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Body Image: Learning to Like Your Looks and Yourself

Reprinted from Eating Disorders Today
By Thomas F. Cash, PhD
Summer 2003 Volume 1, Number 3
©2003 Gürze Books

What Is Body Image and Why Does It Matter?
Body image is an integral aspect of our experience of being human. After all, we each live in a body that uniquely identifies us, to others and to ourselves. We have plenty of personal thoughts and feelings about the body that we happen to live in-about its size, shape, attractiveness, competence, health, and changes. We spend time and effort trying to make our body what we want it to be. We may diet, work out, style our hair, and adorn our body with clothing, cosmetics, jewelry, or body art. That's what body image means, and it's a complex and powerful part of our lives.

Research informs us that many people find it hard to accept what they look like. This is no surprise, given our society's over-emphasis on looks and the media's messages that to be acceptable you must be attractive, or thin, or well-built, or tall, or blonde. These pressures are especially felt by young people and by girls and women. A "negative body image" produces problems. Being unhappy with your looks lowers your overall self-esteem, leads to feelings of depression, anxiety, and social self-consciousness, and can set you up for an eating disorder.

What Part Does Body Image Play in Eating Disorders?
As you know, individuals with eating disorders have a particularly difficult relationship with their bodies. This problematic body image is often one of the factors that contribute to the beginning of an eating disorder. You really want to look different so that you can feel better about yourself, so you diet, fast, over-exercise, or use laxatives or diuretics. If only you could make your body conform to your ideal, you believe that you would be in control of yourself and your life. Your feelings about your body exert more and more influence over your feelings about yourself. Of course, over time you actually become less in control of your eating, your emotions, and your body and body image. Your negative body-image thoughts, feelings, and behaviors also serve to perpetuate your eating disorder once it has begun, intensifying your struggles. Finally, research confirms that a lingering negative body image puts you at greater risk of relapse after professional treatment has helped you restore healthy eating behaviors and, with anorexia nervosa, a healthy body weight.

Greater body acceptance brings about better self-esteem,
less depression and anxiety, as well as healthier eating attitudes.

Can a Negative Body Image Be Overcome?
During the past 20 years, I've devoted much of my professional career to a better understanding of the psychology of physical appearance, particularly body image. One of my main goals has been to develop effective ways to help people overcome a negative body image. The result, based on substantial research, is a program for body-image improvement, which I published as The Body Image Workbook in 1997 (New Harbinger Publications). This eight-step program uses a cognitive-behavioral approach to promote positive changes in how you think, feel, and behave in relation to your body. The program teaches you how to change. Scientific studies have verified that persons who carry out the program's steps indeed develop a more accepting and satisfying relationship with their body. They become more contented with their looks, are less self-critical of their body, experience fewer upsetting body-image emotions in everyday situations, are less preoccupied with their weight, and are less psychologically invested in their appearance for defining self-worth. Moreover, their greater body acceptance brings about better self-esteem, less depression and anxiety, as well as healthier eating attitudes. Our research further reveals that some individuals can make these changes by a self-help usage of the program. Other persons will benefit more by having a therapist as a guide. Either way, this requires a diligent and patient commitment to change by actively carrying out The Body Image Workbook's step-by-step readings and assigned activities.

What are the Steps for Body-Image Improvement?
Now let me take you on a brief descriptive journey through the eight steps of this program. In doing so, I encourage you to think about your personal experiences and some ways that you could enhance your body image.

In Step 1 you start to take inventory of key facets of your body image. The Workbook has lots of self-tests and exercises to help you discover your unique body-image strengths and vulnerabilities. What specific thoughts, emotions, and behaviors do you need to change? You set then your goals. For example, you decide: "I need to spend less time worrying about whether people think I'm fat." "I need to appreciate my body's assets more-my nice hair, attractive eyes and smile, etc." "I need to stop feeling intimidated by people who look like I wish I looked."

