Carolyn Sayers

Carolyn has been a CBT therapist for over 20 years, and has a background in Nursing.

Carolyn’s last post was with the CBT Training Clinical Centre where she was a tutor and supervisor. Carolyn is now semi – retired since July this year. Currently working in private practice, working with Yorkshire water and GMW Training recovery academy.

Carolyn talks about the aims of today’s session, followed by a true or false questionnaire, and some facts around BDD covered were;

  • The most common age to experience body dismorphic disorder is 13 due to
    hormonal changes in puberty
  • BDD effects men and women equally
  • The facial hair, skin and nose are the most common focus area
  • BDD is treatable
  • The cause is unknown; possible thoughts are bullying, teasing, childhood abuse.

What is BDD?

The diagnostic criteria states, preoccupation with an imagined defect in appearance, if a slight physical anomaly is present the persons concerns are markedly excessive.

Carolyn clarified that it is not the same as anorexia.

Discussed BDD in the group and how some people can be focused on birth marks and other ‘flaws’. Explored how this is down to disproportion of anxiety and worry and pre-occupation.

Looked at how addressing the underlining beliefs can be helpful such as, what does that mean if I have a defect…what does that say about me…

BDD can trigger compulsions such as mirror checking, make up, dieting, weight lifting. Many have also turned to plastic surgery.

What keeps it going?

  • Appearance pre-occupation and shame
  • Re-assurance and checking
  • Negative predications
  • Being watchful of others laughing/making comments about appearance
  • Avoidance and safety behaviours


  • Direct negative comments
  • Indirect comments
  • Perceived or actual rejection
  • Situations where appearance is evaluated
  • Situations where you’re in attention, public speaking
  • Seeing an unflattering photograph
  • Exposure to attractive people
  • Noticing a slight change in appearance

Where does it come from?

  • Psychological
  • Biological
  • Environmental

Impact of BDD

It can impact you on emotional, cognitive, physical, behavioural and environmental levels.

Treatment options

CBT is the most preferred treatment option for BDD and is NICE approved. However engagement with the client is crucial.

Recommended model is David Veale’s model.

Jennifer Pennington

Of the 23 attendees, 100% found the presenter’s style and knowledge very good/excellent and 96% found the content and Q&A session very good/excellent.
Comments from the evening included:
“Very informative session, enjoyed learning it” “Super presentation, very knowledgeable”
“Very interesting topic and like the new venue” “Fun as well as interesting”
“Very helpful presentation to uncover the myths of this disorder. I leave much more informed about BDD”