I’m delighted to have Beth Weinstock, PhD  and Jane Shure, PhD, LCSW guest posting for Wise Words for Recovery today. Beth and Jane, both psychotherapists, are well–known in the eating disorder community, contributing their expertise in areas such as trauma, body image issues, and shame–based behaviors.

Be sure to check at the end of this post to learn how you can experience Beth and Jane’s work in person!

Body Image and Self-Esteem

• Do you obsess about your appearance?
• Do you feel guilty after you eat?
• Do you feel “fat” one day and thin the next?
• Are you unrealistic about your body size and shape?

If you answer “Yes” to these questions you may have challenges with body image.

What We Mean By Body Image

Body image is complex and multi-dimensional. It involves emotions, perception, personal history, social context, sensations and physiology. Body image is influenced by messages in childhood, our health and illness history, ethnic or cultural identity and our relationships. It reflects how we see ourselves, how we think others see us, and how we physically feel living in our body. 



Cultural Influences to Body Image Development

Today’s culture bombards us with images and messages about perfection. The media and advertising industries sell us the idea that we will be rewarded if we achieve an idealized standard of beauty. The myth is that we can look like the models we see in the ads if we buy this product, try that diet, or go on the next exercise regime.

The fashion industry is brilliant at convincing us that our next purchase will create the improvement we need in order to feel attractive and likable. What we are really being sold is a sense of inadequacy and defeat. We can never achieve those idealized looks because they are not real. They are airbrushed, digitalized and fake images. In spite of these facts, we remain under the influence and buy in. 




Influences from Family and Peers

Many beliefs and feelings about our bodies were shaped by early childhood experiences and may still be frozen in time. Before we developed language, we perceived ourselves and our environment through touch, sight and sound. We relaxed when touched and talked to lovingly, and we tightened when touched and talked to aggressively. Negative body image can result from early experiences of body deprivation when needs get frustrated or unmet (i.e. hunger, sleep, physical comfort, etc). The opposite is also true. Positive body image can result from sufficient attention to core needs, being treated with compassion, and feeling physically safe and protected.

Family stories can contribute to how we see ourselves in our bodies. If we are told that we look like Aunt Sally who was small and frail, we may have a sense that we, too, are frail, even if we aren’t. In addition, histories of illnesses and surgeries can cause trauma and influence us to feel like our bodies are defective.

Biology also plays a role. We come in all sizes. Some of us are big-boned or small-boned, tall or short. How our environment responds to these givens, and how we relate to the responses, has an effect on our body image. Being the shortest or the tallest person in the grade, being the fastest or slowest, keeping “baby fat,” carrying weight before growth spurts, having a narrow or wide frame, being teased, bullied or criticized for our appearance, succeeding or not succeeding at sports… all these ways of being ourselves in our natural bodies has an impact on how others respond to us and how we then perceive ourselves. 




Why Body Image Is Hard To Change

Our brain has a filtering system that determines what information gets recognized and how that information gets interpreted. Filters organize what we notice, what we attend to, what we remember, and then what we believe. If we believe that we are unattractive and someone tells us differently, we are likely to dismiss the feedback and consider it simply an exception to the rule. We don’t consider that our mindset is a result of our mind’s filtering system and not necessarily a reflection of an objective reality.

Negative body image is hard to change, but it can be done. Our brain patterns can change when we practice new ways of thinking and behaving that break the old patterns and establish new ones. We can actually change our brains over time.

Positive body image doesn’t require that we love and be thrilled with every aspect of our physical being. It requires a willingness to maintain an attitude of self-acceptance, self compassion, and the hard work of replacing body criticism with neutral language that promotes self-esteem. 




Tips for Creating A Healthy Body Image:

1. Question whether or not the body image that you have today is current with the reality of your body shape and size. You may be carrying a child’s image of yourself that is no longer appropriate in the here and now. For example, if you had been a chubby child and are now slim, you may still be feeling chubby even when you are not.

2. Become aware of perfectionism. Stop comparing yourself to idealized images.

3. Resist comparing your body to others. Be realistic about your body size and shape and your genetic predisposition.

4. Identify one part of your body that you like or feel friendly towards. Appreciate this body part for all that it has done for you. You might say a gratitude prayer for it.

5. Pay attention to the people around you and whether or not they support you to hold a positive body image. Do your friends think it’s funny to kid you about your weight? Your nose? Your big hands? Be assertive for yourself and tell people to stop saying hurtful things.

