Body Dysmorphic Disorder
Body Dysmorphic Disorder Treatment in Melbourne & Online
Last updated . Written and reviewed for accuracy by Adam Szmerling. Accredited Mental Health Social Worker (AASW) and PACFA Registered Clinical Psychotherapist
A perceived flaw other people barely notice can still take hours out of your day.
Body dysmorphic disorder (BDD), often called body dysmorphia, is a mental health condition in which worry about one or more perceived flaws in appearance leads to repeated checking, hiding or comparing. About 1.9% of adults live with it, according to a 2016 review of community studies. Here you can see a counsellor or clinical hypnotherapist about it, at our Highett rooms or on video wherever you live in Australia.
Payment is taken when you book online, through PayPal’s secure system. Plans change? Reception can reschedule if you let them know at least 3 business days ahead. To ask something first, phone (03) 9557 9113 between 8:30am and 5:30pm, Monday to Friday.
- $170 per 50-minute session with any of the six counsellors and hypnotherapists below. These sessions have no Medicare rebate, and no GP referral is needed to book.
- Video sessions for adults anywhere in Australia, by Zoom, Doxy.me or phone. Three of the six also see people in Highett.
- Some of the six offer weekday evening appointments (until 8pm) and Saturday sessions.
On this page: Therapists · Signs · Self-check · Treatment options · Hypnotherapy · Fees · FAQs
Body dysmorphia therapists in Highett and online
Sessions here are for adults. If you are booking for someone under 18, their GP is the place to start.
Carolina Rosa
Counsellor & Hypnotherapist
- 10+ years of experience
- $170 per 50-min session
- Available in-person & online
Lawrence Akers
Hypnotherapist & Counsellor
- 10 years of experience
- $170 per 50-min session
- Available in-person & online
Humaira Ansari
Hypnotherapist, NLP Practitioner, Psychotherapist and Counsellor
- 16 years of experience
- $170 per 50-min session
- Available online
Bernadette Cameron
Hypnotherapist, Counsellor, NLP Master Practitioner
- 5+ years of experience
- $170 per 50-min session
- Available in-person & online
Sara Herring
Clinical Hypnotherapist & Counsellor
- 20+ years of experience
- $170 per 50-min session
- Available online
Kelli Tranter
Hypnotherapist & Counsellor
- 10+ years of experience
- $170 per 50-min session
- Available online
What is body dysmorphia?
Body dysmorphic disorder is a preoccupation with one or more perceived flaws in appearance that other people do not see, or see as minor. In the DSM, the diagnostic manual used in psychiatry, BDD sits with obsessive compulsive disorder among the obsessive-compulsive and related disorders, and like OCD it involves repeated actions that are hard to stop.
It can centre on any part of the body, such as the skin, hair or nose. Having BDD does not mean you are vain. It usually begins in the late teens, often after milder worries from about 12 to 14, and it can be up to 15 years before someone talks to a mental health professional about it.
Australia’s National Eating Disorders Collaboration estimates that 1.7% to 2.9% of people have BDD, and that it affects men and women equally. Rates are far higher where people try to change how they look: a 2016 review found BDD in 13.2% of people seeking cosmetic surgery and 11.3% of general dermatology patients.
People differ in how sure they are about the perceived flaw. Some can see that the worry is out of proportion; others feel completely certain the flaw is real and serious. Both fall within BDD, and UK treatment guidelines cover both.
Depression, anxiety disorders, OCD and substance misuse often occur alongside BDD, and so can eating disorders.
Muscle dysmorphia
Muscle dysmorphia is a form of BDD in which a person believes their body is too small or not muscular enough, even when it is well built. It can lead to heavy training and to the use of steroids or other performance-enhancing drugs, and it mostly affects men.
BDD and cosmetic procedures
Many people with BDD look to cosmetic surgery, injectables or skin treatments to fix the perceived flaw. Healthdirect notes that people with BDD who have surgery tend to remain unhappy afterwards, and some go on to seek further procedures.
Since 1 July 2023, doctors in Australia who perform cosmetic surgery must screen patients for BDD with a validated tool, and refer them for an independent assessment by a psychologist, psychiatrist or GP when there are concerns.
Signs and symptoms of body dysmorphia
BDD shows up in what people do as much as in what they think. Common signs include:
- checking the feature in mirrors, windows or phone screens many times a day, or avoiding reflections altogether
- covering or disguising it with make-up, hair, clothing, a beard or the way you stand
- comparing yourself with other people, in person or online
- asking others again and again whether you look all right
- picking at skin, or grooming and adjusting for long stretches
- avoiding photos, social plans, dates, work or leaving the house
- strict dieting or heavy exercise to change your shape
- seeking cosmetic treatment, sometimes repeatedly
BDD can be very distressing. A 2016 review of 17 studies found people with BDD had more than three times the odds of attempting suicide. If you are having thoughts of ending your life, phone Lifeline on 13 11 14, or call 000 in an emergency.
