top of page
difficulty with body image los angeles


Treatment for Body Dysmorphia and BODY IMAGE CONCERNS, LOS ANGELES

In today's world, we can't help but notice how much attention is given to looks. It seems like everywhere we turn, be it in magazines, on screens, or the internet, there's this constant stream of what's considered "beauty." 

One of the big issues with this is Body Dysmorphia Disorder or BDD for short. It's like this annoying side effect of our appearance-obsessed culture, and it can cause significant distress.

Perhaps you find yourself avoiding mirrors because they make you feel anxious and insecure. Or maybe you constantly criticize everything you see in the mirror and wish your body looked different. The pursuit of an ideal body can leave you feeling exhausted, depressed, and hopeless. You might notice that you're fixated on your physical appearance most of the time, leading to constant body-checking. This obsession can make you feel uncomfortable and anxious in your own skin. Simple tasks like choosing an outfit for a night out can become overwhelming. But remember, you're not alone in this struggle.

understanding body image therapy

If you're interested in learning more about me or the way I work, feel free to look at some of the other pages on my website or call for a free consultation. I provide family and couples therapy, as well as therapy for adults. I offer in person sessions in my office in West Hollywood and provide online sessions if you live in California. 

Understanding Body Dysmorphia

In today's world, the emphasis on physical appearance is overwhelming and there's an increasing trend in young people having body image issues and low self-esteem. Body image concerns and eating disorders are increasingly common, especially among children and teens in Los Angeles. At Oliver Drakeford Therapy, we understand the complex nature of these issues and offer strategic treatments to help individuals find harmony between their self-perception and reality.

Body dysmorphic disorder is a prevalent issue, affecting approximately 1.7% to 2.4% of the general population who report poor body image or dissatisfaction with body shape. That equates to about 1 in 50 people. It's characterized by a preoccupation with minor or imagined defects in one's appearance, which can be distressing and lead to various compulsive behaviors.

  • become preoccupied with a wide range of perceived flaws in their appearance or body size or body parts;

  • these might appear minimal or non-existant to others.

  • most often, people with BDD focus on certain areas, including teeth, chin, nose hair, and skin.

  • negative thoughts and negative feelings of judgment and shame around body appearance, size or shape

  • often, people with BDD believe their faces or bodies appear asymmetrical, disproportional or even deformed.

  • This preoccupation about the perfect body can consume several hours a day of thinking about their areas of concern.

  • Frequently compare themselves to other bodies, and have judgments towards themself. 

  • Most importantly, the level of distress they experience causes an impairment in their daily life. 

  • This might include compulsive behaviors to check their body or to check appearances.

Even if someone's concerns about their appearance don't reach this level, a negative body image can be detrimental to one's overall well-being. It often involves an excessive focus on comparing one's size, shape, or appearance with unrealistic ideals. Seeking support from mental health professionals can provide essential support for those facing body image challenges.


Body Dysmorphic Disorder (BDD) is often characterized by inner turmoil and silent suffering that extends far beyond what meets the eye and many lesser-known aspects of BDD do not get talked about as much online or in the media. People with BDD often face profound challenges dealing with the disorder and often have difficulties getting healthcare professionals striving to diagnose it accurately.

Diagnosing Body Dysmorphia Can Be Challenging

For many individuals grappling with BDD, the journey toward diagnosis and treatment is a long and isolating one. It's not uncommon for people to endure this silent struggle for an extended period, sometimes spanning over a decade. This prolonged silence can be attributed to various factors:

  • Lack of Awareness: BDD remains widely misunderstood and often misdiagnosed. Those suffering from it may not even be aware that their distressing thoughts and behaviors are indicative of a recognized mental health condition. Consequently, they may endure their anguish quietly, attributing it to personal flaws rather than a medical condition, or get diagnosed with obsessive-compulsive disorder or social anxiety disorder, which are not unrelated but distinct enough to have a separate diagnosis. 

  • Feelings of Shame: The shame and embarrassment associated with BDD can be overwhelming. Many individuals feel reluctant to discuss their preoccupations with appearance, fearing judgment or ridicule from others and stops them seeking professional help. This silence perpetuates their suffering as they grapple with their perceived imperfections in solitude.

  • Inaccurate Self-Perception: One of the cruel ironies of BDD is that individuals afflicted by it often have an inaccurate self-perception. They genuinely believe that their perceived flaws are readily apparent to others, while in reality, these "flaws" go unnoticed by most people. This distortion of self-image fuels their silence and intensifies their emotional distress.

Challenges in Diagnosis: Navigating the Abyss

Unmasking BDD is an intricate process fraught with challenges for both patients and healthcare professionals. Recognizing the disorder requires a keen understanding of its nuanced symptoms and behaviors. Here are some of the hurdles healthcare providers face when diagnosing BDD:

  • Poor Insight: Patients with BDD frequently lack insight into the irrationality of their concerns. They may vehemently believe in the existence of their perceived flaws and be resistant to accepting a diagnosis of BDD. This poor insight can hinder the diagnostic process.

  • Overlapping Symptoms: BDD shares symptomatology with various other mental health conditions, including obsessive-compulsive disorder (OCD), social anxiety disorder, and major depressive disorder. These overlapping symptoms can lead to misdiagnosis or delayed diagnosis.

