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Track BDD episodes — triggers, preoccupation with the perceived flaw, rituals, and mood impact.
Record each episode of significant preoccupation with your appearance. Note the trigger, what you were focused on, what you did about it, and how it affected your mood.
Introduce early in treatment to increase awareness of the frequency and triggers of BDD-related preoccupation, rituals, and avoidance. Use throughout treatment to track changes in symptom frequency and intensity.
Frame as a curiosity exercise to understand the pattern of BDD symptoms across different situations. Explain that monitoring helps identify triggers and maintaining behaviours that can then be targeted in treatment.
For clients with very frequent checking/rumination (many times per hour), use time-sampling rather than event recording — record at set intervals rather than every occurrence. For those who find monitoring increases preoccupation, simplify to end-of-day retrospective recording.
If monitoring significantly worsens preoccupation or distress without providing useful clinical information, pause monitoring and discuss in session. Some clients need more psychoeducation and rapport before monitoring is tolerable.
Look for patterns in what triggers increased preoccupation (social situations, mirrors, photographs, specific lighting, comparisons with others). Also track the duration of 'good' periods where preoccupation is lower — these provide evidence that the experience fluctuates and is not constant.
Suitable for clients working with bdd, monitoring, diary, cbt, appearance, preoccupation. This tool can be used as a standalone worksheet or as part of a structured homework plan.
Create a free account to access 10 worksheets per month.
Practise using mirrors differently — shifting from selective, critical zooming to a full, descriptive, non-judgemental observation of your whole body.
Build a hierarchy of appearance-related situations you avoid, ranked by distress, to guide graded exposure.
A formulation based on the cognitive-behavioural model of BDD — mapping self-focused processing, distorted self-image, rumination, and safety behaviours.
Compare your mental image of yourself with photographic evidence to test whether the perceived flaw is as visible as you believe.