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The problem of body image dissatisfaction is sadly epidemic in todays world. To dislike your own body is to dislike yourself. A negative body image needlessly diminishes the quality of your life. The arrival of The Body Image Workbook brings hoped-for relief. Dr. Cash is an acclaimed professional whose eight-step program is sensitive and solutiongiving. Dr. Joyce Brothers Dr. Cash is one of the most sensitive and sympathetic voices on the subject of body image. He brings knowledge and care, intelligence and kindness to a complicated, loaded issue. The Body Image Workbook offers a clear road map to understanding body image problems and relieving them. Linda Wells, editor-in-chief, Allure magazine, former beauty editor, New York Times Dr. Cash has a knack for translating the best of what science offers into something friendly, supportive, and helpful. Kelly D. Brownell, Ph.D., director of the Rudd Center for Food Policy and Obesity at Yale University This workbook admirably fulfills the authors objective and promise. It is useful, empathetic, thorough, and common-sensed. My feedback for the author? Nothing, except congratulations! Robert M. Goldwyn, MD, clinical professor of surgery at Harvard Medical School, Division of Plastic Surgery, former chief of plastic surgery at Beth Israel Deaconess Medical Center The suffering associated with body image distress can dramatically undermine ones quality of life. Incisively extracting the most helpful findings from thirty years of scientific research and clinical experience, Cash has very effectively created a beautifully organized body image workbook that will help many people. His program offers both hope for relief from body image suffering and practical strategies that can make that hope a reality. Thomas Pruzinsky, Ph.D., professor of psychology at Quinnipiac University in Hamden, CT Cash has produced an excellent revision of The Body Image Workbook . The content is clear, appropriate, and based firmly on published research evidence. Therapeutic techniques that we know are helpful are presented in an accessible and supportive style, with clear guidance and useful help sheets to enable readers to develop new skills and to monitor change. This is essential reading for anyone with body image concerns. It is also a useful resource for professional therapists who wish to help clients who are experiencing
distressing body-related thoughts and feelings. Dr Sarah Grogan, professor of health psychology at Staffordshire University, Staffordshire, UK, and author of Body Image: Understanding Body Dissatisfaction in Men, Women, and Children
Dear reader, The print edition of The Body Image Workbook comes with many worksheets throughout the book. In order to maintain the usability of the original workbook, worksheets and any other supplemental materials are available for you to download and print in pdf format. Please visit: www.nhpubs.com/5464 You also may find that you can complete the exercises satisfactorily in a notebook or by using the comment function on your ebook-reading device. Thank you, New Harbinger Publications, Inc.
Publishers NoteThis publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering psychological, financial, legal, or other professional services. If expert assistance or counseling is needed, the services of a competent professional should be sought. Copy right 2008 by Thomas F. Cash, Ph.D. New Harbinger Publications, Inc. 5674 Shattuck Avenue Oakland, CA 94609 www.newharbinger.com All rights reserved. Printed in the United States of America. Distributed in Canada by Raincoast Books. Acquired by Tesily a Hanauer; Cover design by Amy Shoup; Edited by Kay la Sussell Epub ISBN: 978-1-60882-616-3 The Library of Congress has cataloged the print edition as: Cash, Thomas F. The body image workbook : an eight-step program for learning to like y our looks / Thomas F. Cash. -- 2nd ed. p. cm. Includes bibliographical references (p. ). ISBN-13: 978-1-57224-546-4 (pbk. : alk. paper) ISBN-10: 1-57224-546-8 (pbk. : alk. paper) 1. Body image. 2. Body image--Problems, exercises, etc. 3. Self-acceptance. I. Title. BF697.5.B63C367 2008 306.4613--dc22 2008016271
With my heartfelt appreciation, I dedicate this work to Natalie. She is my true love, my best friend, and my wife. She enhances each moment of my life, as she will forever and four days.
ContentsPREFACE INTRODUCTION: TAKING STEPS TO A BETTER BODY IMAGE STEP 1: DISCOVERING YOUR PERSONAL BODY IMAGE STEP 2: UNDERSTANDING THE ORIGINS OF YOUR BODY IMAGE STORY STEP 3: MINDFULLY ACCEPTING YOUR BODY IMAGE EXPERIENCES STEP 4: SEEING BENEATH THE SURFACE OF YOUR PRIVATE BODY TALK STEP 5: MINDFULLY MODIFYING YOUR MENTAL MISTAKES STEP 6: FACING YOUR BODY IMAGE AVOIDANCE STEP 7: ERASING YOUR BODY IMAGE RITUALS STEP 8: TREATING YOUR BODY WELL> AFTERWORD: FROM THIS DAY FORWARD: PRESERVING YOUR POSITIVE BODY IMAGE FOR LIFE RECOMMENDED RESOURCES FOR READERS, RESEARCHERS, AND THERAPISTS BIBLIOGRAPHY
PrefaceFor thirty-five years, I have devoted my career to the psychology of physical appearance. The most inspiring aspects of my work have concerned body image and how to prevent and alleviate body image problems. At the core of my professional pursuits is psychological science, which I believe informs us about how best to change lives and ameliorate human suffering. This book builds on its earlier versions, particularly the 1997 edition, by incorporating both scientific and clinical advances from the burgeoning literature on body image development, assessment, and treatment. Indeed, in 2004 I founded a new scholarly journal, Body Image: An International Journal of Research , which publishes excellent and informative work on body image and human appearance. This revised edition of The Body Image Workbook notably integrates the new and popular disciplines of mindfulness, acceptance, and expressive writing with well established, effective cognitive and behavioral procedures for body image change. My heartfelt wish is that this book will genuinely help readers develop a more satisfying and accepting relationship with their body and will aid the therapists who may be guiding them. My career has been blessed by opportunities to work with wonderful students, both undergraduates and graduates. Over the years, some of my doctoral students and I have conducted and published research concerning the treatment of body image difficulties and disorders. I appreciate these meaningful collaborations with Jonathan Butters, Jill Grant, Danielle Lavallee, Melissa Strachan Kinser, Joshua Hrabosky, and Kristin Grasso. I must also acknowledge three eminent psychologists who have given me immense inspiration and valued friendship for many years. Kevin Thompson, at the University of South Florida, is undoubtedly one of the most prolific body image researchers in the world. His excellent insights and investigations have contributed greatly to my knowledge and to the field. Tom Pruzinsky, at Quinnipiac University, is the most genuinely compassionate person I know. His efforts to understand and improve the quality of life among individuals with disfiguring physical conditions are widely respected and appreciated. At the University of Pennsylvania School of Medicine, David Sarwer is a brilliant scientist whose scholarship richly informs us about body image issues in obesity, cosmetic surgery, and dermatology. I have enjoyed the privilege of collaborating with him on several projects. I am very grateful to each of you, my friends. In the preparation of this new edition, I profited greatly from the additional editorial eyes of Natalie Cash, Jonathan Rudiger, and Erin Engle. I appreciate their diligent feedback on the accuracy and clarity of my writing. New Harbinger is an impressively supportive publisher that truly cares about its authors, its readers, and the publication of highly reputable products that benefit therapeutic practitioners and the public. I sincerely thank Kayla Sussell, Tesilya Hanauer, Jess Beebe, and Matt McKay for skillfully assisting me in making this new edition of The Body Image Workbook the best that it can be.
second group, however, their dissatisfaction was more extreme and was associated with a range of emotional and behavioral problems. Having a negative body image spawns other problems in living. Following are some of the most frequent troubles that can and do arise. Often a poor body image lowers self-esteem. Poor self-esteem means feeling inadequate as a person; it means you have low self-worth and dont highly value yourself. As much as one-third of your self-esteem is related to how positive or negative your body image is. If you dont like your body, its difficult to like the person who lives thereyou! Body image is integral to gender identityyour feelings of manliness or masculinity, or your feelings of womanliness or femininity. Some people believe that they dont have the physical qualities necessary to experience themselves as particularly masculine or feminine (like tallness or muscularity for guys, or thinness and having delicate features for women). This can diminish their sense of how acceptable they feel they are to others. A negative body image can cause interpersonal anxiety. If you cant accept your looks, you most likely assume others dont like your looks either. As a result, you feel self-conscious and inadequate in some of your social interactions. Fearful of social inspection and social rejection, you may even shy away from situations in which you feel that your appearance is on trial. And, of course, if nothing is ventured nothing is gainedespecially fun and friendships. If your physical self-consciousness spills into your sexually intimate relationships, it can jeopardize your capacity for sexual fulfillment. If you believe your naked body is ugly or unacceptable, sex becomes anxiety producing. Sex researchers and therapists have found that one cause of sexual difficulties is Spectatoringthe self-conscious scrutiny of ones own body during sex instead of immersion in the sensate experience itself. By dwelling on worries about your attractiveness or on maneuvers to hide your body from your partners view or touch, sex becomes an act of apprehension and avoidance. If you switch off the lights to cloak your body in darkness, you may also be switching off your pleasure! For example, in 1991, Dr. Jill Hangen and I conducted a study of body image and sexuality. We compared fifty women who were highly self-conscious about their bodys appearance during sex and fifty women who werent. Body-conscious women reported that they had orgasms in an average of only 42 percent of their lovemaking occasionsversus an average of 73 percent of the time for less physically self-conscious women. A negative body image can make it hard to give and receive sexual intimacy. Depression and a negative body image are often intertwined. Depression can lead people to detest their looks and vice versa. Self-disparagement and thoughts of hopelessness and helplessness about what you look like are depressing. In turn, this despondency, like quicksand, can further trap you in self-criticisms of your body. It becomes a vicious cycle of despair. As Ill discuss later in this introduction, a negative body image can bring about eating disturbances, such as anorexia nervosa or bulimia nervosa. These are problems that gradually build over time. If you worry about looking fat, you may diet and exercise to excess. Chronic dieting may lead to binge eating, which can precipitate purging. Not only does having a negative, fat-phobic body image predispose you to disturbed patterns of eating, but having an eating disorder undermines your body image. Changing a negative body image is as important to preventing eating disorders as it is to conquering them. So a negative body image is bad news. Not only are you unhappy with your physical appearance,
this can also diminish your quality of life. But heres the good news: A problematic, unsatisfying body image can be changed. The fact that our survey revealed that 54 percent of participants have a favorable, self-accepting body image proves that having a positive body image is really possible (Williams, Cash, and Santos 2004). The Body Image Workbook will teach you how to transform your relationship with your body from a self-defeating struggle to an experience of body acceptance and enjoyment. Before delving into the details of this program, I want to tell you how it came to be and how it can help you.
and body dysmorphic disorder. Because I want you to be sure that The Body Image Workbook is appropriate for you, I will describe each of these four psychological difficulties. Eating Disorders Do you have or think you might have an eating disorder that is driven in part by your body image struggles? To overcome these three eating disorders requires professional assistance: Anorexia nervosa is a disorder of self-starvation in pursuit of thinness. It affects about 1 percent of adolescent girls and young women. Their fear of weight gain and their perception of themselves as fat, even when they are emaciated and physically ill, is intensely overwhelming. Controlling their weight and physical appearance seems to be the only way to control their lives. What begins as a refusal to eat becomes an inability to eat. Unfortunately, 10 to 15 percent of those with anorexia nervosa die from the condition, making it the most lethal of all mental disorders (American Psychiatric Association 2000). Bulimia nervosa is a more widely prevalent eating disorder, occurring in an estimated 3 percent of young women (American Psychiatric Association 2000). This disorder entails recurrent eating binges; that is, the rapid consumption of large quantities of food in a very brief period. Usually carried out secretly, these binges feel out of control. After the binge comes the purge, an attempt to negate the binge and reduce the fear and the likelihood of weight gain. The purge may involve selfinduced vomiting, but it may also involve the excessive, compensatory use of laxatives, diuretics, dietary fasts, or vigorous exercise. People with bulimia nervosa not only hate their body shape and weight, but their eating problem traps them in a vicious, unhealthy cycle. Their body hatred and feelings of guilt, depression, and self-loathing just keep diminishing the quality of their lives and their ability to control their eating behavior. In a third eating disorder, binges take place without efforts to purge or to compensate for the excessive food intake. This is binge-eating disorder , sometimes called compulsive overeating. Understandably, binges often lead to feeling out of control, weight gain, and an even more negative body image. Binge eaters represent about 3 percent of the general population, 8 percent of obese women and men, and a greater percentage of people who seek professional weight-loss treatment (Grilo 2002). For good health and longevity, individuals with eating disorders must gain control over their problematic eating behaviors. But they must also learn to think and feel differently about their looks so that their feelings about their weight or shape no longer define their self-worth. Without repairing their body image, they risk returning to the same old patterns of self-starvation or binges and purges. Although a negative body image is a core aspect of their problems, body image therapy isnt their sole solution. Body Dysmorphic Disorder For some people, perhaps up to 2 percent of the general population, an obsessive preoccupation with their appearance is the severe problem known as body dysmorphic disorder or BDDthe disorder of imagined ugliness (Phillips 2005). They have a grossly distorted view of what they look like. Others who look at them think that they either look fine or have a barely noticeable defect. Although eating disorders are more common among females than males, BDD affects the sexes
equally. Eating disorders involve body weight and shape concerns, but BDD entails other concerns, including facial features, complexion, and hair. One subtype of BDD is called muscle dysmorphia, which is a preoccupation with muscularity even among those who are well built. Individuals with BDD may spend hours every day checking their deformity in the mirror and attempting to hide it or fix it. Social events may be avoided or self-consciously endured. Their desire to fix their flaws may motivate a relentless search for surgical or medical solutions. Those with muscle dysmorphia often compulsively engage in bodybuilding exercise and are at risk for the abuse of anabolic steroids and supplements to bulk up.
Additional HelpCan the solutions offered in this workbook help those with an extremely negative body image and an eating disorder or BDD? Yes and no. Research confirms that the use of this cognitive behavioral approach can greatly help people with these disorders, but the complexity and severity of these problems often make a purely self-help program less useful than therapist-managed treatment (Jarry and Ip 2005; Latner and Wilson 2007). In recent years, effective treatments have emerged for eating disorders and BDD. So, if you recognize yourself in any of these descriptions, please seek professional help. Because your negative body image is an integral part of your difficulties, together you and your therapist can use this workbook to achieve maximum benefits. As a scientist and a clinical psychologist, I understand the power of professional therapy to help people make positive life changes. If you suffer from stress, anxiety, depression, relationship problems, or other difficulties that threaten your self-esteem and happiness, please get the help you need. Obtaining professional help doesnt mean that you are a weak person or a failure. It means that you wisely want your life to be better. You are entitled to seek a happy life. The Association of Behavioral and Cognitive Therapies provides an extensive list of practitioners on its Web site at www.abct.org. Similarly, the Academy of Cognitive Therapy lists practitioners on its Web site at www.academyofct.org. Additional resources, both books and Web sites about body image, eating disorders, and BDD, are provided at the end of the book in the Recommended Resources section.
