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Seeing Beyond the Mirror: How Psilocybin Could Transform Body Dysmorphic Disorder Treatment

Georgiana Cullen-Kerney, ND, LAc

Emerging research reveals that psilocybin, the active compound in magic mushrooms, may offer a groundbreaking approach to treating Body Dysmorphic Disorder (BDD) by enhancing cognitive flexibility and reducing obsessive thought patterns.

Body Dysmorphic Disorder (BDD) is more than mere superficial vanity or worrisome insecurities; it is a serious mental health condition characterized by an intense obsession with perceived imperfections in appearance, which often seem trivial or even nonexistent. Shame plays a significant role in the lives of those affected, contributing to the disorder’s frequent misdiagnosis or delay in recognition.1-2 Although a psychiatric disorder, BDD presents more often in dermatologist and cosmetic surgeon offices due to the areas of concern and perpetual need to alter appearances.3 Alarmingly, individuals with BDD often do not receive a diagnosis until 10 to 15 years after their symptoms have escalated to meet the diagnostic criteria.4 This highlights the critical role physicians play in early identification and intervention. By being attuned to the nuances of BDD, healthcare providers can explore innovative treatment options, like psilocybin, alongside conventional protocols.

Those who suffer from BDD will present as being highly fixated on their looks, feeling they are disfigured or ugly. They tend to have a daily obsession of 3-8 hours per day—repetitive behaviors like hiding or camouflaging a body area, mirror checking, excessive grooming, and skin picking are all classic signs. Other behaviors include: excessive tanning, exercising, or shopping for products to look better. Significant emotional distress occurs, and it interferes with daily functioning.5 It’s crucial to ask about BDD when patients show signs of referential thinking, experience social withdrawal, pursue unnecessary surgeries, display social anxiety, or exhibit suicidality.6-7 BDD is associated with significantly elevated rates of suicidality, with suicidal ideation occurring in 17% to 77% of affected individuals, and rates of suicide attempts widely range from 3% to 63%.8  

Unfortunately, no blood tests, brain scan evaluations, or other diagnostic tools are available. Correct diagnosis of BDD can be significantly enhanced through screening tools. The Body Dysmorphic Disorder Questionnaire demonstrates high sensitivity (94%–100 %) and specificity (89%–93 %). The gold standard for evaluating BDD severity is the BDD Yale-Brown Obsessive–Compulsive Scale (BDD-YBOCS). It’s a clinician-administered interview that assesses the severity of symptoms over a week’s period. It’s often used in clinical trials; however, its length and the potential need for specialized training may limit its feasibility in many clinical environments.8

BDD is a relatively prevalent condition, with epidemiological studies reporting a point prevalence of 0.7% to 2.4% in the general population. It has been identified in individuals ranging from age 5 to 80, impacting people of all genders, although it appears to be more common among those assigned female at birth.9 A subset of BDD, Muscle Dysmorphic Disorder, is defined by an intense focus on achieving a lean and muscular physique. While this condition predominantly affects men, largely due to sociocultural influences that glorify hyper-masculinity as the ideal male form, there is a notable lack of research exploring its prevalence and impact among transgender individuals.10 BDD typically presents during adolescence and often follows a chronic trajectory if left untreated. A notable prospective study on the course of BDD found that the probability of achieving full remission within one year was only 9%, which is lower than the remission rates reported for mood disorders and anxiety disorders in other longitudinal studies. Key predictors of lower remission likelihood include more severe symptoms at baseline, a longer duration of the disorder, and the presence of one or more comorbidities.9

The issue of comorbidity remains largely underexplored. Most individuals with BDD also experience at least one additional disorder, which can complicate their diagnosis and treatment. Most patients with BDD have at least one comorbid disorder, with major depressive disorder being the highest in prevalence. Others included social phobia, social anxiety disorder, eating disorders, obsessive-compulsive disorder (OCD), or substance use disorders.11 Eating disorders appear relatively common in individuals with BDD.12 Notably, social phobia often precedes the onset of BDD, whereas depression, eating disorders, and substance use disorders typically emerge afterward.11-12 BDD is on the OCD spectrum and it’s now categorized as an obsessive-compulsive disorder and related disorder (OCDRD) in the Diagnostic and Statistical Manual of Mental Disorders, DSM-V.13-14

Standard first-line treatments for individuals with OCD and/or BDD include serotonin reuptake inhibitors (SSRIs) and Cognitive Behavioral Therapy (CBT). Research indicates that higher doses of SSRIs may offer greater benefits for those with BDD, although this requires more rigorous monitoring. Additionally, combining CBT with SSRIs has been shown to provide more lasting relief from symptoms.15-16

