EMDR in the treatment of body dysmorphic disorder

Body dysmorphic disorder (BDD) is defined in the Diagnostic and Statistical Manual IV-TR (DSM-IV-TR) as a disorder characterised by a preoccupation with an imagined defect in one's appearance (American Psychiatric Association (APA), 1994). BDD can be treated effectively with selective serotonin reuptake inhibitors (SSRls) or cognitive behaviour therapy (CBT) (Williams et al.. 2006). CBT interventions which are most often described in the literature are exposure and response prevention (ERP) and cognitive techniques. These interventions successfully weaken the catastrophic expectations of the patients. However, they do not affect the negative valence of patients' appearance. This negative meaning is not inborn but acquired during life through association with distressful or even traumatic events. Patients with BDD often report stressful events as the starting point of their complaints (Buhlmann et al., 2007) as well as PTSS like symptoms. i.e. intrusions (Osman et al.. 2004). Processing of these unprocessed memories might free the way to the development of a more positive meaning of their appearance. Indeed, case series have been described in which EMDR has been successfully applied in the treatment of BDD (Brown et al , 1997). In the first part of this workshop background information will be presented which might help identifying BDD patients who might profit from EMDR and planning subsequent EMDR treatment. In the second part of the workshop we share our experiences treating BDD patients with EMDR. Clinical issues will be analysed using videotaped cases of patients for illustration. The goal of this workshop is to increase knowledge and understanding of the use of EMDR in the treatment for BDD. American Psychiatric Association (APA) (1994). Diagnostic and statistical manual of mental disorders. (4th ed.) Washington DC. American Psychiatric Association. Brown, K. W., McGoldrick, T., & Buchanan, R. (1997). Body dysmorphic disorder: Seven cases treated with eye movement desensitization and reprocessing. Behavioural and Cognitive Psychotherapy. 25(2), 203-207 Buhlmann, U., Cook, L. M., Fama, 1. M., & Wilhelm, 5. (2007). Perceived teasing experiences in body dysmorphic disorder. Body Image. 4, 381-385. Osman. S., Cooper, M., Hackmann, A,, & Veale, D. (2004). Spontaneously occurring images and early memories in people with body dysmorphic disorder Memory, 12, 428-436. Williams, J., Hadjistavropoulos, T., & Sharpe, D. (2006). A meta- analysis of psychological and pharmacological treatments for Body Dysmorphic Disorder. Behaviour Research and Therapy. 44, 99-111.

Conference

English

Yanda van Rood
Carlijn de Roos

van Rood,Y., & de Roos, C. (2010, June). EMDR in the treatment of body dysmorphic disorder. Presentation at the 11th EMDR Europe Association Conference, Hamburg, Germany