G&STC Director Jesse and Therapists Brian and James with talk with O.School about the Recognizing the Difference between Insecurity and Body Dysmorphia
Check out G&STC’s Director Jesse Kahn, and therapists Brian Ackerman and James Vining talking with Kelly Gonsalves at O.School about how to tell the difference between body image insecurity and body dysmorphia.
Body dysmorphia is a form of obsessive compulsive disorder wherein a person is preoccupied with a perceived physical “flaw” or several flaws. Jesse Kahn, LCSW-R, CST, sex therapist and director at the Gender & Sexuality Therapy Center tells O.school that often, these “flaws” are not noticeable or appear quite minor to others. This issue is officially known as body dysmorphic disorder (BDD).
“These flaws can be entirely real, entirely imagined, or some imaginary exaggeration of the flaw, resulting in distressing angst often resulting in lower self-esteem,” Brian Ackerman, LMSW, a psychotherapist at G&STC, tells O.school.
What causes body dysmorphia?
There is no specific etiological cause for body dysmorphia, according to James Vining, LCSW, another psychotherapist at the center. It’s thought to be a combination of biological and psychological factors, including potentially a difference in the way the brain of a person with BDD perceives visual cues. A person with BDD may feel self-hatred when they can’t attain often impossible standards of beauty perpetuated by social media, advertisements, and more.
“The most insidious aspect of body dysmorphia is that it is a cultural and systemic disease, not just an individual one. Based on the ever-present myth that we won’t be seen or valued unless we conform to and achieve an aesthetic ideal, we inherit this idea that having a specific kind of body guarantees social acceptance, status, power, desirability,” Vining tells O.school.
The following behaviors in excess may be signs of BDD, according to Ackerman, Kahn, and Vining:
Ruminating on perceived physical flaws, especially ones that other people don't notice
Getting feedback from others on your physical appearance that is positive and incongruent with your internal, very negative views of your perceived flaws
Checking the mirror for the perceived flaws
Grooming, picking at the skin, or trying to hide the perceived flaws
Seeking reassurance from others about the perceived flaws
Comparing your body to others, particularly the parts related to the perceived flaws
Extreme focus on “fixing” or removing the “flawed” part
Anxiety, shame, or embarrassment related to the perceived flaws
Very low self-esteem
“Everyone has body insecurities,” Ackerman explains. “The critical difference with body dysmorphia is that the body insecurities themselves become ‘clinically distressing’ — that is, the bullets listed above become so energy and time consuming in your life, that your ability to function socially, professionally, and in other areas of life is impaired.”
“Sufferers may even be able to rationally identify that they intellectually ‘know’ that their body is ‘fit’ and aesthetically pleasing to them in their own self-assessment, yet still be fixated on changing that part of the body into an unachievable ideal,” Vining says.
Notice your triggers. Get curious about how your dysmorphia emerged, Kahn recommends to O.school. “What was the environment and the cultural narratives that allowed the dysmorphia to thrive?” From there, explore what triggers and activates your dysmorphia, he says. “For example, how does scrolling on social media impact your dysmorphia? Considering images on social media tend to be so edited, manipulated, and unrealistic, social media is a common trigger.”
Rethink your relationship to your body. While it’s okay to want to strive for a certain aesthetic that you like, it shouldn’t come at the expense of your well-being or self-confidence.
“Remember first that you really are already perfect as you are (no, really, make space for that!),” Ackerman tells O.school. “Second, consider the thing you perceive as a body flaw. Is it something you can change, or is it a feature that will be with you no matter what?”
Pay attention to how your body feels. Vining recommends the use of mindfulness and somatic work to help move away from distracting thoughts about your body’s appearance. Try to shift your attention from focusing on how your body looks to focusing on how it feels, he says. What feelings do you have within your body? How can you make your body feel good?
“Mindfulness and somatic work … allows the person to experience and consciously notice how the body feels, rather than focus exclusively on how it looks or how other people value it,” he says. “This is a shift from perception to mindful embodiment and teaches the person that other types of self-experience are valuable.”
Connect to your true values. “Most people would benefit from identifying how their personal values differ from exclusively achievement-based goals (body),” Vining says.
What do you value? Do appearances and status need to be such powerful drivers in your life? What other things do you care about that matter more for you to invest your energy into? Your personal values do not have to reflect our society’s values, Vining reminds. What gets praised on social media, for example, doesn’t have to be the same things you care about.
MORE FROM G&STC DIRECTOR JESSE KAHN ON THIS TOPIC:
Often body dysmorphia also experiences anxiety, shame and embarrassment fueled by the dysmorphia.
When thinking about exercise and fitness, start by getting curious about your motivation when exercising and consider what feels nourishing to your body, what makes you feel good in your body and what your body is wanting.
When I’m thinking about body image issues I begin by getting curious and asking how the person’s dysmorphia emerged and what was the environment and the cultural narratives that allowed the dysmorphia to thrive.
Explore what triggers and activates your dysmorphia and what type of environments allow your dysmorphia to thrive.
If you feel you are alone - you are not. There are other men struggling with body dysmorphia, body image struggles, and struggles connected to how they relate to food, exercise and fitness.
MORE FROM G&STC THERAPIST JAMES VINING ON THIS TOPIC:
Body dysmorphia is an obsessive compulsive disorder wherein the person continually finds their body or certain parts of their body (stomach, pecs, legs) to be repulsive and disgusting regardless of the amount of validation, compliments, or positive reinforcement they receive from others. There is an extreme focus on “fixing or removing” the part. Sufferers may even be able to rationally identify that they intellectually “know” that their body is “fit” and aesthetically pleasing to them in their own self-assessment yet still be fixated on changing that part of the body into an unachievable ideal. The core of body dysmorphia is self-punishment and an overidentification with one’s body as the sole source of personal and cultural value.
Body dysmorphia is the destructive byproduct of the beauty regime wherein a person is made to feel less valuable if they do not match the mainstream definitions of beauty. This self-hatred is constantly reinforced and by social media posts, advertising, gym memberships, calorie counting, fatphobia, all which dehumanize the person into an object of consumption. The phenomenon of body dysmorphic disorder is incredibly painful for the sufferer because it serves to reify them. That is, they become so obsessive with their body as the full representation of who they are that they are deprived of a sense of individuality or personal qualities. Their selfhood always acts in the service of the publicly-valued body and they wind up feeling invisible.
MORE FROM G&STC THERAPIST BRIAN ACKERMAN ON THIS TOPIC:
Body dysmorphia is typically characterized by a persistent thinking or concern about a flaw or flaws in appearance. These flaws can be entirely real, entirely imagined, or some imaginary exaggeration of the flaw resulting in distressing angst often resulting in lower self esteem.
Our media imagery frequently imposes the ideal man as one with a muscular physique and specific patterns of head/facial/body hair, if any of our features feel off from these we might find ourselves persistently feeling like there’s something wrong with our bodies. The key with body dysmorphia is the rumination on this perceived flaw, for men this can be about any part of the body, although a common concern is penis size.
Remember first that you really are already perfect as you are (no, really, make space for that!). Second, consider the thing you perceive as a body flaw, is it something you can change or is it a feature that will be with you no matter what? Approaching fitness with realistic, incremental goals can go a long way to setting yourself up for success mentally and physically. Also consider talking about your feelings about your body with a therapist to get a better understanding of them and to adjust your relationship with these perceived flaws.