Understanding body dysmorphia and how hypnotherapy may help

Body dysmorphia can feel like all your attention collapses onto one part of your appearance. For example, a feature other people barely notice, yet your brain flags as a threat. It’s exhausting, consuming, and often misunderstood. But it isn’t a flaw in who you are. It’s a signal from a nervous system trying to protect you in a world it didn’t evolve for.

For most of human history, safety came from connection, belonging, and being part of the group. Today, the pressure to look a certain way, perform a certain role, and live under constant scrutiny keeps many people in a state of alert. When the body feels unsafe (socially, emotionally, or physically), it redirects that tension somewhere. For some people, it lands on the body.

What body dysmorphia is

The Body Dysmorphic Disorder Foundation has a body dysmorphia disorder test. However, you may receive a diagnosis of body dysmorphic disorder if you:

• Have a preoccupation with at least one perceived "defect" or "flaw" in your physical appearance that is not obvious to others.
• Perform repetitive behaviours that relate to the perceived defect, such as mirror checking, skin picking, reassurance seeking or comparing your appearance to others.
• This focus on your perceived defect causes significant distress or affects your life, personally or professionally.
• If the preoccupation is with body size, it is advisable to check to see whether it is an eating disorder rather than body dysmorphia.

When you experience the symptoms of body dysmorphic disorder, your entire focus is on your perceived fault. The human being comes in many shapes and sizes. There is no perfect human prototype because, if there were, we would all be in the default box. No human has flaws; we are all simply different, but that may not be how you see or feel it.

When you see that a part of your image is "defective", you believe that a different look is the "right" look. As you perceive your defect and others cannot see it in the same way, surgery to change it rarely fixes the problem because, really, there isn’t a problem.

As you spend much of your time checking your perceived defect when you try and use the mirror to find normality, you find it counterproductive. As the fault is not in the body part but in the thinking, surgery is generally perceived as unsuccessful and rarely helps with the symptoms of body dysmorphic disorder. Frustratingly, 50% of people who have surgery to change a perceived default go on to develop a preoccupation with a different part of their body. 

Why your brain fixates on a ‘flaw’

Your brain does not differentiate between a threat to your ego and a threat to your life. A harsh comment, childhood bullying, a period of stress, social comparison, trauma, or simply living with chronic anxiety can push the nervous system into protection mode. Once there, it looks for the source of danger.

It chooses the body because it’s visible, controllable, and familiar. But the problem is the threat response underneath it, not the feature.

This is why:

• other people can’t see the “flaw”.
• you can’t logic or talk yourself out of it
• surgery rarely helps because the issue isn’t in the body but in the survival system perceiving danger
• many people who change the feature find the focus simply shifts elsewhere

How hypnosis can help

Hypnotherapy is shown in studies to reduce the symptoms of body dysmorphic disorder. The main thing to keep in mind is that a hypnotherapist cannot change your body, but we can help you to change your perception of your body and help you redirect your thoughts so that you stop constant checking, grooming and reassurance seeking.

When you seek a hypnotherapist to help you with body dysmorphia, first check that they will give you time to explain your situation in detail. Everyone has a different reason for their symptoms. The reasons range from bullying to trauma to social pressures. This is relevant to the therapy you receive.

Hypnotherapists use hypnosis to enhance the modality of therapy that we choose to use. Your hypnotherapist can help you to redirect your thinking away from your body image, so there is less draw to observe and judge your appearance. Your hypnotherapist might help you view your perceived default differently so you grow to love that part of your body. If necessary, you can ask your hypnotherapist to help you explore previous experiences to try and find the cause of your problem.

Hypnosis helps you see things in your mind more clearly than in a default state of mind. When you reflect, you might find that you realise the origin of the problem was not in fact your perceived defect but a problem with someone else or a situation. For example, when you look back, you might suddenly see that the person who picked on you for your nose actually had a larger nose than you and used you as a diversion away from themself.

Some people find the thought of no longer viewing their body as defective scary. If this holds you back, I would like to reassure you that after therapy, you will still feel like yourself. Hypnotherapy will help you feel like your normal self without the restriction of continually feeling at fault.

Before you choose a therapist

Look for someone who:

• gives you space to tell your story
• understands nervous system dysregulation
• works collaboratively, not from authority
• knows that the goal isn’t to change the body, but to restore safety in the system
• uses hypnosis to enhance therapy, not override your autonomy

References

Sahraei, M., & Ghaderi, A. (2018). Efficacy of cognitive-behavioral hypnotherapy on body dysmorphic disorder: A single-subject study. International Journal of Behavioral Sciences, 12(3), 127–134. 

 https://pdfs.semanticscholar.org/56c6/a38bf7d1319ebfdc2fd61c792a5f687cc3dd.pdf