BODY IMAGE 

Body image is the subjective sense we have of our appearance and our body. Unlike what others see when they look at us, our body image is often different from the objective size and shape of our body. Both men and women sometimes feel dissatisfied with their body and its parts. Who hasn’t met the man who would not like larger biceps or the woman who would not like longer legs. However more women than men report consistently disliking their bodies. The emphasis on women’s experience isn’t meant to imply that body image problems among men are less important than among women - simply less prevalent

Consider the following: By the age of 10, most girls are afraid of becoming fat. Many more adolescent school girls than boys diet. Among college students a larger percentage of women than men report feeling unhappy about their looks. Women in the general population report more negative attitudes about their physical appearance than do men. Sadly, negative body image often begins when girls are young and extends far into adulthood. For some women it lasts their entire lives

Obsessive concern about body shape and weight has become so common among western women of all ages that it is now the norm. Moreover, results of a large survey indicate that body image problems are more common in the USA than in any other nation. When British women are asked what they want to change about their body they respond without hesitation, when asked what they like about their body their response requires considerably more thought.

Weight as a measure of self worth

In our society, the "thin is beautiful and beautiful is good" belief prevails. Consequently women often use weight as a yardstick with which to measure self worth and attractiveness. It is common for women to enter a room and immediately determine their status by assessing which women are thinner and which are fatter than they are. As a result, being female often means feeling fat and inadequate.

A feminist understanding of negative body image views socio-cultural issues as the underpinning for body loathing among women. For example girls are socialised more than boys to focus on external aspects of themselves, such as their appearance. Learning to do their hair, polish their nails and paint their faces is virtually a rite of passage into woman hood in our culture. Boys, on the other hand are typically socialised to concentrate on their athletic abilities rather than their looks. In addition attractiveness is not the prerequisite for masculinity as it is for femininity in our culture. Attractive men as described as handsome. "Handsome" is derived from the middle English word "handsom" which refers to the ability to manipulate or do. It is first a word about action and only secondarily about appearance. Associated with "handsome" are qualities of achievement and strength. How often do you associate these attributes with "beautiful" or "pretty".

Women are expected to have far more control over the body, its function, shape and size, than men. Open discussion and public displays of natural body functions such as sweating, belching and scratching are not as acceptable for women as they are for men. These functions are not only viewed as unfeminine but as evidence of masculinity.

The breeding of body insecurity in women

Susie Orbach and Louise Eichenbaum in their book "Hunger Strike" give strong evidence for a breeding of body insecurity in women which is composed of separate factors relating to child rearing practices and also to issues which arise in the emotional development of females as opposed to males.

These issues may be briefly summarised as follows:

Regarding child rearing: there is anecdotal evidence that mothers in our culture respond less readily to girl children than to boys, feeding them for less time and taking longer to respond to their cries of distress. Autonomy, aggression, and demanding behaviours in girls are not met with unbridled enthusiasm. This suggests maternal unease with raising a girl child to meet her own needs rather than respond to those of other people. In mistrusting her own natural impulses, or feeling guilty about wishing to meet her own needs, a girl may learn to mistrust and disapprove of the needs of her body, which will translate into poor body image in later life.

Some psychologists view poor body image in girls as an expression of rebellion at being too closely identified with the "mother figure." As part of normal psychological development, boys "identify" with male figures at an early age and "separates" from his mother, to resolve the Oedipal complex of wishing to possess her. This separation from the mother does not happen in girls - who when they are older are more likely rebel by rejecting the rounded female form.

Body image among some women began as teasing by family members or peers. The onset and worsening of negative body image often occurs during adolescence, a time of tremendous physical and psychological change accompanied by feelings of awkwardness, particularly in women since the changes are viewed as a loss of power, while in men the changes are associated with a gain in power. Traumatic events such as sexual abuse also have a negative impact on body image. Research has shown that body image during our formative years is affected by many different factors, including how good you are at sport, or how your parent felt about their own bodies. What seems to be significant is the NUMBER of negative body experiences an individual has, rather than the severity.

