(PSYCH 109) Abnormal Psychology

Final Requirement:

Submitted by:

Chumanao, Martin M.

Submitted to:

Mrs. Cricelia Valiente

Submitted on:

April 5, 2017
 TABLE OF CONTENTS

I. Acknowledgement
1
II. Introduction

III. Background Information

IV. Description of Presenting the Problem

V. Diagnosis

VI. Intervention

VII. Conclusion

VIII. References
 Acknowledgement

First and foremost, I have to thank my client. Without her

assistance and dedication involve in every step throughout the

process, this study would have never been accomplished. I would

like to thank her for supporting and participating over these past

months.

To my adviser, thank you for giving us the opportunity to

experience on how to make a case study.

This study would not be possible without the help and

support of my love ones, instructor, and my client.

Introduction

Body Dysmorphic disorder by proxy is a form of body dimorphic

disorder in which individuals are preoccupied with defects they

perceive in another person’s appearance they tend to see and

judge other peoples appearance basing on theirs, like for example

when they see a girl with pretty hair they tend to judge them and

say that their hair is more beautiful than them.

Insight regarding body dysmorphic disorder beliefs can range

from good to absent, delusional. On average, insight is poor; one

third or more individuals currently have delusional body dysmorphic

disorder beliefs. Individuals with delusional body dysmorphic disorder

tend to have greater morbidity in some areas, but this appears

accounted for by their tendency to have more severe body disorder

symptoms.

Body Dysmorphic disorder by proxy is a variant of BDD in which

the primary preoccupation involves perceived imperfections with

another person’s appearance.

Preoccupation can be focused on any body area; but most

often involves skin and hair. Common areas of concern include

others’ teeth, eyebrows, hair and skin. The concern may also be

focused on the POC’s general body shape or signs of aging.

 Most people suffering from BDDBP are very distressed by

perceived flaws in the POC and describe preoccupations as

“painful” or “tormenting”. Moreover, most individuals experience

shame and guilt about their preoccupations. Many worry that

having these concerns makes them a “bad partner/ parent/ child”.

The preoccupations are difficult to control and time

consuming. BDDP is also associated with difficulties in day-to-day

functioning. Because of their concerns, people with BDDBP may miss

work, school, or social functions, or be less productive. In addition to

the often profound impact on the relationship with the POC, BDDBP

usually affects friendships, dating, relationships with family members,

intimate relationships, and social interactions more generally.

Background Information

My Client is a Sixteen year old female that is originally from

Baguio at Bermuda Hills. My Client came from a broken family. She is

living with her aunt and cousins who is looking after her since her

Mother is working abroad and her Father is currently living with his

live-in partner and half-sister here in Baguio as well.

My client grew up as a good child to her parents despite of the

problems that they had when she was younger. As per my Client her

childhood days didn’t go well since her mother left her to her

relatives. Her first three months of living with her relatives went well

but after two months of staying with them she suffered from distress
wherein she is in a very difficult situation in which she doesn’t have

enough money and food going to school because her aunt keep on

keeping the things and money that is supposed to be for her that her

mother is sending here in the philippines. She felt unhappy that time

that maybe affect her mind and body. She also experienced being

bullied by her cousins.

She was studying in a private school from Nursery to Grade 4

she was doing well at class but she have just few friends. She wants

to mingle with larger crowds but she is being denied and that made

her self-esteem lower. On her fifth grade her aunt suggested to her

mom that she must transfer to a public school where her cousins are

studying because as per her aunt it is just near their house. She feels
that her aunt is keeping her away from the good things that she can

have.

She feels that her aunt and cousins are envious of her. After

transferring to her new school she got bullied by no apparent

reason. She experienced that until she graduated from elementary.

She was bullied at home by her cousins and by her classmates in

school. High school became better for her because she is growing

up as a young and beautiful lady and a lot of people noticed that

including some of her classmates in elementary.

She made a lot of friends and she feels that she already fits-in. But

her attitude changed as well. She became rebellious and

disrespectful. She seldom goes home at her aunt’s place as well.

After her mom found out what was happening to her daughter she

decided to communicate with her former husband to take care of

their daughter.