As clinicians seek to adopt best practices and treatment options for BDD, early clinical research on psilocybin “magic mushrooms” has shown promising effects for conditions like major depressive disorder and treatment-resistant depression, and the FDA has granted psilocybin “breakthrough therapy” status.17 In the early 2000s, interest in psilocybin for OCD emerged from a clinical trial that established psilocybin as safe and generally well-tolerated for OCD, leading to decreases in OCD severity scores within 24 hours following oral ingestion.18 Psilocybin works via the serotonergic system, primarily through agonism at the 5-HT2A receptors.19 It can also reduce doubt and rumination, key aspects of obsessions.20 Recent studies suggest that psilocybin alters connectivity in the brain, particularly within the Default Mode Network (DMN), which is linked to self-referential thinking and is overactive in individuals with OCD and  BDD.21-22 It has been suggested that psilocybin’s therapeutic effects may stem from its ability to reset brain connectivity patterns, creating a therapeutic window that fosters the emergence of new insights and facilitates emotional release.23 This mechanism positions psilocybin as a potential treatment for the underlying causes of psychiatric disorders, rather than merely alleviating symptoms.24 For BDD sufferers specifically, this may offer a path forward to confront distorted beliefs about body image in a safe environment, promoting new insights and perspectives. Additionally, the emotional cathartic release often experienced during these sessions can lead to improved emotional well-being, helping individuals feel more motivated to engage in therapeutic practices and seek support for their condition.

Last year, a pilot study was explicitly published on BDD and psilocybin. The research team studied the effects of a 25 mg dose of psilocybin in 12 adults with moderate-to-severe BDD. Using resting-state functional magnetic resonance imaging (rs-fMRI), they scanned participants’ brains one day before and one day after the psilocybin session. Remarkably, significant changes in brain connectivity were observed. Specifically, communication within the Executive Control Network (ECN)—important for cognitive flexibility—was enhanced, along with improved connections to the Default Mode Network (DMN), linked to self-reflection, and the Salience Network, which prioritizes important information. Participants showing the greatest connectivity increases reported significant reductions in BDD symptoms one week post-treatment. Encouragingly, follow-up assessments over 12 weeks indicated these benefits were sustained. The research team suggests psilocybin may enhance cognitive flexibility, allowing individuals to break free from rigid thought patterns and better manage their emotions. Despite the small sample size in the study, there was substantial clinical improvement, and further studies are needed.25 These findings highlight the potential of psilocybin as an innovative treatment option that aligns with holistic approaches to mental health, offering hope for patients struggling with BDD.

As new treatment options for BDD are explored, psilocybin emerges as a potential approach that may complement existing therapies. By facilitating profound self-reflection, psilocybin offers a unique opportunity for individuals to confront and reframe their skewed perceptions of self. This innovative treatment can enhance emotional processing and resilience, potentially leading to lasting improvements in well-being. While traditional methods remain valuable, integrating psilocybin into a comprehensive treatment plan could provide a transformative pathway for those seeking relief from the challenges of BDD.

Q&A

“What real clinical application is there? It seems like all the information about this is from well-controlled research studies?” 

Psilocybin can help people break free from negative thinking patterns and behaviors. It encourages cognitive shifts, making it easier to escape those mental ruts we sometimes get stuck in. Right now, researchers are looking into its potential for treating a range of issues, like depression, anxiety, PTSD, substance use disorder, and OCD. While the results are promising, we’re still in the research phase, and more studies are needed to establish clear clinical guidelines.

It’s important to remember that psilocybin isn’t a magic solution. There are risks, especially for people who might be prone to psychotic or manic disorders. Even for those without such predispositions, the psychedelic experience can bring up strong emotions and vivid imagery, which can be both transformational and, at times, unsettling.

With the right guidance and support from trained professionals, even tough experiences can lead to valuable insights. Psilocybin can create a sense of openness and vulnerability, which is why ethical considerations are so important. It’s crucial for providers to prioritize patient well-being and make sure therapeutic environments are safe and supportive. Sticking to strict ethical standards and trauma-informed care is key to maximizing the benefits while minimizing the risks.

“Do patients really do this? They just trip on mushrooms?”

When people eat mushrooms with psilocybin, they can definitely have a psychedelic “trip.” This might change how they see and feel things, and they could even experience vivid hallucinations. Everyone’s experience can vary based on the dose, their environment, and their mental state. Some folks might find it enlightening, while others might feel overwhelmed.

It’s also worth noting that some of your patients might have had past experiences with psilocybin—maybe they tried it once in high school or college, or they’ve grown their own and experimented with microdosing. Some might have even taken larger doses on their own, with a guide, or gone on week-long retreats both in the U.S. and abroad. If someone is considering trying it, it’s really important to be informed and approach it with care!

“How could I use this in my practice? I can’t advocate this for my patients because it’s illegal.”

