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Objective: Body dysmorphic disorder (BDD) entails a preoccupation with a perceived appearance defect, which causes distress and/or functional impairment. The individual must also perform repetitive behaviours in response to these concerns (e.g., mirror checking, excessive grooming). Prior research has focused primarily on preoccupation, and behaviours have rarely been examined. As such, there is limited insight regarding how these activities are perceived by the sufferer. This study therefore examined how individuals with BDD experience these behaviours. Method: Eight individuals diagnosed with BDD completed a 60-min, semi-structured interview. Inductive thematic analysis was employed to investigate semantic themes within the data. Results: Three themes emerged: "Routine and repetitive", "Safety through control," and "Natural and automatic." These findings portray a complex experience of distressing activities that may also provide comfort and safety, in time coming to embodying what "normal" constitutes for the individual. Conclusions: The experience of BDD behaviour is complex. Camouflaging and using make-up provided a sense of relief and/or reassurance, whereas other behaviours were reported as distressing and likely to promote further concerns. Ironically, participants were seemingly dissatisfied with these symptoms, while also drawing comfort and a sense of identify from them. This inconsistent pattern of reward and punishment supports existing conceptual models of BDD, and may explain why these symptoms are so difficult to manage and/or change (i.e., via negative reinforcement). It also suggests that different types or categories of behaviour may exist for BDD (e.g., checking vs fixing behaviours), reflecting different functions and/or underlying motivations among individuals.What is already known on this topic 1 Appearance-related behaviours are a common clinical feature of body dysmorphic disorder (BDD) and a newly added symptom in DSM-5 nosology. 2 BDD behaviours are thought to be distressing and cause functional impairment (American Psychiatric Association, 2013). 3 The only previous qualitative study on BDD reported on the experience of BDD, but did not explore its behavioural symptoms in detail.What this paper adds 1 Some BDD behaviours are negatively reinforcing (e.g., camouflaging), while others are positively punishing (e.g., mirror checking). 2 The lived experience of BDD behaviour is multi-faceted. These activities may provide reassurance and a sense of identity, but they are also distressing and cause significant functional impairment. 3 BDD behaviour is complex and may not follow the anxietyreduction mechanisms seen in obsessive-compulsive disorder. This finding is consistent with existing literature, and conceptual models of BDD should reflect this. When treating, BDD clinicians should recognise the complex relationship an individual may have with their behaviours and the notable reluctance participants reported about giving them up.Body dysmorphic disorder (BDD) is a debilitating psychiatric ...