What people tell us (composite)
“Everyone says they can’t see it. I see it every time I walk past a window.”
“I’ve been late to work because I couldn’t leave the house looking like this.”
“I had it fixed once. Within a month I’d found the next thing.”
“I didn’t want to tell anyone in case they thought I was just vain.”
These lines are composites. Each combines things different people have said in early sessions, with details changed, so none comes from a single client.
Wondering whether this is BDD? Only an assessment can confirm it, and a GP appointment is the usual first step. The self-check below can help you put your worries into words beforehand.
Body dysmorphia self-check for the past week
This nine-question screen is the Body Image Questionnaire, developed by Professor David Veale and colleagues to help identify likely BDD. Answer each question for how you have felt over the past week, on a scale from 0 to 8. Your answers are scored in your browser and are not saved or sent anywhere.
Question 1 of 9
Please answer the following for how you have felt over the past week.
- How often do you deliberately check your feature(s)? Not accidentally catch sight of it. Please include looking at your feature in a mirror or other reflective surfaces like a shop window or looking at it directly or feeling it with your fingers.
- To what extent do you feel your feature(s) are currently ugly, unattractive or ‘not right’?
- To what extent does your feature(s) currently cause you a lot of distress?
- How often does your feature(s) currently lead you to avoid situations or activities?
- To what extent does your feature(s) currently preoccupy you? That is, you think about it a lot and it is hard to stop thinking about it?
- If you have a partner, to what extent does your feature(s) currently have an effect on your relationship with an existing partner? (e.g. affective feelings, number of arguments, enjoying activities together). If you do not have a partner, to what extent does your feature(s) currently have an effect on dating or developing a relationship?
- To what extent does your feature(s) currently interfere with your ability to work or study, or your role as a homemaker? (Please rate this even if you are not working or studying: we are interested in your ability to work or study.)
- To what extent does your feature(s) currently interfere with your social life? (with other people, e.g. parties, pubs, clubs, outings, visits, home entertainment)
- To what extent, do you feel your appearance is the most important aspect of who you are?
0: Never check8: About 40 times or more a day
0: Not at all unattractive8: Very ugly or unattractive, ‘not right’
0: Not at all distressing8: Extremely distressing
0: Never avoid8: Always avoid
0: Not at all preoccupied8: Extremely preoccupied
0: Not at all8: Extremely
0: Not at all8: Very severely, I can’t work
0: Not at all8: Very severely
0: Not at all8: Totally
Your score
This is below the questionnaire’s cut-off of 40. A lower score does not rule BDD out, and if worry about how you look is still taking time or causing distress, it is worth raising with your GP or one of our therapists.
The questionnaire’s authors say people who score 40 or more are likely to have BDD. This is a screen, so please take the result to your GP for an assessment, and you are welcome to book with one of our therapists. If you are having thoughts of suicide, call Lifeline on 13 11 14 now, or 000 in an emergency. The Butterfly National Helpline (1800 33 4673, 8am to midnight every day) also takes calls about body image.
In the authors’ study, a cut-off of 40 correctly identified 88.9% of people with BDD and 80.6% of a community group who wanted a cosmetic procedure. Body Image Questionnaire: Veale D, Ellison N, Werner TG, Dodhia R, Serfaty M, Clarke A (2012), used as the authors permit, with citation.
What causes body dysmorphic disorder?
No single cause is known, and it differs from person to person. Researchers think several things act together: a family history of BDD or a similar condition, brain chemistry, personality, and life experiences such as childhood trauma or bullying about appearance.
What we think: in our experience the perceived flaw is rarely the whole story. The checking and hiding often guard against a feeling that is hard to sit with, such as shame, a sense of not being good enough or a fear of being rejected, and the worry about appearance gives that feeling a place to land. Working on the routines can bring relief. Some people also want to understand what the flaw has come to stand for, and that work can take longer.
Which body dysmorphia treatment suits you?
UK guidelines recommend cognitive behaviour therapy that includes exposure and response prevention (ERP), an SSRI antidepressant, or both together, depending on how much BDD affects daily life. In ERP you face appearance-related situations in planned steps while holding back from checking or hiding.
Bayside does not offer structured CBT or ERP, and our practitioners do not prescribe. For either of these, a GP Mental Health Treatment Plan can link you with a psychologist experienced in CBT for BDD, or your GP can refer you to a psychiatrist about medication. Some people also see one of our therapists while they do, or once that work has finished.
At Bayside you can see a counsellor or clinical hypnotherapist, who works on the checking, hiding and comparing and on the distress underneath. Which suits you depends on what you have tried and what you hope will change, and your first session is a chance to work that out together.