  • Stigma and Shame: The stigma surrounding mental health issues, particularly those related to appearance, can discourage individuals from seeking help. Healthcare providers must create a safe and nonjudgmental environment to encourage disclosure and accurate diagnosis.

body image therapsit los angeles

My approach to body image therapy

My approach to therapy in general, is often informed through a psychoanalytic lens, which delves into the intricate landscape of one's psyche and unconscious emotions. This approach assumes that our most important interactions occur with our primary caregivers in our formative years, and despite often not being able to remember it, these interactions can wield significant influence over our self-perception and body image.

We all internalize aspects of our caregivers, the good, the bad, and not-so-kind, and can create a distorted version of this that lives with us. Freud referred to this as the critical super-ego, which is supposed to keep us in line. Ideally, it stops us from quitting our jobs when we get frustrated and reminds us to stop at a red light because the rules apply to us, too. Often, this part of us becomes way too critical, destructive, and mean and can focus on self-perception,and body appearance. This critical superego is not a carbon copy of our upbringing. Instead, we are able to internalize the attitudes of others and make them about ourselves. Even if a child has wonderful parents and feels unaccepted or subjected to criticism by others during their formative years, they may grow up excessively critical of themselves, particularly in terms of their physical appearance.


Those grappling with BDD often grapple with profound uncertainty about themselves: uncertainty is one of the worst feelings for human beings to tolerate, we absolutely loathe this. Often we can seek to assert control over things like our appearance as a means of coping with or negating feelings of uncertainty. Such individuals may believe that altering a specific aspect of their body will lead to acceptance and love without recognizing that this belief originates from their past experiences and internalized viewpoints.

A psychoanalytic treatment for BDD necessitates an exploration of these deeply ingrained emotions, internalized perspectives and family of origin. The goal is to fathom how past relationships and experiences continue to shape current self-perceptions and behaviors.

Men, BODY IMAGE AnD Muscle Dysmorphia


Growing up in a challenging environment in which boy were made to feel inadequate, or were compared to others sets many young gay boys on a path to overcompensate for others' affections. Rejection during childhood, such as name-calling, bullying, or ridicule for not behaving in certain expected ways ,can drive these individuals to seek acceptance by perfecting their bodies.

Changing one's body is, in a certain light, is more achievable than changing personality traits or mannerisms and the need for acceptance is so powerful that the two can combine to become a driving force.  Working out tirelessly and reaping the attention that comes from a sculpted physique can temporarily alleviate the anxiety and fear of rejection. However, this excessive focus on achieving the ideal body often fails to address the underlying issues of self-hatred, shame, and unresolved trauma.

Gay men and body image

appearances and body image therapy los angeles

In the LGBTQ community, there's a particularly strong emphasis on appearance and looks. A proliferation of workout routines and the endless stream of shirtless selfies on Instagram are clear indicators of this trend that creates weight stigma and unrealistic standards. You might even consider the way gay men categorize each other as 'twinks' or 'muscle bears' as even more evidence that there's a looks-based culture that emphasizes physical characteristics. Despite these classifications being quite diverse, it does seem that there are various idealized physiques that many gay men strive to achieve.


The pervasive popular culture in Los Angeles, heavily influenced by the entertainment industry, exerts a significant impact on the perception and valuation of body image and the cultural ideal. This influence is not limited to men obviously but extends to models, actors, and other professionals in the entertainment sector, all of whom face immense pressure to conform to extreme societal ideals. The media, including Hollywood movies, television, fashion magazines, and celebrity culture, play a pivotal role in reinforcing and perpetuating this physical ideal. These media outlets often present airbrushed and idealized images of 'perfection', which can lead to unrealistic body image standards and self-perception issues among young creatives and performers. The added stress of the camera adding perceived weight adds further pressure on people in the entertainment industry, where body image is tightly scrutinized and can amount to body shaming. 

If you are concerned about your own body image and are curious about taking a first step towards seeking mental health services, the most important thing is finding someone who is experienced in working with people who have a negative self-image. Therapy is an effective way to help you work towards a more positive body image and body positivity. As a potential mental health provider, I encourage you to take advantage of the free initial call most therapists offer and ask about the time of therapy session they have available, their experience in body image counseling, and how they might help you have a healthier relationship with your body weight or body image dissatisfaction. 


I'm a licensed therapist in Los Angeles, and my private practice is in West Hollywood, where i conduct in-person sessions. I provide couples and family therapy as well as counseling to adults to help address emotional issues that are underlying a lot of our worries and concerns. I address distorted perceptions and faulty thinking to provide a new way of seeing the world, our 'Self' and others. I provide online sessions if you live in California. 

Untitled design (89)_edited.jpg



How can body image therapy help with self-esteem?

Body image therapy can help improve self-esteem by addressing negative self-talk and providing tools and techniques to build a healthier relationship with oneself. Therapists work with individuals to explore the origins of their self-esteem issues and develop strategies to boost confidence.


Who can benefit from body image therapy?

A3: Body image therapy can benefit individuals struggling with negative body image, low self-esteem, emotional distress, trauma related to their bodies, social comparison, and more. It is a versatile approach that promotes overall well-being.


What modalities are used in body image therapy?

Body image therapy often incorporates Cognitive Behavioral Therapy (CBT) to address and replace negative thoughts. Acceptance and Commitment Therapy (ACT) may also be used to foster self-acceptance and compassion.


What are the two types of dysmorphia?

MD or muscle dysmorphia, a main sub-type of body dysmorphic disorder (BDD).

BDDBP Body dysmorphic disorder by proxy is a version of BDD in which a person is too concerned with imperfections they percieve with another person’s appearance.
bottom of page