6. Ask a trusted friend to tell you 3 things they like about your appearance.

7. Learn to listen to your body for hunger cues and for when you are satisfied with what you have eaten.

8. Find ways to exercise for pleasure and health, not just for weight control.

9. Resist the temptation to weigh yourself frequently. Remember that your weight and shape will fluctuate daily, weekly and monthly. It is preferable to know your weight range from how you feel in your clothes rather than from a number on the scale.

 10. Avoid reading fashion magazines. They sell unrealistic images and want you to buy into dissatisfaction with your body.

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Want to hear more from Beth and Jane? Here are two great opportunities:

Next month Beth and Jane will guest  post again for  Wise Words for Recovery. Their topic will be “The Power Of Shame.”

and…

These two accomplished presenters will be offering their workshop, “Quiet Your Inner Critic and Calm Your Anxious Mind,” Oct 23—25, 2009 at Kripalu Center, Stockbridge, MA. Get the details, including how you can register, at their website  selfmatters.org or at Kripalu.org .

See if you recognize yourself in any of the following patterns:

When asked for your preferences, you respond with something like:  “It doesn’t matter to me. Whatever you want.”

It’s not unusual for your conversations with friends or associates to end up 95% focused on the other person.

You never, ever miss a friend’s birthday or stop searching until you’ve found exactly the right card. Neither illness, natural disaster nor loss of a loved one exempt you.

Nobody, at least nobody you know, makes you angry, no matter what they do.

You attack yourself mercilessly if you feel you’ve disappointed someone.

Maybe you thought everyone thinks, feels and behaves in these ways. But the examples above actually represent a highly destructive style of relating to others we might call the  “good girl” reflex. “Good girl” reflexes are extremely common among both young and grown women who have eating disorders.

What is the “good girl” reflex? 

At its heart, the “good girl” reflex is a compulsive pattern of paying attention to everyone else’s needs and concerns while treating your own as if they don’t matter. A “good girl” often pays so little attention to her own needs and desires, she couldn’t even tell you what they are. You could say the  “good girl” reflex is an extreme version of what we’ve traditionally been taught makes for a good woman. Selflessness is the key.

What’s wrong with selflessness, you ask. Isn’t the world too full of selfish people and deeds? Well, it’s hard to argue with that. But the best correction for an extreme in one direction is seldom an extreme in the other direction. Why do some girls and women get stuck in such an extreme pattern? The “good girl” reflex is frequently an example of what we call an attachment strategy.

Attachment strategies are ways of relating to others that are unconsciously designed to keep the relationship secure; that is, to keep people from disapproving of you or, worse, leaving you. When early experiences with caregivers are highly conditional or characterized by great uncertainty, a child lives with undue fear of disapproval or abandonment. These fears carry forward to color all future relationships. For such people, attachment strategies take on a certain desperate urgency.

Women who develop the “good girl” reflex become focused on figuring out and supplying what others want as an attempt to ward off disapproval or abandonment. They are calming their fears (for the moment) but at great cost. Enacting “good girl” reflexes is very hard on selfhood and self–esteem. How can you learn to know yourself when all the focus goes outward to others? How can self–esteem flourish when you are daily living the message that you don’t matter?

What does the “good girl” reflex have to do with eating disorders?

Many women who develop eating disorders started life with the kind of caregiver insecurity that can give rise to a “good girl” attachment strategy. Lacking the reliable internal guidelines that can only develop out of knowing yourself, such women may attempt to substitute the external “guidance” of calories and pounds. Or they seek others’ admiration for their thinness to stand in for the missing self–esteem that only an internal sense of worth can supply.

There’s more. Learning that you’re not supposed to have needs of your own can lead to anorexic restricting or the cycle of bingeing and dieting. A woman with anorexia denies having even the most basic of needs; that is, for food and nourishment (although restricting is usually more about control and perfectionism which is a close cousin of “good–girlism”). The woman who binges is in a fierce struggle with her desires, alternately expressing them by bingeing, then denying them with the next diet (or purge).

How do you update the “good girl” reflex? How does that help with eating disorder recovery?

It can feel very risky at first to even think about letting go of “good girl” reflexes. They’ve seemed like your key to being accepted and loved.

Here’s an exercise for you: start by thinking of a friend or some other woman you really admire who clearly considers her own needs right along with the needs of others. Got your person? How do you feel about the way she balances her needs and wishes with those of others? Is there anything about it you’d like to borrow? Can you find one very small example of her behavior or thinking that you could experiment with? Who can you count on to support you in your experiment?

Remember that when you take your own needs and wishes seriously, your self–esteem automatically begins to improve. As a bonus, you’ll get more respect for showing that you respect yourself. Healthy people instinctively shy away from extremes of selflessness just as they do from selfishness. On the other hand, they gravitate toward people with solid self–esteem.