Thank you for your response. I believe that Anafranil is an SSRI, albeit an old fashioned one. I think it is regarded as the final approach to use, when the more modern SSRIs have failed.
The CBT was delivered by a reputed therapist at my local private hospital, and I know she discussed my case with other colleagues, and I know she was following the NICE guidelines. I did have exposure treatment, too - exposure to mirrors. The way I have got through until now is mirror avoidance, and avoidance of photographs. She also carried out surveys of people - asking for feedback on photos of me to try and prove that there was nothing abnormal about my appearance. The mirror exposure, in particular, caused great anxiety - and precipitated a cosmetic procedure. The reason I didn't get on with CBT was because it was trying to encourage me to be able to tolerate my appearance - in spite of imperfections, and this is where the stumbling block came. I was teased as a teenager, because I had a short jaw, and so goofy teeth, and so I feel I have a deep seated fear, even now, of being unacceptable because of my appearance (I had my jaw broken and reset when I was 21 to correct this - but I still sometimes dream at night that I am still that goofy child). Ultimately my problem is one of self-hate and low self-esteem, even though I am able to list - and even appreciate my positive points. My life is basically happy - I am married, have 2 children and a job. It is just me that I don't like. I had hoped that CBT might help me to overcome these feelings, but as I said, even though delivered sensitively, by a supposed expert in the field, it didn't work. She suggested that my next port of all be to make an appointment to see Dr Veale, who is the expert in BDD, at I think the Priory, but an initial appointment costs £250, just for an assessment, before any treatment is recommended. So I am at a bit of a loss.
Thank you for your time.