Hey, Weight a Minute! In the past thirty years, obesity rates have more than doubled in the United States and in other societies. Currently, about two-thirds of Americans are either overweight (body mass index from 25 to 25.9) or obese (BMI of 30 and higher; Hill, Catenacci, and Wyatt 2005). Rates of bariatric surgery, that is, surgery on the stomach and/or intestines to help a person with severe obesity lose weight, have skyrocketed in recent years. Weight concerns are a primary complaint of people with a negative body image. At any given time, about one-half of adult women and one-fourth of adult men are on a weight-loss diet. For many people, dieting is a way of life. Nevertheless, most dieters regain much of their lost weight after a year or two. Yo-yo dieters lose weight and regain it in a neverending cycle that takes its toll on body image. In one study, for example, I discovered that after taking off an average of fifty pounds, obese dieters body images did improve. However, after regaining an average of only five pounds a few months later, their body image gains eroded significantly (Cash 1994a). Chronic dieting can lead to health problems, binges, emotional distress, and a possible metabolic change that increases the likelihood of weight gain. Many experts have challenged the dieting solution (see Foster and McGuckin 2002) and have written books to provide an alternativea healthy nondieting lifestyle (e.g., Foreyt and Goodrick 1992; Polivy and Herman 1983). If you are a compulsive, recurrent dieter, I know I cant readily convince you to take a different path. But I can ask that you ponder what motivates your habitual dieting. Is it a desire for health and physical well-being? Or is it a wish for attractiveness and a fat phobiaa fear that if you weigh more than your ideal weight youll be a social misfit? Effective weight management is a good idea. Rather than erratic and drastic dieting, weight control entails a healthy lifestyle that doesnt depend on the number on your bathroom scale. The sensible solution involves well-balanced nutrition, spreading out your daily food intake, and regular exercise. It is a myth that weight loss is the only way you can accept your body if its overweight or even just slightly heavier than you would like. For example, University of Vermont researchers (Rosen, Orosan, and Reiter 1995) provided obese people with body image therapy very similar to the program in this workbook. The program enabled participants to greatly improve how they felt about their bodies, without reductions in their weight. People who need to lose weight to improve their health should separate the goals of weight loss and body acceptance. By first learning how to have a positive relationship with your imperfect body instead of a relationship full of loathing, desperation, and abuse, your ability to shed excess weight may be strengthened. Surgical Solutions for Body Dissatisfaction In growing numbers, men and women are seeking cosmetic surgery to change what they look like. According to the American Society of Plastic Surgeons (2007), nearly 11 million Americans received surgical or minimally invasive cosmetic procedures in 2006, at a rate 7 percent higher than in 2005, 48 percent greater than in 2000, and about 800 percent more than in 1992. The greatest recent growth is for minimally invasive procedures (chemical peels, Botox, laser treatments, microdermabrasion, and so on).
Can surgically changing your body improve your body image? In the book Psychological Aspects of Reconstructive and Cosmetic Plastic Surgery (Sarwer et al. 2006), my colleagues and I review the scientific evidence on this question and conclude that for many people cosmetic surgery can relieve their discontent with a specific physical characteristic. However, surgery is no magic wand; it is a catalyst for changing your relationship with yourself. I neither recommend nor oppose cosmetic surgery. Any surgery carries risks as well as potential benefits, both of which depend upon the physical and psychological makeup of the individual having the surgery, the particular surgical procedure, and the skill of the surgeon. Nonetheless, the preoccupied pursuit of surgical solutions, especially one procedure followed by another and then another, indicates there is more wrong than what one sees on the outside. Certainly, reconstructive plastic surgery can help restore or improve the quality of life for individuals whose opportunities for human dignity, productivity, and happiness have been diminished by congenital or traumatic disfigurements. What about surgery for minor, nondisfiguring variations in appearance, such as a few sags or wrinkles or a less-than-perfect nose? Deciding to have surgery should not be like impulsively deciding to get a new hairstyle. Weighing the pros and cons requires thoughtful and knowledgeable deliberation. My advice to you is that before you opt for extensive exterior remodeling, work on the interior problemyour body image. After youve completed this workbook, you may no longer want to change your looks. And if you still want to change them, youll be more likely to reap the emotional benefits from the surgery that you desire.
neutralize your negative body image emotions. You will also begin to keep a private diary of your daily body image experiences. Step 4 You feel what you think. How you feel about your looks is greatly influenced by your privately held beliefs, interpretations, and thought patterns. Most people have particular assumptions about the importance and influence of their looksunchecked assumptions can lead to trouble. In this Step, youll find out whether you unconsciously harbor ten arguable assumptions and, then, learn how to change your mind. Step 5 This Step involves more mind-changing. When you think about your own looks, you carry on a type of inner conversation I call Private Body Talk . If your Private Body Talk is permeated with mental mistakes or distortions, it will devastate your body image. In this step, youll learn about eight common distortions. Youll listen in on your Private Body Talk, identify your own problematic thought patterns, and create a New Inner V oice to communicate with yourself about your looks and how you feel about them. Step 6 A negative body image leads people to act in self-defeating ways to protect themselves from self-consciousness and other uncomfortable feelings. Such behaviors include Evasive Actions, which are habits intended to avoid these distressing experiences. These self-protective maneuvers actually make your body image even worse. In this Step, youll learn to understand, face, and eradicate your imprisoning patterns of avoidant behavior. Step 7 Another self-defeating behavior pattern is called Appearance-Preoccupied Rituals . These compulsive habits perpetuate your negative body image. This Step shows you how to rid your life of these rituals and accept your appearance as it is. Step 8 When you reach this Step, having overcome many negative aspects of your body image, its time to expand the genuinely positive experiences. Step 8 teaches you how to create a more confident, pleasurable, and affirming relationship with your body. Afterword After completing the last Step, you can take stock of your successful changes. But will they last? By being attuned to the Achilles heels of your body image and planning ahead for possible
adversities, you can strengthen your new body image and ward off tough times. In this final section, youll understand why preventative maintenance is your life insurance policy.
scrutinizes himself in the mirror, inspects his balding head, and examines his flexed muscles from every angle. Andrews thoughts about his appearance are angry and self-disparaging. I look like a damned wimp. Its totally unfair. He thinks, I look worse every day. The more hair I lose, the dumber I look. So how does Andrew cope? To escape feeling too skinny, he avoids hanging out with wellbuilt men as much as he can. From time to time he lifts weights at home (the gym is too intimidating), but he is impatient for noticeable changes so he quickly gives up working out. He wears baseball caps, even indoors, to hide his hair loss. Hes tried plenty of hair-growth regimens, but they didnt work for him. Rather than asking a woman for a date and risking rejection, he goes to movies and parties alone, if at all. Katlin is thirty-one-years-old and has been married to Patrick for ten years. They have two children and Katlin also teaches high school English. About three years ago, Katlin was involved in a nearfatal automobile accident that left her face severely lacerated and burned. Despite the improvements that she obtained from plastic surgery, her face remains visibly scarred, mostly on her chin, right cheek, and forehead. These physical changes have scarred her body image as well. She is preoccupied with how she looks to others and what she believes they must be thinking about her. She is extremely aware of strangers stares and is seldom willing to be in public places with her kids, fearing that they will be uncomfortable being seen with her. Sometimes when shes teaching, if she notices students whispering or giggling, she wonders if they are making fun of her looks. Before leaving the house, she always applies a thick coat of cosmetic concealer. In social situations, she tries to stand to the left of people so they cannot see the right side of her face. Patrick worries about her difficulties with looking different and about the fact that even though she is physically capable of smiling, she almost never smiles anymore. She fantasizes that another cosmetic surgery will make her look normal again. Sometimes, Katlin looks at photos of herself taken before the accident and cries. Ill never be me again, she sobs.
On this first self-test, you will discover your evaluative body image. This refers to how you feel about your appearance in general as well as about particular physical characteristics or features. Put a check mark in the column that expresses how dissatisfied or satisfied you are with each characteristic listed.
People differ in how their body image experiences affect other aspects of their lives. Body image may have positive effects, negative effects, or no effect at all. The various ways that your own body image might influence your life are listed below. For each item, place a check mark in a column to indicate how your feelings about your appearance affect that aspect of your life. Before answering each item, think carefully about the answer that is most accurate about how your body image usually affects you.
your Body Image Thoughts score (0 to 40) in your Body Image Profile below. The Body Image Distress Test This test focuses on situations and events that lead to body image discomfort or distress. First, add up the check marks you put in the middle column (Sometimes). Next, add up the check marks in the last column (Often) and multiply that number by 2. The sum of these two values is your Body Image Distress score (ranging from 0 to 40) to enter on your Body Image Profile. The Appearance Importance Test This test is easy to score. Count how many statements that you marked as Mostly True for you and enter this Appearance Importance score (from 0 to 12) in your Body Image Profile. The Body Image Coping Test This test has three scores that reflect different coping strategies that people use to handle body image threats and challenges. The first coping strategy is called Appearance Fixing and its score is the number of check marks you entered in the first column (Mostly Is Like Me) for items 1 through 10. The second score is for coping by Experiential Avoidanceand that is the number of Mostly Is Like Me check marks for items 11 through 18. Finally, count the Mostly Is Like Me check marks for items 19 through 29 to get your score for coping by Positive Rational Acceptance. Enter each score in your Body Image Profile. The possible range of scores is 0 to 10 for Appearance Fixing, 0 to 8 for Experiential Avoidance, and 0 to 11 for Positive Rational Acceptance. The Body Image Quality of Life Test Your final test enables you to understand how your body image affects you and your life. You need to calculate two scores. The first one is the Negative Impact score, which is the number of times (from 0 to 19) you checked Mostly a Negative Effect, in the first column. The second score, Positive Impact, is the number of check marks (from 0 to 19) in the last, Mostly a Positive Effect, column. Enter these two different scores in your Body Image Profile.
pinpoint aspects of your body image with definite room for improvement that you will want to work on. Scores in or near the Problem Zone wave red flags. These aspects of your body image are especially troublesome for you and make important contributions to a negative body image. Problem Zone scores highlight key areas to target in your efforts to change and become more accepting of your physical appearance. Now lets examine each of your test results in detail to understand what your scores can tell you about your body image. You should realize, however, that scores are only numbers and cannot be perfectly precise for specific people. These test results are tools for self-discovery, not pronouncements of absolute truth. I will offer interpretations as food for thought. Ultimately, the most important insights must come from you. So, take the time you may need to really ponder what I suggest. Does it fit? When discussing your test results, I will ask you as much as I tell you. Body Image Evaluation: Where Does It Hurt? People with Risky Zone and Problem Zone scores on this test are dissatisfied with many of their physical characteristics (Cash 2000b). Because you are probably reading this book to overcome a negative body image, dont be surprised if you score in one of these zones. There are at least two possible reasons for such scores. First, you may have several distinct sources for your displeasure. Being overly critical of your looks, you find a number of different physical attributes that you cannot accept as they are. When you look at your body, you look for trouble and are unwilling to find anything that is really okay. Your body is a moving target for your discontent. Second, theres the spillover factor. Not liking your weight, for example, may spill over to any body area (e.g., lower torso, midtorso, muscle tone) that you think betrays your weight. You actually have only one complaint, but it affects your evaluation of several features. Some people may have a low dissatisfaction score on Body Image Evaluation that is more of a problem than the low score actually implies. Often this is occurs because you are content with most of your physical characteristics except for one or two, but feel that the areas of discontent ruin your overall appearance. Did you answer that you were dissatisfied with your overall appearance on item 1? If so, are you blaming your entire body for one or two disappointing features? That can create lots of troublesome problems. Whatever your score and whatever imperfections you focus on, eliminating any dissatisfaction is worth the effort. This workbook will help you accept your physical appearanceimperfections and all. How Thought-Provoking Is Your Body Image? When you took the Body Image Thoughts Test, you began to read your own mind. The test samples negative thoughts that people may have about their looks (Cash, Lewis, and Keeton 1987). Scores in the Problem Zone mean that you tend to think the worst about your looks and you think it often. Youve probably convinced yourself that these mental self-criticisms are really true. As you mull over aspects of your appearance, you focus on your flaws. You ruminate over what other people think about your looks and probably assume they judge you as disapprovingly as you do yourself. Once caught up in the stream of these thoughts, its hard for you to ignore them. If you score
in the Risky Zone, you may be milder in your self-critical thoughts, or you may put down your body in a more focused fashion, picking on some single feature. Either way, you are needling yourself needlessly. Lets consider the other side of the coin. How often do you have positive, self-affirming thoughts about your physical appearance? How open is your mind to pleasant, approving thoughts about your body? If you have a negative reply to these questions, why is that? Why would you close your mind to self-acceptance? Maybe youre oblivious to your physical assets, so you dont believe theres anything good to think about. Or maybe you push aside any complimentary thoughts with a Yes but followed by some self-criticism. For example, I look pretty nice with this hairstyle, but Im still fat. Another reason for a deficit of self-affirming thoughts could be that youve come to believe that only vain, egotistical people think favorably of their looks. If so, then any mental compliment about your appearance may lead to a brief guilt trip, so you dismiss the positive thought with I shouldnt be thinking that. Later in this workbook, youll learn to give yourself permission to acknowledge and enjoy your best featureswithout the guilt. How would it feel if you didnt have self-critical body image thoughts running through your mind? How would it feel to have frequent self-accepting body image thoughts? Where Are Your Body Image Land Mines? Now lets learn more about the situations and events that trigger your troubles. Your Body Image Distress score reflects how many situations trigger you to becoming bothered or upset about your looks (Cash 1994b; 2002b). You might feel anxiety, disgust, despondency, anger, frustration, envy, shame, or self-consciousness. If you have a score in the Problem Zone, daily life is probably like crossing a minefield, with the potential for negative emotions and experiences to erupt almost everywhere. Scores that are in the Risky Zone indicate that you have some times and places that intensify your body image displeasure. Even if your distress is triggered by limited circumstances, you dont need the grief and can learn to eliminate it. In this workbook, youll focus on your most provocative situationsthe ones in which youre conditioned to react emotionallyand you will learn to handle these situations differently. You will learn that the situation itself doesnt cause your distress. Rather, the real culprit that upsets you is how you think about and behave in the situation. Importance of Your Appearance: How Much Do You Bank on Your Looks? The Appearance Importance Test taps a very important aspect of your body image (Cash and Labarge 1996; Cash, Melnyk, and Hrabosky 2004). It provides you with a measurable index to determine how much you are invested in your physical appearance for defining your identity and determining your self-worth. The more you invest, the more vulnerable you are to body image troubles and problems in your life. If you score in the Risky Zone, you believe that your appearance is moderately influential on how you think about yourself or how you believe other people think and feel about you. Scores in the Problem Zone reveal that you place excessive emphasis on your physical appearance in terms of how you think about yourself in your everyday life. The scientific truth is that the more invested people are in their appearance, the more it
preoccupies themin their thoughts, emotions, and behaviors. If you are devoting lots of your hopes, energies, and efforts to being physically attractive or looking different than you do, especially because you believe that this is essential to your self-worth, you actually will feel little self-worth. Do yourself a favor and reread this paragraph and really think about it. Can you see how it applies to you? Several steps in this workbook will focus on helping you to gradually deemphasize your looks and put them in a proper, happier perspective. Your looks are not everything, and you are certainly much more than your looks. How Do You Cope with Feeling Ugly? There are three basic ways that people try to handle or cope with threats or challenges to their body image (Cash, Santos, and Williams 2005). The Body Image Coping Test provides your scores for each approachAppearance Fixing, Experiential Avoidance, and Positive Rational Acceptance. Lets try to understand each coping strategy and what your scores mean. Appearance Fixingisa common coping strategy that involves mental and behavioral attempts to change something about your looks. When troubled by some offending physical characteristic, you may reflexively try to do something to your appearance to feel more comfortable. You might fuss and fret over the characteristic and try to cover it up to make it look better. For example, if something happens that makes you feel fat, you might put on loose-fitting clothing, start planning your next diet, or begin working out to your exercise video. Another Appearance Fixing tactic is called compensation. You try to improve something specific about your looks, such as by getting a new hairstyle or buying new cosmetics or an outfit, so that you make yourself look better in order to feel better. One additional strategy involves seeking reassurance about your looks from other people. When you ask a friend, Do you think I look fat in this sweater? you hope to hear No, of course not and have your concern fixed. You can also fix by fantasyimagining how you will look after weight loss or cosmetic surgery. Later, in Step 6 of the workbook, youll see how coping by Appearance Fixing can become a problematic pattern called Appearance-Preoccupied Rituals. You will learn how to overcome this problem. Dealing with body image discomfort by Experiential Avoidance entails efforts to shut out or evade negative body image emotions. So you may say to yourself, Dont think about this or I cant think about this. Perhaps you avoid by distracting yourself from your upsetting experienceyou may watch television or eat to take your mind off of it. Often, some people cope with anticipated body image discomfort by completely avoiding the situation that they expect will elicit it. If you expect to feel self-conscious at the beach party or aerobics class, you just refuse to go. Avoidance may provide you with temporary relief, but it perpetuates your body image difficulties. In Step 3, you will begin to learn how to accept your feelings instead of avoiding them. In Step 6, you will also learn to stop playing out your Evasive Actions. Unlike the first two strategies for managing negative body image emotions, Positive Rational Acceptance is a healthy approach. As you will see in Step 3, discomfort is neither dangerous nor revealing of some awful inner truth about you. It is merely a feeling. You can learn how to be aware of and accept that feeling, rather than trying to deny it, avoid it, transform it, or allow it to dictate what you do. In Steps 3, 4, and 5 of the workbook, you will learn from your feelings and develop a more honest, self-affirming perspective on your body image experiences.
