Acrophobia and body dysmorphic

[FlowerKiss]

We where at dinner today with my boyfriend, I don't know why but I have been feeling ugly and I think I may have body dysmorphic especially when my boyfriend said 'i wish you could see how tiny you are, you look fine.' That made me think that there is something wrong with me, I always itch for new make-up and feel good when I only wear that, I feel like I need fancy clothes, and I always pick at my face I really need to talk to my therapist about this when I get around to it.

My acrophobia is the biggest problem, it has broken my boyfriend's heart when we went to a school carnival and he wanted to ride the ferris wheel with me. I wound up holding onto him and trying to hide my face when I cry, he knew I wanted to do it too but I just knew I would probably have a panic attack or something if I went up there. How do you get rid of it? I had this sense I was like four and now I am on my way to be being 20 and I still am scared.

[OMFG!You'reActuallySmart!]

People with body dysmorphic disorder (BDD) are always obsessed with a perceived flaw somewhere on their body. They always feel as though they are ugly, not just when talking with a specific person. When you talk with your therapist about it, there may be some questions regarding hallucinations. I don't know your psychiatric history but I mention hallucinations because there are two types of BDD non-delusional and delusional. They're not great descriptions because the delusional type has hallucinations, however, in all psychiatry, hallucinations are not delusions.

With BDD though, there are many risks, particularly with co-morbidity of depression and often suicide (~60% have BDD and depression, many commit suicide). If you talk to your therapist about BDD, there may be some concerns over this. In addition, there are high co-morbidity with eating disorders. It's not common to have BDD without any co-morbidity.

Acrophobia is better treated than BDD. The standard treatment is systematic desensitization, whereby a therapist first trains you to relax. You then are exposed to yours fears in a hierarchical order, so the least fearful phobia is treated first. For acrophobia, it's not always feasible nor safe for a therapist to bring the client to a high altitude, although it still is done. Instead, clients enter virtual reality simulators by wearing specialized goggles and standing on platform that can move.

Below is a link to an article that has detailed images of the virtual reality simulator with a client using it. The text of the article isn't important:
http://citeseerx.ist.psu.edu/viewdoc...=rep1&type=pdf (PDF file)

Alternatively, some therapists use hypnotherapy to relax the client as much as possible then have them imagine fearful heights in as much detail as possible. Hypnotherapy is used for numerous disorders and it's always had a shady past with many researchers, doctors and therapists believing it's not useful since the hypnotherapist has no idea what the client is actually seeing. Also, when people are put into hypnosis, they don't obey ever command. Any commands that violate their morals or are fearful probably won't be done. Lastly, some people are not easily hypnotized.

I couldn't find any great websites, instead I found a good e-book in the link below. The main chapter is chapter 14, going from pages 289-306. At pages 305-306, acrophobia is mentioned however the entire chapter is about phobias in general and how hypnotherapy can be applied.
http://books.google.ca/books?id=-SUl...page&q&f=false