Two weeks removed from a Halloween that inspired thousands of people to dress as reality television’s Honey Boo Boo, child beauty pageants have again entered the national consciousness. From small festival- and fair-based competitions to elaborate, expensive, national endeavors, child beauty pageants are a $5 billion industry. Parents who enroll their children in such pageants fiercely defend them as the child’s choice, and many participants—particularly on pageant-centered shows such as TLC’s Toddlers & Tiaras—seem thrilled to be involved. But what effects do beauty pageants have on children and their impressionable minds?

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Why Children Enter Beauty Pageants

Children are the masters of fantastical ideas, so it’s no wonder that many girls involved in the pageant circuits relish spending a few days a year as Cinderella. But children can’t enter pageants without their parents’ blessing, so involvement ultimately hinges on parental choice rather than the child’s. In a new paper published in the Journal of the American Academy of Child and Adolescent Psychiatry, University of Arizona professor Martina M. Cartwright emphasizes this point. She calls the phenomenon “princess by proxy,” explaining that the real attraction of pageants is for parents who can gain social status, self-esteem, and money when their children participate.

Potential Effects of Beauty Pageants: Eating Disorders and Body-Image Distortion

Pageants, particularly those designed for younger children, focus primarily on appearance, attire, and perceived “cuteness.” Talent competitions occur in some pageants and often are a secondary component of the experience. Thus, pageants suggest to young children that there is value in focusing on their appearance as judged through the eyes of others. This can lead to significant body-image distortions, and adults who once participated in child beauty pageants may experience low self-esteem and poor body image.

As with most adult pageants, child pageants often require crash dieting. Parents may encourage children to quickly lose weight so they can fit into small costumes or display tiny bodies in swimsuit-centered fitness competitions. Some parents put their kids on crash diets designed to help them gain energy and enthusiasm. These diets may consist solely of sugary snacks and sports drinks for several days. This can harm both short- and long-term health and teaches children unhealthy approaches to food that can contribute to the development of eating disorders.

Beauty Pageants and the Sexualization of Young Girls

Sexualization is the tendency to view oneself as a sex object, and children who participate in beauty pageants are sexualized very early. Children may dress in highly suggestive costumes and learn that they gain attention and status when sexualized. This may lead to premature sexual activity and can teach the unfortunate lesson that women’s worth is determined at least in part by their status as sex objects.

The Unhealthy Values Built by Beauty Contests

While some pageants are brief events that require little preparation, the world of pageants can be cutthroat and extremely competitive. Children learn a host of unhealthy values, including the desire to defeat their competition at all costs. Tantrums and meltdowns—by children and parents alike—are common backstage at beauty pageants, and long-term participation in pageants can teach children that their primary source of worth is how many pageants they win and how “beautiful” they are perceived to be. Academic achievement, empathy, social skills, athletic pursuits, and other age-appropriate activities may take a backseat in the world of pageants. And because precious few pageant participants grow up to become models or entertainers, this early experience can stunt their development by focusing their attention on something they are unlikely to be able to do as adults.

References:

1. Giroux, H. A. (2009, May 11). Child beauty pageants: A scene from the “other America.” Truthout. Retrieved from http://archive.truthout.org/051109A
2. Sinpetru, L. (n.d.). Child beauty pageants foster adult body dissatisfaction, eating disorders. Softpedia. Retrieved from http://news.softpedia.com/news/Child-Beauty-Pageants-Foster-Adult-Body-Dissatisfaction-Eating-Disorders-302540.shtml

Adolescent girls are among the most vulnerable for issues that relate to body image. They are assaulted with unrealistic images and unachievable ideals from virtually every media outlet. Teen girls struggle to find their identity at a time when appearance often determines their social circle and affects their self-esteem. In fact, research shows that teen girls worry more about their bodies than they do about academics, family life, or any other stressors. Young women who develop unhealthy eating behaviors can find themselves in a lifelong battle of physical and mental distress. Eating and food issues can lead to other negative psychological problems such as depression, anxiety, or even suicidal ideation.

Kathryn E. Rayner of the Centre for Emotional Health of the Department of Psychology at Macquarie University in Australia recently led a study to explore how peer relationships affect eating and body image issues in young women. Social acceptance is critical to teens, so Rayner theorized that perhaps young women select their friends based on eating and body image similarities, or perhaps they shape their own perceptions and behaviors based on the friends in their social circle. Rayner examined selection versus socialization in a sample of 1,197 teen girls from nine separate high schools in Australia. The adolescents were assessed for bulimic and dieting patterns, body satisfaction, and peer relations over a period of three years.

