrace who you are as a whole person- your spirit shows through - it’s that light of joy that makes your face shape perfect.

Below is my reading list as well as links to more help and resources:

Almost Anorexic: Is My (or My Loved One's) Relationship with Food a Problem? (The Almost Effect) (More for medical studies) The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder (For help) Eating in the Light of the Moon: How Women Can Transform Their Relationship with Food Through Myths, Metaphors, and Storytelling For tolerance and self-love: Radical Acceptance: Embracing Your Life With the Heart of a Buddha

A brief podcast on the topic from All in The Mind.

BDD Conference for sufferers and their families (UK). A doctor who treats BDD successfully. (In the UK)

Resources for support (all included in the back of Almost Anorexic):

Academy for Eating Disorders Referral List

Beat Eating Disorders HelpFinder

International Association of Eating Disorders Professionals Foundation

ANAD (free help groups) and 12 step groups.

Sending you much love xoxo!


BlogSarah May B