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Stacy Blecher's picture

Body Dysmorphic (Dis)order

All of our class discussion about the image of what is “out there” versus the image in our head got me thinking about body dysmorphic disorder (BDD).  Individuals who suffer from BDD have an image of themselves in their head that does not match what the majority of others see in their head when they look at the individual.  The BDD patient perceives themselves to be physically defective in some way, yet even a thorough medical exam cannot find any medical cause for concern.  But is this person really ill?  Many consider BDD to be a mental disorder and write off BDD patients as being crazy and having a warped sense of reality.  However, after these past few classes, I’m pretty sure that there is no such thing as reality –or if there is, it is by no means a universal constant.  If reality lies in the eye / mind / brain of the beholder, then why are these individuals regarded as having a mental handicap? Just because the majority of people produce a similar image in their head when they look at you doesn’t mean that you are disabled if you perceive yourself differently when you look in a mirror.

I have read some articles and web pages that claim BDD could be caused by an imbalance of serotonin in the brain.  Since serotonin is known to regulate emotions (among other things), I wonder if our mood determines the image that is crated in the head.  This seems to make sense to me.  I know that if I have been having a bad day and feel bad about myself, when I go home and look in the mirror I don’t like what I see.  On the other hand, when I’ve had a really great day (and probably have higher levels of serotonin) I don’t mind looking in the mirror.  Another hypothesis is that serotonin, in addition to regulating emotions and moods etc, serves a purpose in the visual system that we are unaware of.  Yet, regardless of the cause of this “disorder,” the fact remains that what these people see in the mirror is reality –it’s their reality.  So, maybe the image of their nose looks different in their head than it does in yours….Your image of red is different than everyone else’s in the world, yet no one has diagnosed you with a mental disorder.  What’s the difference?

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