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Body Image Therapy

Professional body image therapy and psychology services for body dysmorphic disorder and other body image issues

Body Image Issues

What is body image?


The term ‘body image’ refers to our beliefs and emotional attitudes toward the aesthetics of our body; from how we perceive it as a whole, to how we view its component parts. If positive body image refers to acceptance, negative body image refers to dissatisfaction. Someone with a negative body image is said to have ‘body image issues’, which range anywhere from mild discomfort to a recognised mental disorder, such as body dysmorphic disorder.

Body image issues can begin in early childhood or can emerge later in life, and they can have a detrimental effect on our self-worth. Bad body image can lead to issues like anxiety and depression, or to the development of other eating disorders like anorexia or bulimia.

Body image therapy is very effective in treating these issues before they develop further.

What is body dysmorphic disorder?


In a world fixated on beauty, body image and self-esteem intertwine. The measure of some individual’s self-worth can be held in balance by every trip to the weighing scales, or by every glance in the mirror. People with negative body image, therefore, are more likely to suffer from low self-worth. They are also more likely to develop other eating disorders, one of which is body dysmorphic disorder (BDD), also known as body dysmorphia. This is a disorder affecting one percent of the population – both men and women – in which an individual chronically misperceives his or her body. What these individuals see reflected in the mirror is a grossly distorted view of objective reality. Put more simply, it is a disorder of ‘imagined ugliness.’

Body Dysmorphic Disorder is listed in the Diagnostic Statistics Manual under the section on obsessive compulsive disorders. An individual with body dysmorphia obsesses over perceived flaws that are either nonexistent or barely visible to others. They spend hours examining these flaws while performing compulsive, repetitive behaviours, such as grooming excessively or otherwise attempting to conceal the imagined imperfection. They often seek out cosmetic surgery, or make other body modifications – behaviour which provides only temporary relief at best. Because people with body dysmorphia can’t focus on anything but their perceived flaws, and their obsession often interferes with their daily life. Tending to avoid social situations, fearing that others will ridicule and reject them, they miss out on what life has to offer, in some cases leading to further isolation and depression, issues which feed a negative downward spiral.

While BDD is a distinct eating disorder, individuals who suffer from BDD may go on to develop other eating disorders, such as anorexia, bulimia, or binge eating disorder if they do not seek treatment like body image therapy.

The causes and effects of body dysmorphia and other body image issues – as with any type of eating disorders – can be complex and wide-ranging, but some of the more common causes and effects are explored below.

What causes body image issues like body dysmorphia?


As children, our minds are like sponges, soaking up messages – positive and negative – about bodies in general and about our own body in particular. When we are very young, these messages – a reflection of wider societal attitudes about the body – are conveyed mostly by family and peers. As children we internalise whatever messaging we receive, whether positive or negative, implicit or explicit. These childhood internalisations then form the basis of our later, adult self-judgments.

Take messaging about food and the body, for example, which is often couched in moral terms. At home, we might absorb messaging about ‘good’ and ‘bad’ body shapes, or about ‘good’ and ‘bad’ food types. Such messages form part of our internal ‘moral’ barometer. If, later in life, this barometer falls below a certain level, shame and disgust – negative feelings inextricably linked with morality – will result.

But how prevalent in early life is this form of negative messaging, and can its effect be measured?

One study of girls in the home found that more than half were subject to weight-based teasing from their own family members. In this study, teasing – a form of explicit messaging – was correlated with body image issues later in life. Other types of messaging can be implicit; for example, a parent’s attitude towards their own body or their approach to diet and dieting. This type of messaging also correlates with negative body image. Another form of implicit messaging which can impact body image is the quality of our parental relationships. Unsurprisingly, negative relationships with parents were associated with negative outcomes.

Our peers also communicate attitudes about the body, beginning as early as preschool and continuing through primary level. For example, forty percent of minders in childcare facilities overheard comments such as ‘she is/he is fat’ made by children towards their peers. This phenomenon saw the emergence in these facilities of body image issues in a quarter of three to five year olds. By the time children reached the end of primary school this number had doubled.

