EMDR and Body Dysmorphic Disorder: What New Research Is Revealing
Body Dysmorphic Disorder (BDD) can make the way someone sees their own body feel painfully disconnected from how others see them.
A feature that may seem minor—or may not even be noticeable to others—can become the focus of intense distress, shame, anxiety, comparison, avoidance, and preoccupation.
For people living with BDD, mirrors, photographs, social situations, or even everyday interactions can become emotionally charged.
And increasingly, researchers are looking at an important question:
What happens when we address the experiences underneath these patterns—not just the thoughts and behaviours themselves?
A 2024 study published in the Journal of EMDR Practice and Research explored this question by examining the use of Eye Movement Desensitization and Reprocessing (EMDR) with people experiencing BDD. The findings offer an early but important look at how EMDR may help reduce not only BDD symptoms, but some of the emotional experiences that can maintain them.
Understanding Body Dysmorphic Disorder
BDD is characterized by an intense preoccupation with perceived flaws or defects in appearance. These concerns can involve almost any part of the body.
Someone may spend significant amounts of time checking themselves in a mirror, seeking reassurance, comparing themselves with others, grooming, hiding perceived flaws, or avoiding social situations altogether.
The research also highlights three important emotional and cognitive features associated with BDD:
Appearance-based rejection sensitivity — anticipating or fearing rejection because of appearance.
Body shame — experiencing negative emotions toward one's own body.
Low self-compassion — difficulty responding to oneself with kindness and understanding.
These experiences can reinforce one another. Fear of being judged can increase attention toward perceived flaws. That attention can increase shame. Shame can make it even harder to relate to the body with compassion.
Looking Beneath the Symptom
One of the interesting aspects of this research is the way the researchers approached BDD through EMDR's Adaptive Information Processing (AIP) model.
Within this model, distressing experiences can become dysfunctionally stored when they are not adequately processed. Those experiences may continue to influence present-day thoughts, emotions, beliefs, and physical sensations.
For BDD, the researchers used what is known as the Rejected Self EMDR protocol.
The concept of the "rejected self" is particularly relevant to body image. The researchers describe it as the part of ourselves we have learned to reject—the version of ourselves we do not want to be again and may continue comparing ourselves against.
The protocol explores how experiences such as criticism, comparison, bullying, rejection, or other adverse experiences may have shaped the way someone sees themselves.
This is an important distinction.
The work isn't simply about convincing someone that they look different than they believe they do.
It is about exploring the emotional experiences and memories that may have become connected to the way they see themselves.
What Did the Study Do?
The study began with 30 participants, five of whom met the criteria for BDD. One participant discontinued treatment, leaving four female participants in the final study.
Each participant received 10 weekly, 90-minute EMDR sessions, followed by follow-ups at one and three months.
The researchers measured four areas:
BDD symptoms
Appearance-based rejection sensitivity
Body shame
Self-compassion
The treatment incorporated the Rejected Self protocol alongside the standard EMDR protocol when appropriate. Participants also worked with memories connected to rejection, shame, and concerns about their appearance.
What Changed?
The results were notable.
Across the four participants, the researchers reported:
60.54% reduction in BDD symptoms
36.56% reduction in appearance-based rejection sensitivity
54.82% reduction in body shame
51.79% increase in self-compassion
The researchers reported that all four participants no longer met DSM-5-TR criteria for BDD following treatment.
Some of these improvements were also maintained during follow-up, although the degree of improvement varied between participants.
Perhaps one of the most meaningful findings was the increase in self-compassion.
The study suggests that as distressing appearance-related memories were processed, participants became more able to relate to themselves with greater kindness and less judgment.
That shift matters.
Because healing isn't always about suddenly loving every part of ourselves.
Sometimes it begins with no longer fighting ourselves.
From Shame to Compassion
The researchers describe an interesting change that can occur during the Rejected Self protocol.
As adverse experiences are processed, the emotional response may begin to move away from rejection and shame and toward sorrow for the part of oneself that was previously rejected.
That creates space for something different:
Compassion.
In the study, self-compassion increased across all four participants, suggesting that this may be an important part of the therapeutic process.
This speaks to a broader principle in trauma-informed work.
Sometimes the behaviour we see on the surface is only part of the story.
Underneath it may be a nervous system carrying old experiences of criticism, rejection, comparison, fear, or shame.
When those experiences are processed, the present can begin to feel different.
Why This Matters Beyond BDD
The study is specifically about Body Dysmorphic Disorder, but it also highlights something broader about EMDR.
EMDR is increasingly being explored beyond its original application to PTSD. Its approach focuses on processing distressing experiences and the memories, beliefs, emotions, and body sensations connected to them.
In this study, participants worked with appearance-related experiences from the past, current triggers, and future situations.
The researchers suggest that addressing these different points in time may help create more adaptive responses moving forward.
This way of working reflects something fundamental about the relationship between the brain, body, and nervous system.
What happened to us can continue to shape how we respond now.
And sometimes, creating change means going beneath the pattern to understand what the system is still carrying.
The Possibility of a Different Relationship With Ourselves
Body image struggles can become deeply intertwined with memory.
A comment made years ago.
A moment of being laughed at.
A comparison.
A rejection.
A reflection in the mirror.
Over time, experiences like these can become connected to beliefs about who we are and how we believe others see us.
EMDR offers one way of working with those connections.
Not by asking someone to simply think differently.
But by helping process what may still be emotionally and physically present.
And as this research suggests, the goal may extend beyond reducing symptoms.
It may also create room for something quieter and more powerful:
less shame, less fear of rejection, and more compassion for the person looking back in the mirror.
That is an area of EMDR research worth continuing to explore.
An Important Note About the Research
These findings are encouraging, but they are still early.
The study involved only four participants, all of whom were women, and there was no control group. The researchers specifically state that larger randomized controlled trials are needed to determine how broadly these findings apply.
Future research will also need to include more diverse samples, including men with BDD.
So this study does not establish EMDR as a definitive treatment for BDD.
What it does provide is another piece of evidence worth paying attention to—and a reason to continue researching how memory processing may influence body image, shame, rejection sensitivity, and self-compassion.