Body dysmorphic disorder (BDD) is the clinical term for an acute form of psychological distress. It is considered a type of mental illness when it impairs an individual’s ability to function reasonably well in social contexts.
According to Wikipedia, in BDD
the afflicted individual is concerned with body image, manifested as excessive concern about and preoccupation with a perceived defect of their physical appearance. An individual with BDD has perpetual negative thoughts about their appearance; in the majority of cases, an individual suffering from BDD is obsessed with a minor or imagined flaw. Afflicted individuals think they have a defect in either one or several features of their body, which causes psychological and clinically significant distress or impairs occupational or social functioning. BDD often co-occurs with depression, anxiety, social withdrawal, and social isolation.
By no means is it true that one has BDD simply when dissatisfied with the appearance of part (or most) of one’s body. It it were true, just about everyone could be said to have BDD. It only rises to the level of a problem, in general, if it “impairs occupational or social functioning”.
However, the description of BDD sounds suspiciously like how many people actually do feel about their naked bodies. It could very well be that mild forms of BDD help account for why many people cannot imagine being comfortable with social nudity – even if they are largely able to function normally in other respects.
The main problem with many psychiatric disorders like BDD is that they are defined in terms of symptoms, rather than the underlying biological causes (if any). As a result, it is almost impossible to discover medical remedies for the problems that work on the biology – except, perhaps, by trial and error.
Nevertheless, anything that can be learned scientifically about BDD may be of use in dealing with mild forms that prevent people from enjoying social nudity.
Some recently reported research may offer a little bit of optimism:
When people think of mental illness related to body image, the first thing that usually comes to mind is anorexia or associated eating disorders. But, the lesser known body dysmorphic disorder (BDD) is five times more prevalent than anorexia and also causes higher levels of psychological impairment.
In the world’s largest neuroimaging research in disorder published in the prestigious journal Psychological Medicine, Monash University’s Dr Ben Buchanan found there was a weak connection between the amygdala, the brain’s emotion centre, and the orbitofrontal cortex, the rational part of the brain that helps regulate and calm down emotional arousal.
The main symptom of BDD is excessive fear of looking ugly or disfigured. Central to the diagnosis is the fact that the sufferer actually looks normal.
Cognitive behavioral therapy (CBT) is a type of psychotherapy that is sometimes helpful in ameliorating dysfunctional emotions. It has been used successfully as a treatment for BDD. The new research showed that CBT has physiological effects that help emotional and rational parts of the brain communicate more effectively, and hence overcome inappropriate emotional feelings about body appearance.
Anyone who would contemplate cosmetic surgery to correct perceptions of undesirable physical appearance should first look into CBT, which is very likely to be safer and cheaper.
It might even make it easier for some people to become comfortable with social nudity. Plunging directly into social nudity might also help in mild cases of BDD – but making such an attempt might be putting the cart before the horse.