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The Media: To Blame or not to Blame? How can we talk about BDD without bringing the media into the discussion? Many people nowadays are complaining that the media is responsible for everything from anorexia, to normal self-esteem concerns, to the increase in plastic surgery cases, to the number of divorces. I believe the media aggravates BDD, but by no means causes it. Sure, when I see a magazine cover plastered with an airbrushed model, or a movie with a glamorous actress decked out in the newest hairstyles and outfits after three hours in the makeup chair, I will probably start experiencing a BDD episode. I'll start comparing myself with this idea of perfection, and assume that I do not match up to it. Nobody can match up with it. It's not real. But, even without these magazines and movies, I am certain that I would have developed BDD giving the previous circumstances during my childhood.

BDD has been a recorded disorder for over 100 years. That was before TVs, before movies, and before magazines had pictures of smiling girls on the cover. It was before pin up girls. It was before the supermodel era. It was before the time that women could get plastic surgery and turn themselves into a form that couldn't humanly be possible. BDD has truly little to do with looks. BDD is a coping mechanism that uses looks as an excuse. In fact, it's ludicrous to say, but we may even be lucky to live in a day and age when babes come at a dime a dozen, because it makes our BDD rituals much easier. We would try to perform rituals no matter what era we had lived in, so at least over time, society has created the optimal environment for BDD rituals to flourish. My main concern with this is that when we are performing rituals, we have an easier time avoiding the real problem that lies deeper than our surface ritualistic behaviors related to beauty allow us to see.
Childhood "Deformities" I do not believe that this has anything to do with whether a not a person will develop BDD, but it may play a role in our emphasis on appearance and which features we choose to blame our imagined ugliness on. I was born with an underbite, and spent eight years in treatment, which included braces, headgear, rubberbands, retainers, getting teeth pulled, etc. Although nobody ever teased me about this, which is surprising to me, it still added to the feeling of being different and born "wrong". It was often brought to my attention that I had to go through this treatment because I had a "problem" with my teeth and jaw, and even today, I notice that my main BDD concern deals with my jaw and general facial structure. I assume that it is different than other people's and sets me apart as being different. Even though I've been told that my jaw is now in the correct position after years of treatment, I still feel like they could never quite "fix" me and make me like other humans. So if you were overweight, had to wear glasses, went through braces, or had any feature that made you stand out as being different, and could have been considered "wrong" by society, you may have blamed these features specifically when you developed BDD. If you did not have any feature specifically pointed out to you as being wrong, you may develop the sense that you are just overall ugly, and can't quite pinpoint what makes you this way.
Theory Submitted by BDDer The sociocultural context one is born into obviously plays a huge factor, not only in terms of how strongly that culture attempts to dictate it's own ideal but also what that ideal consists of. A genetic component must also play a part in things due to the neurological parallels with obsessive compulsive disorder. Finally there is a complex interplay of psychological variables which I'll attempt to offer my opinions on. I believe that people with BDD, due to unique upbringings, have a different psychosocial reality than everyone else. This in turn affects the social impressions and reactions we make and/or our perceptions of those impressions and reactions, and causes us to have differing social feedback or feel as though we do. Many view the impressions, reactions and feedback in a negative light, whether real or perceived. All of this then either creates or contributes to a feeling that we are different than others and reinforces what seem to be universal feelings of low self-esteem. This also heightens social sensitivity and social impressions, and a link has been established between individuals sensitive to social impressions and being especially influenced by physical attractiveness. For me it's not too difficult to imagine that for someone who lived with the above, and for whom physical attractiveness was such an important variable, the problem they felt existed with their self would be transferred to their body, especially if you add feelings of bodily ineffectiveness to feelings of psychosocial ineffectiveness. All of this is in accordance with both a psychoanalytical perspective, "The mechanism of symptom formation is a simple displacement of the feeling that there is something wrong with the self from the psyche to the soma" and a developmental contextual one, "...body image not only derives from person-social context relations and the individual's cognitive and emotional developments, but also contributes to both of these processes" and "The person's appraisal of his/her body - that is, cognitions and feelings about his/her body are reactions which (1) derive in part from the socializing others' reactions to the person". What I feel must be added to the last quote is that not only do socializing others' reactions play a part but also the individual's perceptions of socialzing others' reactions.
The result of all this is the individual pursuing beauty, a "normal" appearance, or the removal of some perceived flaw in an obsessive-compulsive manner (congruently with the depression, social phobias and other characteristics of the disorder). This pursuit of beauty or a "normal" appearance is not only a pursuit of a psychosocially satisfying body image but also of a psychosocially satisfying self. Or to put it another way, this is another instance of the beauty is good stereotype, with the afflicted individual also unconsciously pursuing the assumed social confidence and adjustment characteristic of that stereotype. However psyschosocial self change is made that much more difficult because the warped body-image ends up continuously reinforcing the aforementioned feelings of being different, simply due to the fact that one's experience of one's body is fundamental to their experience of reality and oneself. Furthermore the neurological underpinnings (which parallel those of obsessive-compulsive disorder) can also make change extremely difficult, because of the inherent qualities of those neurological pathways.
Other Theories to be Included on this Page in the Near Future Unprotected and Afraid
The Inner Child Speaks
Dreams