How Does Your Body Image Influence Your Life? As discussed in the introduction, being dissatisfied with something about your physical appearance may be no problem at all or it may be a very big problem. The difference is determined by the impact or consequences of your body image in your everyday life (Cash and Fleming 2002b; Cash, Jakatdar, and Williams 2004). Does your body image influence your feelings about yourself, your social interactions, your eating and exercise behaviors, your sexuality, and so on? It is essential for you to understand how your body image experiences affect the quality of your life. This is measured by your two Body Image Quality of Life scores. A high Negative Impact score means that your body image produces numerous disruptive, interfering effects on your life. A low Positive Impact score indicates that your view of your looks seldom gives rise to experiences of pleasure, contentment, joy, or pride. The ultimate goal of the program found in this workbook is to enhance the quality of your life by helping you improve your body image acceptance.
I need to become more comfortable with my looks at social events (e.g., at the pool). I need to be able to look in the mirror and not get upset. I need to spend less time trying to decide what to wear before going out. I need to quit comparing myself to every good-looking woman I see (especially in those in the beauty mags). I need to eat healthy instead of doing dumb diets. I need to quit jockeying for the back row in aerobics class. Here are excerpts from Andrews needs list: I need to stop being so angry at myself for my hair loss. I need to quit hiding under my baseball cap, though it scares me to think about that. I need to accept the fact that Im not a muscle man and the reality is that I never will be. I need to spend less time criticizing myself when Im looking in the mirror. I need to give myself credit for the fact that I work out regularly and that Im in good shape. I need to stop thinking that women consider me boring because of my looks. I need to appreciate that I have nice skin, an attractive beard, and I really dress well. I need to be friendlier to muscular guys. Its not their fault theyre built differently than I am. I need to socialize more and stop using my looks as an excuse for staying home. I need to recognize that all single women arent going to reject me for my looks and that the ones who do arent women I ultimately want to be with anyway. What are some of the things Katlin says she needs to change? Here they are: As hard as it is to do, I need to accept that I look different now. I need to work on that. I need to stop looking at my old photos, because that always upsets me. I need to quit trying to make my scars invisible, because they arent and never will be. I really, really need to get more comfortable with other people looking at me.
I need to smile more, because everybody is more attractive when they smile. I need to figure out what to say to people who seem bothered my scars. I need to quit thinking that my husband and kids are ashamed of me, because I know that Im a terrific wife and mom and that they really love me. I need to realize that my appearance doesnt have to prevent my having fun, unless I let that happen.
feeling as though youre at the bottom of a mountain that youll never be able to climb. I understand. This is a natural human feeling. A journey is often hardest at its start. Realize that the climb isnt as steep or as treacherous as it may seem at the moment. Others have taken the same path you are about to take, and they have succeeded. Youve pinpointed your difficulties and used them to identify positive directions, and you can accomplish your goals one step at a time. I commend you for completing this first important step. Onward!
Cultural ReflectionsBy the time children attend preschool they have already started learning how society views various physical characteristics. Little kids know that lovely Cinderella wins the handsome prince; her ugly and mean stepsisters lose out. They know that Barbie and Ken have the good life, with bodies to match. They know that male superheroes and action figures have bulging muscles. Body image takes shape as children absorb concepts of what society values as attractivehow they should look. Kids also form images of what is not attractivehow they should not look. In animated cartoons and feature films for kids, the losers and bad guys are often depicted as ugly or fat. Most importantly, children begin to judge their own bodily appearancehow well does it live up to the shoulds? The answer can affect their sense of self-worth. From the word go, society dictates social values and the meanings of physical appearance. Lets take a closer look at the biased lessons our culture teaches us. My Fair Lady The adulation of thinness hasnt occurred in some cultures to the extent that it has in Western society. For example, in societies where food is scarce and Western media are absent, a heavier body is still viewed as evidence of successful survival. In earlier times, a full-figured physique was the epitome of feminine beauty. The rounded hips and thighs of prehistoric goddesses symbolized feminine fertility. In much of the art of the fifteenth to eighteenth centuries, full-figured women were the standard of beauty. In the ancient Orient, a fat wife was such a symbol of honor for her husband that some men force-fed their wives to enhance their own social standing. In the twentieth and twenty-first centuries, however, a thinner and less curvaceous body type has increasingly been promoted as the standard of feminine attractiveness. In the last thirty years, fashion models, film stars, and beauty pageant contestants have all become thinner, even as the majority of the female population has become heavier. As rates of anorexia nervosa and bulimia nervosa have steadily increased, emaciated waif models appear on magazine covers and fashion runways, in television ads, and in music videos. The message broadcast is that thin is in and feminine. Each year People magazine publishes its Most Beautiful People list. Esthetic accolades have been given to such obviously slender bodies as those of Jessica Alba, Halle Berry, Penelope Cruz, Angelina Jolie, Alicia Keys, Nicole Kidman, Julia Roberts, and Eva Longoriato name just a few. And as reflected by the prevalence of breast augmentation surgerythere were over 329,000 surgeries in the
United States in 2006 (American Society of Plastic Surgeons 2007)large, shapely breasts have become more important to the cultural ideal (just as they were in the middle of the twentieth century). For the sake of beauty, women in our society are told to shave or wax their legs, armpits, and bikini areas, pluck their eyebrows, dye and either curl or straighten their hair, pierce their ears, paint their faces and all twenty nails, and walk around in uncomfortable (and sometimes dangerous) high heels. Women are also told that they should worry about unsightly age spots, split ends, the sprouting of a single gray hair, a chipped nail, and a visible panty line. Its no wonder that many girls and women feel objectified and find so many things faulty about their looks! The Handsome Prince Although less demanding than womens appearance standards, societal norms and expectations definitely exist for men. Guys are supposed to be tall and have broad shoulders, a muscular chest and biceps, a small rear, strong facial features, and a full head of hair. Most manly heroes and leading men are handsome hunksGeorge Clooney, Brad Pitt, Patrick Dempsey, Colin Farrell, Jude Law, Denzel Washington, Orlando Bloom, Richard Gere, and so on. A generation ago, John Duke Wayne protected his masculine stand tall image by refusing to appear topless in publicthat is, without his hairpiece. These masculine body prescriptions lead some boys and men to jeopardize their health with steroid abuse and excessive exercise. A fascinating book entitled The Adonis Complex: The Secret Crisis of Male Body Obsession (Pope, Phillips, and Olivardia 2000) details the difficulties of males with muscle dysmorphia, that is, those who seek a perfect muscular physique but often feel inadequate and scrawny. Today, more than ever before, men seek cosmetic surgery, including nose reshaping, liposuction, hair transplants, and face lifts. In America in 2006, they received over 250,000 surgical and 850,000 nonsurgical cosmetic procedures (American Society of Plastic Surgeons 2007). So, clearly, many men feel pressured to be physically attractive, believing that good looks are a prerequisite for success in relationships and life in general. The popular new term metrosexual was coined to characterize the single, heterosexual, urban male who is highly invested in his appearance and its expression of esthetic style. Cultures are not uniform. Every culture consists of subcultures that may differ greatly from one another. For example, within the United States, African-Americans have norms and values that do not mirror the majority cultures norms and values. With respect to physical appearance, the appreciation of a fuller-figured female body and the valuing of personal style and attitude in dress protect some African-American women from developing as self-deprecating a body image as European-American women (Roberts et al. 2006). Another subculture pertains to sexual orientation. A recent scientific review (Morrison, Morrison, and Sager 2004) of studies comparing gay and lesbian people with those who are heterosexual concluded that, on average, gay men report more body dissatisfaction than heterosexual guys, perhaps in part because of excessive emphasis on appearance among gays. Research findings are less clear for lesbians, but on average they may be slightly more body accepting than heterosexual women of comparable body weight. From Cultural Images to Body Images
In various cultures at various times, attractiveness has required decorative scars on the face, a shaved head, tattoos fully covering the body, jewels placed in holes drilled in the teeth, large disks inserted in the lips, stacked rings to elongate the neck, and the maiming of womens feet to make them petite. All these things were done, and most still are, in service of societal standards of attractiveness. Moreover, societal norms are ever-changing. For example, only a decade or so ago in Western culture, body piercing and tattooing were only popular among menespecially bikers, gangs, and prisoners. Today, body art is very popular among young women. What was once taboo has become socially acceptable and cool. Just as you may dismiss other cultures foreign appearance standards as really crazy, I urge you to begin to question the mandates of your own culture or subculture. Who are the appearance masters that you feel obliged to serve? Throughout this workbook, Ill help you defend yourself against these unhealthy messages. Right now, I want you to contemplate two crucial facts: Fact 1: Societal standards cant harm you unless you buy into them. You dont have to adopt these ideals and pressure yourself to live up to them. You dont have to allow your sense of selfworth to be determined by voices not of your choosing. If you think you should possess some trait that you believe you lack, youll experience distress in situations that remind you of this inadequacy. Fact 2: Other people dont judge you as harshly as you judge yourself. In numerous studies, researchers have discovered that many people demand more physical perfection of themselves than they think others expect of them, and even more than those others truly expect. Often, such people are out of touch with reality. Many men are often more appreciative of a heavier female body type than women believe they are. Guys dont idealize blonde beauty to the degree women assume. Likewise, lots of women dont idolize the narrowly defined images of macho attractiveness that men often assume they do.
Interpersonal InfluencesDr. Kevin Thompson, an esteemed body image researcher at the University of South Florida, points to three pivotal sources of influence in body image development. One of these, as weve already touched upon, is the influence of our cultures mass media. The other two causes are embedded in our relationships with othersour peers and our family. Sticks and Stones: Hey Fatso! Your family has most likely taught you a lot about your own body. Parents remind you to brush your hair, put on clean clothes with patterns and colors that dont clash, and stay trim. When you were growing up, how many times did you hear Youre not really going to leave the house looking like that, are you? Families also communicate expectations by what psychologists call modeling. For example, if you grow up with a parent who consistently complains about his or her appearance, you learn that looks can be something to worry about. If you have a brother or sister doted on for being attractive, you may come to feel shortchanged by your own looks. You may feel resentful and envious that you arent as nice-looking.
Being repeatedly criticized, taunted, or teased about your appearance during the childhood or teen years can leave a lasting effect on body image development. Many adults who dislike their appearance can recall experiences of being teased or criticized as children because of their looks. Deeply etched in their memories are episodes of rebuke or ridicule for being too chubby or too skinny, too tall or too short, for having a large nose or big ears, or for how they dressed or wore their hair. In one study (Rieves and Cash 1996), 72 percent of college students revealed that, while growing up, they had been repeatedly teased or criticized for an average of over six years, usually about their facial features or weight. Many reported having had an unwelcome nicknameBubble Butt, Pinocchio, Freckles, Pizza Face, Four-Eyes, Carrot Top, Beanpole, or Horse Face, for example. Of those who had been teased, 71 percent said it had been moderately to very upsetting, whereas the remainderonly 29 percentwere able to shrug it off. The most common teasers were brothers and peers in general. An earlier study (Cash 1995a) revealed that 65 percent said that appearance teasing had marred their body image. Both studies revealed that a reported history of such treatment was linked to a more negative adult body image. Teasing is just one type of appearance-related maltreatment. People who are overweight also experience other stigmatizing difficultiesfor example, social exclusion, public stares, fat jokes, and shopping for clothes that fit. As a 2004 study by Annis, Cash, and Hrabosky revealed, among overweight women, experiencing such stigma during childhood, adolescence, and adulthood is subsequently associated with more body dissatisfaction, excessive psychological investment in ones appearance, and more psychological problems. Being body-stigmatized represents a contradictory, double message that ones looks are unacceptable yet essential to social and personal well-being. As we grow and interact with our peers, the topic of physical appearance comes up fairly often, especially for females. Girls and young women engage in familiar fat chat with one another. They discuss weight and dieting, and the social expectation is that one is supposed to complain about being too fat. Unfortunately, this ritual of self-criticism seems to encourage and produce body dissatisfaction (Nichter 2000; Tucker et al. 2007). By the same token, its difficult to imagine that skinny talk about male bodies would be very healthy for boys. Romantic relationships can exert strong influences on our thoughts and feelings about our looks. Their power results from the fact that we may see an intimate partners view of us as a valid reflection of our worthafter all, our partner really knows us. Moreover, in a sexual relationship, the partner can see the naked truth of what we look like. Having a relationship in which our loved one is complimentary and accepting can promote a positive body image. Of course, the opposite is true as well. Having a partner criticize or seem oblivious to our looks can erode our body image acceptance. You can clearly see that, as we grow up, our relationships with peers and family members can have both positive and negative effects on our body image development. In a survey of nearly five hundred college students (Cash, Rudiger, and Williams 2008), we asked them how happy they were with their appearance during childhood and during their teen years. For those who had a positive body image as children, we simply asked them to list all the factors that contributed to their acceptance of their physical appearance. You might think they would have talked about having a nice body or cute face, but less than 18 percent of their responses mentioned physical attributes as the most important influence. In both childhood and adolescence, social support was most often given as the primary influence, as 32 percent pointed to having good friends and family who accepted and cared
about them. Moreover, our results indicated that family support was more important than peer support in childhood, while the opposite was true for adolescence.
ones body image. But the inspiring fact is that many of these people come to accept such drastic changes, incorporate them into a healthy body image, and move forward in their lives (Rumsey 2002; Rumsey and Harcourt 2004, 2005). Please appreciate the crucial point Im conveying here: How your body appears on the outside does not have to determine how you feel on the inside. Many people who are quite short or heavy or look their elderly age or have some noticeable physical difference live enormously fulfilling lives, unaffected by what they look like. Some women become upset by their body shape changes during pregnancy; other women dontthey actually value those changes. As some people age, they fret over wrinkles and try to erase them with expensive creams and Botox treatments. Others age gracefully and accept physical changes as a natural fact of life. Among people born with a disfiguring condition, some agonize that they dont look normal, yet many others have little difficulty looking different. At the same time, do you realize that some folks whose appearance you may envy are unhappier with their looks than you might think? Your appearance doesnt mandate how you must feel. If youre faced with unwelcome changes or differences in your appearance, know that it is possible to accept these differences. The Body Image Workbook will teach you how to accept your bodyno matter what.