What is the historical context for negative body image

Throughout history and to the present day, a core belief of our culture is that women should have a certain body type. Far less attention has been paid to, and fewer changes expected of, the male body during this time. Perhaps because of women’s dependent status, their appearance has often served as a reflection of the abilities of their male "protectors". Women who have successful protectors will have the resources, the time and the means, of pursuing the ideal physical physique. Thus, the ideal shape tends to be what ever is most difficult to achieve during a given time period. If too many women were able to meet the ideal, then standards would have to change for the ideal to retain its extraordinary nature. When images of beauty change, female bodies are expected to change.

Different body shapes have been "in" for women during different eras. Examples of adjustment of the female form are seen in foot binding among the ancient Chinese, lip stretching among African women and the corsets of the 19th century which squeezed a woman’s internal organs out of shape. Only one century ago, the ideal female body was the opposite of what it is today. Dimpled flesh, today’s cellulite, was beautiful. Fatness was viewed as a sign of energy and health. The thin silhouette sought today was considered sickly and a sign of a poor bet for a bride. Around the turn of the century, slenderness became more fashionable although it would still be considered too fat for today’s standards. By the 1920s the Victorian hourglass gave way to the thin flapper who bound her breasts to achieve the washboard profile that looked so good doing the Charleston. Just as the girdle achieved its technological maturity, the voluptuous Marilyn Monroe in the 1950s set a new standard for women. Now they needed to rebuild the curves they had tried to stave, bind and restrain. Short lived was that respite, for the 1960s saw the arrival of Twiggy. She weighed in at a shapeless 91 lbs. There are few women in their 40s today who cannot recall trying to fit a female body into jeans designed for a prepubescent boy (Twiggy’s shape). The 1980s beauty ideal remained slim but required a more toned and fit look. Women could no longer just "diet" into the correct size, there was a new pressure to add exercise to achieve the right look. Today the ideal combines such opposite traits as erotic sophistication with naive innocence, and delicate grace with muscularity, maturity with youth. The 1990s body ideal is very slim and large breasted, an almost impossible combination for most American women. Pressures to fulfil conflicting demands and keep up with the images in the ideal body are stressful and have resulted in the majority of Western women suffering with a negative body image.

How are body image problems manifested ?

There are three basic aspects to negative body image:

FEELINGS/THOUGHTS BEHAVIOURS & SIZE PERCEPTION

Example of negative body image thoughts include

• "I am fat and disgusting"
  
• "My thighs are so big I can’t wear a bathing suit"
  
• "I look so fat next to Jane I can't go out with her"
  
• "Everyone notices my flat chest"

Negative body thoughts can dramatically affect behaviour, relationships and self esteem. Sometimes women develop bizarre eating habits, eat a restrictive and nutritionally deficient diet, and / or exercise excessively because of their desire to be thinner. The effect of negative body image on size perception is clearly evident in some women’s tendency to over or under estimate the size of their disliked body parts - even in the face of objective data indicating their error.

Interestingly, research has shown that men who exercise regularly are more likely to do so to build body mass and improve cardiovascular fitness. Women on the other hand, are more likely to exercise to lose weight and change their shape in an effort to increase their attractiveness. Unhappily, this implies that exercise will lose its enjoyable quality for many women as it has become yet another way to manipulate their bodies.

Why is negative body image a problem?

The inordinate emphasis on women’s external selves makes it very difficult for women to appreciate their internal selves. When women are so focused on their body, they are not able to devote much energy to other aspects of their lives.

Attempts to meet the ideal are often ineffective in the long run and can lead to physical, psychological and behavioural problems, including binge eating, obsessions about food and eating disorders. Other psychological effects of the pursuit of perfect body include low self esteem, feelings of failure and inferiority, irritability, loss of libido and memory problems. Body dissatisfaction is also associated with depression, anxiety, relationship problems, self contempt, and social introversion. Women pay a high price for being at war with their bodies.

Most women cannot physiologically nor psychologically attain the ideal; yet, for failing to do the impossible, they are viewed as irresponsible. The belief is that if only they worked hard enough at dieting, they would be thinner and more attractive. This is a myth. Only a small minority of women are genetically designed to naturally fall within the narrow weight range culturally ideal. When women deprive themselves to lose weight, their body retaliates by slowing its metabolism. This makes it more difficult to lose weight and intensifies the problem it was designed to remedy. Some researchers believe that repeated dieting attempts means dieters have to work harder each time they diet, increasing the likelihood of failure.

