Citation

Parker R. Br. J. Psychother. 2014; 30(4): 438-461.

Copyright

(Copyright © 2014, John Wiley and Sons)

DOI

10.1111/bjp.12119

PMID

unavailable

Abstract

This paper sets out a framework for a comprehensive theory of Body Dysmorphic Disorder (BDD), based on interview data and theoretical reading. It combines psychoanalytic, cultural and political insights. It develops the author's earlier work on body hatred (Parker, 2003). The role of the other ? actual, imagined or fantasized ? is central, and ambivalence about the body, inflated by shame, is key to this dynamic. Any part of the body may be involved, and checking is compulsive, betraying an omnipotent struggle for acceptability and normality. The author suggests that BDD sufferers are especially sensitive to the power, pleasure and pain of looking and being looked at, with the objective sense of self dominating any subjective sense. Object relations provides explanations of individual differences in susceptibility to BDD, through failures of maternal mirroring. Lacan's theory of the mirror stage explains the origin of the ambivalent relation of the subject to his/her own image, rivalry with self and other, shame and desire, as well as the enduring power of cultural norms of appearance. Freud's ideas on taboo and ambivalence, and their dynamics in changing cultural forms, are illustrated and linked to Douglas's ideas of pollution and taboo.

Keywords

Ambivalence; Body Dysmorphic Disorder (BDD); Cultural Norms; Gaze; Maternal Mirroring; Mirror Stage; Shame; Taboo