Body Dysmorphia

Body Dysmorphia

Most of us feel unhappy or insecure about the way we look at some point in our life, however these feelings usually come and go. While body dysmorphia is an increasingly common condition (around 1% of the population) it is very different because it affects the individual the majority of the time and leads them to have a permanently distorted view of their appearance, to the extent they are convinced that the way they look is abnormal or ugly, even when it isn't. They will spend a great deal of time looking in the mirror critically, or avoiding mirrors completely, and often leads to a strong desire to have cosmetic surgery.

Fuelling these feelings is the constant thought they are unattractive, which is hugely distressing, and depressing, for the person. Even when friends, partners and family members try to convince the person that they look great, the negative thoughts remain overwhelming. In an effort to combat these negative feelings the person tends to obsess over the way they look, spending hours trying to cover up or hide the perceived flaw, which is why more serious manifestations of Body Dysmorphia are categorised as an obsessive-compulsive disorder, and for this reason CBT is often recommended as the treatment of choice. Sometimes deeper issues with their roots in the past can be the cause of the problem, hence longer-term therapies might be more appropriate.

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Low Self-Esteem

What is self–esteem?

Its that part of us that, when it is low, leaves us feeling depressed, hopeless and causes us to view the world and our lives in a negative way. When our self-esteem is high, we feel that the world is a good place full of opportunities, we feel optimistic and powerful.

What causes low self–esteem?

All sorts of things can cause low self-esteem anything from losing a job to being bereaved. It may be that the latest blow we experience is one too many or the last straw. We may be vulnerable because of things that have happened to us as a child or our physical health may not be good. A blow to our self-esteem can occur when we feel like we have little power in situations such as, starting a new job, being part of a dysfunctional relationship or leaving home for the first time.

Ways to build self-esteem

  • Begin by taking care of your physical health by eating properly and taking some exercise
  • Set yourself goals that you can realistically reach and that will give you a sense of accomplishment
  • Devise a plan that involves treating yourself, remind yourself that everyone including you deserves to have pleasure, fun and nurturing in their lives
  • Notice the things that you do well. We learn new skills all the time, sometimes its good to reflect on how far you have come and on things you have accomplished
  • Identify situations or places where you feel as though you have little power. Visualise these situations or places with you feeling more comfortable and in control
  • Read up on assertiveness skills and practice these new skills on a regular basis. Having your need met will boost your self-esteem

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Self Harm

Self Harm

For many when faced with distressing or stressful life experiences they tend to neglect themselves, perhaps smoking or drinking too much, driving too fast, spending excessively, engaging in unsafe sex, all as ways of numbing or avoiding difficult feelings. For others however the depth and intensity of their pain is such that these ways aren’t enough and they feel direct injury to themselves is the only way to cope.

Self harm can cover a multitude of behaviours. Most common is scratching or cutting the skin, usually the arms or legs, but other parts of the body too. Some burn or scald themselves, pick at their skin, pull their hair out, violently hit themselves against things. These forms of behaviour, which clearly cause pain or harm to the body, can be ways of coping with deep emotional pain, a way of taking control, managing something overwhelming. These acts can be a means of putting an internal pain on the ‘outside’, a tangible way of showing your suffering to the world, a cry for help; not attention for the sake of it but a desperate attempt to show others that something is seriously wrong. For some it can be a way of restoring a feeling of reality, a way of making yourself feel real or ‘connected’ top your body. For others it may serve the purpose of punishing the self, relieving feelings of shame or guilt. These feelings are sometimes linked to abuse, whether emotional, physical or sexual. More broadly these behaviours are often indicators of an underlying depression, low self esteem or poor physical self image.

Self harming behaviour is not necessarily an indicator of severe mental illness but instead a way of trying to cope with pain, and the only way possible. Just because a person self injures this does not make them a danger to others. Their hurt and anger is primarily directed against themselves. Also it is not generally a sign of suicidal intent; these actions aren’t about ending one’s life just a way of coping with it.

Some self help advice

You might begin to make sense of your behaviour by considering:

  • When it began
  • What was happening in your life back then
  • How did self harming help you survive these experiences, both in the past and in the present
  • How do you feel before and after you have self harmed. Maybe keep a diary of thoughts and feelings as they occur around harming behaviours. Are they indicative of buried needs, feelings, thoughts, memories?
  • What does your behaviour represent to you? What is it a response to?

Having identified these you can work towards other ways of responding to your internal distress that is less damaging in the longer term. Along with seeking professional help with the underlying issues, the following suggestions can begin to initiate small steps towards alternative, more productive, self-help behaviours:

  • Cutting less deeply, less often
  • Taking better care of your injuries
  • To get a similar physical sensation, flick elastic bands on your wrist, hold ice cubes in your hand until they melt
  • Tearing up bits of paper and making a collage
  • Avoid drinking too much when self harming
  • Taking better care of your injuries
  • Writing down the feelings instead
  • Drawing or painting your feelings
  • Talking with a friend when the feelings take grip

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