Neurofeedback for Body Dysmorphia

Neurofeedback helps with Body Dysmorphic Disorder and comobidities

Body Dysmorphia (BDD) is often undisclosed by the patient, yet has life-changing consequences. 

BDD has non-specific neurological signatures.  With a Kaiser Neuromap we can identify vulnerability to BDD as well as other frequent comorbidities. 

Applying neurofeedback through Personalised Brain Training can resolve many of these issues.

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What is Body Dysmorphia Disorder (BDD)?

Body Dysmorphia is a visual hypersensitivity in face and body perception, in particular one’s own, combined with compulsive elements.  It shares aspects of OCD, and is in fact comorbid in a third of patients, along with substance-use disorders (30-49%) and social phobia (c.38%).  

Over 80% of BDD (Body Dysmorphia Disorder) sufferers report suicidal ideation, with 25% making an actual attempt. 

Impulsive aggression is common, with almost half reporting violent behaviour.  

Two thirds of BDD sufferers seek cosmetic treatment, which rarely improves symptoms. 

While the official prevalence of BDD is c. 2%, or one in 50, this increases substantially in clinical settings – up to 53% in cosmetic surgery.  

The condition is often not diagnosed, with one study showing that only 15% (one in seven) disclosed body image concerns to their mental health practitioner, largely citing embarrassment as the reason.  

BDD is life-changing in other ways:  sufferers are less likely to be married, more likely to be divorced, and much more likely to be unemployed. 

A major issue is compulsive, and intrusive thoughts – most BDD sufferers spend more than three hours a day thinking about their disliked body parts.  These urges are difficult to resist or control, and their intrusiveness are associated with anxiety and distress, leading to violence, mood disorders and suicidal ideation. 

Current remedies include SSRI (high dose) prescription in the UK, as well as CBT.  

Neurofeedback training is a non-invasive, medication-free complementary therapy.  We work on preconscious processes, and the positive effects are demonstrably lasting

DSM-IV Definition of BDD

The DSM-IV defines Body Dysmorphia Disorder as follows: 

A) “Preoccupation with an imagined defect in appearance. If a slight physical anomaly is present, the person’s concern is markedly excessive.”

B) “The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.”

C) “The preoccupation is not better accounted for by another mental disorder (eg, dissatisfaction with body shape and size in anorexia nervosa).”

Neurology of Body Dysmorphia Disorder

fMRI signature of Body Dysmorphia Disorder

Studies have shown that there are neurological differences in people with Body Dysmorphia Disorder.  By identifying neuromarkers, we can assess vulnerability using a qEEG brain map (Kaiser Neuromap), and then train the affected brain areas accordingly using neurofeedback.

The condition affects higher order visual processing areas, which relates to the emphasis on face and body recognition and the over-attention to detail. 

Also, prefrontal areas pertaining to self-monitoring, risk-taking and empathy are activated differently in BDD. 

Sub-cortical structures involved in reward processing see similar activations. 

BDD has many comorbidities, including anxieties, social phobia, depression and OCD.  Impulsive aggression (violence) and suicidal ideation are also common, as are intrusive thoughts.  

From our experience, these issues show up as vulnerabilities on a Kaiser Neuromap, and we can work on them accordingly using Personalised Brain Training. 

qEEG brain map of Body Dysmorphia Disorder showing neuromarker

Case Study - Teenager, Self-Harm, Gender Dysphoria

Elena had already changed school multiple times due to bullying.  She was exceptionally smart, and creative, and found it hard to be accepted by different playgroups during her early teens.  Home schooling during the last years further reduced her social circle, and after returning to school for a year, her best friend was hospitalised following a suicide attempt.  

Meanwhile, she was having difficulties with body awareness and began questioning her gender identity.  Having voiced urges to self-harm, she began ‘cutting’ after a family vacaction she had long looked forward to turned out to be a disappointment.  

Elena’s mother had made the well-intentioned decision to make herself available to her daughter in all forms of support.  This proved to be overly invasive for the teenager; it also caused issues with the school and other parents, and consequently with Elena and her acceptance by her classmates.  The mother’s intensity, mood swings and hypervigilant obsessions were not of emotional support to Elena.

We did twenty neurofeedback sessions over the course of three months, during which Elena cast away the cloud under which she had found herself and gained acceptance at school.  Her self-harm tendencies quickly abated and were no longer mentioned after a month.  Sleep improved, and her more bubbly, extroverted self came out.  She made friends with a group of students in a class above her.  

Elena enjoyed watching movies, which were part of her curriculum in a film studies class.