The results of the study revealed some interesting trends. First, the participants tended to choose friends with similar body satisfaction/dissatisfaction levels and bulimic behaviors. However, they did not choose girls with similar dieting and eating patterns. The girls also chose to engage in friendships that were bidirectional and avoided one-sided friendships. Rayner discovered that the girls who dieted the least had more people who wanted to befriend them, while those with more depressed mood and overt dieting behaviors had fewer peers soliciting their friendship. Additionally, the girls in the study, although they selected girls with dissimilar behaviors from their own, did not change their own actions to model those of their friends. Rayner believes the results of her study shed new light on some of the factors that influence eating, dieting, and body image in girls at risk. She added, “These findings represent important building blocks in facilitating the formation of more effective prevention and intervention strategies.”

Reference:
Rayner, K. E., Schniering, C. A., Rapee, R. M., Taylor, A., Hutchinson, D. M. (2012). Adolescent girls’ friendship networks, body dissatisfaction, and disordered eating: Examining selection and socialization processes. Journal of Abnormal Psychology. Advance online publication. doi: 10.1037/a0029304

People in their 20s seem to have it all: youth, energy, health, and looks. But they are also still figuring themselves out, and this time of change can bring certain mental health concerns as well. Experts have information on these issues that tend to impact people in their 20s, and provide some solutions for addressing and coping with these problems.

Clinical psychologist Dean Haddock, a marriage, family, and child counselor and the executive director and founder of Community Counseling and Psychological Services, points to a fairly common activity of 20-somethings that can lead to mental health issues if it’s not checked: alcohol and drug use.

“The first problem that leads to many others is alcohol and chemical abuse, which often leads to dependency,” Haddock said in an email. “The mental disorders that follow are often depression, anxiety, and brain injury. Of course, self-esteem and body-image problems often lead to eating disorders.”

Haddock gives three tips to help people in their 20s prevent and get through some common mental health concerns:

1. Know your genetic history of mental disorders. Knowing is half the battle to avoid those disorders in yourself.
2. Be choosey about your friends, as they will influence your decisions. Healthy friends lead to healthier decisions.
3. Self-esteem is often the result of the people who matter to you. If they do not esteem you, then you will not esteem yourself.

Nerina Garcia-Arcement, a clinical psychologist and clinical assistant professor at NYU School of Medicine, suggests that the many life changes people experience in their 20s can cause mental health issues at times.

“Your 20s are filled with life transitions that can be stressful,” Garcia-Arcement said. “This is a time when young adults are solidifying their personalities, developing their independence from family, starting or finishing college, beginning new jobs, developing a career, forming romantic relationships, and learning to manage their existing family relationships and friendships within these context.”

“Individuals in their 20s don’t have a lifetime of experience to draw on when managing multiple life transitions at once,” she added. “When someone experiences these transitions, anxiety and depressive disorders can occur.”

Here are six of Garcia-Arcement’s tips to help people in their 20s cope with mental health issues more common to that age group:

1. Seek out and form strong support networks.
2. Seek out others who are going through similar experiences and share your feelings, whether you are feeling worried, nervous, scared, sad, confused, or excited.
3. Know that you are not alone in your confusion about your career and relationships.
4. Seek out mentors who have achieved their goals, and ask for advice.
5. If you are feeling stress, sadness, or anxiety, engage in activities that will help you manage those feelings such as yoga, meditation, exercise, hobbies, social activities, relaxation exercises, and deep breathing.
6. If you feel you are not getting the necessary support and feel overwhelmed or depressed, seek out mental health professionals who can help you manage the feelings related to your life transitions.

Stephanie Sarkis, a licensed mental health counselor, said in an email that anxiety and depression are some of the main mental health issues 20-somethings face.

“We have seen an increase in these issues due to the lagging economy and difficulties finding employment,” Sarkis said. “Many people in their 20s have moved back in with their parents, which can trigger feelings of failure and frustration.”

Dr. Maiysha Clairborne, a family physician and wellness and stress management coach, added in an email that eating disorders associated with body dysmorphic disorder and body-image issues are also common for people in their 20s. She has three overall tips for people in this age group:

1. Talk to someone. The worst thing that a person can do when they are feeling depressed, anxious, or alone is to isolate more. Many times when we talk with someone we trust about what’s going on, we come to realize that we are not the only ones experiencing it and then we can get support.
2. Get active. Staying physically active not only helps to keep the body fit but also helps release endorphins and serotonin in the brain, which help keep the mood elevated. Physical activity is also a good release for stress and anxiety.
3. Minimize sugar and junk food. Sugar and processed junk foods can worsen the emotions of stress, anxiety, and depression because they cause erratic changes in your body’s blood sugars. This can disrupt the normal release of hormones in the brain that keep your moods stable.

