“Do I look good?” A quick glance in the mirror grabs strands of hair quickly: dealing with your appearance is a ritual of everyday life. For some people it becomes a painful compulsion.

The wisdom that beauty is in the eye of the beholder takes on a deadly new meaning for people with KDS: they cannot stand up to their eyes, they feel ugly, and are convinced that their noses, physical build, and skin disfigure them.

“These people are often very attractive,” says psychologist Victoria Ritter, who researches causes and treatment options for body dysmorphic disorders at the University of Frankfurt / Maine. “Their self-evaluation is very different from their actual appearance.” But because everyone asks themselves, “Am I beautiful?” The needs of those affected are often recognized late.

When Wilhelm Stephen’s daughter locked herself in the bathroom longer and longer, the parents initially thought of a teenage freak whim. Even the doctors who later asked her for advice were puzzled, says a Darmstadt resident, who participates in the relatives’ self-help group. “KDS remains an unknown disorder in the specialized circles,” stresses psychiatrist Stefan Brunhuber, who focuses on body acceptance disorders.

Body dysmorphic disorder first occurs during puberty in more than 80 percent of cases. “If someone spends more than an hour a day on a ritual control, checking their appearance in the mirror, in window panes, on a mobile phone screen, or constantly asking others about their appearance, they should be vigilant,” Victoria Ritter says. Another warning sign: Those affected are withdrawing.

KDS triggers can be bullying or harassment. Media-reported beauty models also play a role: however, body dysmorphic disorder is not a phenomenon in the media age. The disease was actually described under the term “dysmorphophobia” 100 years ago. “Often the causes lie in childhood,” says Brunhuber. A parenting home that is overprotective, for example, can play a role, but it can also always experience being rejected or criticized. Those affected often lack self-esteem and the ability to tolerate and resolve conflicts.

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So therapies focus on practicing such skills, for example. Another important component is what is called exposure. Patients engage other people through a catalog of questions about their appearance – this can also be very general in the pedestrian zone – and discover how they actually look.

Support groups There are hardly any of them. When his daughter fell ill, Wilhelm Steffen found support from one in Darmstadt A group for parents of children with eating disorders. Both diseases are often associated. He remembers that being able to talk to other parents who have gone through similar things was a huge relief.


Stefan Brunhuber: Don’t Be Fear of the Mirror: The Path to Acceptance of the Flesh, Stillwasser-Verlag 2013, € 19.90, ISBN -13: 978-3980869621

Viktoria Ritter, Ulrich Stangier: When a Mirror Image Becomes Torture: A Guide to Body Dysmorphic Disorder, Hogrefe Verlag 2010, € 9.95, ISBN-13: 978-3801721817 (dpa)

Self-help forum

Darmstadt Self-Help Group


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