Sandra is a twenty-three-year-old college student who believes she has blemishes that make her very unattractive; she also despises her curly hair and “droopy” eyes. A few years ago, she began college at an out-of-state university. Throughout her first semester, she began to attend classes less and less and found it difficult to socialize with others in her dorm or eat in the cafeteria. One day, on a break from school, she broke down and told her parents that she couldn’t continue school there. Her parents were shocked. Sandra hadn’t revealed her concerns to them and rarely spoke of her appearance. She did not wish to appear vain or conceited; however, unknown to her family, while at school, she had been spending hours straightening her hair and using foundations and concealers to hide her blemishes until she could her ensure her appearance was “perfect,” even though her flaws were unnoticeable to others. She had even tried many products to attempt to lighten the skin under her eyes. The anxiety and stress of this constant quest for perfection was taking its toll on Sandra’s ability to lead a normal life.
Her parents sought therapy and Sandra was diagnosed with Body Dysmorphic Disorder (BDD). She agreed to a course of intensive behavioral treatment which included exposures to feared situations while not camouflaging her perceived flaws. Her unhelpful thoughts regarding her appearance or judgements from others were also targeted in cognitive therapy. She was able to return to a new school, closer to home, and now spends drastically less time, money and effort on getting ready. She has made new friends and is engaged once again in her coursework.