I think my son is stuck in a teenage mindset. Perhaps with such an illness like BDD or OCD, there is a desire for the safety and security found in the teenage years. As a teenager, life was scheduled and mostly trouble free. You weren't worrying about finances, chores and what you needed to buy for the cupboard. You didnt think work was a sentence and recreation another chore. Personal relationships werent filed by the court system.
So when mental illness does descend it is only a normal response to retreat back to a teenager's life. A life when anticipation of the awaiting adult adventure was how we reasoned the future would be for us.

So if we enter adult life still as a teenager, we might set our amygdala to react like a teenager too.
What if the brain never receives an upgrade? 14 years later, we are still responding to some comment made about our looks that we didn't like at 13 to 19 years old.
All it takes is for our amygdala to form a template for how we should react with alarm to this comment about looks. Then anything that reminds the brain of this looks comment triggers the amygdala hijack and off we go to panic.

When in BDD, your mind's template hasnt changed to adopt more age specific software.
This leaves you craving a 19 year old look. With your mind hijacked by this teenager you still focus attention on what you look like and not what you do.

This teenager only exists in you because the adult hasn't taken charge and found that assertive adult voice that stops impulsiveness and stops abuse. Are you the people pleasing type? Wanting to be liked so you don't want to offend anyone? Do you want to own yourself? Or is the neediness to be loved so strong that almost anyone who says they love you will be OK, regardless of how hurt you are and how badly you get treated?

It is sometimes easier to find fault in yourself than look at the bigger picture and find fault in the bit of the world you have made home. It is harder to recognize the fault in the people we chose to be with. It is harder still to do something about it. So self sabotage is a much easier option.

In a way, your own body is the most precious home you will ever live in. It is a legacy bestowed on you by ancestors. It has the job of taking you on this journey called life. But how easy is it to find fault within. It can become a magnificent distraction from the main game when we become obsessed.
So BDD has a dual purpose. It traps us in a role for our impulsive teenager and it stops our adult firing up to allow us to overcome fear. That is just my negative spin really. The positives are that the adult doesn't have to turn up for work and never speaks up to defend their own abuse. Symbolically, you become stuck as a teenager with body concerns and so avoid facing adult concerns. I suppose that makes BDD, a maladaptive displacement of fear.

The goal for the adult in you, is to accept your own adult body. Surrender the teenager's impulsiveness to the adult's will and higher awareness. The adult wants and needs to be the master. You are then free from obsession and compulsion to fill your life with what you can do to make today better. The adult role. Marg