Scott Carroll, a psychiatrist with dual board certifications in adult and child and adolescent psychiatry, said there are many issues specific to people in their 20s, including problems associated with medication use.

“Many people were on stimulants/meds for their ADHD when they were younger, but they thought it was okay to stop their meds when they were done with school,” Carroll said. “Now they are struggling at work and don’t know why. I’ve also seen young adults stop all kinds of meds like their thyroid meds because they didn’t know why they were even on it, and then they have all kinds of problems.”

Bad habits involving drug and alcohol use can start to become a major substance abuse issue when people are in their 20s, and other mental health issues start coming to the forefront at this time in peoples’ lives. Examples include bipolar disorder and schizophrenia. Also, panic attacks can start for people who have a genetic predisposition and who have higher amounts of stress associated with newfound adulthood.

“The 20s are an important time of social/emotional development,” Carroll said. “Unlike previous generations, identity formation often takes the entire 20s due to the complexity of modern society. It could be said that adolescence lasts until the early 30s in today’s society due to [prolonged] periods of education (grad school, law school, med school, etc.), lack of stable job options, and delays in getting married and starting families.”

Carroll, who is also an assistant professor at the University of New Mexico School of Medicine, suggests that when it comes to serious relationships and marriage, people in their 20s should consider how their choices could eventually affect their mental health and how their brain plays a part in their decision.

“Many 20-somethings are tempted to get married, but it is generally a bad idea because the brain in not done developing until about 25 [years old] … which leaves young adults vulnerable to having their rational mind be overwhelmed by their feelings or stress,” Carroll said. “Relationship choices often dramatically change from the early 20s to the late 20s, so many people find that the person that was perfect at 22 is a disaster at 27.  This can be an incredibly hard transition, to have to break up with your former soul mate that you thought you’d love for life because you’ve changed so much over the last several years.”

Related articles:
Do I Have a Healthy Relationship With Food and My Body?
Social Anxiety Can Be a Hidden Problem in College
How Schools Could Prevent Depression

Many people, but primarily young, educated, Western women, struggle to sustain a positive body image—for a multitude of reasons that have been discussed in previous posts. Often a negative body image leads to a poor relationship with the body and other aspects of self. It is associated with impoverished self-care and unhealthy eating and lifestyle habits.

Having a negative body image is related to general low self-esteem and depression or anxiety. Women with poor body image often struggle with boundaries in relationship to self and others. In this post, I will attempt to shed some light on the issue of boundaries related to poor body image, a concept often discussed and infrequently understood.

Women with poor body image tend to have a compartmentalized approach to well-being. For example, they may be overly focused on certain parts of the body or particular goals, such as weight loss, while devaluing other important aspects of overall health and fitness. People who have poor body image demonstrate an all-or-nothing approach to wellness, swinging from one extreme to the other, sometimes within the same day. They tend to have an exceptional level of acquired knowledge about what is healthy and set idealistic goals based on this knowledge and also are frequently disappointed and blame themselves when they are unable to attain these goals.

The lack of a holistic perspective is evidenced in an inability to balance fitness with relaxation, healthy food choices with enjoyment of food, and so on. Not surprisingly, it is common to hear that they have dissatisfying relationships with others. The all-or-nothing tendency is implicated in their sense of being overwhelmed in relationships. They sometimes become preoccupied with the other person, swinging from feeling too close to feeling uncomfortably vulnerable even feeling lost in a relationship and wanting to cut it off.

The biggest and most obvious issue I see in working with women with poor body image is that most of the information used to make decisions about relationships and well-being comes from external sources. A total and complete lack of trust in the body and the self’s ability to regulate is obvious in their decision making. There is usually a clear history in the development of this lack of trust with regard to personal, familial, and cultural messages that have been internalized. (A full discussion of these factors is beyond the scope of this article). A lack of trust in the body and in the self leads to poor listening and misinterpretation of the cues that emerge from within. After a prolonged period of not paying attention to these signals, one’s ability to understand and act in accordance to one’s own needs becomes weakened. The needs of others become the focus of too much energy and attention, often referred to as a boundary issue.

