BDD Formulation (Veale)
A formulation based on the cognitive-behavioural model of BDD — mapping self-focused processing, distorted self-image, rumination, and safety behaviours.
Written by Tarun Vermani, Trainee Clinical Psychologist Last reviewed
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BDD Formulation (Veale)
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BDD Maintenance Cycle
BDD Cognitive-Behavioural Model (Veale)
Trigger
Distorted Self-Image
Self-Focused Attention
Rumination & Negative Appraisal
Distress
Safety Behaviours
How the boxes connect
- Trigger: leads to Distorted Self-Image.
- Distorted Self-Image: leads to Self-Focused Attention.
- Self-Focused Attention: leads to Rumination & Negative Appraisal.
- Rumination & Negative Appraisal: leads to Distress.
- Distress: leads to Safety Behaviours.
- Safety Behaviours: Reinforces, to Distorted Self-Image.
Protective Factors & Strengths
What resources, strengths, and supports might help in recovery?
Reflection
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When to use the BDD Formulation (Veale)
The BDD Formulation (Veale) is an interactive cognitive behavioural therapy (CBT) formulation model, most often used in CBT for body dysmorphic disorder (BDD).
It is designed to be used within therapy rather than as a standalone self-help tool: a therapist and client complete the model together and make sense of what it surfaces. You can preview the full formulation above, then assign it digitally for clients to revisit between sessions on any device or download it as a print-ready PDF.
How it works
Most people work through it in around 25 minutes. It moves through three short steps:
- BDD Maintenance Cycle
- Protective Factors & Strengths: What resources, strengths, and supports might help in recovery?
- Reflection
Completed on the Formulate platform, your client's answers are saved automatically and shared straight back to you, so you can review them before the next session rather than waiting for a paper copy to come back.
The CBT approach behind it
In common with other CBT methods, the BDD Formulation (Veale) works by mapping how the parts of a problem connect and keep it going (formulation). The aim is not positive thinking but a clearer, shared understanding of what keeps a difficulty going and practical, testable ways to change it.
Because it is a CBT tool it stays focused on the here-and-now links between thoughts, feelings, the body and behaviour, and it works best as one part of a wider course of therapy rather than as advice or a diagnosis.
Evidence & sources
This formulation is grounded in established cognitive behavioural therapy theory and practice. Key sources include:
- Veale, D. & Neziroglu, F. (2010). Body Dysmorphic Disorder: A Treatment Manual. Chichester: Wiley.
- Greenberger, D. & Padesky, C.A. (2016). Mind Over Mood (2nd ed.). New York: Guilford Press.
For use alongside professional support
Formulate provides educational CBT resources for use with a qualified therapist. They are not a substitute for professional assessment, diagnosis, or crisis care.
If you need urgent help now:
- Emergency services: 999 — if you or someone else is in immediate danger
- Samaritans: 116 123 — free, day or night, 365 days a year
- SANEline: 0800 689 5555 — 4:30pm–10:30pm, every day
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