How Can I Help Overcome My Body Image?

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Trigger warning: this blog post includes sensitive topics relating to body image.

What is 'Body Image'?

Body image refers to your mental representation of your body. It may differ significantly from your objective physical features. For example, someone with poor body image might experience severe anxiety and negative self-talk about leaving their house with a pimple on their face that is barely noticeable to others. People with a negative view of their body tend to experience high levels of anxiety and distress related to their appearance (CCI, 2019).

Common areas impacted by body image (CCI, 2019): 

  • Skin (i.e., acne, wrinkles, complexion)
  • Thinning or excessive hair
  • Nose shape or size
  • Eye shape and eyebrows
  • Lips, smile, teeth, or mouth 
  • Cheeks, chin, or jaw
  • Ears
  • Overall face shape 
  • Legs, thighs, or calves 
  • Weight
  • Genitals 
  • Breasts
  • Buttocks
  • Height
  • Scars
  • Muscles/build

How is poor body image different from body dysmorphic disorder?

An individual can have a negative image of their, and still not meet the diagnostic criteria for Body Dysmorphic Disorder (BDD). The latter is a serious mental health issue that can lead to severe depression and suicidal thoughts and behaviour. BDD is a mental health disorder in the DSM-5 that's characterized by "preoccupation with a perceived flaw in one's physical appearance..." and "individuals with BDD often spend significant periods of time worrying about and evaluating a particular aspect of their appearance" (CCI, 2019).

It's estimated that BDD affects approximately 2% of the population (CCI, 2019; Hong, Nezgovorova, & Hollander, 2018); approximately 40% of those diagnosed with BDD are men and approximately 60% are women (Philips, n.d.). People with BDD have a negative image of their body.

How is body dysmorphia/BDD different from eating disorders?

Low self-esteem and depression are common to both. The main difference is that eating habits must be impaired to be diagnosed with an eating disorder. Someone may be diagnosed with BDD, however, it does not impact their eating habits. Furthermore, body dysmorphia can be focused on specific areas of the body, whereas eating disorders tend to be centred around weight and shape. It's possible to be diagnosed with both BDD and an eating disorder (Schaefer, 2017; Ruffolo et al., 2006).

Negative Impact of BDD or Negative Body Image

  • Social and romantic relationships
  • Work or study
  • Life enjoyment and satisfaction
  • Isolation and shame
  • Finances

What therapy is best for improving body image?

Treating body image issues can also be thought of as building body (and self) acceptance. Therapy might involve learning coping skills for dealing with shame, anxiety, and low self-worth. Cognitive behaviour therapy (CBT) is a proven treatment for improving body image and self-concept (Dworkin & Kerr, 1987; Wilhel, Philips, & Steketee, 2012; Philips, 2017). Cognitive therapy techniques and cognitive behaviour therapy techniques are aimed at gaining insight into the negative impact that preoccupation with body image has on one's life.

Truly understanding why you are going to put in the work towards positive change helps to commit to the practices involved. Identifying costs of current behavioural patterns helps to do that. Moreover, effective therapy in the treatment of image issues will likely involve a level of emotional engagement, whereby you'll learn to confront your feelings about your body.

There is no 'one right way' to do this in therapy. Processing your feelings can be done using: talk therapy, freestyle writing, journal prompts, mindfulness practice, trauma processing, radical acceptance, movement, exposure outside of sessions, hypothesis testing, and targeted discussions around shame, anxiety, and image.

Common therapy approaches for body image-related issues: 

  • Cognitive Behaviour Therapy (CBT)
  • Acceptance and Commitment Therapy (ACT)
  • Compassion-focused therapy

Click here to enquire about therapy with one of our clinicians.

Free Workbook Download for Building Body Acceptance here

In this workbook, you will:

  • Understand BDD and body image
  • Identify your appearance assumptions and triggers
  • Understand the behavioural patterns that keep it going 
  • Acknowledge the negative impacts
  • Address the barriers to change
  • Develop skills for attention, self-compassion, acceptance, and coping 
  • Practice thought challenging and reframing
  • Start realistic goal setting 

"Grace means that all of your mistakes now serve a purpose instead of serving shame."

- Brene Brown

References

  1. Dworkin, S. H., & Kerr, B. A. (1987). Comparison of interventions for women experiencing body image problems. Journal of Counseling Psychology, 34(2), 136-140. https://doi.org/10.1037/0022-0167.34.2.136
  2. Hong, K., Nezgovorova, V., & Hollander, E. (2018). New perspectives in the treatment of body dysmorphic disorder. F1000Research7.
  3. Philips, K. A. (n.d.) Who gets BDD? International OCD Foundation. Retrieved from: https://bdd.iocdf.org/about-bdd/who-gets/#:~:text=BDD%20affects%3A,around%20age%2012%20or%2013.
  4. Ruffolo, J. S., Phillips, K. A., Menard, W., Fay, C., & Weisberg, R. B. (2006). Comorbidity of body dysmorphic disorder and eating disorders: Severity of psychopathology and body image disturbance. International Journal of Eating Disorders, 39(1), 11-19.
  5. Schaefer, J. (2017, March 23). Is it an eating disorder or body dysmorphic disorder? Eating Recovery Center. Retrieved from https://www.eatingrecoverycenter.com/blog/eating-disorder-body-dysmorphia
  6. Wilhelm, S., Phillips, K. A., & Steketee, G. (2012). Cognitive-behavioral therapy for body dysmorphic disorder: A treatment manual. Guilford Press.