Boundaries can be physical, mental, or emotional. Clear boundary violations are easy to identify and are well known as something that is usually morally or legally wrong and/or clearly harmful to another person’s safety, integrity, or well-being. However, there is a huge gray area between what is ideal and what is harmful, and sometimes subtle violations can lead to hurt, shame, self-doubt, and low self-esteem. Violations usually happen by the person who is in a perceived position of power, as in the obvious case of an adult taking advantage of or imposing his or her personal needs on a child, or a doctor over a patient. But there are other relationships in which people can feel vulnerable and open to influence, harmful or positive. In these more subtle cases of power and vulnerability, the delivery of emotional (or more direct) messages about the self can also lead to unhealthy attitudes, self-doubt, and low self-worth. For example, people in positions of perceived or felt power who regularly directly or indirectly impose their opinions and choices can influence others to have doubts about their own choices.

A healthy boundary between people is a perceived buffering zone, whereby a felt sense of acceptable difference exists. Respectful support of differences by people in positions of perceived power and influence can help a person grow a strong sense of self and hence the ability to re-enact these perceived boundaries in other relationships. Good boundaries lead to healthy awareness of needs of the self and also positive choices that enhance the sense of self and relationships. Supporting an individual’s development involves a strong sense of self and honoring differences in others, an open attitude of acceptance and humility. A supportive stance involves allowing another person to feel, think, struggle, learn, and identify what is right for him or her without unwelcome advice or control tactics or too much distance or silence.

Recognizing and accepting differences, a supportive stance, involves sharing personal views and opinions with a sense of humility and recognizing that they are indeed personal and individual and should not be imposed on others. Offering help when it is asked for and refraining from taking over, micromanaging, or rescuing another person is important. Healthy boundaries lead to healthy relationships, and healthy relationships lead to healthy development of individuals.

Where the development of healthy boundaries has been challenged, an individual will often be overly dependent on external information and feedback to feel safe in their decision making and hence may have a poorly developed or negative sense of their own worth. In the case of the person with poor body image, this person becomes adept at information gathering, using perceived feedback to set expectations for the self that are often unrealistic. Perception itself is flawed and is often skewed towards negative, self-fulfilling ideas of self-worth. By engaging in a selection bias, people with low self-esteem will seek out and attend to cues that confirm what they think they know about themselves that is usually negative. In addition, they may believe it is possible to please others all of the time, which is clearly faulty.

Emphasis on interpretation and internalization of other people’s expectations is a recipe for impoverished self-worth. Living according to perceived notions of other people’s expectations often leads to repressed resentment, disempowerment, and disappointment. In some cases, the only way to assert the self is in a passive-aggressive manner, which is usually not received well by others. While indeed it is healthy to have a sense of social expectation and be kind and thoughtful towards others, these behaviors need to be enacted based on a clear and healthy sense of self, which requires an awareness of personal thoughts, beliefs, feelings, and needs and the differences between self and other. Healthy self and healthy relationships interrelate and influence the development of both. The development of clear boundaries has a positive impact on individuals and on others with whom they have relationships.

However, the responsibility for nurturing clear boundaries falls on individuals in a position of power of any kind. Most people in some domain of their lives are in a position to help or hinder the development of another person. It is important that we always be aware of the difference between our own needs and feelings and those of others and to refrain from overstepping and imposing or, conversely, mistakenly taking on responsibility for other people in a way that invalidates or challenges their own development.

Where boundaries were violated, or not properly developed, psychotherapy can help to personalize new ways of being that include more emotional self-awareness and self-regulation, as well as assertiveness and effective communication skills. Healthy boundaries and self-esteem are achievable goals.

Related articles:
Our Bodies/Ourselves
The Vanity Myth: Eating Disorders and Beauty
Self-Esteem and Standards

There are styles of thinking that are commonly related to anxiety and unhappiness. One patterned way of thinking that is identified by therapists who work with cognitions is the all-or-nothing style. It is often part of the negative body-image experience. This way of thinking can lead to a lot of unnecessary distress, but it is also a symptom of feeling overwhelmed. When the mind is faced with too much to deal with, a tactic it uses to conserve energy is to reduce its interpretation of experiences to simple categories: black or white, all or nothing, all bad or all good. In this effort to simplify and manage complex experiences, the mind protects itself in a short-term gain, long-term pain manner. Because life experiences can indeed be complex, we need to be able to tolerate the discomfort of staying open-minded as much as possible. The more we can withstand the discomfort, the more readily we can grow into new understandings, accommodating the complexity into our frame of thinking. This impacts relationships to self and others.