This refers to the need to present oneself to other people, in actions and appearance, as exemplary and flawless. Having this need is likely to lead to excessive investment in ones looks and concerns about being less than perfect. One recent investigation (Rudiger et al. 2007) found that this type of perfectionism leads people to have more body image ups and downs in their day-to-day lives. Of course, the converse is also true; less perfectionism about self-presentation lowers ones vulnerability to negative body image. Let me give you the bottom line about the people who are most resilient to threats and challenges to their body image. First and foremost, they are individuals who are protected by not being overly invested in their physical appearance for their identity or self-worth. In Step 1, they would have scored in the Acceptance Zone for body image investment (i.e., on their Appearance Importance Test). For them, looks arent everything and dont affect everything. This doesnt mean they dont care about how they look, because they do. They enjoy looking nice, as a simple pleasure in their relationship with themselves, but not because they think of life as a beauty contest or because their worth as human beings is dictated by conforming to some societal standard of physical perfection. They keep their looks in perspective and are invested in many other things (family, friends, achievements, work, leisure interests, etc.) for self-fulfillment.
often persist, now separated from the original events that created these feelings. Sometimes these experiences even overshadow memories of events that were truly positive and satisfying during that period. As a result, we just live and react to our current feelingsdisconnected from their formative history. The purpose of Expressive Writing is not to ventilate or get things off your chest. Its aim is to help you create a coherent narrative that tells the meaningful story of your past experiences, along with your emotions about them. The narrative that you will write concerns your body image and the events that you believe have been influential over the course of your life. In writing your story, you will revisit the unfolding of your body image and its difficulties. You will pull together your formative body image experiences into a personally meaningful narrative. Before you start worrying that youll have to write an autobiographical novel, let me reassure you. You will write for only twenty minutes each day over the next four days. You will write in a stream of consciousnessjust letting your thoughts flow, without getting bogged down with a need for correct spelling or grammar. This is not a graded assignment by an English teacher. What is essential is that your writing tells your personal story from your own viewpoint and reflects the guidelines following the Self-Discovery Helpsheet.
Write in the first person (say I and me) and write only for yourself. This is not a letter and is not to be read by anyone but you. Just express yourself honestly. For each twenty-minute session, write at a time and in a place where you have complete quiet and privacy. You dont want to be interrupted by telephones ringing or by distractions from friends or family. Write continuously for twenty minutes without taking breaks. If there are topics that you arent ready to write about yet, dont push yourself to do so. You can always write about them later when you are ready. When you write about specific events that happened, describe the events and express your deepest thoughts and feelings. Dont just focus on negative thoughts and feelings. To tell the whole story, include positive feelings as well. It is not essential to write on four consecutive days. If you need to take an occasional one-day break, thats perfectly fine. However, Expressive Writing will be most helpful if you accomplish all four sessions within a single week. To facilitate your Expressive Writing there are two Helpsheet pages for each session. The first page gives you instructions for that session. At the end of each session, you will answer a few questions about your writing experience. Here are the Helpsheets:
today is tomorrows history, and thats history you can do something about. Taking responsibility for change starts with a two simple realizations: First, you feel what you think. Your judgments and interpretations of events, not the events themselves, govern your emotional experiences. Second, how you mentally and behaviorally react to your thoughts and feelings can either make things worse or make them better. Step 3 will empower you take this responsibility for acceptance of your inner experiences and your body.
ExperiencesConsider Joyces body image experiences: Whenever she thinks about her figure, she gets a sinking, hopeless feeling deep down inside. She is repulsed by the size of her thighs and hips. Whenever her fianc, Jeff, catches a glimpse of her as she emerges naked from the shower, at first Joyce feels intensely self-conscious. Then, she quickly cloaks her body in a towel and is flooded with embarrassment and makes up an excuse to banish him from the bathroom. Her embarrassment gives way to shame and then becomes anger. She is angry that Jeff saw her body so closely, and even angrier with her body for the betrayal. Joyce also routinely locks the bedroom door to get dressed privately, so Jeff wont see her body. She becomes terribly frustrated as she tries to find the right outfit to conceal the curves of her hips and thighs. The struggle to dress to conceal her body is one version of the emotional roller coaster that Joyce rides daily, without amusement. From many painful experiences like these, Joyce has concluded she is both ugly and a hopelessly messed-up person.
The Pivotal Power of Now: The Eyes of the Beholder Belong to YouAt the end of Step 2, I explained that the most important causes of body image problems exist in the here and now. Specifically, your body image emotions are driven by your thoughts. The often subtle and unspoken messages you give yourselfyour assumptions, perceptions, and interpretations decisively dictate your feelings about your looks. Your patterns of relating and interacting with yourself produce a negative body image. You create your own conditioning. Although the seeds of body image distress may have been planted in your cultural and interpersonal history, a negative body image exists and grows in the presence of your mind. Right now, in the here and now, I want to ask you to try something: I want you to think about the aspect of your appearance you like least. Picture it clearly in your minds eye. Now think these thoughts about this attribute: It looks awful. Ugly. Its really ugly. I hate it. I really hate it. Everybody hates looking at it. People think Im ugly. Im really, really ugly. After saying these things to yourself, over and over, for one entire minute, check your feelings.
For many people, this little exercise gives rise to extremely unhappy body image feelings. After only one minute of immersing your mind in such self-critical thinking, you start feeling homely and hopeless. Did this one-minute exercise have a familiar ring to it? Let me further illustrate the pivotal power of human thought by describing an eye-opening experiment conducted by psychologists at Dartmouth University (Kleck and Strenta 1980). The investigators used theatrical makeup to create a facial scar on their research participants before they were to interact face-to-face with a stranger. The stranger worked for the researchers and had been trained to act in a standard neutral way with each subject. What the participants didnt know, however, was the hideous scar had actually been removed before their conversation with the stranger. After the conversation, they were asked questions about how the stranger had related to them. Compared to the control group, who had not been given a scar, the participants who believed they had the facial scar witnessed more discomfort in the strangers behaviorsuch as staring at them or avoiding looking at them at all. They reported experiencing the self-conscious and adverse effects of their facial flaw, even though no flaw existed. Obviously, since there was no actual scar, these people created their own reality. Their experiences reflected what they believed about their looks, not the objective facts of the situation. This fascinating experiment demonstrates a profoundly important truth: The most influential dictators of negative body image emotions are your own ways of judging and thinking about your looks. Many of your thought patterns may have become so automatic and habitual that youre not even conscious of them as they occur. Specific events may trigger these thoughts, but once they start up, the emotional damage follows, which breeds more self-critical ruminations and, in turn, even greater despair. Then, to cope with your self-inflicted distress, you may avoid those people or situations that triggered your cascade of negative thoughts and feelings. Or, you may carry out time-consuming rituals in which you try to fix or hide the flaws in your appearance. Obviously, these self-protective efforts dont fix your long-standing body image problems. In fact, they provide only temporary relief and actually perpetuate your problems. Figure 3.1 Body Image Experiences: Here-and-Now Influences
In Step 2, you learned and wrote about historical factors that predisposed you to create negative body image experiences. Figure 3.1 is an informative flow diagram of the here-and-now causes of a negative body image. It shows the vicious cycle of self-defeating thoughts, emotions, and behaviors. When you develop a different mind-set that breaks this cycle, it becomes possible to overcome a negative body image. You can learn to change your experienceshow you think, act, and feelnow and in the future.
The Body Image Workbook will help you do this, so that your old painful patterns give way as you discover new and satisfying ways to experience your body and yourself.
What is Mindfulness?Throughout your work with The Body Image Workbook , you will cultivate a new mind-set that greatly differs from how you currently think, feel, and act. This new mind-set is one of mindfulness and acceptance. Put most simply, mindfulness is a way of directing attention or awareness. It is a way of consciously and purposefully stepping back and observing your inner experiences in the here and now. Far from being new or modern, mindfulness has been a part of Eastern psychological and philosophical (especially Buddhist) perspectives for centuries. Mindfulness is a central facet of many (but not all) approaches to meditation. Becoming mindful certainly doesnt require converting to a particular religious doctrine. It simply means being open to and practicing a novel mind-set. In recent years, mindfulness has become innovatively integrated into Western approaches to psychotherapy and human growth (e.g., Baer, 2006; Germer, Siegel, and Fulton 2005; Hayes, Follette, and Linehan 2004; Kabat-Zinn 1994; Segal, Williams, and Teasdale 2002). Of course, given the Western commitment to science, mindfulness-based approaches have been subjected to much scientific scrutiny, and theyve been found to provide valuable and enhanced benefits in health promotion and the reduction of psychological suffering (e.g., Hayes, Follette, and Linehan 2004; Marra 2005). I believe that a more mindful orientation toward your body image experiences holds great promise for you.
What Is Acceptance?Acceptance means seeing things as they really are and seeing them in the present moment. A stomachache is a stomachache and it hurts. Feeling anxious or self-conscious or sad or mad are just what they areyour feelings of the moment. Not liking your body in some situation is simply what it is, nothing more and nothing less. Currently, you judge your negative body image experiences. From Step 2 of this program, youve learned how these experiences and your judgments of them came about. In judging, you reach four verdicts: 1. The first verdict equates thoughts and feelings with truth. When you think or feel that youre ugly or fat or physically unacceptable, you judge these experiences as a valid indictment of your body and your self-worth. Of course, they are only thoughts and feelings. They are not evidence of any truth. Acceptance means recognizing that your experiences are merely inner events. You can be objectively aware of these events and see them for what they truly arejust inner thoughts and feelings. 2. The second judgmental verdict deems your inner experiences as intolerable. You judge them by concluding, I cant handle feeling this way (self-consciousness, shame, or anxiety). Acceptance means being mindfully aware of your emotional discomfort and seeing it as familiar and as just discomfort. 3. From the first two verdicts, the third concludes that you must do something or must not do something so that you might escape or avoid this intolerable experience. You tell yourself to
avoid a threatening situation, to modify your appearance in some way, and/or do something else to fix this. Mindful acceptance just witnesses your habitual impulses for self-protective action, but it doesnt require your action. Instead, you objectively observe your impulsive wishes or intentions as internal experiences, as voices in your head. You notice your inner voices and hear what they are commanding that you do or not do, but you dont follow their commands. You simply become aware of them as your experiences. 4. The fourth verdict involves your indictment of yourself as sick, screwed up, hopeless, or a worthless person for having the above-described experiences. You dont accept the experiences and cannot accept yourself if you have them. With the practice of mindful acceptance, you come to see that you give yourself a hard time for having a hard time. You recognize what you are doingthat you add this additional self-loathing layer to your experience. Your indictment of yourself is not evidence of the truth of your negative thoughts. It is only an additional inner voice. Having emotions, including painful emotions, is characteristically human. Emotions can serve as important, potentially adaptive signals to get our attention to process information about something thats happening. When we reflexively seek to turn off the emotion instead of becoming more aware of it, a problem occurs. Another problem arises if we engage in self-defensive maneuvers to prevent our experiencing the emotion in the future. Such efforts, called Experiential Avoidance, turn us against our own mind and against ourselves. Attempts to deny, disregard, deflect, or defend against discomfort ultimately create profound psychological suffering. The suffering is especially intense if we loathe ourselves for our own humanity.
2. Put a second raisin in your palm next to the first. Notice how they look alike. Notice how they look different. 3. Roll one of the raisins continuously between your thumb and index finger. Notice how what you just saw now feels. Feel the crevices. Feel the softness and the hardness and the stickiness. 4. Put the raisin into your mouth, but dont bite into it. Roll it around, feeling with your tongue what you just felt with your fingers. Notice its texture. As you move it around in your mouth, be aware of how it feels in different places in your mouth. 5. Now, bite down once on the raisin. Notice its taste. Bite down again. Notice its changing texture. Swallow it and stay aware of the sensation of the raisin as it slides down your throat. 6. Place the second raisin in your mouth and chew it very slowly. As you keep chewing, notice as the raisins consistency becomes mushy and then even mushier. Take note of how this raisin feels in comparison to the first one. Swallow it when you wish. How did this compare with your usual experience of eating raisins? Body Scan Because your experiences of your body are troubling to you, this second exercise is a really important one. You often live in your body as if it were an esthetic objectsomething that is looked at only from the outside. Now, I encourage you to experience your body mindfully from the inside. Heres how to do that: 1. First, choose a quiet, private, and comfortable place to lie down. Make sure you will not be distracted by the phone, television, bright lighting, or interruptions from friends or family. Once there, lie down on your back and allow your eyes to gently close. 2. Simply become aware of your breathing as you slowly inhale and exhale. Notice your stomach rising and falling with each breath. 3. Then, simply become aware of sensations from your body as a whole. Notice how your body feels. Notice how it feels where it touches your clothing, where it touches the surface beneath you. 4. Focus on the toes of your left foot. Be aware of how they feel. As you pay attention to them, see if you can transfer your experience of breathing to them, as if you are breathing into your toes and breathing out from your toes. Just imagine the sensations of your breathing moving downward from your nose first to your belly and then to your toes. Just focus on the sensations of this breathing into your toes. Allow yourself to experience this. If you cannot, just be aware that this is not your experience. Thats okay. Not having these sensations is your real experience. Theres nothing to judge.
5. Slowly move on, transferring the sensations of breathing in and out to another part of your body, followed by another part, and then another, as you move the flow of your breathing and your awareness to specific areas throughout your body. The aim of the body scan is to mindfully experience in the present whatever occurs. Its not a test. It is a valuable opportunity for you to learn to be mindful and to accept whatever your experiences are, without judging them. I strongly encourage you to give yourself a full or partial body scan for about twenty to thirty minutes a day for at least a couple of weeks. You will see that your capacity for mindfulness will grow. Ultimately, youll see how this capacity can contribute to your acceptance of your body on the outside. Be Mindful of Minutiae You can cultivate mindfulness as you carry out routine chores and tasks in your daily life. These are the things we most often do mindlessly, because they are so familiar or habitual they are on automatic and require no thought. Here are some examples: Sitting and standing Walking around a room, in random directions Climbing and descending stairs Taking a shower Brushing your teeth Sweeping the floor Drinking a glass of water Petting your cat or dog Dressing and undressing Cooking Eating Washing dishes Listening to music Gardening Walking in the rain
Making love By doing these activities mindfully, you will stay focused in the present and on your mental and sensory experiences. If your attention drifts elsewhere, dont judge it. This is what minds do. They wander. So just notice it and then bring your attention back to the activity. These three exercises are just a small sample of ways that you can begin to help yourself create a life of mindfulness and acceptance. Later, in Step 6 of this workbook, youll learn Body-and-Mind Relaxation exercises that can further enhance your mindful acceptance of your experiences. If youre curious, take a peek at Learning Body-and-Mind Relaxation in that chapter. Moreover, in the Recommended Resources section at the end of this workbook, you will find some terrific books filled with useful insights and exercises for the enhancement of mindfulness and acceptance. Right now, I want to introduce a very special activity. It enables you to begin to directly apply mindfulness and acceptance to your body image.