Although body image problems play a central role in dieting and in the development and maintenance of eating disorders, they also warrant treatment in their own sake. Research with non eating disordered college women indicates that many women want treatment simply for negative body image. This suggests the discomfort of negative body image, even at sub-clinical levels, is sufficient to interfere with quality of life. The sad part of this is that pressures against body acceptance are so great that women feel incapable of changing without help.

What role does the media play?

We must admit that what we know about cultural standards comes form the media. TV shows, movies, commercials, ads in newspapers, magazines - even on the backs of buses, show us what is beautiful, good, and desirable. 

The media presents a thinner than average women as ideal, and implies a strong connection between being thin, using beauty products, and being happy. In both entertainment and advertising, thinness is typically associated with status, wealth and success for women. Although there is no evidence that happiness is directly related to weight, that is the message continually pounded home. And females learn that lesson well.

Unrealistic and changing body standards breed a society of women who cannot accept their bodies as they are. Even if they are within a healthy weight range.

Powerful as the media’s "thin is good" message is, it is unfair to exclusively blame the media for women’s body image ills. Advertisers and entertainment decision makers build their empires on prevailing tastes and historical / cultural norms. If fat sold "cokes", you can bet the "ahah" girls would have been a size 40! The media plays on our likes and dislikes. Unfortunately, it also has the widespread reach that enables it to perpetuate and exacerbate biases and beliefs. The media is not responsible for the body dissatisfaction epidemic but is an integral part of it.

Are thin women happier than other women?

No. Many women believe that if they were thinner they would be happier. Research has clearly demonstrated that women who meet the body / beauty ideal are just as likely to be unhappy about their looks as women who do not.

Interestingly, recent research with women who have had a mastectomy for breast cancer suggests they feel more satisfaction with the body than women who have not had breast surgery or disease. Despite not meeting the societal ideal, the women with the mastectomy report they become more appreciative of their body and less likely to treat it as an object to manipulate into a particular shape.

There is also strong evidence from research that "drive for thinness" recedes as women become older - reaching their 40s and fifties. Although this may be reflected in women being kinder to themselves on the dieting front, we do not yet know whether this is replaced by concerns and behaviour designed to reduce the effects of ageing.

Why do women try to meet the ideal?

Historically, attractiveness has been the only bargaining power women have had to access resources controlled by men. This has led to women competing with each other to meet the beauty ideal and reap the associated benefits. Despite the advances made by the Women’s Movement, appearance remains intertwined with their identity, social success, economic pursuits and accomplishments. This stands in contrast to men, whose self image is based more on their activities and accomplishments. Some feminists believe the association between women and appearance allows society to continue its male dominated structure and prevents women from becoming too powerful.

How do feminist therapists combat negative body image?

The feminist approach to dealing with negative body image hinges on consciousness raising and education. Discussion of the changes in the body ideal over time as well as the influence of media, helps women to consider external attributions for their negative feelings. Rather than blaming their discomfort exclusively on their (perceived) ugly bodies, women learn to see the bigger picture. There may also be discussion of cross cultural views of appearance and role of social class and race.

Another component of feminist therapy involves challenging myths about beauty and dieting and addressing the ways in which societies promotion of unrealistic ideals limits them in power. Discussing these issues in a group setting can be particularly helpful for some persons. Treatment may also include a specific focus on the thought, feelings and behaviours associated with negative body image.

Where body image has been associated with negative events such as teasing or sexual abuse, feminist therapy may incorporate discussion of these issues as well.

Conclusion

Feeling at home in our bodies is essential to our well-being as women examine the source of their body image dissatisfaction, they may view the discontent less as individual pathology and more as part of a larger system that oppresses women.

