Clarke - Overcoming Body Image Problems including Body Dysmorphic Disorder

DR DAVID VEALE is a Consultant Psychiatrist in cognitive behavior therapy at the South London and Maudsley Trust and The Priory Hospital North London. He is an Honorary Senior Lecturer at the Institute of Psychiatry, Kings College London. He is an accredited cognitive behavior therapist and was President of the British Association for Behavioural and Cognitive Psychotherapies from 2006 to 2008. He sat on the National Institute for Health and Clinical Excellence (NICE) working group that provided guidelines for treating Obsessive Compulsive Disorder (OCD) and Body Dysmorphic Disorder (BDD) in the UK. He has about 70 publications to his name, and his own website: www.veale.co.uk . He runs a national specialist service for BDD at the Maudsley Hospital, London.

ROB WILLSON is a cognitive behavior therapist in private practice. He is a tutor at Goldsmiths College, University of London. He holds an honours degree in Psychology, an MSc in Rational Emotive Behavior Therapy, and a Postgraduate Diploma in Social and Behavioral Health Studies. He has been involved in treating individuals with body image problems for the past 13 years. David Veale and Rob Willson are authors of Overcoming Obsessive Compulsive Disorder and Manage Your Mood, also published by Robinson.

DR ALEX CLARKE is a consultant clinical psychologist in plastic and reconstructive surgery at the Royal Free Hospital, Honorary Lecturer in the Department of Mental Health Sciences at the Royal Free and University College London Medical Schools, and Visiting Professor at the Centre for Appearance Research at the University of the West of England. She has acted as consultant to the organization Changing Faces, a charity for individuals with disfigurement, and she has a particular interest in the psychological aspects of disfigurement and reconstructive surgery.

The aim of the Overcoming series is to enable people with a range of
common problems and disorders to take control of their own recovery program.
Each title, with its specially tailored program, is devised by a practising
clinician using the latest techniques of cognitive behavioral therapy
techniques which have been shown to be highly effective in changing the
way patients think about themselves and their problems.
The series was initiated in 1993 by Peter Cooper, Professor of Psychology
at Reading University and Research Fellow at the University of Cambridge
in the UK, whose original volume on overcoming bulimia nervosa and
binge-eating continues to help many people in the USA, the UK and Europe.

Titles in the series include:

OVERCOMING ANGER AND IRRITABILITY

OVERCOMING ANOREXIA NERVOSA

OVERCOMING ANXIETY

BULIMIA NERVOSA AND BINGE-EATING

OVERCOMING CHILDHOOD TRAUMA

OVERCOMING CHRONIC FATIGUE

OVERCOMING CHRONIC PAIN

OVERCOMING COMPULSIVE GAMBLING

OVERCOMING DEPERSONALIZATION AND FEELINGS OF UNREALITY

OVERCOMING DEPRESSION

OVERCOMING GRIEF

OVERCOMING INSOMNIA AND SLEEP PROBLEMS

OVERCOMING LOW SELF-ESTEEM

OVERCOMING MOOD SWINGS

OVERCOMING OBSESSIVE COMPULSIVE DISORDER

OVERCOMING PANIC

OVERCOMING PARANOID AND SUSPICIOUS THOUGHTS

OVERCOMING PROBLEM DRINKING

OVERCOMING RELATIONSHIP PROBLEMS

OVERCOMING SEXUAL PROBLEMS

OVERCOMING SOCIAL ANXIETY AND SHYNESS

OVERCOMING TRAUMATIC STRESS

OVERCOMING WEIGHT PROBLEMS

OVERCOMING WORRY

OVERCOMING YOUR CHILDS FEARS AND WORRIES

OVERCOMING YOUR CHILDS SHYNESS AND SOCIAL ANXIETY

OVERCOMING YOUR SMOKING HABIT

All titles in the series are available by mail order.

Please see the order form at the back of this book.

www.overcoming.co.uk

Including Body

Dysmorphic Disorder

A self-help guide using

Cognitive Behavioral Techniques

DAVID VEALE, ROB WILLSON

AND

ALEX CLARKE

ROBINSON

London

Constable & Robinson Ltd

5556 Russell Square

London WC1B 4HP

www.constablerobinson.com

First published in the UK by Robinson,

an imprint of Constable & Robinson Ltd 2009

Copyright David Veale, Rob Willson and Alex Clarke, 2009

The right of David Veale, Rob Willson and Alex Clarke to be identified as the authors of this work has been asserted by them in accordance with the Copyright, Designs and Patents Act, 1988.

All rights reserved. This book is sold subject to the condition that it shall not, by way of trade or otherwise, be lent, re-sold, hired out or otherwise circulated in any form of binding or cover other than that in which it is published and without a similar condition including this condition being imposed on the subsequent purchaser.

A copy of the British Library Cataloguing in

Publication Data is available from the British Library.

Important Note

This book is not intended as a substitute for medical advice or treatment. Any person with a condition requiring medical attention should consult a qualified medical practitioner or suitable therapist.

ISBN 978-1-84529-279-9

eISBN 978-1-47210-570-7

Printed and bound in the EU

1 3 5 7 9 10 8 6 4 2

We would like to acknowledge the host of individuals who have inspired or taught us and who have done most of the research into body image. We have not included full references in this book but most of the research findings are taken from the publications of Tom Cash, Christina Lambrou, Fugen Neziroglu, Sandra Mulkens, Katharine Phillips, Nichola Rumsey, Roz Shafran, Sabine Wilhelm, and many other researchers too numerous to mention. Lastly, we thank all our patients, from whom we have learnt so much. We recognize the struggle they face every day, and hope that this book will be helpful to them and others.

The approach this book takes in attempting to help you overcome your body image problems is a cognitive behavioral one. A brief account of the history of this form of intervention might be useful and encouraging. In the 1950s and 1960s a set of therapeutic techniques was developed, collectively termed behavior therapy. These techniques shared two basic features. First, they aimed to remove symptoms (such as anxiety) by dealing with those symptoms themselves, rather than their deep-seated underlying historical causes (traditionally the focus of psychoanalysis, the approach developed by Sigmund Freud and his associates). Second, they were scientifically based, in the sense that they used techniques derived from what laboratory psychologists were finding out about the mechanisms of learning, and they put these techniques to scientific test. The area where behavior therapy initially proved to be of most value was in the treatment of anxiety disorders, especially specific phobias (such as extreme fear of animals or heights) and agoraphobia, both notoriously difficult to treat using conventional psychotherapies.

After an initial flush of enthusiasm, discontent with behavior therapy grew. There were a number of reasons for this, an important one of which was the fact that behavior therapy did not deal with the internal thoughts which were so obviously central to the distress that many patients were experiencing. In particular, behavior therapy proved inadequate when it came to the treatment of depression. In the late 1960s and early 1970s a treatment for depression was developed called cognitive therapy. The pioneer in this enterprise was an American psychiatrist, Professor Aaron T. Beck. He developed a theory of depression which emphasized the importance of peoples depressed styles of thinking, and, on the basis of this theory, he specified a new form of therapy. It would not be an exaggeration to say that Becks work has changed the nature of psychotherapy, not just for depression but for a range of psychological problems.