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BDD FROM THE PAST AND AROUND THE WORLD: DESCRIPTIONS OF BDD
I found descriptions of BDD from more than 100 years ago. I was struck by how descriptions from more than a century ago were just like the patients I was seeing. William Stekel, wrote in 1949 about “the peculiar group of compulsive ideas which concern the body. There are people,” he wrote, “who occupy themselves continuously with a specific part of the body. In one case it is the nose; in another it is the bald head; in a third case the ear, the eyes, or (in women) the bosom, the genitalia, etc. These obsessive thoughts are very tormenting.”
Wolf Man”?probably had BDD. The legendary Sigmund Freud, the Wolf Man’s first psychoanalyst, didn’t even mention BDD symptoms in his description of his patient, even though they were a significant problem. Why not? Had the Wolf Man mentioned it to Freud, or had he kept it a secret? Was he too embarrassed to bring it up? Perhaps he wasn’t yet worried about his appearance, although BDD usually begins during adolescence. Ruth Brunswick, the Wolf Man’s second psychoanalyst, did describe her patient’s preoccupation. In 1928 she wrote that “(he) neglected his daily life and work because he was engrossed, to the exclusion of all else, in the state of his nose” (its supposed scars, holes, and swelling). “His life was centered on the little mirror^in his pocket, and his fate depended on what it revealed or was about to reveal.”
This quote describes many of the patients I’ve seen. Jennifer, too, neglected her daily life and work because she was so engrossed with supposed defects in her appearance. And her life was also centered on the little mirror in her pocket. Without realizing it, when Jennifer repeatedly checked her pocket mirror at work, she was doing what the Wolf Man had done more than half a century before.
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