A 2019 trial of 120 adults compared CBT with supportive psychotherapy, a talking therapy built on the relationship with the therapist. Both groups improved. At one of the two hospitals CBT reduced BDD symptoms more, and at the other the two did about as well. Overall CBT gave more consistent gains in symptoms and quality of life, and the gains held six months later. Results differ from one person to the next.
If the approach you start with does not suit you, your therapist can point you to someone in the team who works another way.
| Approach | What it involves | Who offers it |
|---|---|---|
| Counselling and clinical hypnotherapy | Looks at what sets off the checking or hiding, what you fear would happen without it and what else you could do. Hypnotherapy works in a calm, focused state and often sits alongside counselling within one appointment. Lawrence Akers also draws on ACT, CBT skills and mindfulness. | Lawrence Akers (GoAH); Kelli Tranter (AACHP; Hypnotherapy Council of Australia); Humaira Ansari (AHA Clinical Member, also a psychotherapist); Sara Herring (AACHP Vice President; Hypnotherapy Council of Australia); Bernadette Cameron (AACHP); Carolina Rosa (AACHP) |
| CBT with exposure and response prevention | Structured therapy in which you face appearance situations step by step and cut back the rituals. It has the strongest research support for BDD. Bayside does not provide it. | A psychologist elsewhere, generally arranged with a GP Mental Health Treatment Plan |
| Medication | SSRI antidepressants can reduce BDD symptoms, alone or with therapy; fluoxetine is the usual first choice in UK guidelines. | Your GP or a psychiatrist |
Hypnotherapy for body dysmorphia
All six of our BDD therapists offer hypnotherapy. In Highett you can see Lawrence Akers, Carolina Rosa or Bernadette Cameron, who also work by video. Kelli Tranter, Sara Herring and Humaira Ansari work online only, and with Kelli a short phone or email chat comes first.
During hypnotherapy you are guided into a calm, absorbed state, and your hypnotherapist works with the pull to check or hide and the feelings attached to the perceived flaw, often alongside counselling in one appointment. You book it as a hypnotherapy session.
Published research on hypnotherapy for BDD is limited to individual case reports, so we offer it as one possibility and discuss with you whether it fits.
A hypnotherapy session costs $170 and has no Medicare rebate. Humaira Ansari belongs to the AHA and Lawrence Akers to GoAH, so some private health funds pay a rebate on sessions with them; your fund can confirm.
Between sessions, some people listen to our body dysmorphic disorder self-hypnosis recording at home.
When to see your GP first about body dysmorphia
Bayside is a private outpatient practice for adults. We do not provide crisis care, medication or structured CBT.
Please see your GP first, and they can bring in a psychiatrist where needed, if:
- BDD has stopped you working, studying or leaving the house, or you would like to consider medication
- you feel completely certain the flaw is real and serious, with no room at all for doubt
- you want a psychologist, CBT with ERP, or a Medicare-rebated psychology plan
- you are restricting food or losing weight, or using steroids or other drugs to build muscle; the Butterfly National Helpline (1800 33 4673) can help too
- you are under 18
If you are in crisis, ring Lifeline (13 11 14), or 000 if it is an emergency.
We cannot offer sessions where a relationship or household involves family violence or coercive control. 1800RESPECT is available 24 hours a day on 1800 737 732.
Ready to talk about the perceived flaw that takes up your day?
Your first BDD session, and what follows
Book online or through reception, and you will be sent an intake form to complete beforehand. When you book online, the fee is charged straight away through PayPal’s secure payment page.
Your first appointment usually covers which features worry you, how much of your day the checking and hiding take, what you have already tried (including any cosmetic treatment) and what you would like to change. You decide how much detail to share at first. On video, you can turn your camera off if seeing yourself on screen makes it harder to talk.
How many sessions you need is decided case by case. The perceived flaw often stands in for something harder to name, such as shame or a fear of being rejected, so the length of therapy depends on that as well as on the BDD itself and your therapist’s way of working.
Much of the change depends on you. If you are willing to explore the side of you that wants the checking to end and the side that keeps returning to the mirror, therapy has a great deal to work with. A session or two normally shows whether the fit with your therapist feels right.
Sessions last 50 minutes, in Highett or by Zoom, Doxy.me or phone, and are open to adults anywhere in Australia. Living overseas? Email us first and we will let you know whether we can help. To move a session, let reception or your therapist know a minimum of 3 business days in advance.
Fees and Medicare rebates for BDD therapy
Every session is 50 minutes.
- $170 a session with any of the six: Kelli Tranter, Lawrence Akers, Bernadette Cameron, Carolina Rosa, Sara Herring or Humaira Ansari. These sessions have no Medicare rebate.
- The full fee is charged when you book. There is no bulk billing, and you do not need a GP referral.