People with negative body image are often throwing the baby out with the bath water. Just like people who complain of low self-esteem, they make global and categorical assessments of their worth. They are not using a logical stance to assess their strengths and areas of challenge. Their minds are locked into an all-good versus all-bad perspective. Instead of thinking of the multitude of pleasures and purposes of the body and of the complexity of the concept of attraction, they decide that they, as a whole, are unappealing. People with extremely poor body image rarely actually look at their whole selves. When they look in the mirror, they visually dissect their image into small parts which they then taint with a negative emotion. Negative feelings overall can impact what we think we are seeing. Perception is influenced by mind and emotion states. What we see can be a trick. If one who is already stressed or sad then looks only at one aspect or one piece of their physical body, the scene is ripe for negative body image. This becomes a very unhealthy habit that perpetuates itself—getting stressed and then over-focusing on one aspect of the body that brings about more negative feelings. This person may believe he or she can control that one area of the body. This sends people into very unpleasant experiences with exercising.

Categorical thinking about the body perpetuates unhealthy attitudes about wellness overall and sabotages efforts to stay fit. Instead of going to work out or enjoy sport or physical activity, the person with negative body image will sometimes resentfully engage in excessive exercise to try to manage the hated parts of the body. This usually fails, as spot-training is often a futile endeavour. Since they cannot reach their all-or-nothing goals, they often become demotivated to work out. A healthy and balanced approach to being fit in mind and body is not about spot-training or sculpting the body. A sustainable and healthy approach is one that allows a person to accept the natural ebb and flow of energy and motivation. Cherishing life, one heads to physical activity with joy, keeping in mind the goal of health, wellness, and balance itself. Self-enhancement through dedication to feeling good keeps a body well. This kind of accepting attitude leads to overall better health and fitness, which contributes greatly to relaxation and strengthened capacity to deal with emotion and stressful challenges.  Ultimately, respecting the body and the whole self, rather than trying to conquer and control it, helps to change stubborn all-or-nothing attitudes. One must humbly surrender to the emotionally provoking complexity of being human, honoring and respecting strengths and vulnerabilities in self and others. After all, life would be very boring if it was truly black and white.

One of the most prevalent and harmful misconceptions about eating disorders is that they are all about vanity. Many people believe that sufferers are vain, beauty-obsessed brats that could easily recover if they’d simply stop looking in the mirror and get over their need to be pretty. This isn’t even close to the truth. As someone who has been personally offended by this belief, I wanted to share my story and my thoughts to hopefully shed some light on the vanity myth.

Before anorexia took hold of my life, I believe I had a pretty unusual level of self-esteem when it came to my body and looks. Sure, I had my days when I scowled at my reflection. They often occurred in dance class when I pranced around in my leotard amidst a room of mirrors. With a naturally lean frame and a fast metabolism, I was used to eating what I wanted and easily keeping in shape with my hobbies and lifestyle. I had been called skinny my entire life, and I actually hated it because it was usually said with a derogatory tone. In fact, there were times were I actually felt guilty about being thin and liking the way I looked. How messed up is that? It was so rare among my peers for someone to be satisfied with their looks and to truly love their body that I felt completely awkward and tried my best to always avoid the subject.

In college, after a series of unfortunate, traumatic events, everything changed. Within a few months I went from having good self-esteem and body image to completely loathing my entire being. How did this happen? Nobody had called me fat, I was never teased about my looks, and I didn’t get the sudden urge to pursue a runway career either. No, this wasn’t about beauty. This wasn’t about being thin. It was about becoming trapped in a “perfect storm.”

Eating disorders are about control, fear, anger, punishment, avoidance, rebellion, needs, security; I could go on and on. They don’t instantly develop over night. The circumstances have to be just right, just like the circumstances of nature that contribute to the development of a “perfect storm,” where all the elements of  location, air temperature, wind speed, and direction, levels of condensation, and evaporation. For an eating disorder to develop, it usually takes a vulnerable personality, usually one with heightened emotional sensitivity and perfectionist tendencies. It often involves one or several difficult life changes, like abuse, the death of a loved one, or the start of a new school. Finally, the beauty-obsessed society we live in, the one that values physical appearance more than anything else, creates the recipe for disaster.

