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Low Self-esteem & Body Dysmorphia (BDD)

Feeling “not enough” can seep into everything – studies, work, friendships, relationships. You might find yourself constantly comparing yourself to others, fixating on perceived flaws, checking mirrors or photos, avoiding social events, or seeking reassurance that never quite sticks. This can strain relationships too: pulling back when you feel exposed, overcompensating with perfectionism, or feeling unseen even by people who care.

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I’m a qualified and accredited therapist with over 15 years’ clinical experience in NHS Talking Therapies services and private practice, specialising in high-intensity CBT and Interpersonal Psychotherapy (IPT) for low self-esteem, body image concerns and related difficulties.

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With a warm, non-judgemental approach, we’ll work together to ease the pressure you put on yourself and loosen the grip that appearance worries and harsh self-criticism have on your day. We’ll map the patterns that keep low self-esteem and body-focused concerns going, build kinder and more balanced self-talk, and gradually reduce unhelpful checking, camouflaging and reassurance-seeking.

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We’ll also introduce steadier routines – clearer boundaries with mirrors, photos and social media, alongside habits that support sleep, movement and connection – so that confidence grows from the inside out. Step by step, you can widen your identity beyond looks, show up more fully in study, work and relationships, and feel more at home in your own skin.

Does this sound familiar?

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You might find yourself constantly comparing how you look to other people and speaking to yourself in a way you’d never speak to anyone else. You may fixate on particular parts of your appearance – skin, hair, face, body shape – in ways that other people either don’t notice, or see very differently.

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It might feel like you’re always checking or correcting: mirror-checking, zooming in on photos, examining your skin or hair, camouflaging with clothes or make-up, or asking for reassurance that doesn’t really stick. You may start to avoid cameras, social events, bright lighting, dating, or situations like exercise classes where you feel “on show”.

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Sometimes the focus shifts into perfectionism, procrastination, or overworking to hide how you really feel. Even when you’re surrounded by people who care about you, there can still be a heavy sense of feeling unseen or “not good enough”.

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How CBT helps

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CBT focuses on what keeps the problem going right now, then tests kinder, more effective alternatives.

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Core elements we’ll use (tailored to you):

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  • Psychoeducation & formulation: a clear map of your loops (triggers → thoughts/images → feelings → checking/avoidance → short-term relief → long-term stuckness).

  • Cognitive work: noticing self-criticism, shrinking “appearance rules,” building balanced self-statements, and widening identity beyond looks or achievement.

  • Behavioural experiments: small, planned tests that disconfirm the “I must fix/hide/avoid” rules.

  • Exposure & Response Prevention (ERP) for BDD: gradually face feared situations (mirrors, photos, natural lighting, social contact) without checking/camouflaging/reassurance.

  • Mirror retraining: time-limited, compassionate looking (whole-person focus, non-zoomed) to reduce scanning and fault-finding.

  • Reassurance & checking reduction plan: practical steps for mirrors, selfies, skin/hair checks, size checking, and social media.

  • Values & routines: sleep, movement, boundaries with screens, and activities that re-expand your life.


 

What sessions look like

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  • First meeting (free, 30 minutes): goals, brief screening for BDD/low self-esteem patterns, suitability for CBT, and next steps.

  • Assessment (1–2 sessions): collaborative formulation and treatment plan.

  • Treatment (typically 8–16 sessions, weekly): skills practice each week; you’ll have clear, doable between-session tasks.

  • Review & relapse prevention: consolidate gains and create a plan you can keep using.


 

Practical changes you’ll notice

 

  • Less time lost to mirrors, selfies, and mental checking

  • More ease in social/contact situations (less avoidance, more presence)

  • Softer, more accurate self-talk; fewer rules about appearance/perfection

  • Confidence built from action, not reassurance

  • A broader sense of identity and worth


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FAQs

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Is this vanity?


No. BDD and low self-esteem are mental-health difficulties, not vanity. The distress is real, and CBT has a strong evidence base.

 

Will CBT ignore my feelings?

 

No—feelings are central. We’ll validate your experience and use structured tools so feelings don’t have to run the day.

 

Do I need a diagnosis?

 

A formal diagnosis isn’t required to start CBT. We’ll assess whether your pattern fits BDD, low self-esteem, social anxiety, or a mix—and treat what’s present.

 

How long until I notice change?

 

Many people notice small shifts within 2–4 sessions (less checking, fairer self-talk). Meaningful change builds across weeks with consistent practice.

 

Ready to start?

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Book a free 30-minute consultation to see if CBT is a good fit and map your next steps.

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