Famous People with Body Dysmorphia Disorder

Famous people with BDD (Body Dysmorphia Disorder) include:

Billie Eilish

Reid Ewing

Robert Pattinson

Franz Kafka

Sylvia Plath

Andy Warhol

Michael Jackson

Shirley Manson

The Process Explained

Step 1: Brain Map

A qEEG recording takes about 45minutes for a 20 minute recording.

A cap with 19 sensors is is fitted to our head and gels inserted to ensure connectivity.  The sensors only read – there is a tiny voltage on the surface of our head that these pick up.  The gels are easily washed out later.  This is also the last time we wear the cap (until a remap after ten sessions); training is done with single sensors. 

We analyse the data with Kaiser Neuromap software which gives us a unique view into character traits and vulnerabilities.  

Findings are presented in a separate one-hour conversation where we discuss the key elements.

Step 2: Neurofeedback

Neurofeedback process explained, illustrating real-time analysis of brain waves and feedback given

 We use a movie of choice as the feedback mechanism – our conscious mind engages with the film, and feedback is delivered by small changes in volume or picture size.  

Our pre-conscious mind adapts its behaviour to preserve the more comfortable volume and picture size, and learning occurs. 

Volume changes are slight, not stop-start, and the process is enjoyable. 

Key is that we are interested in the movie – our conscious mind is engaged with the content, which forms the reward, and our preconscious mind – without our conscious effort – changes its behaviour in response to the feedback.

Capturing the ultradian cycle with neurofeedback Personalised Brain Training using Kaiser Neuromap

A two hour training session allows us to do 90-110 minutes of neurofeedback training during which we can work on various brain sites. 

This captures an entire ultradian rhythm cycle and corresponds to the approximate duration of feature film movies.  

We can start with shorter sessions as appropriate, mainly with children. 

Ideally, we do two or more sessions per week to start with.  

We would expect to see responsiveness within the first few sessions and remap after twenty hours or about ten sessions.  

Generally, we would expect to doing twenty sessions over two months, though this can vary substantially. 

We can also accommodate intensives, where we do two sessions per day over a number of days, and have had good results with these.


Brain Maps and Personalised Brain Training Explained

Brain Maps expose Individual Vulnerabilities

With a Kaiser Neuromap, we can identify character traits, vulnerabilities and strengths. 

Different brain areas and networks govern our behaviour.  For example, there are parts of our brain which control mood regulation; spatial distractibility; physiological arousal; our sense of self; self-critical thoughts; anger and emotional attachment; and there are various sources of anxiety.

A brain map shows us which brain areas are behaving immaturely, and thus expose us to vulnerabilities or mental health issues.

Rather than fitting people into categories – diagnosis – we can assess vulnerability to behaviour patterns.  Every brain is different.  A brain map provides a more granular approach to understanding our strengths and weaknesses.

Personalised Brain Training with Neurofeedback

Neurofeedback lets us train dysrythmic brain areas.  With sensors comfortably fitted to the brain areas we want to train, we detect brainwave patterns real-time while watching a movie.  When these patterns are inefficient, the volume drops momentarily.  This is the feedback we are giving our brain, short and instantaneously.  

The brain area we are training recognises this – while our conscious mind is focussed on the movie – and adjusts its behaviour to restore the normal volume.  With repetition, throughout a session, learning occurs.  

Meanwhile our conscious mind is solely focussed on the movie; the training process is passive in this sense.    

The drop in volume is subtle, so we continue to understand the flow of the movie.  No current or electrical stimulation is fed to the brain; sensors simply read brainwaves and the feedback is purely audio-visual.

Neurofeedback is preconscious brain training aimed at enhancing our mental, emotional and spiritual health

Neurofeedback trains our Pre-Conscious Mind


Rather than engaging the conscious mind, which slows us down, we are training preconscious processes

This equips us with the ability to live in the moment and attain our potential (if we have to resort to conscious control, we are not living in the moment).

We take a holistic approach to healthy brain self-regulation, rather than categorisation or diagnosis. 

Personalised Brain Training is an advanced qEEG brain map-based approach to neurofeedback training developed by the founders of the field.  Taking Othmer Method / ILF training methods further, it employs Default Network Training protocols as developed by David Kaiser.

Neurofeedback is Evidence-based

Neurofeedback training is an evidence-based complementary therapy.  Its efficacy was first demonstrated some 50 years ago, and with advances in technology, training protocols have become more efficient and the feedback method – watching movies – thoroughly enjoyable. 

Neurofeedback is evidence-based.  It’s first application was discovered in 1971 when it was used to resolve intractable epilepsy. 

There are over 2,000 peer-reviewed research reports on PubMed demonstrating efficacy across a number of pathologies. 

In the US, it is an accepted complementary treatment for many challenges. 

Neurofeedback is evidence-based complementary therapy with over 2000 PubMed peer-reviewed research reports