Specificities of Mental Functioning and Referential Process in Body Dysmorphic Disorder: A Single Case Study Using...

Area of Science:

• Psychiatry
• Psychotherapy
• Linguistics

Background:

• Body dysmorphic disorder (BDD) presents significant challenges in psychotherapy, particularly regarding symbolization.
• Patients with BDD often exhibit difficulties in emotional expression and connecting experiences to language.

Purpose of the Study:

• To accurately diagnose a patient with severe BDD and comorbid personality disorders.
• To explore challenges in symbolization during early and middle psychotherapy stages.
• To analyze therapist and patient language to understand treatment dynamics.

Main Methods:

• Psychodynamic Chart and Referential Process language measures were used for assessment.
• Analysis focused on early and middle psychotherapy sessions.
• Therapist interventions were adapted to the patient's abstract linguistic style.

Main Results:

• The patient presented with severe BDD, somatizing, schizoid personality disorders, and impaired mentalization.
• Markedly abstract and intellectualized speech indicated difficulty linking emotions to words.
• Therapist's "aided symbolization" approach facilitated gradual improvement in mental functioning.

Conclusions:

• "Aided symbolization" can be an effective therapeutic strategy for patients with BDD and severe symbolization difficulties.
• Language analysis provides valuable insights into the psychotherapeutic process for BDD.
• Addressing challenges in symbolization is crucial for improving overall mental functioning in BDD treatment.