Chapter 16.

Introduction

Student Video Activities for Abnormal Psychology
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Body Dysmorphic Disorder: An Obsessive-Compulsive-Related Disorder

Author: Ronald J. Comer, Princeton University

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Photo for illustrative purposes only; any individual depicted is a model.

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16.1 Body Dysmorphic Disorder: An Obsessive-Compulsive-Related Disorder

This video case focuses on a woman who suffers from body dysmorphic disorder, now listed as an obsessive-compulsive-related disorder in DSM-5. She perceives her normal facial skin as horribly disfigured. This distorted body image severely impairs her personal and professional life. The case also focuses on how her concerns have unfolded since her adolescence.

Beyond Perfection: Female Body Dysmorphic Disorder

[MUSIC PLAYING]

I'm still obsessed because I feel like I just haven't become perfect looking. I keep, every day, trying to look that certain way. I want my skin to look flawless without any makeup on—naturally. I won't go out unless I'm wearing a lot of foundation, because I feel like I have to cover all the blemishes and the scars I've made.

It takes me about three hours to get ready. And I'll wash all my makeup off and start over. And I do it over and over, and over again, and then I just get frustrated.

30-year-old Jennifer is an attractive looking woman, yet she believes she's terribly disfigured.

When I look in the mirror—when I'm able to look in the mirror—I see a monster. Freddy Krueger's face. My skin is all I can see.

Some areas of it are yellow, some areas of it are white, some are bright red, and some of them are deep purple, raised keyloid-type scars that are white and thick. I just can't—I can't bear to look. I just—it's horrible.

Despite evidence to the contrary, Jennifer believes everyone else also sees the same disfiguring scars on her face.

I was walking down Newbury Street, which is a fabulous shopping street in Boston. I was getting whistles and guys calling out about my body, like nice butt, cute butt, or hey, sexy. So for a moment—brief moments—I feel like I must be good looking, because it happens so frequently.

But I'm thinking, they're too far away to see me. That's the only reason they said that. They can't really see me that far—I mean, if they got close to me, then they'd be like, oh, I made a big mistake.

[GALLOPING]

Although Jennifer comes from a wealthy family and is well-educated, she only manages to work part-time in McDonald's. Her therapist thinks she has a number of conditions.

Jennifer meets criteria for OCD, for obsessive compulsive personality disorder, borderline personality disorder, body dysmorphic disorder, post traumatic stress disorder, major depressive disorder—and her overriding obsessions about appearance.

Jennifer is so unhappy with the way she looks that she literally wants to be someone else. At University, she had several obsessions with other students who looked more perfect.

There was this one girl at school, in particular, that was one of my close friends that I started to become very obsessed with, because her life seemed so perfect. I saw that she was wearing this beautiful Tiffany bracelet. And I went out and bought the same bracelet.

I ended up being obsessed with buying Tiffany jewelry, and I just couldn't have enough of it. I keep going in there and buying more and more and more and more. And then I noticed one day her socks had these little polo ponies on them from Ralph Lauren. And I went home I threw away all my socks and went out and bough 30 pairs of the polo pony socks.

Her handwriting was so perfect. It looked like typewriting. And she was able to keep up with the teacher and write that way.

And I spent so much time trying to emulate her handwriting that I missed almost all the notes in class. And it didn't matter to me. I wanted my notebook to look exactly like hers. I started to fail my classes, and so I dropped out of school.

I thought that if I look like her, I would be like her—happy and perfect. And I'm not happy and perfect. I obviously am failing miserably at looking like her. So I guess it's just a losing battle.

About three years ago, I had a nose job, and it made me feel much better. And now I'd like to get dermabrasion, which is where they use a machine to slowly sand away the top layers of your skin so that the underneath layers are the only ones remaining. So it's fresh, unscarred skin. Every time I get one of the procedures done and start saving towards my next procedure, I feel like I'm getting closer to my goal, and it makes me feel happier.

16.2 Check Your Understanding

Question 16.1

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Correct!
Incorrect.

Question 16.2

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Correct!
Incorrect.

Question 16.3

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Correct!
Incorrect.

Question 16.4

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Correct!
Incorrect.

16.3 Activity Completed!

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