Eliminating beauty and body standards is unrealistic. However, a more diverse view of beauty is necessary to save women from additional physical and psychological tolls. To be productive, happy members of society, women must be well nourished and have energy to channel to other pursuits. This is not possible if they are obsessively counting calories, restricting their intake, daydreaming about food and weight, and futility whipping their bodies into an unattainable shape. It is essential for women to consider the effects that the pursuit of the perfect body has on their lives and to challenge their beliefs about weight and appearance. With awareness of the cultural context and socio-cultural issues, and with the aid of additional strategies aimed at thinking and behaving differently, women can enhance their relationship with their body. This will allow women to live life more fully and meaningfully.

Suggested readings

• Cash, T and Pruzinsky T Body Images - Development Deviance and Change 1990 New York Guildford Press.
• Allen P, Katzman M and Wooley S - Feminist Perspectives on Eating Disorders 1994 - New York Guildford Press.
• Freidman R, -Beauty Bound - 1986 Lexington Books
• Freidman R, - Body Love- learning to Like our Looks and Ourselves - 1988 New York, Harper and Rowe.
  

PEOPLE WHO HAVE BODY IMAGE PROBLEMS

What is body image?

A complex set of ideas, judgements, attitudes and feelings of the self which give a picture of oneself in ones mind eye and a sense of the space we occupy in the world. It includes ideas about how we are viewed by other people. Body image experience has a complex causation.

The ABCs of body image - body image experience includes

• A for AFFECT - feelings of satisfaction or dissatisfaction about the body
• B for BEHAVIOUR - what do we do in relation to our perceived appearance - from grooming to weighing and exercising, and what do we avoid.
• C for COGNITIONS - what are our thoughts and beliefs about how we look

In contrast to how we look on the outside, our inner body images are central to how we feel about ourselves. A major part of self esteem is connected to how we feel we look. Individuals with negative body image are more susceptible to other unhappy experiences such as depression, feeling shy or socially anxious, struggling with eating behaviour or having difficulties achieving sexual satisfaction. Clearly, body image is a core part of our personality and affects life in many ways.

An epidemic of body dissatisfaction

About 2 out of 5 women and one third of men are unhappy with their overall appearance. Most people are dissatisfied with one part of their body. Only 28% of men and 15% of women are happy with every part of themselves. ( Psychology Today 1996). Weight is the most disliked facet of the body, disliked by 60% of women and 40% of the men. Men are worried about being skinny as well as fat but women are mostly concerned with being fat.

Overweight is a state of mind as well as a state of body. 2 out of 3 teenagers diet, twice as many as are actually overweight. In the same survey 47% of the women and 29% of the men who were NORMAL viewed themselves as overweight.

In 1990 Thomas Wadden reported that NORMAL weight persons who described themselves as being overweight were highly at risk of poor psychological well-being, dieting behaviours and eating disorders.

Manifestations of poor body image

• Expressed as an overweight person who is extremely self critical.
  
• A normal weight person desperate to lose weight.
  
• An underweight person who feels fat OR is terrified to gain weight.
  
• Body image problems are also expressed through excessive exercising especially in men.
  

What you should know

• Normal women overestimate body size - not just anorexics, as formerly believed.
• Persons who are underweight will ALWAYS experience deep hunger until normal weight has been restored FOR A WHILE. That is just the way it is.
• Fat people who lose weight will continue to experience themselves as fat. Fat women who have lost weight report feeling fat much more than women who were never overweight. This is like the ‘missing limb’ syndrome. They continue to retain a sense that their body is unacceptable. They focus on areas where less weight was lost. Stunkard reports that people who were overweight as children are more likely to experience this "phantom fat"
  They need to understand that this is normal.
• Persons overweight since childhood are likely to catastrophise if they regain just a few pounds after losing weight, and are less likely to have recovery strategies.
• Fat people who do not improve in body image as they lose weight are more likely to drop out of weight loss programmes.
• Bulimics continue to have poor body image even after successful treatment ; however other elements of self esteem improve.
  

The magic ideal weight

What is it and what is the quality of longing for it.. Where does it come from? Is it precise? What are the influences which conspire to set it - is it the past, the present, personal history, (note the importance of having body problems in childhood like being too tall or having glasses and the effect of teasing) note also the influence of other people... friends or family.

