"A Bully in Your Brain": What I Shared on Good Morning America About Body Dysmorphic Disorder
Robyn Stern, LCSW, featured on Good Morning America discussing Body Dysmorphic Disorder — June 2021.
For a long time, I did not tell anyone the full truth of what was happening to me.
I missed a semester of college because I could not leave my house for a month. I took three or four medical leaves from work because some days, functioning was not possible. And the reason — the thing driving all of it — was a conviction so consuming and so private that I did not have words for it. I thought I was ugly. I thought my skin was so flawed and repulsive that I did not deserve to be seen in public. I did not understand that what I was living with had a name, a clinical profile, and a treatment that could actually work.
That condition is Body Dysmorphic Disorder. And on June 30, 2021, I was featured on Good Morning America to talk about it.
Why I Chose to Share My Story on National Television
Being on Good Morning America was not something I took lightly. Speaking publicly about BDD — especially from the inside, as someone who has lived it — requires a willingness to be seen in exactly the way the disorder told me for years I should not be.
I chose to do it because I remember what it felt like to suffer without knowing what I was suffering from. I remember sitting with something so shame-laden and specific that it never occurred to me to name it in a therapist's office. I thought I was just ugly. I thought that was a personal failing, not a psychiatric condition.
The GMA segment was an opportunity to reach the person who is in that same place right now — managing something quietly, convinced it is too strange or too shameful to say out loud, and having no idea that what they are experiencing has a name and a path out of it.
What Body Dysmorphic Disorder Actually Is — and What It Is Not
One of the things I pushed back on in the segment is the casual use of the phrase "body dysmorphia" to describe everyday insecurity. I hear it constantly — someone dislikes how they look in a photo and says they have body dysmorphia. And I understand the impulse, but it does a real disservice to people who are living with the actual disorder.
Body Dysmorphic Disorder is not dissatisfaction with your appearance. It is an intrusive, consuming preoccupation with a perceived flaw — one that is minor or invisible to everyone around you — that overrides your ability to function. It is spending hours at the mirror and feeling worse, not better. It is canceling plans, missing work, avoiding relationships, and organizing your entire day around managing something no one else can see. It is doubt that reassurance cannot touch.
BDD affects an estimated 2 to 3 percent of the general population. That makes it more common than OCD, schizophrenia, or anorexia nervosa. Most people who have it are not diagnosed until years — sometimes decades — after symptoms begin, because the shame involved makes it almost impossible to disclose, and because the most common response is to seek cosmetic treatment rather than mental health care.
Cosmetic treatment does not help BDD. In most cases it makes it worse, either by intensifying preoccupation with the original concern or by introducing new ones. I have worked with clients who have had multiple procedures and are more consumed by appearance-based intrusive thoughts than before any of them.
Why BDD Goes Undiagnosed for So Long
Part of what I wanted to communicate in the GMA segment is how invisible BDD is. Not just to the people around someone who has it, but to the person themselves.
In my own case, I never connected what I was experiencing to a psychiatric condition because I thought the problem was my appearance. I thought if my skin were different, I would be fine. I did not disclose the appearance-based preoccupation to the therapists I saw early on because it felt too shameful and too specific — and because I did not recognize it as the center of what I was dealing with.
This is one of the reasons why working with a specialist matters so much for BDD. A generalist treating depression or anxiety may never ask the right questions to surface what is actually driving the symptoms. And a well-meaning therapist using standard talk therapy can inadvertently give BDD more to work with — more content to analyze, more reassurance to seek — rather than interrupting the cycle.
What Treatment for BDD Actually Involves
The most effective treatment for Body Dysmorphic Disorder combines Cognitive Behavioral Therapy and Exposure and Response Prevention — the same evidence-based foundation used for OCD, adapted for how BDD specifically operates.
CBT addresses the distorted beliefs about appearance — the faulty thinking that has become so ingrained it feels like fact. ERP addresses the compulsive behaviors that maintain the cycle: the mirror checking, the reassurance seeking, the comparing, the camouflaging. Each compulsion brings temporary relief and teaches the brain that the threat was real, which is why the doubt always comes back stronger.
What makes BDD treatment distinct is the depth of shame and core belief work involved. Stopping the checking behaviors is one part of the work. The other part — the part that determines whether recovery holds — is addressing the underlying belief that there is something fundamentally wrong with how you look, and by extension, who you are. That requires more than behavioral interruption. It requires exploring the roots of those beliefs and building something more stable in their place.
I know this both as a clinician and as someone who has done the work myself. The goal is not to make you see yourself differently in the mirror. It is to change your relationship to the doubt itself — so that it stops having the power to run your life.
Recovery Is Possible — and I Am Proof of That
I want to be clear about something: BDD is a chronic condition, but it is not a permanent sentence. People recover. I recovered. And the clients I work with recover.
What recovery looks like is not the absence of intrusive thoughts about appearance. It is a fundamentally different relationship to those thoughts — one where they arise and you are no longer compelled to respond to them, check them, neutralize them, or hide from them. You can be in the world. You can be seen. The thoughts lose their charge.
That is what I wanted people watching Good Morning America to understand. Not just that BDD exists, but that there is a way through it — and that if you have been suffering quietly, you do not have to keep doing that.
If You Are Recognizing Yourself in This
If what I have described here sounds like something you have been living with — the intrusive doubt, the mirror checking, the compulsive reassurance seeking, the avoidance — I want you to know that what you are experiencing has a name, and it responds to the right kind of treatment.
A free 15-minute consultation is a no-pressure way to talk about what has been going on and find out whether working together makes sense. You do not have to have it all figured out before you reach out.
Robyn Stern, LCSW is a licensed therapist specializing in OCD, BDD, and related conditions. She provides teletherapy to clients in New York, California, Florida, Connecticut, and New Jersey. To learn more or schedule a free consultation, visit the contact page.
