The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder

by Katharine A. Phillips

In a world obsessed with appearances, it is not surprising that body dysmorphic disorder, or BDD, has manifested itself as a troubling and relatively common problem for many individuals. In The Broken Mirror , the first and most definitive book on BDD, Dr. Katharine Phillips draws on years of clinical practice, scientific research, and professional evaluations of over 700 patients to bring readers her expertise and experience with this often debilitating illness.
BDD causes sufferers to be obsessed by perceived flaws in their appearance and may afflict as much as two percent of the population, or nearly five million people. Many sufferers are able to function well in society, but remain secretly obsessed by their "hideous acne" or "horrible nose," sneaking constant peeks at a pocket mirror, or spending hours at a time redoing makeup. Others find their lives disintegrate because of their appearance obsessions. It is not an uncommon disorder, simply a hidden one, since sufferers are often embarrassed to tell even their closest friends about their concerns. The author presents the stories and interviews of over 200 individuals to show the many different behaviors and symptoms of BDD, and includes a quick self-assessment questionnaire. Four new chapters provide updated information on treatment of BDD, frequently obtained treatments to be avoided, and more detailed advice for family members and friends on how to cope with the disorder.
Left untreated, the torment of BDD can lead to psychiatric hospitalization and sometimes suicide. With treatment, many sufferers are able to lead normal lives. The Broken Mirror is literally a lifesaving handbook for sufferers, their families, and their doctors.

Genres: Psychology, Self Help, Nonfiction, Mental Health, Counselling

428 pages, Paperback

First published June 25, 1998

Reviews

[Jody · Rating 5 out of 5]

I read this book so many years ago but truly believe it saved me from feeling so alone with such a bizarre obsessive disorder known as BDD aka body dysmorphic disorder. Essentially what I see in the mirror isn't what others see. I have a completely distorted self perception as does anyone with this truly miserable 'illness'. I'm convinced that for me this formed 'the perfect storm' when combined with anorexia and OCD at a young age.
As a person who's struggled with it all my life--it seems to go in cycles--it's embarrassing to be thinking about stuff that sounds so shallow and vain. I WISH I were obsessed with the ozone layer or world peace for god's sake. No, I get obsessed with something as trivial as hair. At this point I would love to be UGLY and HAPPY minus these relentless thoughts of appearance. Good lord, I'm a FEMINIST! OK..back to my review.
And to top it all off for those of us who have this we KNOW it's irrational. And that's what earmarks it as an obsessive disorder. It's definitely interfered with my daily functioning and relationships. I felt so validated by this book years ago when it first came out. I truly feel it's underrated. I had my best friend call me excitedly and say 'this is YOU!'when it was featured on Oprah. It gave this bizarre disorder a 'name'. AND, there are others like me so knowing we are not alone is so comforting. Now there are even online support groups for it! Highly recommended to anyone who'd like to learn more.

[lisey · Rating 3 out of 5]

Just some thoughts I had about this book – by no means a comprehensive review, but I thought I should write something! I finally finished this after a six month slog. I found it difficult to read, I think it was a little triggering for me. You might have a different experience, but I thought it was worth mentioning.

This is probably the best resource on BDD out there. I've waded through some other books and this seems to be the most nuanced. There's information here about how to seek help, forms of treatment, some speculations about what causes these feelings, and numerous case studies. There's checklists so you can evaluate yourself.

I found the way it was written to be quite dull. It reads like a wikipedia article, although slightly more personable. There are plenty of statistics, and much repetition. Plenty of information I personally didn't care about, but would likely be of use to somebody doing research. It is informative, evaluative, and offers concrete solutions. The book delves into how medication can help, as well as CBT.

My main gripe with this isn't unique to this book. Particularly in the case studies the author would comment on how the patient's feelings about their body were incomprehensible, because they were otherwise attractive. This judgement call on what constitutes attractiveness and what is irrational self-hatred makes me uncomfortable. I feel this is missing the point. It doesn't matter what the patient looks like – BDD is never logical. Does it make the BDD more or less real if someone deemed beautiful is experiencing these feelings? Rather, I think resources about this should avoid focusing on objective judgments about what an individual looks like, and rather focus on cultivating a sense of esteem that transcends the physical form.

I am glad this exists though. I only wish there were more resources out there!

