Psychiatry research: When the mirror becomes an enemy

September 8, 2008

A nose that's too big, hair that's too curly or a beauty mark in the wrong place – who hasn't focused on a small detail of their appearance while staring at a mirror?

But when these imperfections take over our thoughts, or exist only in our heads, it's a sign that such obsessing is a disorder, according to Université de Montréal psychiatry professor Kieron O'Connor.

About 350,000 Canadians suffer such a phobia, while the prevalence is higher among those already experiencing some type of anxiety. "Sufferers are convinced that part of their body is abnormal, which is not the case," says the psychologist who also works at the Fernand-Seguin Research Centre. "They have difficulty separating what is real from what is not."

And it has nothing to do with vanity, he insists. It's a bit like hypochondria, where people are convinced they are sick or may get sick, or anorexia, which comes from poor body image, he adds. People suffering from this phobia will focus on the physical attribute they consider flawed, constantly viewing it in a mirror or asking the opinions of others. They may go to obsessive lengths to "fix" the problem by wearing too much make-up, going to a tanning salon or getting plastic surgery.

"It's as if these people are looking at themselves in a mirror that deforms their image," says O'Connor, who completed his clinical training in England. "They'll carry on an internal conversation and convince themselves that there's a problem with their bodies, although it's not based in reality. I've seen people who have flagrant physical flaws, yet are preoccupied by a completely different aspect of their appearance."

Skin receives the most attention from sufferers (73 percent), while the chest gets the least (21 percent). The hair, nose and stomach are also popular objects of obsession.

O'Connor's approach to treatment is to look at the reasons a person starts criticizing a part of his or her body in the first place. The source is difficult to pin down – whether genetic, parental influence or stress – but the consequences can be serious, including suicide.

"This problem can affect all aspects of life, work, studies and love and family relationships," says O'Connor. "It can stop someone from going out, or at least hiding the body part about which he or she is obsessing."

Source: University of Montreal