When the client is not "yours"...
Non-intervention tactics: why you shouldn’t work with clients suffering from body dysmorphic disorder
Psychiatry began with deciphering the physical symptoms of mental illness, and science now identifies and broadly classifies these symptoms. One of them is dysmorphophobia (dysmorphophobia, dysmorphia, body dysmorphic disorder).
Alena Snigur, cosmetologist, teacher at the Beauty Academy, certified Algotherm trainer
Prevalence of the phenomenon
Can a cosmetologist, who is primarily a doctor, ignore such an important phenomenon? After all, «Do no harm!» — the main commandment of medicine. Of course not, unless dermatologists, cosmetologists and plastic surgeons dealing with a patient who suffers from a dysmorphism-comorbid disease are simply not knowledgeable enough.
According to specialized literature, the range of conditions in which skin pathology is combined with mental pathology reaches 30-40% of patients visiting a dermatologist. What is dysmorphism?
Dysmorphism (dysmorphophobia/dysmorphomania) is a mental disorder dominated by the idea of an imaginary physical disability. This term was proposed in 1886 by the Italian psychiatrist, professor of psychiatry and neuropathology Enrico Morselli. Subsequently, the term «beauty hypochondria» was introduced — the desire to maintain an ideal appearance and the fear of loss of attractiveness.
Clinical picture
Dysmorphism is characterized by a person’s obsessive ideas that others are unpleasant about some of his physical defects, with a fixation on minor dermatological abnormalities (wrinkles, hyperemia, thinned skin, peeling, pronounced vascular pattern, sebum secretion, excess hair, or vice versa, baldness). The hypochondriacal mood is inextricably linked with certain rituals, including those involving destructive behavior (hair pulling, burning out age spots, excoriation).
And although this condition is primarily based on mental disorders, such patients often go to cosmetology clinics and insist on multiple aesthetic procedures (botulinum toxin injections, contouring, microdermabrasion, mesotherapy, etc.).
An important aspect in such a situation is the urgent need to eliminate the possibility of harm from cosmetic procedures and prevent patient complaints about dissatisfaction with the result. Since body dysmorphomania is associated with the patient’s painful conviction of his imaginary defect and a lack of criticism of his condition, not a single result will satisfy him or bring an improvement in the quality of life, and in some cases it will worsen the current condition.
First Published in the magazine “PRO Cosmetology by “Cosmetologist” No. 4, 2021
*Full version of the access article in Ukrainian and Russian