Medicare rebates for mental health care come through your GP. Under a Mental Health Treatment Plan, Medicare can rebate a maximum of 10 individual sessions in a calendar year with an eligible psychologist, social worker or occupational therapist. None of the therapists who see BDD at Bayside is covered by that scheme.
If someone you love has body dysmorphia
BDD rarely stays with one person. Partners and family can find themselves answering “Do I look all right?” many times a day, checking photos before they are posted, or planning outings around the perceived flaw. In our experience this comes from care, and it can also keep the worry going.
It can help to stay kind and brief when asked for reassurance, without arguing about the perceived flaw, and to encourage the person to see their GP or a therapist. You are welcome to book sessions for yourself to work out how to respond, even if the person you are worried about is not ready to get help.
The Butterfly National Helpline (1800 33 4673, 8am to midnight every day) also supports family and friends of people with body image concerns.
Body dysmorphia FAQs
Is body dysmorphia a real mental illness?
Yes. Body dysmorphic disorder is a recognised mental health condition, classified with obsessive compulsive disorder in the manual clinicians use to diagnose mental health conditions (the DSM). It goes well beyond disliking a feature: the worry takes up a large part of the day, drives checking or hiding that is hard to stop, and causes distress or gets in the way of work, study or relationships.
How can I tell BDD from ordinary worry about my looks?
Most people dislike something about their appearance. BDD is more likely when the worry is hard to switch off, when you check, hide or compare yourself in ways you struggle to stop, and when it keeps you from things you would otherwise do. The self-check on this page can help you gauge it, and your GP can assess you.
Can body dysmorphia go away?
Symptoms can lessen considerably with treatment. In a 2019 trial, more than 80% of adults who had CBT for BDD responded to it, and many also improved with supportive psychotherapy. Australia’s National Eating Disorders Collaboration advises against waiting to see whether BDD passes on its own, so it makes sense to get help early.
Is BDD an eating disorder?
No, although the two can occur together, and then both are diagnosed. In BDD the concern can be about any feature, such as the skin, hair or nose. When worry about weight and shape comes with restricting food, bingeing or purging, it may point to an eating disorder, and your GP should check your physical health first.
Can hypnotherapy help with body dysmorphia?
It can be part of the work. All six of our BDD therapists use hypnotherapy, working in a calm, focused state on the urge to check or hide and on the feelings around the perceived flaw, often together with counselling. Research is limited to case reports, so CBT with ERP and medication, arranged through your GP, are worth considering too.
Do I need a psychologist for BDD, and will Medicare help?
If you want a psychologist, your GP can set up a Mental Health Treatment Plan, which brings a Medicare rebate for up to 10 individual sessions in each calendar year. That route suits people who want structured CBT. Our BDD therapists are counsellors and clinical hypnotherapists, none of them psychologists; their fee is $170 a session, Medicare does not rebate it, and you can book directly.
Can I have BDD therapy online?
Yes. Every therapist on this page sees adults anywhere in Australia by Zoom, Doxy.me or phone, and three of them (Kelli Tranter, Humaira Ansari and Sara Herring) see people online only. Sessions cost the same online and in Highett. If you live outside Australia, email us before booking and we will tell you whether we can help.
Related conditions and reading on body image
You might also find these useful:
- Obsessive compulsive disorder (OCD)
- Trichotillomania (hair pulling)
- Bulimia
- Binge eating
- Social anxiety
- Self-esteem counselling
- Depression counselling
- Compulsions and habits we treat
- Body dysmorphic disorder self-hypnosis MP3
- Hypnotherapy in Highett and online
- How social media misinformation affects mental health (article)
Talk to a therapist about body dysmorphic disorder
Book a time when you are ready, even if part of you would still prefer to keep this private.
Pick Highett or a video session, choose a time and pay as you book; PayPal handles the payment securely. If you are unsure who to choose, the Find your therapist quiz is quick and anonymous, and points you to practitioners who may suit you.
Rather talk it over first? Reception answers (03) 9557 9113 between 8:30am and 5:30pm, Monday to Friday.
Getting to our Highett rooms
8/539 Highett Road, Highett VIC 3190. Our name is on the glass door of Suite 8. You can park free at the front of the building or in the car park at the back.
Get directions in Google MapsNote: This information is informative only and is not to be used for diagnosis or substitution of appropriate assessment and/or treatment by your GP or another qualified health professional. We take care to keep our information accurate and up to date, but it may contain errors or omissions. To the extent the law allows, we’re not responsible for loss caused by relying on it, as explained in our Website Disclaimer.
If you are in immediate danger call 000. Lifeline 13 11 14 is available 24/7. For body image concerns, the Butterfly National Helpline answers on 1800 33 4673, 8am to midnight every day.