Whether doctors can talk about the benefits of psilocybin really depends on where they are. In many areas, psilocybin is still considered a controlled substance, which can limit how it’s discussed in medical settings. However, in places where it’s being studied or has been decriminalized, doctors can talk about its potential benefits, especially in relation to research or treatment.

Some states and cities in the U.S. are moving toward decriminalizing psilocybin or allowing its use for therapy, even though it’s still classified as a Schedule I substance at the federal level. So, it’s important for physicians to stay updated on local laws and regulations. They might also direct patients to clinical trials or research studies that are looking into psilocybin’s effects. It’s always best for healthcare professionals to consult legal guidelines. 

Great news! In January 2025, there’s a bill proposal in Oregon that would allow licensed medical professionals to talk to their patients about using psilocybin as a treatment option without facing any penalties. This is a big step forward! It means doctors in Oregon can have open conversations about the benefits and risks, helping patients make informed decisions. It’s definitely going to enhance education and support for both doctors and patients as they explore this option together.

“How can you practice using psilocybin?”

Since Oregon passed Measure 109 in 2020, it became the first state in the U.S. to allow psilocybin services. Right now, if you want to facilitate psilocybin sessions, you need a licensed psilocybin facilitator license. However, you can’t do this in a medical practice. In fact, if you hold both a medical license and a psilocybin facilitator license, you can’t use them at the same time.

Psilocybin services are only available at state-licensed service centers, which primarily provide space for sessions. These centers handle the purchase and management of psilocybin, ensuring everything is compliant with state laws. They also support facilitators by providing the necessary environment and resources for sessions. While the service center reps take care of the logistics and product handling, it’s the facilitators who lead the sessions and spend hours preparing clients for the experience, as well as sit with the client through the entire journey. So, while the centers provide the space and product support, the facilitators are responsible for creating a safe and effective environment for the participants.

“What would a course of treatment look like?”

Psilocybin isn’t classified as a medical treatment in Oregon, so people can use it for various reasons—even just out of curiosity—without needing a specific diagnosis. However, there are some steps involved: you’ll need to go through an initial assessment, a preparatory session, and an administrative session, plus an optional integration session afterward.

There are only three situations where using psilocybin is prohibited under Oregon law:

  1. If you’ve used the prescription drug lithium in the past 30 days.
  2. If you have thoughts of harming yourself or others.
  3. If you’ve been diagnosed with or treated for active psychosis.

The main concern is that there are many other factors that might make psilocybin sessions unsafe for some people. I really hope doctors will take a more active role in working with their patients to spot potential drug interactions or health issues that could make psilocybin a less suitable option. More training and a focus on harm reduction are crucial for keeping patients safe!For further information please visit this non-profit organization: Health Advocacy Fund https://healingadvocacyfund.org/ They have furnished a Client Guide useful for physicians to understand more.

Dr. Georgiana Cullen-Kerney, ND, LAc, also known as Dr. G, is a naturopathic doctor, licensed acupuncturist, and certified homeopath with a passion for integrative healing. A graduate of NUNM and the New England School of Homeopathy, she blends plant medicine, Chinese medicine, and mind-body tools to support her patients’ healing journeys. Dr. G has trained with leading experts and most recently became a certified psilocybin facilitator through Oregon’s InnerTrek program. Her mission: to reflect your inner healer back to you through deep listening, collaboration, and compassion.