Mirror ReflectionsI once conducted a research survey and asked people, What do you see when you look in the mirror? Here are excerpts from some poignant reflections: What I see I really hate. I hate my thighs. I hate my butt. My mouth is too big. My hair is too straight. I wish I didnt have to spend so much time on my looks. Tomorrow, Ill start working out. (white woman, age twenty-five) What I see is a body I regret to call my own. I wasnt fond of it as a child. I really disliked it as a teenager. My adult years have been filled with constant contempt of my ugly fat body. I would trade it in for almost anything else. (white man, age forty-five) I see a slim, healthy-looking woman, until I look into her eyes. What am I going to do about these bags growing under my eyes? I look pretty good for thirty-two. But what will I see when Im fifty or sixty? Perish the thought! (white woman, age thirty-two) I see an average-looking dude. I wish I was bigger. I wish my hair was thicker. I wish I was a couple of inches taller. Why am I kidding myself? Im less than an average-looking dude. Id settle for average. (African-American man, age twenty-six) I see an old fart. How and when did this happen? (white man, age sixty-three) I see a tall, well-built young man who has a crippling injury of his right hand. If it werent for my deformity, Id be the happiest guy in the world. (white man, age nineteen) I see a gal who looks pretty good. Just dont ask her to take her clothes off. Then youll get another story. But Ill spare you the ugly details. (Hispanic woman, age forty-one) I see a woman who looks like a girl. If it werent for my big nipples Id have no breasts at all. (white woman, age thirty-one) I see a fairly attractive young lady who cant stop thinking about the things that keep her from being a very attractive young lady. (white woman, age twenty-eight) I see a skinny guy with a receding hairline and acne scars. I see a loser! (Hispanic man, age thirty-one)
What I try to see (but cant) is what I dream about being: Rich! Rich enough to afford plastic surgery on my nose, to have my teeth fixed plus a chin implant, to have my makeup and hair done professionally. Then, there are the fashionable clothes. Dream on! Im always going to be a plain Jane. (white woman, age thirty-three) I see a short girl with an hourglass figure, but the sand has all settled on the bottom. (white woman, age nineteen) All I see is a guy in a wheelchair with skinny legs. Unfortunately, I know thats all everybody else sees too. (Asian man, age forty-eight) I see that I need to lose weight. My arms are covered with dark hair that Im always hiding or bleaching. Why cant I be as pretty as other girls? (white woman, age twenty-two) When I look in the mirror, I see nothing. Thats because Im too scared to open my eyes. Sorry. (Pacific Islander woman, age nineteen) I see zits and fat cheeks. Yuck! (white woman, age nineteen) Mirror, mirror on the wall, whos the fairest of them all? It aint me, babe! (Hispanic woman, age thirty-eight) Your Current Mirror Reflections So what do you see when you look in the mirror? Before learning how to apply mindfulness and acceptance, first answer this question based on your characteristic experience of looking at yourself in the mirror. Spend about five minutes privately viewing your reflection in a full-length mirror. Please do this without being overly clothed. For example, even though it may be a bit uncomfortable, view yourself while wearing only your underclothes, after youve taken a bath or shower. Be mindful of what you are looking at, the thoughts that pass through your head, and the emotions you are aware of. Use the following Self-Discovery Helpsheet to record this experience. Your Mindful Mirror Reflections If you are like many people, your experience of looking at your reflection in the mirror is probably biased, judgmental, and mindless. It is biased to the extent that you focus on some aspects of your physical self and not others. A negative body image leads you to focus on whats wrong with your lookswhat you have the strongest concerns about. These are your body image hot spots. Your bias also means that you have blind spots, which are the facets of your appearance that you neglect to focus on in the mirror.
Your experience is also likely to be judgmental. You dont merely observe. You evaluate, and you do so critically. Your inner thoughts may use harsh words. You say fat or ugly or gross or other words similar to those of many of the people I quoted earlier in this chapter. Understandably, this can be a very emotional experience that triggers discomfort, disgust, or despair. Maybe you compare what you see with what you wish you saw. Maybe this leads to thoughts about how you could fix what you see, by changing your body or concealing certain aspects of your body. Maybe you leave the present to recall past disappointments with your body or jump to the future and make predictions about what might happen because of how you are judging your looks. Maybe these judgments and uncomfortable emotions lead you to want to avoid looking at yourself and cause you to retreat from the mirror. Finally, the experience is likely to be a mindless one. You are not merely standing back and objectively observing your thoughts and feelings. You are reacting to them. You are in your mind and not out of your mind. You are not controlling your mind; rather, it is controlling you. Now its time to apply mindfulness and acceptance in an exercise of looking at your reflection in the mirror. This is not a silly little assignment. It is a very important opportunity to begin to change how you experience your body. In fact, scientific studies have verified that this exercise can produce
meaningful improvements in those with body image problems (e.g., Delinsky and Wilson 2006; Hilbert, Tuschen-Caffier, and Vgele 2002; Key et al. 2002). What makes this mirror exposure experience especially significant and helpful is that it actually represents a microcosm of your body image experiences in your daily life. Therefore the exercise is an excellent training ground in developing a new mind-set that you can carry with you everywhereeven beyond the mirror. Ill guide you step-by-step through Mindful Mirror Reflections. Lets do this in four sessions, each separated by one day. Allow about twenty minutes for each session. After each session, use the Helpsheet for Change that follows to summarize your experiences. Mindful Mirror ReflectionsSESSION 1
Use a full-length mirror where you have complete privacy and wont be interrupted. Dress as you normally do. Stand in front of the mirror and for two minutes look at your reflection from head to toe. Rather than zooming in on hot spots or ignoring blind spots, I want you to look at each area of your body. View your body from the front, side, and back. Then, from head to toe describe each aspect or feature of your body. Describe it out loud. Describe it as you would to a blind person who wants to know what you look like, or to an artist who is sketching you without seeing you. Be objectively descriptive, not evaluative or judgmental. Include descriptions of color, texture, size, shape, symmetry, etc. Do not use subjectively critical or exaggerating words (ugly face, gross, dumpy, scrawny legs, bad hair, beady eyes, fat ass, and so forth). If you become aware that you expressed a judgment or criticism, pause to look at the feature again and use a more objective, factual term. Continue to look at your body from all angles. If there are areas or features you are aware of that you left out, describe them objectively and nonjudgmentally. Complete your session by spending a minute silently looking at your total reflection, your body as a whole and not as parts. During this session, be aware of any feelings you experience at the moment that you are viewing and describing a particular feature. Just notice your feelings and briefly describe them aloud (e.g., I am feeling happy or I am feeling anxious). Then simply shift your attention to the next area you will describe objectively.SESSION 2
Repeat everything you did in Session 1. This time move from toe to head, instead of from head to
toe, and again view your body from the front, side, and back. Be sure to attend to both hot spots and blind spots. At the end, spend three minutes silently looking at your body as a whole, not as parts.SESSIONS 3 AND 4
In these two sessions, you will do exactly what you did in Sessions 1 and 2, except that you will dress differently. Wear more revealing attire so that you can see more of your own skin. Ideally, you would be wearing only your underwear. If you are too uncomfortable to do so at this point, then wear shorts and a snug, sleeveless top. In Session 3, youll wear less and follow the instructions for Session 1. In Session 4, youll wear less and follow the instructions for Session 2.
about my body. Being intensely aware of your appearance or deeply immersed in emotion is not self-monitoringits actually part of the problem you want to change. To change, you must develop a more objective view of your experiences. If youve loathed your looks for many years, its difficult to separate the self-hatred from whatever it is about your appearance that you hate. Besides, if youve persuaded yourself that your body is the problem, then your body image miseries will seem justified. You argue, My awful looks make me feel awful. In time, youll see that youre wrong, so bear with me. With time and practice, you can become open, observant, and objective enough to monitor reality and change your self-hating or negative body image experiences.EPISODES
Some people insist that they dont have episodes of body image distress. When the concept is explained to them, all they see is that life is one big, nonstop episode. Allow me to explain what I mean by an episode. Although you may always dislike your nose, your weight, your pear shape, or any other physical attribute, you arent constantly thinking about it, nor are you continually upset about it. Like a sleeping dragon, your discontent is sometimes dormant; other times it breathes fire and belches smoke. Something happens to rouse your dissatisfaction. Then, as you dwell on that something, your emotions are aroused and become especially negative and intense. These particularly troublesome times that enter your consciousness are what I mean by body image episodes. Learning Your Body Image ABCs You probably have experienced some episodes that repeat themselves like a broken record. If that is the case, take some time to recollect several recent episodes of body image distress, particularly ones that you expect to recur. You will identify three elements of each episode and record them in your Body Image Diary. The following three elements make up the ABC Sequence. They are derived from figure 3.1, depicting your here-and-now body image experiences: 1. A stands for the Activators. What events activated or triggered your feelings about your looks? In your diary, youll write down a brief, specific description of the situation and occurrences that immediately preceded your distress. 2. B stands for your Beliefsyour thoughts about and interpretations of the activating events that were going through your mind at the time. Replay the tapethe mental conversation you were having with yourself. How were you viewing the situation? What were you saying to yourself about the events? Recalling your thoughts out of their actual context can be difficult. Remind yourself by filling in the blank: I was thinking ___________ , or I was probably thinking ___________ . 3. C stands for the Consequences of your thoughts and beliefs. How did you react emotionally? How did you react behaviorally? In your Body Image Diary, you will describe the Consequences in terms of the TIDE of the episode. TIDE is an acronym to help you analyze the four essential aspects of consequences that
occur: 1. T stands for the Type of emotion you felt in the situation. Self-consciousness? Anxiety? Anger? Depression? Shame? Disgust? Envy? Embarrassment? A mixture of emotions? Identify the feeling or feelings that you had. 2. I stands for the Intensity of your emotions. Rate their strength at their peak, from 0 for not at all intense to 10 for extremely intense. 3. D stands for the episodes Duration. How long did your distress last? About how many minutes or hours did it take before you felt noticeably better? 4. E represents the Effects of the episode on your behavior. Your actions at this point are often reflexive efforts to cope with or defend yourself against your unwanted emotions. Did you try to get out of the situation? Did you become sullen and withdraw? Did you attempt to fix or conceal the part of your physical self that you were bothered about? Did you take your feelings out on others? Did you take them out on yourself? The more types of emotions you feel with greater intensity for a longer duration and with more behavioral effects, the more powerful the episodelike being caught up in a turbulent TIDE.
five or more recent, past episodes. For each, mentally recreate the experience. Close your eyes and picture the situation. Replay your mental tape of the episodethe triggering events and your thoughts, emotions, and actions. After analyzing the ABC Sequence and Emotional TIDE of past episodes, youll be ready for current, up-to-date self-monitoring. Here-and-Now Self-Monitoring For at least four or five days, monitor any episode as it occurs. Apply what youve learned about mindfulness and acceptance in this Step. Just observe the ABCs as they unfold. Be aware of the situational events that activate your inner experiences. Dont try to change the episode. Just let it flow and observe your experiences without judging them. Listen to the thoughts you have as if they were the dialogue from a movie you are watching. Attend to your emotions. What are they? How strong are they? What do you do or want to do in reaction to these thoughts and feelings? Afterward, as soon as possible, make a Body Image Diary entry.
crawl into a hole and hide. In spite of the fact that they are identical twins, Sherris Private Body Talk was hardly identical: Her Private Body Talk went like this, Gee, I look kind of nice today. I really like this new lip gloss. It makes me want to smile, which shows my nice teeth. This blue shirt accentuates the blue in my eyes. I love blue. Id like to lose a few pounds, but my life wont end if I dont. Besides, my body really feels energized from my workout today and I feel great. Whose Private Body Talk sounds more like yours? Like Kerri, do you torture yourself with a stream of malicious remarks and dire predictions? How derogatory are the dialogues that youve recorded in your diary? To change your self-demeaning Private Body Talk, you must ask another important question: Why do I do this to myself? Why do I carry on such self-disparaging dialogues in the first place? Ill tell you why. To do that, lets go back to the twins and ask this question: Why did Sherri have an inner conversation that gave her confidence and cheerfulness, while Kerris Private Body Talk had nothing nice to say and made her miserable? You might guess that their parents or peers may have interacted more favorably with Sherri than with her sister. Perhaps some people somehow preferred her and praised her looks more. Maybe it stemmed from when she was six years old and their daddy nicknamed her my little chipmunk. Maybe she had a more bothersome bout with teen acne than Sherri did. Maybe Kerri used to have a boyfriend who badgered her to shed weight because he liked the cheerleader look. Maybe, maybe, maybe you could go on forever guessing about the differences in the twins personal histories that forged different Private Body Talk. Youd probably be right in some of your speculations. Its true that disturbing events can have a lasting effect on your body image and how you think about yourself. I suspect that you wrote about some of these personal experiences in Step 2 of the workbook. Such unfortunate events may have taught you somethingsomething that fed upon itself and remains with you still. This something drives your negative Private Body Talk and causes you body image distress. Now, Ill explain exactly what this something is and Ill tell you what you can do about it.
yourself and your self-worth on the basis of what you look like. You probably never stop to question their accuracy. Most likely, you ignore or reject any possible evidence that your Appearance Assumptions might be off base. Appearance Assumptions are your body image rulersin both senses of this word. They are the dictators of your Private Body Talk, and they are the yardsticks by which you measure your physical acceptability. Take a look at the following diagram (figure 4.1). It shows how Appearance Assumptions eventually lead to the emotions you feel that relate to your appearance. Figure 4.1 From Assumptions to Emotions
In Step 1 of the workbook, one of the self-tests you took, the Appearance Importance Test, provided an index of your Appearance Assumptionsyour investment in your looks for self-worth. Go back to your Body Image Profile and see what your results were for this self-test. If you scored in the Risky or Problem Zones, then Step 4 has plenty of help to offer you.
On each self-test, the vast majority of Assumers clearly had more problematic body image experiences than the Doubters did. They were much more dissatisfied with most aspects of their appearance. They more often felt body image distress across a range of everyday situations. They experienced a much poorer body image quality of life, with more adverse consequences to their social and psychological well-being. Appearance Assumption Doubters seldom had a negative body image. They had a more positive, accepting view of their appearance, had episodes of body image distress infrequently, and felt that their body image contributed favorably to the quality of their lives. Assumers Private Body Talk always seems to disrupt their peace of mind, while Doubters are more clearheaded about their looks. Step 4 will enable you become a Doubter instead of an Assumer.
