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thoughts and feelings

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BDD is particularly devastating because of the thoughts and feelings that accompany the appearance misperceptions. Most of us are not happy about some aspect of our appearance, but we are are able to go on and lead happy, full lives because we do not have BDD thoughts and feelings: we do not think the flaws are so important that they doom us and we do not get intense, painful feelings every time we see, imagine, or think about our appearance. Below are some of the typical thoughts and feelings of BDD sufferers.

Range of beliefs about their appearance Most feel they are ugly, deformed or hideous and just wish to look normal. However, a few think they are okay looking, but that life is not worth living unless they are extremely attractive.
Persistent intrusive thoughts about their flaws Generally people think about their perceived flaws for hours each day, often virtually all their waking hours, though at times the thoughts are somewhat in the background. They think about how awful they look, what others must be thinking about them and about what that means for their lives.
Shame & embarrassment They are overwhelmed by feelings of shame and embarrassment about their appearance. This leads to social avoidance and other BDD behaviors.
Overvaluing attractiveness They believe that appearance is profoundly important, at least their appearance is. They often feel they can never be loved or have a relationship because of their physical flaws. They may feel their appearance will keep them from career success, even if they want a career in which appearance is unimportant. Note they are often not judgmental about the appearance of others.
Worthlessness & hopelessness Their focus on their perceived appearance flaws and their belief that attractiveness is extremely important leads to feelings of worthlessness and hopelessness. They may feel doomed.
Ideas of reference They interpret all bad reactions and events as due to their appearance flaws. They think everyone is looking at their flaws and viewing them as they do. For example, if a person has freckles and thinks they are disgusting, they believe everyone is looking at them and thinking how disgusting they are. If someone mentions freckles, they will think it's because they are thinking about their freckles and how disgusting they are.
Anticipating how others will react to them Much of their time is spent anticipating how others will react to them. They anticipate being rejected, ridiculed, and humiliated.
The solution to all their problems is to fix their appearance They believe that fixing their appearance is the only solution to their problem. Therefore, they seek surgical or other medical solutions to fix their appearance. They may dismiss and be insulted by the idea of psychological/psychiatric treatment.

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