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The Bad Gets Worse: Self-Amputation and Suicide

Severe cases of BDD can lead to such behaviors as self-amputation and suicide. I think suicidal thoughts are very common to the average BDDer, and a high percentage of them actually commit suicide. I've heard that this number was around 30%. Thoughts of self-amputation are not that unusual either, but it's usually just a fleeting idea that is somewhat between a joke and seriousness. For instance, you dislike your chin, and cover it up with your hand, just to realize you like it better when you can't see it. So, you might run to family members and ask if they think you also would benefit appearance wise from the lack of a chin. After a few rolls of the eyes and sighs, you realize it was a stupid question, but still think that you might be on to something. I think it is very uncommon for a BDDer to actually go through with dismembering a body part, although they might hurt themselves on accident, while performing a ritual. The most common destructive behavior would probably be cutting all their hair off in a desperate attempt to make it look more acceptable, or accidentally picking their skin too much, leading to scarring. Some BDDers seem to have a preoccupation with visiting plastic surgeons and getting multiple surgeries. I've never had the chance to personally talk to one of them that's undergone several surgeries, but I know that many BDDers have either had a consultation with a surgeon, or at least supported the thought of getting surgery, at one time or another, believing it might be the answer to their problems. I do know that I've never heard of a single BDDer that has been satisfied with their plastic surgery, once again showing that BDD most likely has little to do with appearance at all. If you change one part of your appearance, you will most likely find a new aspect to hate.

Negativity

BDDers have an extreme tolerance for negativity and negative self-talk. If every person on earth except for one told a BDDer that she was beautiful, and the remaining person said she looked tired, I assure you she would convince you with all her heart that everyone thought she was ugly because she had bags under her eyes. BDDers look for negative evidence to back up their beliefs. If it is not available, they make up evidence. I know that I often put words in random peoples' mouths, saying such things as, "they didn't say bye to me because they thought my nose was too big," even though I didn't know the people, and they said nothing about my nose. The interesting part is, we truly believe what we say, at least until we realize it's ridiculous. But by the time we realize that our thinking is faulty, we've already come up with another strange idea that we believe is 100% true. Most people complain that BDDers are much too pessimistic and that it ruins their days to hear such horrible comments. These are people that only have to be around the BDDer. Think how it must feel to actually believe these comments and have them aimed at your very being. I find that outside of bashing themselves, BDDers are usually very positive people that give everyone else, but themselves, the benefit of the doubt in all situations. If the topic turns to themselves, they will be negative.

Perfect is Perfect, Right?

It's been brought to my attention several times that BDDers definitely possess an all or nothing attitude. We can convince ourselves that even if we have a nice figure, eyes, and hair, if our nose is large, then the world is over. If one feature is considered ugly to a BDDer, then the overall person is also ugly. We will think such things as, "If I'm not the most beautiful person on the face of the earth, then I am a bad person that will be rejected and would be better of dead." Such thinking is especially common during bad BDD episodes and BDD attacks.

Instability of Self-Image

I've found that most BDDers can change their views on their appearance in the same fashion that a person with Bipolar Disorder can shift from being majorly depressed to overly euphoric. I've heard several BDDers who claim to actually really like their appearance on certain occasions, and during this time, they are usually extremely motivated and feeling on top of the world. They will remind themselves of the times in which they received positive evidence illustrating that they were attractive. Usually within twenty-four hours, they will invent negative evidence to convince themselves that they are ugly again, and will then refuse to believe that they ever felt attractive.

Lack of Strong Identity

Most of us, never having risen from the bottom levels of Maslow's Pyramid, also have a very weakly defined identity, and know very little about ourselves. Even during a good BDD moment, we often find it difficult to form opinions and find any direction in life, because we don't feel we truly know ourselves.

I am You, You are Me

I've seen that many BDDers have a difficult time setting boundaries. They say yes when they mean no, and do things just to please other people. Some let others openly control them and abuse them. We often do not know where we end and others begin. We dedicate our lives, when not performing other rituals, to pleasing others, in a frantic attempt to be accepted.

Authority Figures

Some BDDers have a fear of authority figures. I think this depends on childhood circumstances, and how you developed BDD. It's somewhat like the rectangle/square theory, where a rectangle is not a square, but a square is a rectangle. Well, a person without BDD may also have this trait and not have BDD, and a BDDer may have this trait, or not express it at all. For the BDDers who do have this problem, they often avoid speaking with anyone that could be considered a controlling adult. If they do speak with them, they usually end up trembling, and sometimes resort to crying. Because this is a potentially embarrassing situation, they often avoid it altogether, leading them to miss meetings with teachers or talking with bosses about promotions.