Conversing with Your Assumptions: Your New Inner Voice Self-esteem comes from the ability to experience yourself honestly and accurately. There are two psychological forces that may lead you to play mind games in which you hold a distorted view of yourself and your body image. These forces prevent you from making worthwhile changes. The first is self-deception. Because honest self-awareness can make you uncomfortable with your shortcomings, you may deceive yourself to achieve a false sense of self-acceptance. For example, you may gloss over or deny how demeaning your Private Body Talk is because youd prefer not to think of yourself as so viciously self-critical. A second force that may lead you to play mind games is based on a need for self-consistency. Youve decided that your view of yourself is the absolute truth, so you can see only things that consistently confirm these self-perceptions, however unflattering. For example, you may have convinced yourself that your nasty inner conversations about your looks are the only valid view that could possibly exist. You insist that you should have a negative body image. If this is so, then, obviously, your self-deception and your need for self-consistency will interfere with your being able to change what you need to change to be happier with your appearance and yourself. Cognitive therapy can help you develop honest and accepting self-awareness. This approach teaches you how to find, listen to, and nurture that aspect of yourself that I call your New Inner V oice. This voice speaks in ways that are mindful, understanding, tolerant, fair, realistic, logical, and assured. This New Inner V oice doesnt care where you are on anybodys scale of physical attractiveness. It cares about and accepts you! It doesnt sound a bit like the old critical voice of your upsetting Private Body Talk. Impeaching your long-standing Appearance Assumptions isnt easy. The first words of your New Inner V oice will simply question the validity and value of your assumptions, purposefully challenging their authority over your thoughts and emotions. Each assumption paints a picture, and your New Inner V oice will ask, Whats wrong with this picture? Each is an arguable assumption, containing a bit of
truth and a lot of falsehood. Tackling the ten Appearance Assumptions, one at a time, will make you more aware of the falsehoods and leave you with a more reasonable mind-set. After reading about these assumptions, you will use a Helpsheet for Change to create a New Inner V oice that speaks to each assumption. Assumption 1: Physically Attractive People Have It All Societys preoccupation with and marketing of physical attractiveness reinforces the assumption that being good-looking pays bigger benefits than it actually does. The undeniable truth is that being good-looking is sometimes advantageous. However, as the French author Stendhal asserted in his famous essay on love in 1822, Beauty is only the promise of happiness. Nonetheless, for many reasons, attractiveness doesnt keep most of its promises. There are also plenty of reasons why being average-looking or less doesnt close off opportunities for happiness. To help you challenge Appearance Assumption 1, I want to take a few pages here to explain to you why looks arent everything. These are not reasons that I made up; these are facts established by scientific research on the psychology of physical appearance (Cash 1990; Feingold 1992; Jackson 1992). Fact 1: Beauty is as beauty does. Its true. Actions do speak more loudly than looks. Friendliness, warmth, intelligence, honesty, a sense of humor, and social sensitivity are highly valued human traits, regardless of what you look like. Think about people who are important in your life. Are they all perfect 10s on the appearance scale? Ill bet their looks arent that crucial to how you feel about them. Fact 2: First impressions dont always last . Our initial reactions to someones appearance are not frozen forever in our minds. We come to see good people as increasingly good-looking. Have you ever met a person whose appearance wasnt so appealing, but as your relationship evolved, that persons looks seemed more and more interesting and attractive? On the other hand, have you ever noticed how the halo of physical attractiveness can fade over time? In 1903, playwright George Bernard Shaw aptly observed, Beauty is all very well at first sight, but who ever looks at it when it has been in the house three days? Fact 3: Birds of a feather do flock together . We are often attracted to people who are similar to us in certain ways. For example, we seek out those with shared interests, ethnic heritage, religious or political values, and educational background. This is sometimes true of physical appearance as well. Many times, best friends, dates, and mates are comparable in physical attractiveness. This pairing off based on similarity of attractiveness has the fortunate result that nobody gets left out. Fact 4: Beauty can backfire by implying egotism. Appearance Assumption 1 ignores the ugly faces of beauty. Paradoxically, the assumed advantages of physical attractiveness can cause disadvantages. If we believe that good-looking people are desirable and reap social benefits, we may also think that they are well aware of their good looks and their privileged status. So we infer that they must be self-absorbed and opportunistic. Then, we may assume they are less responsible or trustworthy as friends, romantic partners, or parents. This negative (and false)
stereotype of attractive people can complicate or cancel the benefits of their looks. Fact 5: Beauty can backfire because of sexism. Another factor that undermines the power of attractiveness is sexism. Pretty women are sometimes presumed to possess feminine personality traits, such as passivity and emotionality. Handsome guys are sometimes thought to have masculine characteristics, such as a dominant personality and a low emotional IQ. Although these stereotypes are untrue, such sexist biases about physical attractiveness erode some of its positive power. Fact 6: Beauty breeds envy and jealousy. The eighteenth-century historian Edward Gibbon once said that beauty is an outward gift which is seldom despised, except by those to whom it has been refused. Have you ever heard anyone exclaim, They are so good-looking (or thin, or well built). I hate them? When we compare ourselves to people who have the looks we idealize, we usually end up feeling worse about our own appearance and then we dislike these good-looking people for making us feel unattractive. My own research has concluded that people who are highly invested in being physically attractive are more likely to distrust and disparage goodlooking people of their own sex. Fact 7: Beauty can transform people into sex objects. In a well-known popular song, Rod Stewart posed the question Do ya think Im sexy? Although most of us want our romantic partners to find us sexy, few of us enjoy being seen solely as a sex object by everyone we encounter. Good-looking people, especially women, are often subjected to unwelcome sexual comments about their bodies. These remarks are frequently demeaning and harassing. Would you really want to be seen as only a sexy body or a pretty face? Fact 8: Beauty can foster self-doubt. Fact 7, above, gives rise to another problem for attractive people: They may think that people are nice to them only because they are attractive. Allow me to explain this by repeating a conversation I once had with my longtime friend, Nancy, who is strikingly lovely. One day, I complimented her, telling her how beautiful I thought she was. To my surprise, she became very upset and said, I thought you liked me for who I am. Now, Ill never be sure that its not just because of what I happen to look like. Nancys point poses important questions. Wouldnt you rather know that people like you because youre a splendid person and not merely because youre nice to look at? Wouldnt you rather feel that you deserve the recognition you get than have to wonder if somebodys being nice to you just because he or she is enchanted with your looks? Fact 9: Beauty is a weak foundation for self-esteem. The more people invest in a beauty bank, the more vulnerable their self-worth becomes. So, contrary to Appearance Assumption 1, good-looking people dont have it all, if it all rests on being attractive. Time and life events alter ones appearancefor better or worse. A foundation for self-worth built on beauty is a shaky foundation indeed. Fact 10: Looks dont matter to everybody . The nineteenth-century poet Robert Southey wrote, How little do they see what is, who frame their hasty judgments upon that which seems. We all know nearsighted people who judge others solely on appearances. Fortunately, however, there are many people who arent swayed by whether were fat or skinny, dressed to the nines or
wearing our comfy but sloppy clothes. They dont expect us to look perfect. They see us and appreciate us for who we are. We should all try to become more like these terrific appearanceblind individuals. They make our world a more just and accepting place. Changing a negative body image requires that you seriously question Assumption 1 and keep your looks in perspective. Your New Inner V oice will remind you that beauty is a mixed bag that contains many false promises. In the absence of a positive body image and solid self-esteem, good looks arent worth much. Relinquishing stereotypes and pursuits of physical perfection will free you to embrace many opportunities for appreciating yourself. Assumption 2: My Worth as a Person Depends on How I Look This important assumption is really at the root of the body image problems of many people. It asserts that your physical appearance is the only or the most crucial aspect of everything that you are. You believe that you are defined by your looks more than by all the assets of your personality, your actions, or your experiences. This belief can lead you to minimize your many fine qualities that have nothing to do with your looks. It can lead you to spend huge amounts of time thinking about or worrying about what you see when you look in the mirror, as well as countless hours trying to create or enhance the looks that you deem essential to your self-worth or social worth. This is a dictatorial assumption that you must challenge! How? Mindfully take inventory of all the other aspects of yourself that represent who you are. What are the qualities you possess that you really are happy about? What are your attributes that people who know you value? For example, are you funny? Are you kind, considerate, and emotionally open to others? Are you a good listener? Are you quite knowledgeable about certain topics? What do you like about yourself? You need to start hearing your New Inner V oice say, Instead of what I look like, its really my caring attitude, infectious sense of humor, devotion to family, competence at my job, conversational skills, ethics and morality, dependability, and so on, that reflect my special worth. In other words, you need to begin to recognize that your looks are less important in defining you than many other attributes of yours. Assumption 3: I Should Always Do Whatever I Can to Look My Best The words should and always imply that looking your best is your duty and that by not looking your best you have failed. Ask yourself the following questions about this assumption: First of all, why have you saddled yourself with this obligation? What do you expect will happen if you can look your best on all occasions? What might happen if you cant? Looking your best is extremely subjective, so how will you know youve performed your duty? Who can possibly look his or her best all the time? Because we can always imagine ways we might look better, this assumption sets you up for failure by requiring the impossible. Do you require other people to have the best imaginable appearance at all times? Would you be so harshly judgmental if a friend wore less than perfectly flattering clothing, had a hair out of place, or got a zit? I hope not. Nor do I hope
that you would tolerate such a demanding expectation from a friend. So why should you demand this of yourself? Its nice to feel that you look nice; its not nice to feel that you always have to. Your New Inner V oice will speak out against perfectionism: I enjoy liking how I look, but I could loosen up some. I dont have to look perfect all the time. When I look less than my best, nobody ever commands me to look betternobody but me! Im the one pressuring myself. Im the one giving myself grief! I need to do whatever I can to accept my looks. Its okay to look acceptable, rather than look exceptional. Assumption 4: The First Thing That People Will Notice About Me Is Whats Wrong with My Appearance Again, this is only a partial truth. Heads will turn if you have spiked orange hair, a large pierced nose ring, or a likeness of Bugs Bunny tattooed on your forehead. But then, you probably want others to take notice. What about having physical characteristics that are not of your choosing? Heres what you must realize in questioning Assumption 4: If youre obese or have a pronounced physical disfigurement, few folks will fail to notice. Thats the reality of human nature. We all notice what people look like. But, so what? Just because others are aware of this doesnt mean that theyll despise or mistreat you, or that your life is ruined. Your own actions are up to you. Your personalityyour friendliness, good humor, kindness, conversational skills, and so forthis much more influential than whatever might be wrong with your looks. Assumption 4 is false about most people most of the time. What is true is that you are the one observing what you dont like about your appearance. Other people usually couldnt care less. Theyve got other things to think about. Of course, if they, too, have a negative body image, theyre probably busy being self-conscious and worrying that you will notice their physical imperfections. Your New Inner V oice will help you keep things in perspective. It will be saying, So what if people notice that Im short, or heavy, or balding, or have a facial scar, or whatever? What difference does that really make? Life goes on! Im a pretty likable person. People tell me they like me because Im . Assumption 5: If People Knew How I Really Look, They Would Probably Like Me Less Assumption 5 is akin to Assumption 4, as both reflect your belief that people are judgmental about your looks. For Assumption 5, however, you believe that others would judge you harshly if they only knew. This assumption breeds shame. Believing it will force you into hidingto conceal those aspects of your physical self that you think other people find repulsive. You worry about what you assume to be the hidden or naked truth. The problem with this assumption is that it becomes an untested truth. Disproving Assumption 5 requires that you test it. Hiding only makes you feel worse. A client of mine, a college student named Harriet, did this program. She had always been ashamed of her thick legs and was convinced that anyone who saw them would stare at them in
disgust. So she always wore long pants. Finally, one hot day when the program was ending, she conjured up the courage to bring her legs out of hiding and wear shorts to school. She saw me walking across the campus and approached me. Look, Im wearing shorts! Harriet exclaimed. So far, nobodys run away in horror. I cant believe I avoided doing this for so long. Try this indirect test: Ask yourself how often you stopped liking someone upon discovering some imperfection in his or her appearance. How often have you said or thought something like I didnt know that Matthew has an appendectomy scar. Ill be sure to avoid him from now on? Or, Now that Ive seen Sharon without her makeup on, I have no more use for her? Or, Beckys breasts are smaller than I first thought they were, so thats the end of our relationship? In Step 6, Ill help you come out of hiding and test this assumption directly, as Harriet did. Once we test the assumption, we typically find that we have been mistaken all along. People accept us, flaws and all. And that feels so much better, and so much more real, than hiding. Your New Inner V oice will help you keep matters in perspective. You are the one who is uncomfortable with your physical feature. Its your own shame, not somebody elses judgment. If people knew how you really look, their opinions would not, in fact, change. Everyone else would be more accepting of you than you are. Your New Inner V oice will coax you out of hiding. Listen to it. It will say something like I worried that Id be rejected and hurt if people knew how I really look that if they saw what I dont like about my body, theyd be revolted and Id feel bad. But all my worrying makes me feel bad. Would I really feel that much worse if I stopped concealing what I look like? Is it possible that Im making this into a bigger issue than it really is? Assumption 6: By Managing My Physical Appearance, I Can Control My Social and Emotional Life You have tremendous control over your looks. Consider all the available tools for managing your appearanceclothing, cosmetics, jewelry, hairstyling, hair-coloring, a healthy diet, regular exercise, and sensible skin care. Good grooming can certainly enhance your looks and make you feel attractive. The hazard, however, comes from relying excessively on these tools and believing that they are necessities instead of niceties. In arguing with Assumption 6, you must start to see that you cannot effectively manage your selfesteem and your life by asking your appearance to do all the work. Just as a carpenter cannot construct a house with only a hammer, you cannot build a happy life using only your looks. Appearance management works only if it improves your body image. Stylish clothes are useless if you dont like how you look in them. Moreover, as you saw for Assumption 5, if all the clothes do is cover parts of your body that you dislike, they arent really helping your body image. Depending on clothing for damage control only reinforces your belief that your unadorned body is objectionable.
