Practise using mirrors differently — shifting from selective, critical zooming to a full, descriptive, non-judgemental observation of your whole body.
Mirror retraining replaces the BDD mirror checking habit (zoomed-in, critical, judgemental) with a new approach: standing at a normal distance, describing your whole body from top to bottom using neutral, descriptive language (like describing a friend). Practise regularly.
Introduce in the active treatment phase of CBT for BDD once the formulation is established and the client understands the role of selective attention and safety behaviours around mirrors. Mirror retraining shifts from evaluative checking to objective, holistic description.
Explain that current mirror use maintains BDD by focusing attention on specific perceived flaws. Mirror retraining teaches a different way of using mirrors — describing the whole body from top to bottom using objective, non-judgemental language rather than zooming in on 'problem areas.'
Start with less challenging mirrors (e.g., a small mirror at arm's length showing only the face) before progressing to full-length mirrors. For clients with severe mirror avoidance, grade the exposure. Adjust the duration based on the client's tolerance.
Do not introduce before the client has some understanding of the maintenance model and the rationale for changing mirror behaviour. If the client uses mirror retraining as another form of reassurance-seeking, address this function.
The key shift is from evaluative ('my nose looks horrible') to descriptive ('my nose is medium-sized with a slight curve'). Coach the client to keep their eyes moving rather than fixating. Practice in session first with therapist modelling. Sessions typically need to be at least 15-20 minutes to allow habituation.
Suitable for clients working with bdd, mirror retraining, cbt, veale, appearance, body image. This tool can be used as a standalone worksheet or as part of a structured homework plan.
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Build a hierarchy of appearance-related situations you avoid, ranked by distress, to guide graded exposure.
Track BDD episodes — triggers, preoccupation with the perceived flaw, rituals, and mood impact.
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.