The selfie that started it

Specialist CBT therapy for anxiety, OCD, depression and more in West London

A photograph can become much larger than the moment it captured. Someone may take one selfie, see an image they dislike and find themselves returning to it, comparing it with older pictures, editing it repeatedly or imagining what everyone else will notice. The distress can be immediate and real, even when other people do not see the image in the same way. Feeling unsettled by a photograph does not establish body dysmorphic disorder or explain why the experience has become difficult. Camera angle, lighting, lenses, social media, comments from others, body changes, bullying, anxiety, depression, trauma and existing concerns about appearance can all shape how a selfie feels. A blog cannot decide whether a person has BDD, whether one image caused their distress or what they should do next. It can be useful to ask what happened after the photograph. Did checking increase? Did the person begin avoiding mirrors, events or being photographed? Did reassurance, editing, camouflage or comparison start taking up more time? These patterns may be worth exploring in assessment, alongside physical health, relationships, safety and the person’s own account of what matters. New or concerning changes to appearance, vision, skin or physical health should be discussed with an appropriate medical professional rather than assumed to be an anxiety or body image concern. A medical review and psychological support can both be relevant, depending on the circumstances. CBT may be considered if assessment indicates it is appropriate. It does not tell someone that their appearance concerns are trivial or make a medical decision for them. It can explore the relationship between attention, fear, checking, avoidance, self criticism and the need for certainty. Behavioural or exposure based work is not self directed from a blog. If it is part of therapy, it is planned collaboratively with a qualified clinician, consent and attention to safety and medical advice. If appearance distress is accompanied by severe restriction, purging, self harm thoughts, crisis or an inability to keep yourself safe, urgent appropriate help is needed. For related information, see <a href="/therapy/body dysmorphic disorder/">CBT for BDD</a>, <a href="/guides/body dysmorphic disorder cbt west london/">the BDD clinical guide</a> and <a href="/guides/mental health weight diet movement/">body image, weight and wellbeing</a>. The Lyceum Clinic offers assessment led CBT online and in West London. The next step can remain small and considered.