[Verna · Rating 4 out of 5]

I learned an awful lot about this uncommonly known disorder. The person with BDD, Body Dysmorphic Disorder has a false distorted view of their appearance. This can take the form of obsessing constantly about a certain aspect of their body that they feel is flawed and unfixable. These individuals try their best through repetitive rituals of grooming, mirror checking and physical manipulation to gain some control over their perceived problem areas.These people also are big shoppers of cosmetic surgeries. This condition has a lot in common with OCD and other anxiety disorders. The author who treats BDD, feels that medication along with cognitive therapy is the best treatment outcome for these patients. If you, or someone you know suffers from BDD, this book is full of information and what to do about getting help. It is obvious this is not a disorder to be taken lightly and will only worsen if not treated by a knowledgable professional. Many more people have BDD than is recognized. It is thought that Michael Jackson, the famous pop star, who changed his appearance almost beyond comprehension had this little known mental disorder. From what I have read in this book, he certainly seems to fit the profile.

[Laura · Rating 3 out of 5]

I realize that this book was published nearly twenty years ago, but it was frustrating to hear the author repeatedly say, "Not much information is known about this yet." I also wish that Phillips took more time to research cognitive behavioral therapy instead of saying that medication is the solution for anyone with BDD. Hopefully more research has been proven in the past twenty years to test therapy as treatment instead of heavily relying on medication. However, this book provided great insight to a disorder I did not know that much information about. I do think a lot of the information was repetitive, which made me wonder if the author felt like she did not feel confident that she was getting her point across to the readers. I really enjoyed the book overall but I think quite a few pages could have been edited out because of how repetitive and similar a lot of the information was.

[S. Westwood · Rating 5 out of 5]

This is the BDD bible. If you suffer from body dysmorphic disorder this book will help you to understand yourself and will make you relieved that others have had the same issues that you have had. If you are reading it because you know someone with BDD or are just interested- this is the book you should read. I can't praise this highly enough- it is easy to read and really made me feel better about my own BDD. I'm sur a lot of people owe a debt to Katherine Phillips.

[Laura · Rating 5 out of 5]

Well this isn't a review as such, I just felt compelled to jot down my thoughts.

I have BDD, so this was a difficult book to read. I ended up sobbing miserably every time I sat down to read it. Needless to say, I have a lot of work to do. I thought I didn't. I thought I was used to it, and had made my peace, but I guess I was wrong.

I highly recommend this to anyone with BDD, especially if you haven't sought help already.

[Gloria · Rating 5 out of 5]

Absolutely is the Bible of BDD, with case examples (several of them in each chapter), treatment exploration as well as possible causes. I'm sad there are more books on this as this is a hideous illness. If you're looking for a good accompaniment to this is the BBC documentary "Too Ugly For Love", which is a scary look into the lives of 3 people who have this.

[Mike · Rating 3 out of 5]

Though this does a good job of describing the problem, it downplays the importance of community, CBT or alternative therapies in solving it...relying instead on a rigid regimen of psychopharmacology.

[Jason Phillips · Rating 1 out of 5]

A light shone on the disorder, bringing it much needed publicity. But my problem with the book lies in it's claim of a cure in anti-depressant pharmaceuticals. There has to be a better way.

[casey (ink drinker) · Rating 4 out of 5]

‘The Broken Mirror’ is an excellent and well-read book. Phillips' work clearly portrays (in the best way possible) the struggle of those who have BDD. Through her numerous real-life stories, Phillips lets the words of those who struggle with BDD speak out, and gives them a real chance to be heard. As a present from my sister due to my long-term struggles with numerous eating disorders and diet obsessions, it was just what I needed. It provided a good theoretical and psychological basis as well as what evidence based treatments that were effective in this population. It also provided great chapters on effective forms of medication to use, how to conduct an assessment and case studies. Anyone suffering from a BDD or think they may be suffering should give this book an in-depth read.

[Nada · Rating 3 out of 5]

Its a nice book about body dysmorphic disorder.
The studies included might need to be updated since the book was written longtime ago.
It provides a great informations for joiners in mental health.
* It was supposed to be for community, although the management chapters might be a little detailed for the public community.

[Juneberby · Rating 5 out of 5]

A bit of a slog and repetitive writing but absolutely essential information for anybody with BDD or close to somebody else with this mental disorder. As someone who has suffered tremendously from BDD for over 20 years, this book provided solid next steps to better manage my BDD. As other people noted, it was triggering to read; if you have BDD, be prepared for it to be potentially activated.