My Client went to live with her father again together with the second

wife and her half-sister. The second family noticed that my client is so

concerned about her appearance or in short she’s so conscious with

the way she looks despite her knowing that she is pretty but the bad

thing is that when someone appreciates her appearance she needs

to brag out to everybody that someone appreciates her beauty she

also often looks at the mirror every 10 or 20 mins.

Her step mom also noticed that she is always comparing herself to

her step sister in a negative way. She is also always pointing out the

things that she doesn’t want about her sister’s physical appearance

like her sister’s hair, teeth and weight. Her relationship with the

people around her is already affected because of the attitude that

she have around them. She always feels the urge to point out flaws

of other person in a bad way which may hurt them mentally or even

physically.
DSM-V: Diagnostic Criteria for Body Dysmorphic

Disorder

A. Preoccupation with one or more perceived defects or

flaws in physical appearance that are not observable

or appear slight to others.

B. At some point during the course of the disorder, the

individual has performed repetitive behaviors (e.g.,

mirror checking, excessive grooming, skin picking or

mental acts (e.g., comparing his or her appearance

that of others) in response to the appearance

concerns.
 C. The preoccupation causes clinically significant distress

or impairment in social, occupational, or other areas of

functioning.

D. The appearance preoccupation is not better be explained by

concerns with body fat or weight in an individual whose symptoms

meet diagnostic criteria for an eating disorder.

DESCRIPTION OF THE PRESENTING PROBLEM

People with BDDBP often believe that other people take

special notice of the person of concern because of the defect they

perceive. Often they believe that others would reject them because

of perceived imperfections. Like with my client her relationship with

the people around her doesn’t go well because of her behavior

towards them.

When you have a body dysmorphic disorder, you intensely

obsess over your appearance and body image, repeatedly

checking the mirror, grooming or seeking reassurance, sometimes for

many hours each day. Your perceived flaw and repetitive flaws and

repetitive behaviors cause you significant distress, and impact your

ability to function in your daily life. Like with my client she needs to

brag or to boast her appearance to all of the people she know.

Interventions

COGNITIVE- BEHAVIORAL APPROACH

Body Dysmorphic disorder is a distressing or impairing

preoccupation with a perceived defect in physical appearance.

BDD by proxy is a significant but understudied variant of BDD in

which the primary preoccupation involves perceived imperfections

of another person. Like BDD individuals with BDDBP engage in time

consuming rituals to “fix” the other person’s appearance or alleviate

distress.

Avoidance is common and the Impact of BDDBP on social

functioning is profound. Cognitive- Behavioral therapy is the best

studied and most promising psychological treatment for BDD, but no

studies have examined its generalizability to the BDDBP variant.

One of the possible reasons if why is she acting that way might be

her experiences when she was younger what I did as an Intervention

to my client is to talk with her to look at the good things about

someone for her to avoid being misunderstood by the people

around her.
HUMANISTIC APPROACH

Humanistic therapy encourages self-awareness and

mindfulness that allows clients to transition from a pattern of

reactionary behavior into a healthier and more productive practice

of self-aware and thoughtful actions.

During a humanistic therapy sessions, the patient is treated in a

manner that emphasizes their innate goodness and potential. The

humanistic therapist is encouraged to act in a manner consistent

with the themes of unconditional positive regard, empathy,

genuiness and congruence.

 What I did for this is that I offered myself to be her friend in times

of distress. And I tried to comfort her even if it has been so hard for

some time. I taught her how to understand her self by observing her

actions and she will learn how to be self centered. That’s how I used

the humanistic approach to my client that I hope would help and

change her behavior.

Recommendations

It is Important to diagnose BDDBP, as it causes significant

impairment in functioning and is associated with markedly poor

quality life and relationship of the person diagnosed with others. So

as for my client since her case is still made, I highly recommend to

treat it early with the approaches stated above before it becomes

severe.

We may not be able to control one’s life nor dictate what

will happen in the future that’s why I therefore conclude that

acceptance is a key to self actualization. As long as we keep our

faith and believing that we can do something despite our difference

with others we will be able to achieve our goals in life.

References

DSM-5 pp 117

https://bdd.iocdf.org/expert-opinions/bdd-by-proxy/

www.sciencedirect.com/science/article/pii

mghocd.org/clinical-services/bdd-by-proxy/