To the person with an eating disorder, many of these factors are not apparent. That’s why, when you ask them what they’re feeling, most often the answer is,”Fat.” When you explain to them that fat isn’t a feeling, the next answer is most likely, “I don’t know what I’m feeling.” This discrepancy is where the vanity-myth is born.  The person with the eating disorder focuses on their body in order to avoid focusing on all the deep, dark, seemingly uncontrollable and overwhelming feelings and circumstances that lie beneath the surface. The endless pursuit of beauty becomes the scapegoat for dealing with society.

What is beauty to you? Can you even put it into words? The first definition that appears in my dictionary states that beauty, as a noun, is “a combination of qualities, such as shape, color, or form, that pleases the aesthetic senses.” Following this is the definition for the adjective version: “denoting something intended to make a woman more attractive.” Hmm. More attractive than what? More attractive than she already is?  More like the air-brushed celebrities that you see in magazines?  It is no coincidence that the number of eating disorders is rising drastically. The idea of the perfect body is being forced upon us earlier and earlier in life. While capitalizing on the beauty within, instilling body-appreciation at any size, and drastically altering the size-zero ideal won’t eliminate eating disorders, it is certainly a step in the right direction.

What did you first think of when you saw that an article titled “Bodies and Identity” was posted on a mental health care blog? Likely, words such as “anorexia,” “bulimia,” and “compulsive eating” ran through your head. An article about bodies and body image is often assumed to be about negative body image. We’re so used to talking about bodies as problems that need to be overcome, addressed, or “worked on” that a direct relationship between bodies and negative body image is almost a reflex. But what does “body image” really mean? In what way does how we see our bodies impact how we see ourselves? And how does our identity impact how we see our bodies?

Watching a baby interact with his or her body is a great way to remember all of the different ways people can relate to their bodies. With rapt attention, a baby will stare at a hand, looking at how it moves, sucking on it to see what it feels like. Babies spend a lot of time figuring out where their bodies end and where their parents’ bodies begin. It strikes me that in our cultural obsession with our bodies in relationship to others and the media as adults, we’re still trying to determine where the boundary between ourselves and others lies.

In her book, Bodies, psychotherapist Susie Orbach (2009) remarks on how the relationship between body and self in Western culture has changed over time. Before industrialization, our bodies were used to make things. Working class bodies allowed farmers to plant, tend, and harvest their crops; craftsmen used their bodies to manipulate wood, metal, stone, and fabric to create the objects needed to survive. The body image that is upheld as ideal today—thin, tan and muscular—was the result of the daily physical labor of the working class and the poor. Today this visual aesthetic plasters the covers of magazines, television, and the internet, but it carries a different meaning. A body that is lean, tan, and muscular shows that a person has the resources, time, and privilege to work on their body. Bodies are no longer used to make things; instead we are encouraged to make our bodies, as “Our bodies are and have become a form of work. The body is turning from being the means of production to the production itself” (Orbach, 2009 p. 8).

These days our bodies often act as a vehicle to share things about our identities with other people. The color of our skin, the shape of our features, our hair and eye color, the way we dress, how we carry ourselves, and even the jewelry we wear often act as a way to tell others about our race, ethnicity, cultural background, age, socioeconomic status, gender, sexual orientation, relationship status, and our personal values. Some of these aspects we have control over, and others we don’t. Because it’s so entrenched in our lives we often forget that the visual body that we share with others is carefully crafted through the choices we make.

This brief discussion of the connections between identities and bodies only begins to touch on some of the deeper issues that people experience while navigating this intersection. For example, the way that women’s bodies have been sexualized or desexualized depending on race, class, and culture marks women as objects and impacts how women see themselves and the world around them. This objectification is perpetuated by sexism, and continues to control the lives of both men and women by creating unrealistic expectations and a hierarchical power dynamic kept in check by popular media.

More and more objectification is also beginning to be applied to men’s bodies. The meaning of “body image” is shifted from a personal understanding and relationship with our bodies, to a terrible dilemma filled with shame and guilt. But what if our relationship with our bodies focused on being in them instead of how we look in them? What if we were able to be more aware of how our bodies felt and less aware of how others perceived them?

Our bodies shape our identity, and our identity is intricately linked with the body that we were born into. Exploring these connections can open up new areas of understanding and integration as we struggle to navigate intersecting identities in a polarized world.

References:
Orbach, S. (2009). Bodies. New York: Picador.

Let’s face it, hardly anybody has a completely healthy relationship with food. Unfortunately for our society, disordered eating is the norm, whether it’s crash dieting, stress eating, or whatever else you want to call it. Because of this, it can be really hard for someone in danger of developing an eating disorder to recognize the slippery slope of the diet they’re on until they’re well on their way down. Clearly, not everyone who diets develops an eating disorder, but research does show that 35% of occasional dieters become pathological dieters, and as many as 25% of those diets will progress into full-blown eating disorders. So when does dieting become dangerous? What’s the difference between a diet and an eating disorder? Sometimes the line is an awfully thin one.

