Alicia Douvall: Addicted to cosmetic surgery

Pumped so full of silicone that, if chucked into the nearby swimming pool, she might bob to the surface, Alicia Douvall purses her trouty lips, takes a deep breath, and begins explaining why she's just checked into an exclusive Malibu rehab clinic. The pneumatic glamour model, a famous purveyor of "kiss-and-tell" stories, is suffering from a potentially-deadly addiction. It has ravaged her body, alienated friends and family, and cost every penny of the fortune she accumulated telling red-tops about the peccadilloes of former boyfriends such as Mickey Rourke, Calum Best and Mick Hucknall. "Imagine playing Russian roulette with your life," she says. "That's what I'm doing. It's out of control, and has cost me more than £1m. Before I decided to come to Malibu, I'd accepted that I was going to carry on with it until I was either bankrupt or dead."

Douvall isn't dependent on cocaine, alcohol, painkillers, or any of the other substances that traditionally lead to a celebrity's downfall. Instead, she suffers an unlikely obsession: she is addicted to cosmetic surgery. "I've had so many operations that I can't feel my stomach, my left breast, or anything under my right arm," says Douvall, who first went under the knife as a teenager. Now aged 29, she has clocked up more cosmetic procedures than she can count, saying only that the exact figure is more than a hundred.

"I've had 15 boob jobs. I've changed my eyes and nose, had facelifts. My philosophy is 'if it can be changed, it will be'. It's got to the stage where doctors in Britain refuse to treat me any more, so I've been flying to the US for surgery and lying about my medical history."

Douvall's addiction is related to a psychiatric problem called body dysmorphic disorder (BDD), which she was diagnosed with several years ago. It is a condition on the obsessive compulsive disorder spectrum which causes victims to become preoccupied with their physical appearance, fretting over small or non-existent defects.

A cynic might say that in the old days BDD was known as vanity. But actually, it's the reverse: sufferers believe they are hideous, rather than attractive. They avoid mirrors, and spend hours each day worrying about being ugly. In extreme cases, they become deeply depressed, and reclusive. The suicide rate for victims in the US is 45 times the national average.

Douvall is a textbook case. Though outwardly attractive (she is, after all, a professional model) and intelligent, her adult life has been consumed by concerns that she is unspeakably hideous. She takes anti-depressants and sleeping pills, and has repeatedly submitted herself to the cosmetic surgeon's knife. "I'm on a quest for change," she says. "Every two weeks, I'll go see another doctor. Often I'll walk in, not even knowing what I want doing, and say something like 'what do you think might be wrong?' or 'what do you think of my eyes?' I keep hoping I might wake up one day feeling happy with myself."

Douvall recently discovered that submitting herself to the medical version of cut-and-pasting isn't the only way to deal with BDD. She was speaking at the exclusive Passages Addiction Centre in Malibu, near Los Angeles, where she spent four weeks being treated and filmed for a reality TV show, called Rehab. This sometimes compelling, if slightly tasteless series, which begins this week on the satellite channel Living, follows seven "fallen celebrities" who have agreed to undergo intensive courses of therapy in an attempt to find a potential cure for addictions that have ruined both their lives and careers.

It will show former Bay City Roller Les McKeown, Happy Mondays backing singer Rowetta, and Robin Le Mesurier, the musician son of actor John and Hattie Jacques, attempting to cure alcoholism. Model Cassie Sumner is treated for bulimia, Victoria Sellers attempts to kick drugs, and Karate Kid star Sean Kanan tries to wean himself off prescription painkillers. Tacky though it sounds, it also provides a priceless insight into the rehab industry. Passages, on a hillside overlooking the Pacific ocean, is one of the world's most exclusive clinics. It resembles a boutique luxury hotel, and charges well-heeled clients, who have included the fashion designer Marc Jacobs, an eye-watering $78,000 a month for their pains.

Unlike almost every clinic, Passages does not treat patients with a version of the traditional "12-step programme". Instead, its founder, Chris Prentiss, has pioneered a regime that rejects the notion that alcoholism and drug addictions are incurable diseases, and instead views them as symptoms of deeper psychological problems. Prentiss, who founded the clinic after helping wean his son Pax off heroin and alcohol, believes that most addictions stem from a person's failure to come to terms with a traumatic past event. Through intensive therapy sessions, his team work to identify this event, before forcing patients to look at it in a positive light – trying to convince them that, as Voltaire said, everything is for the best in this best of all possible worlds.

"If someone has been abused as a child, or says 'I was raped when I was six', we help them reframe it, by showing them that it was actually a perfect event in their lives, because it made them who they are," says Prentiss. "We show them, for example, that wisdom and strength and information didn't come from their ho-hum days, it came from these power points."

Prentiss claims, perhaps in a bid to justify his exorbitant fees, to have an 85 per cent success rate at "curing" addiction. This is three times higher than rival clinics such as the Betty Ford Centre, but has been widely questioned. Some critics have dubbed him a snake-oil salesman. Yet Douvall's experience frames him in at least a moderately positive light. The model, who was born plain Sarah House, and had a comfortable upbringing in Sussex, was originally sceptical about her chances of being treated, and planned to celebrate her release from the clinic by having a "toe facelift" – an highly-complex operation to straighten her feet.

"You couldn't have got a bigger cynic than me," she says. "I didn't believe in counselling or rehab, or in a person being able to change." But after intensive therapy sessions at Passages, many of them filmed, Douvall reveals the cause of her BDD: she was abused as a child (details are not broadcast, apparently for legal reasons) and was also assaulted by an ex boyfriend, destroying her self confidence. She became a teenage mother – her daughter is now 13 – effectively cutting short her adolescence.

During the treatment, Douvall says she was reduced to tears three or four times a day by the the acupuncturists, hypnotherapists and assorted counsellors. After the cameras stopped rolling, she stayed at Passages for an additional fortnight to continue treatment. Today, though she doesn't claim to be "cured" of her cosmetic surgery addiction, Douvall's condition has at least improved. Shortly before leaving Passages, she cancelled her planned "toe facelift".

"It was one of the toughest things I ever had to do," she says. "They break you down to build you up, and keep chipping away until they find a crack. But they do it because it helps, and I now think everyone should go into rehab at least once in their lives. After all, who can say they're perfect?"

'Rehab' is on tomorrow at 9pm on Living

Drastic plastic: Body dysmorphic disorder

* Plastic surgery addiction usually arises from "imagined ugly syndrome", also known as body dysmorphic disorder (BDD).

* According to Adam Searle,former president of the British Association of Aesthetic Plastic Surgeons (BAAPS), sufferers may "express distorted ideas about their body".

* Repetitive behaviour such as excessive grooming and obsessive checking of appearance in reflective surfaces are also symptoms.

* Sufferers may seek plastic surgery to correct their imagined defects. Often, once one perceived problem with their face or body has been "fixed", they will develop a new fixation.

* It is not known how many people suffer from BDD, but the best estimates suggest the figure could be about 1 per cent of the population.

* According to a survey last year, 33 per cent of plastic surgeons said the number one reason for turning potential patients away was owing to their unrealistic expectations and the belief that surgical procedure would "solve all their problems".

* Thirty per cent of surgeons also turned away patients wanting unnecessary surgery, including facelifts in their thirties.

* Five per cent of BAAPS surgeons said patients who were "obsessed with celebrity looks" was also one of the most common reasons for refusing treatment. www.baaps.org.uk Amy Oliver