Step 2 teaches you about body-image development in general and your own development in particular. You turn back the clock to discover: What events in childhood or adolescence were important in shaping your feelings about your body? How have our culture's messages about looks affected your body image? How have family members and peers influenced your attitudes about your looks? Next, you examine the present: What situations and events trigger your body-image vulnerabilities? How do these experiences unfold in your day-to-day body image? The self-discovery process includes mirror-exposure exercises to get in touch with your body image and involves your writing an autobiography of your personal body-image development. You use a structured Body Image Diary to monitor your current body-image experiences by attending to and writing down the "A-B-Cs": What are the Activators (events or situations) that set off your negative body-image thoughts and emotions? What Beliefs (thoughts, inner conversations, and conclusions) fill your mind in these situations? I call these mental monologues "Private Body Talk." What are the Consequences of your Private Body Talk? How do you react emotionally and behaviorally? You use your diary every day throughout the program. It is a crucial tool for self-awareness and change.

In Step 3 you learn Body and Mind Relaxation. It combines muscle relaxation, mental imagery, diaphragmatic breathing, and positive self-talk to promote skills for managing your body-image emotions. You apply these skills in your life to "turn on" body image comfort and control in those troublesome, activating situations. The ability to relax physically and mentally is a powerful coping strategy for dealing with challenges to your body image as well as other sources of stress.

Step 4 helps you identify your problematic Appearance Assumptions- certain basic beliefs that set you up for chronic worry and distress over your looks. Examples include: "If I could look just as I wish, my life would be much happier." "Physically attractive people have it all." "The only way I could ever like my looks would be to change them." In this step of the program, you learn to become alert to the influence of such assumptions in your everyday life. You learn to question the truth or importance of your assumptions. You come to reject them as guiding principles for your life.

Step 5 further helps you learn to think straight. People with body-image problems often have Private Body Talk filled with faulty or distorted ways of perceiving and interpreting events and reaching conclusions. Such Body-Image Distortions include comparing your appearance against "better looking" persons in order to determine if you look okay, thinking of your looks in extremes (as either ugly or attractive; either fat or thin), and arbitrarily blaming your appearance for life's disappointments. Again, diary-keeping enables you to recognize your mental mistakes. Then, you learn to apply a range of specific strategies for correcting your Body-Image Distortions. You discover how these changes in your Private Body Talk greatly improve your body-image experiences in daily life.

Step 6 tackles behaviors that undermine body acceptance. You learn specific ways to alter "avoidant body-image behaviors." These behaviors include avoiding particular activities (exercising, going without make-up, or having sex), situations (the beach or gym), or people (physically attractive persons) that lead you to feel self-consciousness and body-image discomfort. You also target and change your "appearance-preoccupied rituals," such as relentless weighing or mirror checking, or spending hours primping and grooming in preparation for going out. You create and gradually execute your personal plan so that you can more comfortably face what you avoid and can restore control over frustrating, compulsive body-image rituals.

Step 7 helps you understand that your relationship with your body is much like an interpersonal relationship (a friendship, marriage, or family relationship). A happy, satisfying relationship is built upon respect, acceptance, and shared positive experiences. In this step of the program, you work to promote a caring, considerate, and intentionally positive relationship with your body. You perform prescribed exercises for "body-image affirmation" and "body-image enhancement"-for example, you engage in rewarding activities that pertain to your physical fitness, appearance, and sensate enjoyment. This step emphasizes "treating your body right" and creating experiences of bodily mastery and pleasure.

Step 8 completes the program. Here you take stock of what you've achieved and the changes you need to keep working on. You identify current or future circumstances that could potentially undermine your improvements-for example, weight gain, romantic difficulties, or certain overly critical people in your life. In this final step of the program, you develop strategies for solving problems in advance to prevent relapse and strengthen your successes.

A Final Encouraging Word
The creation of a positive body image is not only a worthwhile pursuit, especially for persons who've experienced an eating disorder, it is also an objective that's really possible to achieve. My best wishes for happiness in your embodied life!

Thomas F. Cash, PhD is Professor of Psychology at Old Dominion University in Norfolk, Virginia. In addition to authoring The Body Image Workbook, he is co-editor of Body Image: A Handbook of Theory, Research, and Clinical Practice (Guilford Press, 2002) and is Founding Editor-in-Chief of Body Image: An International Journal of Research.

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Additional Resources:
Nutrition Hotline - Determining a 'Healthy Weight'
Nutrition Hotline - Finding a Healthy Meal Plan
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Osteoporosis and Eating Disorders
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