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Through the looking glass: investigating body dysmorphic disorder

New study shows that mirrors are central to most people’s experiences of body dysmorphic disorder

by George Wigmore (Senior Communications Officer)

Academics at City University London have found that mirrors are central to most people’s experiences of body dysmorphic disorder (BDD), with participants often describing feeling trapped by mirrors and the negative feelings associated with them.

Published in the Journal of Health Psychology, study participants viewed themselves as objects and also described mirrors as being controlling, imprisoning and disempowering forces that had a crippling and paralysing effect on life. As a result, the research provides evidence for the need for health psychologists to ask clients about their experiences when looking in the mirror as well as their general mental health.

Body dysmorphic disorder is defined by psychiatrists as a disabling and distressing preoccupation with perceived physical flaw or flaws. To investigate the experiences of participants when they look in the mirror, the team from City recruited 10 participants (7 females and 3 males) who identified themselves as suffering from the condition.

Participants were recruited from advertisements placed on BDD websites, internet support groups and word of mouth. All participants identified themselves as suffering from BDD. The age of participants ranged from late teens to mid-30s and participants had suffered from BDD for between approximately 4 and 25 years.

By getting them to take photographs that related to their body dysmorphic disorder experience, the researchers were able to discuss these feelings in interviews. It was found that mirror gazing in body dysmorphic disorder is an embodied phenomenon – in that it’s a process of embodied being and living through a relational, spatial, material and socio-political world. As a result motivations for mirror gazing were confusing, complex and masochistic, but overall participants described mirrors as being controlling and having a paralysing effect on life.

One participant, who went by the pseudonym Louise, spoke about her experiences, saying: “I once stared at myself in the mirror for eleven hours. When I look in the mirror I can’t go again until I’ve kind of made peace with the picture that I see there... And during that time when I am stuck I can’t do anything, I can’t pick up the phone, I can’t walk to open the door if someone comes round to try and help me, I can’t drink anything or eat anything or go to the bathroom. I am just stuck there completely.”

Speaking about the research, Dr Jacqui Farrants, co-author of the study and a consultant Psychologist at City University London, said: “We found that mirrors are central to most participants’ experiences of BDD, with people with the condition viewing themselves as objects in the mirror. Participants also reported feeling extreme shame when looking at themselves in the mirror.”

Dr Joanna Silver, co-author of the study and a counselling psychologist at the Nightingale Hospital, said: “BDD can have a devastating impact on people’s lives, with many finding it hard to leave the house, as a result hopefully this study can help health psychologists when they speak to their clients, as this research shows that it is important to them to about their unique embodied experiences of mirror gazing as well as asking them about their general mental health.”

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City, University of London is an independent member institution of the University of London. Established by Royal Charter in 1836, the University of London consists of 18 independent member institutions with outstanding global reputations and several prestigious central academic bodies and activities.