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Body Dysmorphic Disorder (BDD) is a condition marked by a distressing preoccupation with an imaginary or minor defect in a facial feature or a localised part of the body. However, the link between such excessive preoccupation and perceptions of self throughout the life course has rarely been examined. The aim of this study was to examine narrative accounts of the self across different life-time periods. Eleven participants diagnosed with BDD in England were recruited from the National Obsessive Compulsive Disorder (OCD) clinic and a BDD self-help group. In the context of a semi-structured interview participants presented photographs of themselves across a variety of time periods and drew a self-portrait to prompt memory and generate discussion. Transcribed interviews were analysed using Michele Crossley's (2000) narrative analytic approach. The findings suggest that the majority of participants perceived their past self as excessively attractive. Rather than believing that the alteration of their current appearance would rid them of BDD, participants indicated that a return to their former infantile and pure self that was devoid of blemish, defects and emotional responsibility would provide comfort. These findings indicate that the difficulties associated with appearance are less to do with beauty per se, but are more likely associated with narratives of loss, aging and decline and death.

Body Dysmorphic Disorder (BDD) is defined in the Diagnostic and Statistical Manual of Mental Disorders –IV-TR (2000) as a condition marked by excessive preoccupation with an imaginary or minor defect in a facial feature or a localised part of the body. The diagnostic criteria specify that the condition must be sufficiently acute to cause a decline in the patient's social, occupational, or educational functioning (DSM-IV-TR; American Psychiatric Association, 2000). BDD affects both men and women, manifesting itself in differing ways. Whilst men appear to be more worried about genitals, build, and thinning hair, women seem more concerned about skin, stomach and breasts (Phillips, Menard, & Fay, 2006). However, a common feature for both genders is the fundamental belief that the self is defective due to flawed appearance (Cororve and Gleaves, 2001, Phillips, 2005 and Veale, 2004b). Thus negative perceptions of self in individuals diagnosed with BDD has been specifically linked to the particular association of appearance with self-worth. To effectively address issues of selfhood in the context of BDD, our aim is to outline an approach that attends to the participants' narrative context, as well as to the social-cultural background of embodiment and body modification more generally.