BODY IMAGE PROBLEMS (BODY DYSMORTHIC DISORDER)
Concerned about your appearance?
Wanting to be attractive is something that people strive for all across the world. For many people, enhancing their appearance with stylish clothes and jewellery brings a sense of pleasure and pride in how they look. It makes perfect sense to want to look our best; there are many advantages to being attractive. For example, there is extensive evidence to suggest that attractive children and adults are treated more favourably. However, research also suggests that physically attractive people are not necessarily happy with their appearance, and less conventionally attractive people are not always unhappy with their looks.
What’s important here are our perceptions, beliefs and feelings about our appearance. If we feel uncomfortable with the body we live in, this is going to have a negative impact on how we ultimately feel about our external appearance. Below is a list of questions which could help you to identify whether you are unhappy with the way you look. By recognising that there may be a problem, it gives you the chance to then put into practice positive steps to help tackle any difficulties.
- Are there parts of your physical appearance that you are really unhappy with?
- Do you focus more attention on the parts you dislike rather than what you do like?
- Do you spend a lot of time worrying about what others think about the way you look?
- Do your looks play a key part in shaping your self-worth?
- Do the same critical thoughts about your looks continue to pop into your head?
- Would you avoid anything because you feel self-conscious about the way you look?
- Do you spend lots of your time, energy, or money to try to change your looks?
- Do you rely cosmetics or clothes to conceal “imperfections” in your appearance?
- Do your thoughts and feelings about your looks prevent you from accepting yourself or enjoying your everyday life?
- Do you find it difficult to accept your body? Would you rather be living in someone else’s body?
Why is a healthy body image important?
Appearance, in particular shape and weight, play an important part in our self-worth. How we see ourselves, and who we think we are develops from a very young age, and is particularly sensitive in adolescence when we begin to build a strong sense of identity. We base a large proportion of our self-worth on our appearance (research suggests up to a third). If we are dissatisfied with how we look and place a large proportion of our self-worth on our appearance this is going to have a powerful impact on our self-esteem and self-confidence. Since body image is central to how you feel about yourself, it’s critical that people learn to change their body image towards a healthy and positive view of themselves. An unhealthy, negative body image can be a serious problem which can lead to depression, shyness, social anxiety and self-consciousness in intimate relationships and is strongly linked to issues such as eating disorders.
Why do we have such a problem with body image?
By far the most powerful influence on body image is culture (McCarthy 1990). The mass media standards of physical attractiveness at the moment are for women to be unnaturally thin. We are constantly bombarded with idealised images of extremely thin women. This can lead people to believe that thinness equals attractiveness, happiness, status and success. At the same time they may also link being overweight, or girls not wearing makeup, to negative ideas such as ugliness, greed and failure. Images of male models with ‘perfect’ muscular bodies are becoming increasingly prevalent in magazines and poster campaigns. These idealised images could be partly responsible for the rise in male eating disorders in recent times and the increase in male cosmetic surgery.
A good example of the impact of the media on perceptions of beauty can be seen through the figure of Barbie. In 1965 when Barbie was introduced to children, she was very slim and would seem to have the perfect proportion in body size – an ideal body size for all young girls to admire and strive for? These proportions are unachievable. If Barbie was a real woman she would stand at 5’ 8” with a 39” bust. She would have an 18” waist, 33” hips, and her shoe size would be 3. Due to her proportions she would be forced to walk on all fours and would eventually die from malnutrition. Many young girls play with Barbie and are therefore exposed to an idealised body shape from a very young age.
These are pressures that are important in influencing how you feel about your body. For example, you may have grown up in a household that places significant value on being athletic or thin, this could result in parental criticism of your appearance. Another example could be working in an environment where there is importance placed on your appearance. Another example could be that your partner directly or indirectly pressures you to have a specific body shape.
This is something about your appearance that makes you feel like you stand out from the crowd and has increased your sensitivity to how you think and feel about yourself. It could be that you were always the tallest in your school or that you suffered with acne in the past. These personal features could have lead to unwanted attention or teasing and as a result impacted on the development of your body image.
Critical incident in the past
This is an event or experience that has negatively impacted on your body image. For example being bullied about your appearance or not being included in the school sports team for not being physically fit enough to complete the task.
In many cases, people with depression will often have a distorted view of themselves and believe they are less attractive than they really are.
What maintains a negative body image?
There may be certain things which reinforce our negative perception of our bodies.
For people who are unhappy with their bodies a common strategy to help manage these feelings is to avoid situations that might remind them of their appearance. This could mean avoiding going shopping for clothes, or going to the beach or swimming, not looking at mirrors, or avoiding being naked in front of people (this could mean that you avoid sexual relationships). It can also be common for people not to weigh themselves so they can avoid thinking about their weight. Although body avoidance can help you feel better in the short-term, it can have long-term consequences. Avoiding is actually maintaining the negative beliefs that you hold about your body. We are never learning that we might actually be ok in a situation that we are avoiding and that what you fear may not actually happen.
For example: Jane has a fear of speaking in public so avoids situations where she may have to speak in front of people. In the short-term this works well for her, but in the long-term the avoidance is just maintaining the fear of speaking in public. Jane has found a job that she would really like. She has been invited for interview but is horrified to find that she will have to do a short presentation. Jane is confident in her knowledge of what to present, but fears the presentation. She declines the interview and continues in her current job that she finds unchallenging and dull. By declining the interview, Jane is re-enforcing her perception that she is ‘no good’ and maintains her fear of public speaking.
Body checking is the opposite of avoidance. Body checking is when someone is frequently checking their body, checking for evidence to confirm their negative beliefs about their appearance. Someone who is checking may spend hours in front of the mirror, or constantly feeling and pinching their body to check how much “fat” they can feel; they may weigh or measure themselves many times in one day.
Distorted view – imagined ugliness
This is where we look in the mirror and see a grossly distorted view of what we actually look like. This is a more extreme body image disturbance, where someone will spend hours examining, attempting to conceal, and/or obsessing over their perceived flaws. Some people will actually go to great length to change their bodies using plastic surgery and spending thousands of pounds.
No matter what happened in the past, how you think and behave in the present is what is most important. How you feel about your looks is greatly influenced by your personal beliefs, interpretations and thought patterns. Most people hold certain assumptions about the importance and influence of their looks. If these assumptions go unchallenged then problems can arise. For example: “If I always look my best then people will like me and I will feel confident” But what if you were injured and were no longer able to keep up with the things you do to maintain a perfect image, what would happen to your confidence and your sense of self worth? How would you start to feel?
How can Cognitive Behavioural Therapy (CBT) help?
The good news is that whilst we cannot change past experiences, we can start to change the things we do in the present which are keeping the unhelpful beliefs going. We can start to challenge the negative views that we have developed about ourselves, and break the cycle of low self-esteem and self-confidence. CBT helps to change the maladaptive cognitive and behavioural responses which maintain issues such as body dysmorphic disorder.