Unquestioning Belief in Others' Opinions

A lot of people with BDD really rely heavily on opinions of others. A complete stranger could tell a BDDer that he's ugly, and he might actually think about it for the next 10 years. Most BDDers will not fight with these antagonists, but instead accept what they say as the truth. I find that most people with BDD accept anything that others are willing to dish out, and never question others, and certainly never assume somebody else is wrong. Most nonBDDers have a values system. When they hear outside input, they accept it, process it, decide whether or not they believe it, use the criticism, or toss it out. BDDers take almost everything extremely personally, as if every person has the right to judge them.

Dressing Down

Something else that I have found very common with most BDDers is the desire to dress frumpy. The more a BDDer tries to dress up attractively, the more likely he or she will experience a BDD attack. Very often, a BDDer will spend hours applying makeup, and then go out wearing a t-shirt, shorts, and tennis shoes. Also, I noticed that many can have a wonderful body image from the neck down, but have a horrible body image concerning their face, and vice versa. Often they don't care about 95% of their body, and would not even mind if it became severely disfigured, but only concentrate on what they believe is the important part of their appearance. For some BDDers, dressing up and keeping in shape are extremely important though. I've noticed that several males with BDD pay special attention to dressing nicely, but might neglect some other part of their appearance.

The Perfect Person

The BDDer will often have an idea of who the perfect person is, and it is sometimes a public figure, and at other times, someone they know personally. Sometimes they just know a type of person that they find perfect. Usually, it does not agree with the average human being's standard of beauty, and often, this person has something in common with somebody they admired in childhood that was totally different from themselves. For instance, I went through a phase where I wanted to look like a short, male, Samurai warrior even though I am a female. Another time, I wanted to look like Conan O'Brien. I've heard of many BDDers who have come up with other random wishes like my own. To the BDDer, these desires seem absolutely normal, until they realize that they aren't so normal, which usually will take a few years. Most BDDers cannot understand how another BDDer could want to look like Conan O'Brien, but think it's totally acceptable to want to look like Howard Stern. Usually, they will not look at the whole picture, and realize that it would require a sex change operation to look like the person they admire. Instead, they think about things like the person's facial structure is exactly the opposite of her own, and obsessively think about how they could change their facial structure to match the desired face shape. Often, the self-talk goes as so, "if I looked like him or her, then I would (fill in the blank with anything you think you aren't now: E.g. Be happy, be accepted, wouldn't complain, etc.)." I also found that many BDDers have a celebrity role model, who they think they might look like on good BDD days. This gives them hope that they look like somebody that is accepted. On bad BDD days, they usually have a backup celebrity, that has the reputation of being quite homely and looks nothing like the first celebrity. They will waiver back and forth between thinking they look like the one, and they look like the other, and will sit in the mirror trying to decide which is more true.

We Can Speak Like the Doctors

I've noticed that many BDDers study up on their perceived defect so much, that they will actually be able to use the jargon that doctors, having been to medical school for several years specializing in that feature, would use. A BDDer will often have a difficult time learning new things while their mind is preoccupied thinking about their appearance, but will have no problems picking up very specialized information on their defect at lightning speed!

Common Link in Displayed Behaviors

All of the previous behaviors probably seem quite different from one another, but if you analyze them closely enough, you'll find that most of them have something in common. They are behaviors that can help the mind dissociate. Each of them can be repeated over and over again, with perfection rarely being achieved, meaning that the task can never be completed. Imagine a husband, that has been working hard all day, to come home to his wife who yells at him for throwing his dirty clothes on the ground, and a houseful of screaming children that are jumping up and down in the background. All he wants is some peace of mind, so he decides to head on outside and do some yard work. This yard work is not done because he has the desire to work even harder after his long day of tedious work, but it's because he wants to get his mind off things that are really bothering him. By mowing the lawn, and clipping leaves, he can worry that things don't look quite perfect instead of worrying about what he'll say to his wife to make her happy, or how he can convince his kids to settle down. The more he wants to avoid going back inside, the more work he'll find to do outside. The more complex issues on a BDDer's mind, the more likely he or she will perform endless rituals.