Body image therapy can be helpful in unravelling the effects of this messaging and untying the knots of these internalisations.

Body image during adolescence and puberty


The number affected by body image issues continues to rise in adolescence. At this age, negative attitudes about the body can continue to be conveyed in the relatively benign form of peer pressure. As children we want to fit in, and what our friends think and do has a considerable effect on what we think and do. The attitudes of our peers, therefore, have considerable influence on our attitudes towards ourselves. Studies show that both adolescent boys and girls report feeling pressure to alter their looks, with up to 68% identifying friends’ comments as the source of this pressure.

Messaging in older schoolchildren can also assume malign form. Bullying typically begins around the age of ten – continuing into adolescence – with children who are overweight more likely to be targeted. Over half of young people have experienced appearance-based bullying, with half of those describing themselves as anxious, thirty percent as depressed.

The onset of puberty further exacerbates anxieties. Differences begin to emerge when some adolescents turn up to puberty later than their peers. And, with not every adolescent developing in the same way, some failing to achieve societal ideals, further differences emerge. At puberty, with the awakening of sexuality, sensitivities to our attractiveness take on vital import. The emergence of difference at this age, therefore, increases already existing issues.

It is into this hormonal mix that an even more aggravating factor is introduced when – around this age – many teenagers are gifted their first mobile phone and they enter the world of social media.

Women and social media


With body image issues affecting women at double the rate of men, let’s consider the impact of social media from the perspective of women in a world where internet usage has reached an average of seven hours per day.

Consider this. Study after scientific study explores the negative effect on women of looking at beauty content. One study, for example, measured the effect on mood of women exposed to images of models versus images of ordinary consumer products. After viewing images of consumer products, five percent of women experience a decrease in mood. However, this number rises to fifty percent when women view thin, bikini-clad models; a tenfold increase. Similar studies exploring the effect of online video content reach similar conclusions.

Consider also this. Since World War Two, popular media has held up a decreasingly thinner body as the feminine ideal. The cultural icons of the 1940s and 1950s – the Mae Wests and the Marilyn Monroes – would be considered overweight by today’s standards.  In the West, the average woman is 5’4’’ tall and weighs 75 kilos, whereas the average model is 5’11’’ tall; weighing in at 53 kilos. Genetically, only 2% of women match this image. With 98% of women falling short, this is the largest discrepancy ever between women and the cultural ideal. And – as if genetic shortcomings weren’t enough to contend with – most of today’s models receive an electronic makeover. Most beauty content today is airbrushed or otherwise computer enhanced, with flaws magically disappearing, hips and waists slimmed, and breasts enlarged. Furthermore, what is true of the fashion world is increasingly true of peer-to-peer beauty content as more and more technologically astute filtering apps become available to the everyday internet user.

The online beauty landscape, therefore, is one that promotes an increasingly unattainable standard. For those trying to keep up, the world beyond this landscape has become one in which eating disorders have flourished, and body image issues are the norm.

Body image therapy


Body image therapy is an effective place to explore body image issues like body dysmorphia. Within the framework of a supportive, therapeutic environment, all factors contributing to our attitudes toward our body image can be addressed through body image therapy.

One very common and effective form body image therapy is Cognitive Behavioural Therapy (CBT). Using CBT, we can learn to recognise when we are being unfair to ourselves – to recognise the situations promoting self-criticism – and learn to avoid or mitigate such triggers. By untying the knots of our internalisations – in CBT terminology, by examining our ‘core beliefs’ – we can accept ourselves for who we are, liberate ourselves from the social obligation to look ‘perfect’, and finally free ourselves from the cycles of anxiety, shame and disgust.

To find out more about our body image therapy and how we can help you with your body image issues, get in touch by contacting [email protected] or 01 611 1719, or completing the Request An Appointment form on this page.

Find out more about disordered eating and other issues here.

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