Review your own experiences for evidence that contradicts Assumption 6. If all your appearance-managing efforts to control your social and emotional life are so effective, then why do you still have a negative body image? We can reword Assumption 6 and make it truer; for example, By changing my body image, I can better control my social and emotional life. What will your New Inner V oice say to help you modify this faulty assumption? It will say, Spending too much effort trying to fix my looks is misdirected effort. Constant repairs on my appearance are only a temporary Band-Aid. Im still unhappy with my looks. I want to feel better permanently. So, I need to focus on changing my mind instead of my looks. Thats a change that will give me more control over my life. Assumption 7: My Appearance Is Responsible for Much of What Has Happened to Me in My Life Yes, your appearance has affected some things in your life. At times it paid off, and at times it was a detriment. Nevertheless, most things that have happened in your life had absolutely nothing to do with your looks. Most were either the product of your personality, intelligence, decisions, and actions, or were simply the result of chance or another persons actions. History demonstrates that attractiveness is not a prerequisite for success in most endeavors of life other than certain media, performance, or modeling roles. Abraham Lincoln, Winston Churchill, Mikhail Gorbachev, Henry Kissinger, and former New York mayors Ed Koch and Rudy Giuliani wouldnt exactly qualify as handsome hunks. Golda Meir, Eleanor Roosevelt, Margaret Thatcher, and Mother Teresa would be unlikely winners of a beauty contest. What widely respected leaders from world history, the arts, or literature can you think of who were not, in your opinion, good-looking? Of course, if you choose your heroes or heroines only from movies or other parts of the media culture based on their physical attractiveness, you are not selecting fairly. Most people weve personally known who have meaningfully touched our lives arent necessarily great-looking. Can you think of individuals whom you have loved or admired for reasons that had nothing to do with their looks? This is not a rhetorical question. I really want you to think about it. Your New Inner V oice argues against Assumption 7 by realizing and saying, My appearance may have influenced some things in my life, but ultimately, Im responsible for my life. I can make choices about how I deal with any effects that my looks have. Though my history has already been written, my present and my future are up to me, not to my appearance. Assumption 8: If I Could Look Just as I Wish, My Life Would Be Much Happier The trouble with Assumption 8 is its implication: Unless I can look the way I want to (that is, taller, thinner, more muscular, less wrinkled, or with a straighter nose), theres no way I can be happy. What makes you unhappy is not your physical appearance. Its your wish that sells you short and robs you of self-acceptance. Challenge this assumption in these ways:
Remember this scientifically established truth: Physically attractive people are not necessarily happier than less attractive people. Good-looking individuals have their body image wish lists too. Have you ever had experiences in which the more desperately you wanted something, the less you appreciated what you had? To justify your wishing for the new you have to berate the old. Your burning desires destroy your ability to enjoy what you have. Wishing magnifies your discontent, which you believe can be resolved only by getting what you wish. Your New Inner V oice can put you in touch with reality. It reminds you that your goal is to achieve a better body image, not to have a different body. Listen to your New Inner V oice say, I realize that my appearance doesnt really prevent me from being happy. I do know this: I make myself unhappy trying to look like my idealized image. I cause myself despair by beating myself up for my wishes not coming true. Once I learn to accept my looks, my life will be much happier. Thats up to me, not my body. Assumption 9: My Cultures Messages Make It Impossible for Me to Be Satisfied with My Appearance With this assumption, you make yourself into a victim. Poor me! So youve come to feel powerless? Then, whats the use in trying to change your negative body image? Okay, its certainly true that the cultural media convey powerful and unhelpful images and messages about physical appearance. They try to convince you there are only two ways that you can be happy and succeed in life. Either you must be born with good looks or you must buy all the products and services needed to manufacture physical perfection. Lets take a closer look at Assumption 9: Genius isnt required to recognize how extreme and distorted these messages are. If they were all-controlling, no one would have a positive body image. And some people do like their looks despite these unhelpful forces. Thats because they know that personal fulfillment does not require physical perfection. Do you know what is certain to be much worse than not being a perfect 10? Its worrying about not being a perfect 10. The media and the huge appearance industry certainly make it difficult to accept your body, but difficult isnt the same as impossible. They are indeed a brainwashing force to be reckoned with, but they are not aiming a loaded gun at you and commanding you to believe and do everything we say, or else! What you believe and what you do is entirely up to you. Think about it. So what do you do? A character in the movie Network proclaimed the medias injustices by yelling from a rooftop to the passive public below, Im mad as hell, and Im not gonna take it anymore! You dont have to take it anymore either. Should you trash your television and cease reading magazines or watching music videos? Should you boycott all appearance-altering products and services? Probably not. Our society could certainly use improvements, but the best place to start is within yourself. Your own Private Body Talk does not have to echo the medias appearance-preoccupied voices. You dont have to be a victim. Body-accepting individuals
have learned how to see these cultural messages as distorted and irrelevant and to tune them out. Your New Inner V oice will be assertive and will empower you not to take it anymore. It will say, Im tired of expecting myself to look like all these perfect bodies in the media. Seeing them isnt believing them. Im not them and I dont have to look like them. Im going to work hard to accept myself. The media dont make it impossible for me to accept my looks. I do. Assumption 10: The Only Way I Could Ever Accept My Looks Would Be to Change My Looks This is one very self-defeating assumption! It drives people to try just about anything to alter or correct their appearance. My new clients often want me to help them lose weight or refer them to a cosmetic surgeon. They believe that only then would they have a positive body image. When I suggest that we should first work on body image and then decide about weight loss or surgery, they look at me with disappointment and disbelief. They think I dont I understand what they need so that they can be happy. I understand the basis and power of Appearance Assumption 10. If something is broken, fix it. So, you go on a diet again, work out a lot, buy new clothes, get a different hairstyle, use the expensive wrinkle product, or have cosmetic surgery. Maybe youve done some of these things, and some even felt pretty goodfor a while. But if all the fixes still havent repaired how you feel about your looks, ask yourself the obvious question: Whats really broken? Whats not working here is your body image, and thats what needs fixing. Research I described earlier in this workbook confirms that you can improve your body image without altering your body. Heres the corrected version of Assumption 10: The only way I could ever like my looks would be to change my body image. Tackle Assumption 10 head on! Your New Inner V oice urges you to shift your emphasis: Say to yourself, Ive spent too much of my life trying to change my looks. What I need to do is focus on the real problem and real solutions. Fixing my appearance feels good at the moment, but it doesnt last. I just keep looking for more ways to be better-looking. The best way that I can like my body is to work directly on my body image. Thats really the problem I need to fix.
needs to speak more clearly and forcefully. And then you can listen to it and hear it. Heres how: The following ten Helpsheets for Change: Arguing with My Appearance Assumptions, will help you to develop and nurture your New Inner V oice. Use your own words to talk to yourself about each arguable assumption listed. Read over the arguments against each assumption that Ive discussed above. Think hard about other possible arguments. Dont expect to believe everything you write. Write down what you want to believewhat sounds healthier, more rational, and more accepting of yourself. On the Helpsheet for each Appearance Assumption, begin by (1) noting how the assumption influences what you pay attention to, (2) what automatic thoughts run though your mind, and then (3) how you feel. Finally (4) write out your arguments against each Appearance Assumption, even those you didnt check earlier in your Self-Discovery Helpsheet as statements you find true or mostly true. After putting your words into writing, read them out loud to yourself. Next, try to find ways to express your New Inner V oice to other people, including those who know about and support your efforts to develop a more positive body image. If we convey these new, desired beliefs to others, the beliefs are more likely to become our own. At first, your New Inner V oice may seem foreign to youlike somebody else talking. Thats okay; thats understandable. Each day, take a few minutes to reread your words aloud. Soon this voice will begin to sound familiar and the wisdom of your New Inner Voice will become self-evident.
leads you to disregard the shades of gray, and to make exaggerated conclusions about your looks. Distortion 2: Unfair-to-Compare The Unfair-to-Compare Distortion involves pitting your appearance against some unrealistic or extreme standard. When you compare yourself with these standards, you make yourself the loser. Magazines, newspapers, movies, television, music videos, and the Internet hit you so heavily with societys ideal images that you cannot escape being aware of them. Mere awareness isnt the problem, however. When you personally absorb these images, that is, when you accept societys standards as your own, you become vulnerable to the societys unreal idealscomparing provokes despairing! Gauging your physical worth by unrealistic ideals can cause you to fixate on your inadequacies. You focus on what you dont look like and on what you dont like about your looks. You engage in wishful thinking: I wish I had thicker hair. I wish I were really thin. I wish I had a bigger chest. Your Private Body Talk will also be loaded with what I call too thinking. Im too short (or too fat or too this or too that). Thumbing through certain magazines, seeing some ads on television, and watching certain videos may lead you to mentally compare your appearance with how the models look. Unless youre also airbrushed or digitized to perfection (and perhaps even if you are), chances are youll conclude that you dont measure up to the models. This Unfair-to-Compare Distortion may take you beyond the media and mental images of perfection. You may also compare your appearance with that of real people you encounter in everyday life. However, your comparison is skewedmade only with people you judge to have the physical qualities that you wish you had. Obviously, your thoughts are biased against you from the very start. You play the comparison game, but with the rules you choose, you always lose. If you always compare yourself to a taller standard, you can only come up short. The Unfair-to-Compare Distortion is unfair in another respect. Rarely do people pick just any physical characteristic for comparison. Its typically the one you like least, the one that bothers you most. In this way, you add insult to insecurity and make your insecurity that much worse. Which Appearance Assumptions that you discovered in Step 4 instigate this distorted Private Body Talk? Assumption 1, Physically attractive people have it all, heralds good-looking people as winners, so you make them a standard for self-evaluation. Assumption 8 maintains that if I could look just as I wish, my life would be much happier. This underlying belief keeps you reviewing your ideals to see if you should be happy yet. Similarly, if Assumption 3 commands you always to look your best, youll compare your looks to some notion of best and find ways youve not met the lofty expectation. Finally, theres Assumption 9, which complains, My cultures messages make it impossible for me to be satisfied with my appearance. But then, you empower these media images by comparing yourself to them. The ruminations on this mental mistake are terribly self-critical and use words like should, must, and ought; for example, I should have a clearer complexion or I ought to have a smaller waist. Furthermore, when your comparisons are with actual people, not only do you have negative feelings toward your body, but you may also experience envy and jealousy toward the people with
whom you compare yourself. If you think, They make me look bad, you become intimidated. You may try to avoid them, or gossip about them, or retaliate by giving them unwarranted grief. After all, if you could take them down a notch or two, you might be able to feel more adequate yourself. Obviously, the Unfair-to-Compare Distortion becomes unfair to everyone. Distortion 3: The Magnifying Glass The Magnifying Glass Distortion represents what psychologists call selective attention. You focus on an aspect of your appearance that you dislike and then exaggerate itas if youre putting your body under a magnifying glass. You commit this mental error when you cannot contemplate your looks without zooming in on this one disliked feature. All you see is one huge flaw. You equate your entire appearance with your squinty eyes, chipmunk cheeks, knobby knees, or bulging butt. Your Private Body Talk is defective because all it talks about are defects. Your inner dialogues repeat themselves like a broken record. Youre tired of hearing it, but you still keep playing it. The Magnifying Glass Distortion entails underemphasis as well as overemphasis. It involves a blind mindas you ignore or minimize your positive physical qualities. The Magnifying Glass mistake prevents you from appreciating the very features that others find most attractive about you. For example, in his Private Body Talk, a man with a handsome face says, Oh, sure, my face is fine, but who the hell cares? Just look at this flabby mess of a body! One reason that some people commit this distortion is a fear of being seen as vain. They may be afraid that being pleased with their own looks would necessarily mean that they are conceited. So, if they ever catch themselves having a positive perception of their looks, their Private Body Talk zaps them with guilt and orders them to change the subject. Most often, however, this distortion derives from the bad habit of focusing on what is seen as a body image threat. Distortion 4: The Blame Game The Blame Game Distortion happens when you incorrectly conclude that some disliked physical attribute is directly responsible for certain disappointments and difficulties that you experience. This psychological phenomenon is called scapegoating. You need to blame something for your troubles, and because you already see your appearance as offensive to you, its the convenient target. Distorted Blame Game thinking goes like this: If I didnt look so ___________ , then something (bad) wouldnt have happened. If you dont get the job or the date or the social courtesy you wanted, you readily point the finger of blame at your appearance. Your Private Body Talk alleges that your looks have stolen something you had hoped for. Your appearance stands accused, without a shred of solid evidence. We know that a persons looks sometimes can affect life events. Being 6'8" will benefit an individual in the basketball tryouts relative to someone who is 5'7". The pretty blonde might be shown favoritism in her bid to get a public relations job. It is unfortunately true that obese individuals and those with disfiguring conditions are sometimes treated unfairly in our society. In the Blame Game, however, even in the absence of evidence, people scapegoat their appearance for any problems that may arise. After a social disappointment, its natural to try to figure out why things happened as they did. Its clearly wrong, however, to jump to the automatic conclusion that your appearance is responsible for your disappointment.
Why are you so accusatory of your looks? Well, in Step 4, did you endorse Appearance Assumption 7the basic belief that your appearance is responsible for much of what has happened in your life? If so, then you probably play the Blame Game often. This assumption falsely establishes a criminal record for your appearance and predisposes you to scapegoat your looks in your Private Body Talk. In the self-test for this distortion, I asked you to imagine going to a party and meeting someone you find attractive. This happened to Terri, who was upset when the dreamboat left the party with another woman. Terris Private Body Talk blamed her own appearance: It was my flat boobs and dumb curly hair. Whod be interested in me? I look like a stalk of broccoli! She concluded, Its my bodys fault that he left with someone besides me. My looks arent good enough. What Terri did not know at the time was that her heartthrob had left the party with his sister. Distortion 5: Mind Misreading Mind Misreading leads people to reason that if I think I look bad, others must think I look bad too. They see me exactly as I see myself. The truth is other people may have entirely different ideas. Psychologists call this faulty mental process projection, because we project our own beliefs or thoughts into the minds of others. In the example above, Terri also committed Mind Misreading by inferring that the fellow at the party had thought she was goofy-looking. That was her own evaluation of her appearance, which she projected into his mind. Mind Misreading and Blame Game Distortions often go hand in hand. To blame your looks for how people react (or dont react) to you, you have to presume what those people must be thinking. Appearance Assumption 2 may propel this distortion. If you assume that your worth is defined by your looks, you place undue importance on what others may think about your appearance. If you also buy into Assumption 4, that the first thing people will notice about you is whats wrong with your appearance, youre ready to misread their minds at a moments notice. If youre worried about your weight for example, your Mind Misreading says, They see how overweight I am and think Im a fat slob. Distortion 6: Misfortune Telling The Blame Game and Mind Misreading involve inferences about past and current events. The Misfortune Telling Distortion pertains to your predictions about how your appearance will affect your future. You predict that your physical shortcomings will have dreadful effects on your life. This may influence your expectations in short-term situations (i.e., People at the gym will stare at me and snicker) or in the long-term (i.e., With my looks, Ill never be taken seriously in my workplace). Misfortune Telling uses extreme words such as never or always when you anticipate how your looks will be a detriment. For instance, you may think, With my homely face, Ill always be unloved or I look so old and wrinkled that Ill never get promoted. Such sweeping expectations encompass what everybody will think about you and how they will act toward you. Face itlife and people are much less predictable than this. What Appearance Assumptions fuel Misfortune Telling? Assumption 8 says that if I could look just as I wish, my life would be much happier. So, the converse of Assumption 8 leads to the
Misfortune Telling Distortion that unless you look exactly as you wish, your life will never be happy. And, of course, an implication of Assumption 7, which states that your appearance has adversely affected your past, is that your looks will surely mess up your future, too. Misfortune Telling permeates your Private Body Talk with gloomy, pessimistic predictions. Distortion 7: Beauty Bound The Beauty Bound Distortion is reflected in Private Body Talk that says you cannot do certain things because of your looks. This distortion imprisons you. When you limit your activities and aspirations because of your negative body image, you become its prisoner. Typical Beauty Bound thinking begins with the words I cant. You forbid yourself to go places, do things, or be with certain people because you think you dont look good enough. You tell yourself you cant wear particular styles or colors of clothing. You deny yourself certain social or recreational activities. Your I cant thinking usually takes the form of I look too ___________ to do that. Sometimes, the prohibitions are temporary: Until I get a tan, I cant go to the beach or Until I lose ten pounds, I cant go dancing. Other times, the Beauty Bound prohibitions are permanent: With my hairy arms, Ill never be able to wear short-sleeved shirts or With my ugly body, I should never have sex. Notice how the various Body Image Distortions often team up to create your troubles. Beauty Bound seldom operates alone. For example, a woman who decides I cant go to the office picnic because my hair looks weird is restricting her activities (Beauty Bound thinking) because she tells herself that people will snub her because of her looks (Misfortune Telling). A man whose Beauty Bound thinking dictates Im too fat, so I cant eat in front of other people is also Mind Misreading when he concludes that others will judge him as a fat man who always overindulges with food. Beauty Bound beliefs are fueled by several Appearance Assumptions. Return to Step 4 and reread Assumptions 5, 6, 8, and 9. Can you see how each of these assumptions can lead you to constrain your freedom of choice in living a fuller life? Distortion 8: Moody Mirror The Moody Mirror Distortion reflects what psychologists call emotional reasoning reasoning based purely on feeling. You start with a strong emotion that you need to justify. You end up with a faulty conclusion that justifies and may even strengthen the emotion. The Moody Mirror mistake has three variations. In its first form, your initial emotion is a negative feeling about your looks. You notice it and you ask yourself, Why do I feel so unattractive? Then, with very little thought, you readily answer the question, Its because I am so unattractive. This version of the Moody Mirror Distortion follows the not-so-brilliant logic that because I feel ugly, I must be ugly. Heres an analogy: Imagine that you and a friend are on a leisurely walk through the park. All is serenethat is, until your friend wonders aloud if any snakes might be lurking about. Not being especially enamored of such creatures, you notice your heart is galloping. You also notice plenty of places where these reptiles might be hiding. There are logs where they could lie in wait for you. There are low-hanging branches from which they could launch an aerial assault. This park is viper city, you conclude. There must be hundreds slithering about. Lets get out of here! Your fear leads you to decide that snakes must be there somewheredespite having absolutely no evidence of them!