References

  1. Nicewicz HR, Torrico TJ, Boutrouille JF. Body Dysmorphic Disorder. In: StatPearls. Treasure Island (FL): StatPearls Publishing; January 20, 2024.
  2. Weingarden H, Shaw AM, Phillips KA, Wilhelm S. Shame and Defectiveness Beliefs in Treatment Seeking Patients With Body Dysmorphic Disorder. J Nerv Ment Dis. 2018;206(6):417-422. doi:10.1097/NMD.0000000000000808
  3. Phillips KA, Dufresne RG. Body dysmorphic disorder. A guide for dermatologists and cosmetic surgeons. Am J Clin Dermatol. 2000;1(4):235-243. doi:10.2165/00128071-200001040-00005
  4. Cleveland Clinic. Body Dysmorphic Disorder. Cleveland Clinic. Published January 11, 2023. Accessed September 10, 2024. https://my.clevelandclinic.org/health/diseases/9888-body-dysmorphic-disorder
  5. Phillips KA. Signs & Symptoms of BDD. International OCD Foundation. Accessed September 10, 2024. https://bdd.iocdf.org/professionals/signs-symptoms/
  6. Phillips KA. Body dysmorphic disorder: recognizing and treating imagined ugliness. World Psychiatry. 2004;3(1):12-17.
  7. Phillips KA, Coles ME, Menard W, Yen S, Fay C, Weisberg RB. Suicidal ideation and suicide attempts in body dysmorphic disorder. J Clin Psychiatry. 2005;66(6):717-725. doi:10.4088/jcp.v66n0607
  8. Krebs G, Fernández de la Cruz L, Mataix-Cols D. Recent advances in understanding and managing body dysmorphic disorder. Evid Based Ment Health. 2017;20(3):71-75. doi:10.1136/eb-2017-102702
  9. Singh AR, Veale D. Understanding and treating body dysmorphic disorder. Indian J Psychiatry. 2019;61(Suppl 1):S131-S135. doi:10.4103/psychiatry.IndianJPsychiatry_528_18
  10. Amodeo AL, Esposito C, Antuoni S, Saracco G, Bacchini D. Muscle dysmorphia: what about transgender people?. Cult Health Sex. Published online October 8, 2020. doi:10.1080/13691058.2020.1814968
  11. Gunstad J, Phillips KA. Axis I comorbidity in body dysmorphic disorder. Compr Psychiatry. 2003;44(4):270-276. doi:10.1016/S0010-440X(03)00088-9
  12. Ruffolo JS, Phillips KA, Menard W, Fay C, Weisberg RB. Comorbidity of body dysmorphic disorder and eating disorders: severity of psychopathology and body image disturbance. Int J Eat Disord. 2006;39(1):11-19. doi:10.1002/eat.20219
  13. Frías Á, Palma C, Farriols N, González L. Comorbidity between obsessive-compulsive disorder and body dysmorphic disorder: prevalence, explanatory theories, and clinical characterization. Neuropsychiatr Dis Treat. 2015;11:2233-2244. Published 2015 Aug 26. doi:10.2147/NDT.S67636
  14. Phillips KA, Kelly MM. Body Dysmorphic Disorder: Clinical Overview and Relationship to Obsessive-Compulsive Disorder. Focus (Am Psychiatr Publ). 2021;19(4):413-419. doi:10.1176/appi.focus.20210012
  15. Phillips KA, Hollander E. Treating body dysmorphic disorder with medication: evidence, misconceptions, and a suggested approach. Body Image. 2008;5(1):13-27. doi:10.1016/j.bodyim.2007.12.003
  16. Nezgovorova V, Reid J, Fineberg NA, Hollander E. Optimizing first line treatments for adults with OCD. Compr Psychiatry. 2022;115:152305. doi:10.1016/j.comppsych.2022.152305
  17. Business Wire. FDA grants Breakthrough Therapy Designation to Usona Institute’s psilocybin program for major depressive disorder. Business Wire. Published November 22, 2019. Accessed September 10, 2024. https://www.businesswire.com/news/home/20191122005452/en/FDA-grants-Breakthrough-Therapy-Designation-to-Usona-Institutes-psilocybin-program-for-major-depressive-disorder
  18. Moreno FA, Wiegand CB, Taitano EK, Delgado PL. Safety, tolerability, and efficacy of psilocybin in 9 patients with obsessive-compulsive disorder. J Clin Psychiatry. 2006;67(11):1735-1740. doi:10.4088/jcp.v67n1110
  19. Ling S, Ceban F, Lui LMW, et al. Molecular Mechanisms of Psilocybin and Implications for the Treatment of Depression. CNS Drugs. 2022;36(1):17-30. doi:10.1007/s40263-021-00877-y
  20. Barba T, Buehler S, Kettner H, et al. Effects of psilocybin versus escitalopram on rumination and thought suppression in depression. BJPsych Open. 2022;8(5):e163. Published 2022 Sep 6. doi:10.1192/bjo.2022.565
  21. Li W, Arienzo D, Feusner JD. Body Dysmorphic Disorder: Neurobiological Features and an Updated Model. Z Klin Psychol Psychother (Gott). 2013;42(3):184-191. doi:10.1026/1616-3443/a000213
  22. Reggente N, Moody TD, Morfini F, et al. Multivariate resting-state functional connectivity predicts response to cognitive behavioral therapy in obsessive-compulsive disorder. Proc Natl Acad Sci U S A. 2018;115(9):2222-2227. doi:10.1073/pnas.1716686115
  23. Carhart-Harris RL, Nutt DJ. Serotonin and brain function: a tale of two receptors. J Psychopharmacol. 2017;31(9):1091-1120. doi:10.1177/0269881117725915
  24. Nutt D, Erritzoe D, Carhart-Harris R. Psychedelic Psychiatry’s Brave New World. Cell. 2020;181(1):24-28. doi:10.1016/j.cell.2020.03.020
  25. Schneier FR, Feusner J, Wheaton MG, et al. Pilot study of single-dose psilocybin for serotonin reuptake inhibitor-resistant body dysmorphic disorder. J Psychiatr Res. 2023;161:364-370. doi:10.1016/j.jpsychires.2023.03.031

Georgiana Cullen-Kerney, ND, LAc

Emerging research reveals that psilocybin, the active compound in magic mushrooms, may offer a groundbreaking approach to treating Body Dysmorphic Disorder (BDD) by enhancing cognitive flexibility and reducing obsessive thought patterns.

