Body image, mental health and the importance of attending to the underlying emotional distress

How do you feel about your body? What do you think when you look at yourself in the mirror or picture yourself in your mind’s eye? Positive or negative, your body image will likely have an impact on your self-esteem. And for many people that can also affect their mental health leading to issues such as depression, obsessional thinking and eating disorders to name just a few.

Where does your body image come from?

Our body image can be based upon our past experiences. For example, the child who was called chubby by an aunt may grow into an adult who still believes that they are overweight. That person may fear being judged as it stirs up the feelings of the hurt child.

Body image perceptions can also be based upon comparisons we make with other people. As human beings we naturally compare ourselves with others, constantly evaluating our place in this world. This helps us to understand how we should look, feel and act, providing relief from anxiety about being different. The difficulty arises when we choose to compare ourselves to the unrealistic images that are often portrayed in the media.

Unrealistic comparisons

Images in magazines, on social media or television may be filtered, airbrushed and focused on unrealistic body size or shape. They can easily set unrealistic expectations of how we should look. Many people are aware that these pictures do not provide an accurate representation for comparison but can’t help doing so. This is particularly true for people who already have a negative body image.

For example, if someone believes they are overweight, their mind may unconsciously become preoccupied with actively looking for evidence suggesting everyone else weighs less and discard any evidence suggesting they are a healthy weight. People with an eating disorder may even discard evidence that they are significantly and dangerously underweight.

Psychotherapy can help

Psychotherapy provides a safe environment to challenge any negative beliefs people hold about their body, and help them take a more compassionate view of themselves. But that’s only one part of the therapy. It is essential to try and understand the emotional distress that has led them to judging their looks and appearance in such a critical manner. If we ignore these underlying reasons it is all too easy to slip back into old patterns of behaviour.

If someone is unhappy with an aspect of their body, their mind may chose this aspect to fixate on as a solution for something else. I often hear people say, ‘I will be happy when I lose X amount of weight’ or ‘I will be happy when I have a cosmetic procedure’. The problem is that they could lose the weight or have the cosmetic operation and the underlying distress remains, which could lead to them setting a goal to lose more weight or have another invasive operation. So as a clinician the therapeutic work does not stop when we help someone to view their body in a better light, we also need to provide understanding and attention to the underlying distress that the person has potentially been facing.

Six tips for improving your body image

I am often asked what people can do to improve the way they view their body, some tips that I often recommend is to:

• Understand just how great your body is, instead of focusing on what we don’t like, spend time thinking about what we do like.
• Start to identify what can trigger us to feel bad about our bodies. Notice when we start to feel negative about ourselves. When did this occur? Could it be reading specific social media that leads us to feel bad that we don’t look a certain way or could it be a specific person who seems to say something that we take as critical or just makes us feel bad. By becoming increasingly aware of these situations it can help us to make a conscious choice whether we want to put ourselves into that situation or not.
• Realise you don’t know what someone’s inner world is really like. From my experience many people whose online lives paint a picture of pure bliss struggle with the same worries that we all do.
• Become aware of the language you use and challenge it if necessary. If you realise when you are talking about your body that you are using words such as ‘should’ and ‘must’ you may be doing yourself some harm. For example, if you hear yourself say ‘I should be a size 10’ or ‘I should have a six pack’ understand you are probably placing an unrealistic expectation on yourself.
• Ask yourself what you like about your best friend, usually people do not mention they like their friend because of their looks, it is typically about how they are a good friend, are funny or trustworthy. This can help to realise what areas of our lives we should be placing importance on.
• If you hear yourself saying something critical about your body, ask yourself if you would say this about anyone else. In my career I have asked that question hundreds of times and not one person has ever said ‘yes’, they have always said ‘no’ followed a statement such as ‘because that would be mean’. So, if you hear yourself saying something overly critical about yourself ask why you would say such horrible things about yourself when you wouldn’t dream of saying that about anyone else.

Body image requires significant attention within the psychotherapeutic encounter, but I strongly believe that it is essential to keep an eye open for other areas that may be causing the person to feel unhappy.

If you enjoyed this blog then you can also Listen to our podcast where we spoke to Dr Christian Buckland to find out how to become more body positive.

The United Kingdom Council for Psychotherapists can help you find an expert therapist near you

You can also find support by contacting:

The Samaritans 24-hour helpline, call: 116 123

Anorexia and Bulimia Care’s helpline: 03000 11 12 13

Beat’s helpline for under 25’s Helpline number for under 25’s: 0808 801 0711 (Daily 3pm-10pm)

NHS (England), call: 111

NHS Direct (Wales), call: 0845 46 47