A typical diet begins with a longing to lose weight. Often, this longing is coupled with a genuine wish to improve overall health and nutrition. A typical diet ends when either the weight goal is achieved or the dieter stops due to some inadequacy of the regime—too many restrictions, too few calories, etc. An eating disorder often begins the same way—with a longing to lose weight. In fact, 80% to 90% of eating disorders begin with a diet … but that diet never ends. The transition from diet to disorder has no one purpose and no one cause.

While diets are about food and weight, eating disorders become much, much more than that. Food and weight become all-powerful, and people with eating disorders use both in an attempt to better their lives (by gaining a sense of control, numbing painful emotions, earning approval or acceptance, etc.). Eating disorders do not end when a weight goal is reached because a new one will always be set. One begins to believe and behave as if “the perfect body” is attainable, and will strive for this allusion no matter what. Over time, a person’s self-esteem and general outlook on life become dependent on weight and appearance. At that point, nothing else matters.

A common danger in assessment by a professional not familiar with eating disorders is that too much emphasis is placed on a person’s weight and other physical symptoms. While these factors are often good indicators of a problem, they are not always “alarming enough,” if present at all. Equally important, if not more important, are the symptoms that cannot be seen—the symptoms in the mind. The psychological disturbances that both cause and perpetuate eating disorders are often the most difficult to treat. It’s important to understand that although someone does not fit all the criteria for a specific eating disorder, such as anorexia, bulimia, or compulsive overeating, they can still be doing a great deal of damage to their body, mind, and soul.

In a world where not being on a diet is abnormal, and restraint is a sought-after skill, being healthy and loving your body can almost feel awkward. I’m reminded of a scene in the movie Mean Girls when new girl Cady enters public school for the first time after growing up in Africa for 16 years. While her new friends nitpick their appearances in the mirror, Cady muses to herself, “I used to think there was just fat and skinny. Apparently, there’s a lot of things that can be wrong with your body.“ It’s an unfortunate message, but a true one. The body-confident girls and guys are few and far between.

What about you? Are you balancing the thin line between diet and disorder? Do you feel preoccupied with food, weight, calories, or a desire to be thinner? Do you feel the need to rigidly control your food intake or exercise schedule?  Don’t let these obsessions rob you of another minute, day, or year of your life. Remember, you’re most beautiful when you are confident and accepting of yourself, just as you are. Then and only then will you be able to make positive, lasting changes in your life.

Imagine a life where you are continually tormented by an inner dialogue that screams of your worthlessness, your hideous appearance, and your pitiful, meaningless existence. Imagine a life where you mange your day solely around food, either by avoiding it, getting rid of it, or consuming as much of it as you can. Imagine spending your birthday in a psychiatric ward, perhaps too sick and too weak to even stand up on your own. And now imagine that there is a very strong part of you that wants to be worse. This is the horrible trap of an eating disorder.

One of the most difficult aspects of eating disorder treatment is the mind-boggling fact that those suffering would often do almost anything to cling to their disease. As much as part of them wants to be happy and healthy and free from the constant torture, there is another part, often referred to as “the eating disorder self”, that convinces the sufferer that they will be nothing without it. When your eating disorder becomes your identity, medicals markers used to gauge its severity, such as amenorrhea (absence of menses in women), or the body mass index scale, are looked upon as levels of achievement. When you’re trapped in this mindset, worse really does seem better.

Throughout the years that I struggled with anorexia, I used the presence of my period as a way to prove to myself that I was still safe, that I still had weight to lose. Some individuals will stop menstruating fairly quickly after substantial weight loss, others, myself included, can maintain dangerously low weights yet continue to menstruate. I remember my therapist and my doctor both diagnosing me with anorexia nervosa, but I had seen and memorized what the Diagnostic and Statistical Manual of Mental Disorders said about anorexia. I had to lose my period to be “officially” classified. The diagnosis went in my charts nonetheless. Yet, I had this strange longing to fit the bill, to really be able to call myself anorexic, because it meant that at least I was doing something right. If I failed at everything else in life, at least I would master my eating disorder. I would be the best anorexic I could be.