Body Dysmorphic Disorder (BDD) is more than mere superficial vanity or worrisome insecurities; it is a serious mental health condition characterized by an intense obsession with perceived imperfections in appearance, which often seem trivial or even nonexistent. Shame plays a significant role in the lives of those affected, contributing to the disorder’s frequent misdiagnosis or delay in recognition.1-2 Although a psychiatric disorder, BDD presents more often in dermatologist and cosmetic surgeon offices due to the areas of concern and perpetual need to alter appearances.3 Alarmingly, individuals with BDD often do not receive a diagnosis until 10 to 15 years after their symptoms have escalated to meet the diagnostic criteria.4 This highlights the critical role physicians play in early identification and intervention. By being attuned to the nuances of BDD, healthcare providers can explore innovative treatment options, like psilocybin, alongside conventional protocols.

Those who suffer from BDD will present as being highly fixated on their looks, feeling they are disfigured or ugly. They tend to have a daily obsession of 3-8 hours per day—repetitive behaviors like hiding or camouflaging a body area, mirror checking, excessive grooming, and skin picking are all classic signs. Other behaviors include: excessive tanning, exercising, or shopping for products to look better. Significant emotional distress occurs, and it interferes with daily functioning.5 It’s crucial to ask about BDD when patients show signs of referential thinking, experience social withdrawal, pursue unnecessary surgeries, display social anxiety, or exhibit suicidality.6-7 BDD is associated with significantly elevated rates of suicidality, with suicidal ideation occurring in 17% to 77% of affected individuals, and rates of suicide attempts widely range from 3% to 63%.8  

Unfortunately, no blood tests, brain scan evaluations, or other diagnostic tools are available. Correct diagnosis of BDD can be significantly enhanced through screening tools. The Body Dysmorphic Disorder Questionnaire demonstrates high sensitivity (94%–100 %) and specificity (89%–93 %). The gold standard for evaluating BDD severity is the BDD Yale-Brown Obsessive–Compulsive Scale (BDD-YBOCS). It’s a clinician-administered interview that assesses the severity of symptoms over a week’s period. It’s often used in clinical trials; however, its length and the potential need for specialized training may limit its feasibility in many clinical environments.8

BDD is a relatively prevalent condition, with epidemiological studies reporting a point prevalence of 0.7% to 2.4% in the general population. It has been identified in individuals ranging from age 5 to 80, impacting people of all genders, although it appears to be more common among those assigned female at birth.9 A subset of BDD, Muscle Dysmorphic Disorder, is defined by an intense focus on achieving a lean and muscular physique. While this condition predominantly affects men, largely due to sociocultural influences that glorify hyper-masculinity as the ideal male form, there is a notable lack of research exploring its prevalence and impact among transgender individuals.10 BDD typically presents during adolescence and often follows a chronic trajectory if left untreated. A notable prospective study on the course of BDD found that the probability of achieving full remission within one year was only 9%, which is lower than the remission rates reported for mood disorders and anxiety disorders in other longitudinal studies. Key predictors of lower remission likelihood include more severe symptoms at baseline, a longer duration of the disorder, and the presence of one or more comorbidities.9

The issue of comorbidity remains largely underexplored. Most individuals with BDD also experience at least one additional disorder, which can complicate their diagnosis and treatment. Most patients with BDD have at least one comorbid disorder, with major depressive disorder being the highest in prevalence. Others included social phobia, social anxiety disorder, eating disorders, obsessive-compulsive disorder (OCD), or substance use disorders.11 Eating disorders appear relatively common in individuals with BDD.12 Notably, social phobia often precedes the onset of BDD, whereas depression, eating disorders, and substance use disorders typically emerge afterward.11-12 BDD is on the OCD spectrum and it’s now categorized as an obsessive-compulsive disorder and related disorder (OCDRD) in the Diagnostic and Statistical Manual of Mental Disorders, DSM-V.13-14

Standard first-line treatments for individuals with OCD and/or BDD include serotonin reuptake inhibitors (SSRIs) and Cognitive Behavioral Therapy (CBT). Research indicates that higher doses of SSRIs may offer greater benefits for those with BDD, although this requires more rigorous monitoring. Additionally, combining CBT with SSRIs has been shown to provide more lasting relief from symptoms.15-16

