“He's a good-looking chap aint he?”: Narrative and visualisations of self in body dysmorphic disorder

Body Dysmorphic Disorder (BDD) is a condition marked by a distressing preoccupation with an imaginary or minor defect in a facial feature or a localised part of the body. However, the link between such excessive preoccupation and perceptions of self throughout the life course has rarely been examined. The aim of this study was to examine narrative accounts of the self across different life-time periods. Eleven participants diagnosed with BDD in England were recruited from the National Obsessive Compulsive Disorder (OCD) clinic and a BDD self-help group. In the context of a semi-structured interview participants presented photographs of themselves across a variety of time periods and drew a self-portrait to prompt memory and generate discussion. Transcribed interviews were analysed using Michele Crossley's (2000) narrative analytic approach. The findings suggest that the majority of participants perceived their past self as excessively attractive. Rather than believing that the alteration of their current appearance would rid them of BDD, participants indicated that a return to their former infantile and pure self that was devoid of blemish, defects and emotional responsibility would provide comfort. These findings indicate that the difficulties associated with appearance are less to do with beauty per se, but are more likely associated with narratives of loss, aging and decline and death.