Bodily Integrity in Body Dysmorphic Disorder [Preprint]

Body dysmorphic disorder (BDD) poses a significant challenge to an individual’s mental well-being. The obsessive preoccupation with perceived defects in one’s appearance affects individuals’ daily functioning and can result in serious risks, including suicidal ideation and self-surgery. While treatments such as cognitive behavioural therapy and serotonin reuptake inhibitors can provide relief, they do not achieve complete remission. It has been suggested that therapy should not only interrupt the harmful behaviour, but should also address their sense of self, and that after addressing their internalised values, individuals with BDD will be able to incorporate their perceived defect in a manner similar to how individuals with real deformities often do. Phenomenology of psychopathology analyses subjectivity in cases of pathology, and analyses of BDD show that the perceived defect has become a locus of shame. This implies that individuals with BDD have permanently incorporated the gaze of the Other and constantly experience their body as a body-for-others. This paper further explores the sense of self in individuals with BDD through Jenny Slatman’s interpretation of bodily integrity: bodily integrity as a never-ending process of identification. By comparing the experiences of individuals with BDD to those with real deformities and to those who have undergone cosmetic surgery, I will show that re-identification does not occur in individuals with BDD. This suggests that their bodily integrity is fundamentally disturbed and that addressing their internalised values alone will probably not be sufficient for the disorder to go into remission.