…..  and How I Became Interested in Body Dysmorphic Disorder.

In fact, I did not start out to write a book.  I started out trying to understand why some patients who got good results that achieved exactly what they had requested could be so unhappy postoperatively.  In the mid-1980’s, I operated on three such patients without having made the diagnosis of body dysmorphic disorder ahead of time.  All seemed like perfect surgical candidates, but all became dismally upset afterwards, leaving their jobs, becoming recluses, or trying to hurt themselves.  Why did this happen?  And why couldn’t I reason with these patients who suddenly became childlike, untrusting and acting like victims?  I was so distraught that I began to read the literature, and have kept at it since then.

What has become obvious is that most of the answers to my questions were already in the mental health literature, but parts of it were sequestered among subspecialties that did not cross-pollinate.  As I read and added my own clinical research, the pieces began to fall together.

Body dysmorphic disorder and many of the other addictions and self-harming behaviors often begin in childhood with abuse and neglect of various types, causing toxic shame that manifests in different ways.  All surgeons see these patients –– in fact physicians and dentists see them as well, in different forms.  The more trauma that occurs in childhood, the more health problems people have as adults.

I hope is that this book will educate both patients and providers, so that their childhood becomes a regular part of every patient’s history, and so that patients with body image disorders will get the right treatment instead of having more operations.

It’s a good read.