[Chet Lee Kowalski · Rating 4 out of 5]

Well written. Provides a wealth of information and insight as to how to recognize if you have bdd and what to do if you do. Also did a good job at offering options between medication and other treatments available for bdd.

[Nicole · Rating 4 out of 5]

really great book about body dysmorphic disorder.

[Sue · Rating 1 out of 5]

I felt that to really understand this book that you need to be a psych major

[Wiki · Rating 5 out of 5]

Insightful! Hope it helps

[Michelle · Rating 5 out of 5]

Such a wonderful, insightful read. You feel understood and it gives hope and reassurance.

[Tom Collins · Rating 4 out of 5]

'The Broken Mirror' clearly aims to be the definitive resource for the little-known and poorly understood mental disorder of Body Dysmorphic Disorder (BDD), as the comprehensive, exhaustive amount of angles from which the author approaches the subject testify. Indeed, this desire could easily make the book off-putting to many upon first glance, as it has resulted in a sizeable 412-page tome. That said however, it is not as inaccessible a work as it might ostensibly appear; Dr. Phillips has also endeavoured - successfully - to produce a book as comprehensive in target audience as it is in content, meaning that while there is a fair amount of 'psychology speak' for the clinical purchaser, this is generally broken down sufficiently for laypersons (e.g. sufferers of BDD and their friends/families) to understand.

The author must be given credit for the sympathetic way in which she conveys the severe, often debilitating, impact of BDD upon the lives of sufferers, going as far as to allow patients' own testimonies of their experiences. It should also be recognised that she was way ahead of her time in even examining BDD in such depth, which includes an exploration of the important question as to whether BDD is a self-contained clinical entity, a symptom of another specific mental illness, or a symptom of a variety of other mental health conditions... as the book notes, there are outward similarities between BDD and eating disorders, and - as I've found in my own personal experience - doctors can be very quick to rule out appearance concerns off-hand (and, for that matter, equally willing to heavily downplay their significance and effect upon a person...) as a by-product of depression when - sometimes - the truth can be that depression is the consequence of BDD.

However, while I have no doubts that the author means well and is genuine in her conclusions, her faith in medication and CBT borders on evangelical (I haven't experienced such a glowing espousal of the former since reading 'An Unquiet Mind'). While one or both of these treatments are undeniably helpful to many - for various conditions, not just BDD - it is also the case that a significant number of patients do not respond to these approaches. Unfortunately though, Dr. Phillips effectively brushes such people under the carpet, which - sadly - is what too many contemporary mental health professionals seem to want to do. Something else which is sadly congruent with the 'medication and CBT' school of treating mental illness is a lack of discussion regarding psychosocial influences upon the formation and prevalence of BDD... this seems like an oversight to somebody like myself who believes that drugs and cognitive treatments aren't the be-all and end-all of psychiatric care, and a strange one too considering that the blurb on the rear cover begins with the text; "In a world obsessed with appearance...".

Overall though, the fact is that - as of the publication of the edition I read (2005) - the available literature on BDD was extremely limited, and so the author - both in terms of her book, and indeed her everyday professional care - has done the best she can with what relatively little she had to work with. Hopefully - as the author herself seems to wish - this book will inspire further research on BDD, and in doing so perhaps yield a broader range of theoretical and treatment perspectives about the condition than 'The Broken Mirror' details.

[Aaron · Rating 2 out of 5]

This book was EXTREMELY repetitive. I find this a fascinating subject, however, the author keeps asking/answering the same questions over and over and over again. Questions like, what makes people with BDD different from normal people who worry about their looks. Then the author will use a case study to say "they obsess over their looks and it prohibits their functioning in everyday life". I would suggest people to read the first chapter or so, then skip to the end because the stuff in the middle just sounded like a freshmen's term paper...not much content and a lot of receptiveness and fluff.

[Horror_Reader1973 · Rating 5 out of 5]

This book helped me beyond words. I am very fortunate to be in recovery from Body Dysmorpia now and this book certainly helped me on my journey. It was comforting reading the stories of others, knowing I was not alone and could actually relate my behaviour to others. There is a lot of helpful information and guidance about support.

[Cheyenne · Rating 3 out of 5]

this book helped me alot.