As clinicians seek to adopt best practices and treatment options for BDD, early clinical research on psilocybin “magic mushrooms” has shown promising effects for conditions like major depressive disorder and treatment-resistant depression, and the FDA has granted psilocybin “breakthrough therapy” status.17 In the early 2000s, interest in psilocybin for OCD emerged from a clinical trial that established psilocybin as safe and generally well-tolerated for OCD, leading to decreases in OCD severity scores within 24 hours following oral ingestion.18 Psilocybin works via the serotonergic system, primarily through agonism at the 5-HT2A receptors.19 It can also reduce doubt and rumination, key aspects of obsessions.20 Recent studies suggest that psilocybin alters connectivity in the brain, particularly within the Default Mode Network (DMN), which is linked to self-referential thinking and is overactive in individuals with OCD and  BDD.21-22 It has been suggested that psilocybin’s therapeutic effects may stem from its ability to reset brain connectivity patterns, creating a therapeutic window that fosters the emergence of new insights and facilitates emotional release.23 This mechanism positions psilocybin as a potential treatment for the underlying causes of psychiatric disorders, rather than merely alleviating symptoms.24 For BDD sufferers specifically, this may offer a path forward to confront distorted beliefs about body image in a safe environment, promoting new insights and perspectives. Additionally, the emotional cathartic release often experienced during these sessions can lead to improved emotional well-being, helping individuals feel more motivated to engage in therapeutic practices and seek support for their condition.

Last year, a pilot study was explicitly published on BDD and psilocybin. The research team studied the effects of a 25 mg dose of psilocybin in 12 adults with moderate-to-severe BDD. Using resting-state functional magnetic resonance imaging (rs-fMRI), they scanned participants’ brains one day before and one day after the psilocybin session. Remarkably, significant changes in brain connectivity were observed. Specifically, communication within the Executive Control Network (ECN)—important for cognitive flexibility—was enhanced, along with improved connections to the Default Mode Network (DMN), linked to self-reflection, and the Salience Network, which prioritizes important information. Participants showing the greatest connectivity increases reported significant reductions in BDD symptoms one week post-treatment. Encouragingly, follow-up assessments over 12 weeks indicated these benefits were sustained. The research team suggests psilocybin may enhance cognitive flexibility, allowing individuals to break free from rigid thought patterns and better manage their emotions. Despite the small sample size in the study, there was substantial clinical improvement, and further studies are needed.25 These findings highlight the potential of psilocybin as an innovative treatment option that aligns with holistic approaches to mental health, offering hope for patients struggling with BDD.

As new treatment options for BDD are explored, psilocybin emerges as a potential approach that may complement existing therapies. By facilitating profound self-reflection, psilocybin offers a unique opportunity for individuals to confront and reframe their skewed perceptions of self. This innovative treatment can enhance emotional processing and resilience, potentially leading to lasting improvements in well-being. While traditional methods remain valuable, integrating psilocybin into a comprehensive treatment plan could provide a transformative pathway for those seeking relief from the challenges of BDD.

Q&A

“What real clinical application is there? It seems like all the information about this is from well-controlled research studies?” 

Psilocybin can help people break free from negative thinking patterns and behaviors. It encourages cognitive shifts, making it easier to escape those mental ruts we sometimes get stuck in. Right now, researchers are looking into its potential for treating a range of issues, like depression, anxiety, PTSD, substance use disorder, and OCD. While the results are promising, we’re still in the research phase, and more studies are needed to establish clear clinical guidelines.

It’s important to remember that psilocybin isn’t a magic solution. There are risks, especially for people who might be prone to psychotic or manic disorders. Even for those without such predispositions, the psychedelic experience can bring up strong emotions and vivid imagery, which can be both transformational and, at times, unsettling.

With the right guidance and support from trained professionals, even tough experiences can lead to valuable insights. Psilocybin can create a sense of openness and vulnerability, which is why ethical considerations are so important. It’s crucial for providers to prioritize patient well-being and make sure therapeutic environments are safe and supportive. Sticking to strict ethical standards and trauma-informed care is key to maximizing the benefits while minimizing the risks.

“Do patients really do this? They just trip on mushrooms?”

When people eat mushrooms with psilocybin, they can definitely have a psychedelic “trip.” This might change how they see and feel things, and they could even experience vivid hallucinations. Everyone’s experience can vary based on the dose, their environment, and their mental state. Some folks might find it enlightening, while others might feel overwhelmed.

It’s also worth noting that some of your patients might have had past experiences with psilocybin—maybe they tried it once in high school or college, or they’ve grown their own and experimented with microdosing. Some might have even taken larger doses on their own, with a guide, or gone on week-long retreats both in the U.S. and abroad. If someone is considering trying it, it’s really important to be informed and approach it with care!

“How could I use this in my practice? I can’t advocate this for my patients because it’s illegal.”