I  wanted to be the thinnest in the room, the sickest, and many times over I did hold that title. It became my prize, my sense of accomplishment. I became quite accustomed to the label “skinny, blonde girl.” Anorexia became my identity and when recovery (and the inevitable weight gain) threatened that, I would panic and slip right back into the disordered behaviors. Who would I be without it? I needed this disease to survive, or so my eating disorder constantly told me.

It is a very sick way of thinking, I know, but I also know that I was not alone in thinking. I have spent a great deal of time among other eating disordered individuals, and there is a definite cognitive pattern when it comes to symptoms and diagnostic labels. In short, it seems the worse you are, the better you feel. I can’t count how many times I’ve heard people with bulimia wish they had the “control” of their treatment peers with anorexia, and those who compulsively overeat long for the ability to easily purge like those with bulimia. There is an unfortunate perceived hierarchy among patients, with the “purity” and “cleanliness” of anorexia appearing to outrank the “hedonistic” behaviors of bulimia or compulsive eating.  But in reality, they are all equally serious, and all deadly. Whether you’re starving or stuffing or purging, your eating disorder is a distraction, a desperate attempt to control the un-controllable.

Eating disorders, in general, are very control-focused. Whether it’s an attempt to control anxiety, or anger, or relationships, they trigger and feed off of the  competitive and perfectionist personality traits that many sufferers share. I thought that if more control equaled more medical complications, so be it. But the crux of the matter is that sufferers inevitably reach a point, often quite quickly, where the lotus of control shifts completely out of their hands, and into the hands of the eating disorder.

It’s too hard to battle an eating disorder alone. Reaching out is the first step in successful recovery. Share your secret with a trusted friend or family member. Even that act of sharing a secret can often relieve some of the pain. Seek professional help. There are people who have been in your shoes and are willing to guide you out of the darkness. Hope is real. Recovery is real.

One of the cornerstones of Acceptance and Commitment Therapy (ACT) is the concept of workability. The aim of ACT is for our clients to create a rich, meaningful, and vibrant life. Workability is how we determine whether a client’s behaviors are serving that end. Usually, people know when their behaviors are not working for them, but because they are often fused with their thoughts, they may have a hard time acting any other way. Instead of bringing them closer to the life they want, their behaviors are more or less a means of struggling with or avoiding painful thoughts and feelings. To demonstrate how this might appear in a therapy session I’d like to present the case of Samantha (Of course names and details have been altered to protect confidentiality):

Samantha is in her late twenties, single, no children, has her own apartment in a suburban neighborhood, a cat, a steady job for the last year and a half, an unused gym membership, and hasn’t been on a date in four years. She complains about her female co-workers being “fake” and “slutty” yet she secretly wants to be like them and to be liked by them. Any time an opportunity arises where she is invited to attend a happy hour with work people, she has an excuse not to attend. She then goes home and cries before opening a pint of ice cream and watching pre-recorded episodes of “fill-in-the-blank-reality-television.” (more…)

A new study suggests variance in the brain activity of people suffering from body dysmorphia. According to Dr. Jamie Feusner, a UCLA assistant professor of psychiatry, people with body image issues have decreased brain activity when they view holistic images. “No study until this one has investigated the brain’s activity for visually processing objects in people with BDD,” said Feusner, director of the Obsessive-Compulsive Disorder Intensive Treatment Program at UCLA. “This is an important step to figuring out what’s going wrong in the brains of people with body dysmorphia so we can develop treatments to change their perceptions of themselves.”

Body dysmorphia is found in nearly two percent of people and more prevalent in those with obsessive-compulsive tendencies. The study, which involved 14 people with body dysmorphia and 14 control subjects, involved the use of a brain scans in order to determine the brain activity of the subjects while they viewed pictures of houses that were altered and houses that were unaltered. Those with body dysmorphia displayed significantly lower amounts of brain activity in the region of the brain that process visual details. The more severe a person’s symptoms of body dysmorphia, the less activity they displayed. (more…)

Each of us has our own unique identity made up of a combination of personality traits, personal and family history, and other attributes. But what happens inside when an identity is not celebrated by a person’s community?

In Stigma: Notes on the Management of a Spoiled Identity (1963), author Erving Goffman uses the term “spoiled identity” to refer to an identity that causes a person to experience stigma. For Goffman, “stigma” describes the experience of moving through life with an attribute that is deeply discrediting. This attribute divides people into those-who-are-normal and those-who-are-not, thereby making those-who-are-not less worthy. Spoiled identities include racial minority, ethnic minority, sexual orientation, gender, sex, and religious identities, body size, and visible and invisible disabilities. (more…)