Is the Magic Weight to do with Weight Watchers (note that the concept of a goal weight is faulty) . A range is more realistic and the lower level is set by fat cell biology.

Research has shown that bulimia is associated with poor body image in the mother. Dieting in a mother is more likely to lead to dieting behaviour and weight dissatisfaction in daughters.

How people with serious body image problems will be in therapy

• Over restraint. Narrow range of foods. Address by broadening choices.
• Subtle dieting. Advise the client to give up dieting "just for tomorrow" after that they can re-decide.
• Continual complaints about weight. If the client is bulimic and/or normal weight and desperate to lose, remind them that they may have to choose between being as they are and stable in their eating, or thinner and compulsive.
• "I want to go on a diet" can be construed as a cry for help. What else is not working in their life. What things will not change if they are thinner. What would they be prepared to barter for an extra half stone less in weight.
• "I FEEL FAT!" .. Reframe if possible by asking them to identify exactly how they feel fat. Is it the feeling of their clothes of the size of a particular part of their body or is it the sight of someone else or is an internal experience like being bloated. It is often a trigger for bad eating - a sense of being a failure. What has triggered this feeling? Could it be just knowing that something fattening has been eaten. Often women experience themselves as feeling fat when they are really suffering from a mild temporary depression. Feeling fat is a way of taking on the cultures ideas of what fatness represents such as laziness, greediness, lack of success, being unloved etc.

The important thing is to help people not REACT to fat feelings with their usual strategies (cutting back) or thought processes (beating oneself up).  People sit back and wait peacefully for the feeling to pass - such as relaxation / doing something nice for oneself on a fat day / going for a gentle swim or walk etc. No point in sending someone out for an hour of aerobics.

It may help them to feel less tense but it doesn't do that much to calories.

Is there any point In specific work to correct body image?

• A) SELF ESTEEM - body Image improves with self esteem, plus the ability to relax and to handle feelings. There is some research showing that massage is helpful for persons with anorexia and bulimia.
• B) WRITING A HISTORY OF THE WAY BODY IMAGE HAS DEVELOPED CAN BE USEFUL - helping people to get in touch with the old experiences which have influenced the way they feel about themselves.
• C) SELF DISCOVERY OF "BODY BLAME" TRIGGERS - explore in what situations people feel bad about their bodies. Identify what they could do to help themselves feel better in these situations.
• D) COGNITIVE THERAPY FOR BODY BLAME - I feel that it can be useful to separate peoples feelings from reality, such as asking them if their body is the problem really or their experience of it. For example you can help someone with anorexic type feelings take on board the fact that her real problem is her experience of fatness not the fat itself.
  
  Cognitive approaches look at thinking distortions which keep a client stuck in bad body feelings. These distortions include
  - BEAUTY OR BEAST thinking (I look good or terrible)
  - MIND READING (projecting ones own body appraisals into other people)
  - BLAME GAME (making faulty assumptions about the effects of eating or being fat e.g. no-one will want to talk to me)
  
• E) EMPATHY - the obese client will have realistic feelings about her body image which are reinforced by cultural values of fatness. Careful not to be patronising, and acknowledge the pain of being big. Dont say "you have to accept yourself as you are."
• F) MOVE ON - sadness is no excuse for being stuck. Target the self-defeating avoidance behaviours and rituals that are the clients attempts to manage body distress. Help your client stop wearing shapeless black clothes, or avoiding buying new clothes. Help them to exercise and deal with the fear of ridicule and shame that they imagine they will encounter in these situations. DOING things will help reduce anxiety and other negative response feelings.
• G) BUILD UP POSITIVE BODY-SELF RELATIONS - by doing exercises which stress sensual experiences rather than just weight control, and grooming to enhance rather than hide one’s appearance.
  

Summary of developmental influences on body image

Bruner Mazel JED volume 5

Critical experiences in the development of body image

Source Rosen Orosan-Weine Tang Journal of Eating Disorders, Vol.5 1997

• Sexes do not differ in the type or importance of critical experiences (CEs)
  
• Critical experiences predict body image disturbance and psychological symptoms
  
• Women report more "critical experiences than men" AND more negative ones
  
• The MORE CEs a person has in their life - the greater the effect on body image