Whether doctors can talk about the benefits of psilocybin really depends on where they are. In many areas, psilocybin is still considered a controlled substance, which can limit how it’s discussed in medical settings. However, in places where it’s being studied or has been decriminalized, doctors can talk about its potential benefits, especially in relation to research or treatment.

Some states and cities in the U.S. are moving toward decriminalizing psilocybin or allowing its use for therapy, even though it’s still classified as a Schedule I substance at the federal level. So, it’s important for physicians to stay updated on local laws and regulations. They might also direct patients to clinical trials or research studies that are looking into psilocybin’s effects. It’s always best for healthcare professionals to consult legal guidelines. 

Great news! In January 2025, there’s a bill proposal in Oregon that would allow licensed medical professionals to talk to their patients about using psilocybin as a treatment option without facing any penalties. This is a big step forward! It means doctors in Oregon can have open conversations about the benefits and risks, helping patients make informed decisions. It’s definitely going to enhance education and support for both doctors and patients as they explore this option together.

“How can you practice using psilocybin?”

Since Oregon passed Measure 109 in 2020, it became the first state in the U.S. to allow psilocybin services. Right now, if you want to facilitate psilocybin sessions, you need a licensed psilocybin facilitator license. However, you can’t do this in a medical practice. In fact, if you hold both a medical license and a psilocybin facilitator license, you can’t use them at the same time.

Psilocybin services are only available at state-licensed service centers, which primarily provide space for sessions. These centers handle the purchase and management of psilocybin, ensuring everything is compliant with state laws. They also support facilitators by providing the necessary environment and resources for sessions. While the service center reps take care of the logistics and product handling, it’s the facilitators who lead the sessions and spend hours preparing clients for the experience, as well as sit with the client through the entire journey. So, while the centers provide the space and product support, the facilitators are responsible for creating a safe and effective environment for the participants.

“What would a course of treatment look like?”

Psilocybin isn’t classified as a medical treatment in Oregon, so people can use it for various reasons—even just out of curiosity—without needing a specific diagnosis. However, there are some steps involved: you’ll need to go through an initial assessment, a preparatory session, and an administrative session, plus an optional integration session afterward.

There are only three situations where using psilocybin is prohibited under Oregon law:

  1. If you’ve used the prescription drug lithium in the past 30 days.
  2. If you have thoughts of harming yourself or others.
  3. If you’ve been diagnosed with or treated for active psychosis.

The main concern is that there are many other factors that might make psilocybin sessions unsafe for some people. I really hope doctors will take a more active role in working with their patients to spot potential drug interactions or health issues that could make psilocybin a less suitable option. More training and a focus on harm reduction are crucial for keeping patients safe!For further information please visit this non-profit organization: Health Advocacy Fund https://healingadvocacyfund.org/ They have furnished a Client Guide useful for physicians to understand more.

Dr. Georgiana Cullen-Kerney, ND, LAc, also known as Dr. G, is a naturopathic doctor, licensed acupuncturist, and certified homeopath with a passion for integrative healing. A graduate of NUNM and the New England School of Homeopathy, she blends plant medicine, Chinese medicine, and mind-body tools to support her patients’ healing journeys. Dr. G has trained with leading experts and most recently became a certified psilocybin facilitator through Oregon’s InnerTrek program. Her mission: to reflect your inner healer back to you through deep listening, collaboration, and compassion.

