1. Unique CaseStudy of Body Dysmorphic Disorder (BDD)
• Case Title: Reflections of Perfection: Zara's Journey to Acceptance
• Case Narrative:
• Zara, a 22-year-old university student, started avoiding social
gatherings and mirror reflections. For over a year, she spent hours in
front of the mirror scrutinizing her nose, convinced it was too wide.
Despite reassurances from friends and family, she believed everyone
noticed and judged her appearance. This led to missed classes,
withdrawal from friends, and even attempts to cover her nose with
makeup or scarves. Her distress grew, leading her to seek therapy.
3.
2. Demographic Dataof the Case
•Name: Zara A.
•Age: 22
•Gender: Female
•Education: Undergraduate (BS Psychology)
•Marital Status: Single
•Religion: Muslim
•Nationality: Pakistani
•Living Situation: Lives with parents
•Referral Source: University Counselor
4.
3. Presenting Complaints
•Excessivepreoccupation with the shape and size of her nose
•Mirror checking (2–3 hours daily)
•Avoidance of social interactions
•Low self-esteem
•Anxiety in public places
•Repeated attempts to hide facial features
•Academic decline due to absenteeism
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4. Client’s Goals
•Reduce preoccupation with her nose
• Improve self-image and self-acceptance
• Resume normal social and academic functioning
• Decrease avoidance behavior and safety behaviors
• Gain control over negative thoughts and emotions
6.
Case Formulation (CBT-Based)
•EarlyExperiences: Childhood teasing about appearance
•Core Belief: “I am unattractive”
•Intermediate Belief: “If people see my nose, they will reject me”
•Triggering Situation: Looking in the mirror or being photographed
•Automatic Thought: “My nose is too big; I look terrible”
•Emotion: Shame, anxiety
•Behavior: Mirror checking, avoidance of photos and people
•Consequences: Reinforced belief, increased anxiety and avoidance