References

  1. Nicewicz HR, Torrico TJ, Boutrouille JF. Body Dysmorphic Disorder. In: StatPearls. Treasure Island (FL): StatPearls Publishing; January 20, 2024.
  2. Weingarden H, Shaw AM, Phillips KA, Wilhelm S. Shame and Defectiveness Beliefs in Treatment Seeking Patients With Body Dysmorphic Disorder. J Nerv Ment Dis. 2018;206(6):417-422. doi:10.1097/NMD.0000000000000808
  3. Phillips KA, Dufresne RG. Body dysmorphic disorder. A guide for dermatologists and cosmetic surgeons. Am J Clin Dermatol. 2000;1(4):235-243. doi:10.2165/00128071-200001040-00005
  4. Cleveland Clinic. Body Dysmorphic Disorder. Cleveland Clinic. Published January 11, 2023. Accessed September 10, 2024. https://my.clevelandclinic.org/health/diseases/9888-body-dysmorphic-disorder
  5. Phillips KA. Signs & Symptoms of BDD. International OCD Foundation. Accessed September 10, 2024. https://bdd.iocdf.org/professionals/signs-symptoms/
  6. Phillips KA. Body dysmorphic disorder: recognizing and treating imagined ugliness. World Psychiatry. 2004;3(1):12-17.
  7. Phillips KA, Coles ME, Menard W, Yen S, Fay C, Weisberg RB. Suicidal ideation and suicide attempts in body dysmorphic disorder. J Clin Psychiatry. 2005;66(6):717-725. doi:10.4088/jcp.v66n0607
  8. Krebs G, Fernández de la Cruz L, Mataix-Cols D. Recent advances in understanding and managing body dysmorphic disorder. Evid Based Ment Health. 2017;20(3):71-75. doi:10.1136/eb-2017-102702
  9. Singh AR, Veale D. Understanding and treating body dysmorphic disorder. Indian J Psychiatry. 2019;61(Suppl 1):S131-S135. doi:10.4103/psychiatry.IndianJPsychiatry_528_18
  10. Amodeo AL, Esposito C, Antuoni S, Saracco G, Bacchini D. Muscle dysmorphia: what about transgender people?. Cult Health Sex. Published online October 8, 2020. doi:10.1080/13691058.2020.1814968
  11. Gunstad J, Phillips KA. Axis I comorbidity in body dysmorphic disorder. Compr Psychiatry. 2003;44(4):270-276. doi:10.1016/S0010-440X(03)00088-9
  12. Ruffolo JS, Phillips KA, Menard W, Fay C, Weisberg RB. Comorbidity of body dysmorphic disorder and eating disorders: severity of psychopathology and body image disturbance. Int J Eat Disord. 2006;39(1):11-19. doi:10.1002/eat.20219
  13. Frías Á, Palma C, Farriols N, González L. Comorbidity between obsessive-compulsive disorder and body dysmorphic disorder: prevalence, explanatory theories, and clinical characterization. Neuropsychiatr Dis Treat. 2015;11:2233-2244. Published 2015 Aug 26. doi:10.2147/NDT.S67636
  14. Phillips KA, Kelly MM. Body Dysmorphic Disorder: Clinical Overview and Relationship to Obsessive-Compulsive Disorder. Focus (Am Psychiatr Publ). 2021;19(4):413-419. doi:10.1176/appi.focus.20210012
  15. Phillips KA, Hollander E. Treating body dysmorphic disorder with medication: evidence, misconceptions, and a suggested approach. Body Image. 2008;5(1):13-27. doi:10.1016/j.bodyim.2007.12.003
  16. Nezgovorova V, Reid J, Fineberg NA, Hollander E. Optimizing first line treatments for adults with OCD. Compr Psychiatry. 2022;115:152305. doi:10.1016/j.comppsych.2022.152305
  17. Business Wire. FDA grants Breakthrough Therapy Designation to Usona Institute’s psilocybin program for major depressive disorder. Business Wire. Published November 22, 2019. Accessed September 10, 2024. https://www.businesswire.com/news/home/20191122005452/en/FDA-grants-Breakthrough-Therapy-Designation-to-Usona-Institutes-psilocybin-program-for-major-depressive-disorder
  18. Moreno FA, Wiegand CB, Taitano EK, Delgado PL. Safety, tolerability, and efficacy of psilocybin in 9 patients with obsessive-compulsive disorder. J Clin Psychiatry. 2006;67(11):1735-1740. doi:10.4088/jcp.v67n1110
  19. Ling S, Ceban F, Lui LMW, et al. Molecular Mechanisms of Psilocybin and Implications for the Treatment of Depression. CNS Drugs. 2022;36(1):17-30. doi:10.1007/s40263-021-00877-y
  20. Barba T, Buehler S, Kettner H, et al. Effects of psilocybin versus escitalopram on rumination and thought suppression in depression. BJPsych Open. 2022;8(5):e163. Published 2022 Sep 6. doi:10.1192/bjo.2022.565
  21. Li W, Arienzo D, Feusner JD. Body Dysmorphic Disorder: Neurobiological Features and an Updated Model. Z Klin Psychol Psychother (Gott). 2013;42(3):184-191. doi:10.1026/1616-3443/a000213
  22. Reggente N, Moody TD, Morfini F, et al. Multivariate resting-state functional connectivity predicts response to cognitive behavioral therapy in obsessive-compulsive disorder. Proc Natl Acad Sci U S A. 2018;115(9):2222-2227. doi:10.1073/pnas.1716686115
  23. Carhart-Harris RL, Nutt DJ. Serotonin and brain function: a tale of two receptors. J Psychopharmacol. 2017;31(9):1091-1120. doi:10.1177/0269881117725915
  24. Nutt D, Erritzoe D, Carhart-Harris R. Psychedelic Psychiatry’s Brave New World. Cell. 2020;181(1):24-28. doi:10.1016/j.cell.2020.03.020
  25. Schneier FR, Feusner J, Wheaton MG, et al. Pilot study of single-dose psilocybin for serotonin reuptake inhibitor-resistant body dysmorphic disorder. J Psychiatr Res. 2023;161:364-370. doi:10.1016/j.jpsychires.2023.03.031

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