You reasoned from your fear, inferring facts that may not be true from your feelings. Can you apply this analogy to the Moody Mirror Distortion? Your Private Body Talk is an emotional dialogue that confuses feelings with facts: No wonder I feel so ugly, just look at me! Look how ugly and ___________ (fat, or short, or beer-bellied, or bald, or pale skinned ) I am! A second but related form that the Moody Mirror Distortion can take occurs when feelings of unattractiveness about one physical characteristic spill over to other features. Operating on the faulty principle of guilt by association, your Private Body Talk searches for guilty parties. As it zeros in on some unacceptable attribute, you feel unattractive and dissatisfied. Then you ask yourself emotionally loaded questions: Just how ugly am I? or What else is wrong with my looks? In answering, your mind is like a bug zapper that zaps anything coming its way. You annihilate one physical feature after another, feeling uglier each time. And the uglier you feel, the more you notice or create any imperfection in order to justify your feelings. In the third manifestation of the Moody Mirror, you start with negative feelings about something unrelated to your looksfor example, being stressed out or in a bad mood. Then, the wildfire of your bad mood spreads and ignites your body image experiences. How can this happen? Your brain stores various Private Body Talk tapes that it plays and replays, producing predictable emotions. These tapes remain on pause until something switches them on. Negative emotions can set off these dormant dialogues, especially those tinged with a similar emotion, such as shame or anxiety. So your nasty mood seeks a ready target, and you unfairly malign your appearance. The Moody Mirror just looks for troubleand really stirs it up.
and self-defeating ways you think about your looks. Cognitive therapists have developed highly effective strategies for changing the way you think about your experiences. These strategies are called cognitive restructuring or corrective thinking . Because corrective thinking can be difficult to learn in the midst of a distressing episode, youll develop your corrective thinking ahead of time. Then, with a little practice, youll be ready to apply what youve learned to alter your Private Body Talk in your daily life. On the following pages, well take aim at each of the eight Body Image Distortions, one at a time. Ill give you plenty of examples to show you exactly how to talk back to your distorted Private Body Talk. Heres what you need to do: First, go back in this chapter to your Thinking About Your Thinking self-test. If your score was anywhere between 1 and 4 for a particular distortion, read the specific items you found to be characteristic of your own thought patterns. Next, as detailed in the exercises below, read about disputing each distortion that is characteristic of how you think. If your score for that distortion was between 2 and 4, its one youll really want to work on. Underline or take note of anything in the exercises that hits home or seems potentially valuable. Afterward, it will be your turn to take aim, with the aid of the Helpsheet at the end of the section on each specific distortion. Based on your review of your self-test answers, pick a familiar scenario that causes you the most problems and reflects this particular Body Image Distortion. On the Helpsheet, write down the typical Activators of your body image distress. Write down the words of your Private Body Talk that commit this mental mistake. Include your beliefs, self-statements, and interpretations that reflect the distortion. Finally, talk back! Based on the discussion and examples of how to dispute the distortion, compose the narrative of your corrective thinking that will take issue with your distortion. Please understand that this isnt osmosis therapy, in which you decide that just absorbing my words will be as helpful as finding your own voice. Because your New Inner V oice must talk back with your chosen words, you need to spend the small amount of time required to put your words on paper. In doing so, you are mindfully discovering, dissecting, and disputing the personal inner causes of your body image difficulties. Correcting Your Beauty-or-Beast Distortions Remember, Beauty-or-Beast thinking is either-or thinking: Either Im attractive or Im homely. Either I lose ten pounds or Im fat. Some people have it and some dont; I dont. Here are some ways to dispute such dichotomous, black-or-white ways of thinking:
Force yourself to see things on a continuum. See the shades of gray. Remind yourself that not being a 10 on a 10-point scale of attractiveness doesnt necessarily make you a 1. Say to yourself, Okay, so Im not totally perfect; but Im not totally imperfect either. I have features that enhance my appearance. Then, remind yourself of these physical assets. Ponder how you think about other peoples looks. Do I judge others with only two extreme categories? Or do I see them on a continuum? If the latter, ask yourself, Why should I view other people more fairly than I see myself? Eliminate the loaded language of your thoughts by being more objective. Replace I have a horsey face with I have a long nose. I have potholes for my complexion is, more objectively, My complexion isnt smooth. Replace Im a damned scarecrow with I have a thin physique. Hippo hips becomes rounded hips. Im a chrome dome should be I have hair loss. Ask yourself, Honestly, what is the evidence, other than my own harsh judgments, that Im seen as extremely homely? Ask, What is the evidence to the contrary? Think about compliments you receive. Think about those occasions in which you felt pleased about some facet of your appearance.
Correcting Your Unfair-to-Compare Distortions The Unfair-to-Compare Distortion comes in three forms. You pit your appearance against your own personal ideals, the media images of physical perfection, or people you find good-looking whom you encounter in everyday situations. So, you compare your appearance only with images of what youd like to have. As a result, you spend a lot of time noticing others who you think look better than you do. And, not surprisingly, you end up feeling unattractive. This distortion fills Private Body Talk with words and phrases like should, ought, must, or I have to be. Shame, envy, and intimidation arise from unfair comparisons. Examples of faulty Private Body Talk here are I should be more attractive, or I wish I were as attractive as that person is, or That person makes me feel so ugly. Seldom do you notice that there are few people who come close to meeting your ideals for yourself. Corrective thinking for this distortion first recognizes what youre doing. It catches you in the act of comparing yourself with somebody, leaving you upset about your looks. Use the following suggestions to let your corrective thinking set you straight:
Replace shoulds, musts, and oughts with less demanding language. Instead of saying, I should be better looking, taller, thinner, or , correctively assert, It might be nice if I lost a few pounds, but I look pretty good the way I am. I refuse to belittle myself for not looking like a magazine cover model. Other helpful corrective thoughts are I dont have to have a perfect body to have an appealing appearance. Or Nobodys perfect; even models have imperfections that are digitally removed. Or Nobody (but me) expects me to look different. Nobodys complaining about me but me. (If someone else is complaining about how you look, Ill help you deal effectively with his or her unhelpful comments in the Afterword of this book.) Be adamant in a stance that says, I refuse to continue to buy into this societal ideal of attractiveness; its sexist and I refuse to treat myself that way. The reality is that everybody is better-looking than somebody else, and everybody is less attractive than somebody else. Tell yourself, I dont have to feel bad just because theres something about me that I dont like as much as I like what someone else has. Recognize that your mental compliment of someone else doesnt have to be a mental criticism of you. The fact that I like the way a person looks has nothing to do with how I look. That person doesnt make me look bad; he or she doesnt make me do anything. Your New Inner Voice says, Okay, if Im going to compare, then I need to be fair. So, whom am I more attractive than? Finally, say to yourself, Im going to take time now to think of something else about me (a special skill, talent, or personality trait) that compares quite favorably with other folks.
Correcting Your Magnifying Glass Distortions When you view your looks through the distorted Magnifying Glass, you focus on what you dont like and minimize the attributes that dont cause a problem. You take a tunnel-vision perspective on yourself. When you think about your loved ones, do you think only about their weight, warts, or wrinkles? Of course not! You have a fairer, more balanced picture of their looks and who they are as people. Freed from this distortion, your Private Body Talk will reflect a more balanced view of your looks and yourself. Begin by asking yourself, Am I dwelling on what I dont like and forgetting about those parts of me that are fine? When you magnify, you can correct your minds eyesight by saying to yourself, Im just focusing on my dislikes and thats not the whole picture. I do like (for example) my expressive eyes, my warm smile, and if I say so myself, I do have good hair. Say to yourself, I may not like my ___________ (hair, hips, muscles, etc.), but other people see
more to me than the feature that Im hassling myself about. Just as you do to correct the Beauty-or-Beast Distortion, replace pejorative statements about magnified attributes with less demeaning descriptions. Small-chested is more accurate than flat as an ironing board. When you start self-criticizing in the mirror, interrupt your thoughts and say, I caught myself picking on myself again. Im going to stop, give myself a smile, walk away from this mirror, and say something accepting of myself. Promise to abide by the Equal Time Rule, which states that you should spend an equal amount of time on your likable features or traits whenever you catch yourself mentally harping on what you dislike about your body.
Correcting Your Blame Game Distortions The Blame Game makes the mistake of misattribution. That occurs when you too quickly infer that your appearance is responsible for some disappointment or other undesirable event. Examples of Private Body Talk based on playing the Blame Game are I dont have a boyfriend because Im so unattractive and People are unfriendly to me because Im balding. To correct Blame Game thinking, you first must realize that blaming your looks for unfortunate events usually involves jumping to conclusions based on a guessa biased guess. Whats the real evidence? If you objectively examine the facts, often the only evidence that indicts your appearance is your own discontent with your lookshardly convincing proof. How can you talk back to the Blame Game? Sometimes all you need to do is catch yourself blaming your looks, see that you have no evidence for your conclusion, and tell yourself, Stop blaming! Then, move on to more important thingslike being friendly or having fun. Or you could say to yourself, Here I go again, blaming my looks for ruining everything. Im going to leave my appearance out of this and focus on what I can do to make things better. Your New Inner V oice is a voice of reason and says, I know Im probably blaming my looks simply because I dont like them. That doesnt mean my looks are actually causing anything bad to happen. Blaming isnt sufficient evidence to warrant a conviction. Ask yourself, Okay, what real evidence do I have that my appearance is to blame for this? What other explanations are there? Suppose you do have reasonably good evidence that your looks really did cause the problem; for example, you asked someone out for a date and the person declined, giving your looks as the reason. So what? Not everyone will like everything about your looks. For that matter, not every person you meet will like your car, your clothes, your politics, or your religious beliefs. One persons opinion is not everyones opinion. If a few folks reject you because of such reasons, it may be their problem, and their loss! There are some judgmental, prejudiced people in this world. If youre overweight and someone is hatefully biased against overweight people, this person is not rejecting you; he or she is rejecting an entire category of people. Do you really need to be concerned about what such a bigoted person thinks about you? Say Adios and move on.
Correcting Your Mind Misreading Distortions Mind Misreading happens when you project your own thoughts about your looks into the minds of others. You leap to the incorrect inference that other people see and judge your appearance in the same way that you do. Then you fill their heads with your own thoughts. You think, Everybody who sees me is thinking about my ___________ (large ears, acne, big breasts, short stature, or whatever). As I mentioned earlier, Mind Misreading often occurs in tandem with the Blame Game Distortion. Suppose, for instance, that your Private Body Talk is blaming: My partner didnt want to have sex last week because he or she is turned off by my awful body. While you condemn your looks as the reason for sexual rejection, you reached your verdict only by Mind Misreading. How do you know that your partners thoughts about your looks led to a lapse of interest in sex? Could it be that your partner was simply not in the mood or was preoccupied with work? Besides, did you make it clear you were interested in sex? If not, why did you expect your partner to read your mind and know that you were feeling amorous? The strategies for handling Blame Game thinking are also useful in managing Mind Misreading.
Here are more ideas to help you keep your thoughts to yourself: First, accept what youre doingyoure thinking about what someone else might be thinking about you. Do the thoughts and opinions you suspect others are having about your looks strangely resemble your own opinions? If youre being presumptuous, simply admit that you may be Mind Misreading. Accept reality: Say to yourself, Im fairly bright, but I cant read minds. The only mind Im reading here is my own. Do you have any evidence that contradicts what you presume another person is thinking? If its someone you know well, has the person ever made positive or affirming comments about your looks? Has he or she ever disagreed and reassured you when you complained about your appearance? Ask yourself, If my appearance isnt what bothers people, what else could it be? Among alternative explanations, consider several that are often true. People arent likely to be warm and amiable if you are not friendly. Could you have been acting cool and distant because of your worry that others wont like you or your looks? Also, others may be shy or having a bad day. Could their behavior mean that something is wrong with themnot with you? Talk back assertively to your Private Body Talk when it is disparaging: Say to yourself, I need to stop thinking about what others may be thinking. Instead, I need to change what I am thinking.
Correcting Your Misfortune Telling Distortions The Blame Game charges your appearance with past or current offenses, but Misfortune Telling distorts your thinking about the future with pessimistic predictions that bad things will happen because of your looks. Your Private Body Talk uses words like always or never. For example, consider this thought: Ill always be a misfit because of my looks. Misfortune Telling can also distort expectations about specific situations, such as Ill have a terrible time if I wear this bathing suit at the beach or Once my boyfriend sees me naked, our relationship will end. Can you detect the Mind Misreading thats happening here? When correcting this faulty thinking, you should again see that you are jumping to conclusions in the absence of evidence. How do you really know that your worst fears will come true? Separate your emotions from your judgments of your future. Here are some helpful ways to do that: Realize that your pessimism may actually stem from the expectation that youll feel self-
conscious in some situation. In fact, your discomfort is probably the worst thing that will happen. So quit making dire predictions and start finding ways to accept feeling some self-consciousness in the situation. When you think, Ill never be loved because of my appearance, realize that what you may really be feeling is this thought about your future: Im worried that I wont be loved. But by definition, your future hasnt occurred yet; its your experience of despair or apprehension thats occurring. If you focus on feeling more accepting of your appearance, youll feel less apprehensive. Tackle other worries separately. Analyze the evidence. Have your pessimistic predictions always come true? Think about instances in which events turned out more favorably than youd expected. What did you do to make a difference? Listen to your New Inner V oice say, Im going to quit worrying about the future and concentrate on now. What can I do now to prove my doom-and-gloom predictions wrong? The answer, of course, is to live your life with the opposite assumption: My future is up to me!
Correcting Your Beauty Bound Distortions When you think, I cant do that because of my looks, you are engaging in the Beauty Bound Distortion. This is a hazardous distortion because it can set self-fulfilling prophecies in motion. For example, imagine you tell yourself youre too fat to go to the pool party. Misfortune Telling and Mind Misreading drive you to make this Beauty Bound mistake in your thinking. So, you pass on the party and sit at home wallowing in self-pity, lamenting that your loathsome looks have robbed you of a good timeagain! Of course, your looks didnt deprive you of anything, your emotional decision did. Beauty Bound Distortions also create catch-22 situations like I cant go to the gym and exercise to lose weight until I lose weight. Later, in Step 6, Ill teach you some terrific behavioral techniques to overcome the limits you allow Beauty Bound thinking to set for you. Until then, here are some ways to talk back to this distortion:
Ask yourself, So why cant I do such-and-such?for instance, I cant go to the class reunion unless I lose twenty pounds. Why not? Will there be a sign posted that says, Heavy Folks Not Admitted Under Penalty of Law? Your answer is Because I am self-conscious about my weight and will worry about what others are thinking. Dispute your Misfortune Telling and Mind Misreading mistakes. Its your own discomfort stopping you, not your looks or what other people are truly thinking. Talk back to I cant do it by asking, How can I do it? What would make it easier to do? For example, I cant go to the mall with this haircut becomes I can go if I wear my favorite hat. Replace I cant go to the gym until I lose weight with I can go to the gym if I remind myself that facing my anxiety is an act of admirable courage. Face the fact that other people, who are far from being perfect physical specimens, engage in the same activities that you deny yourself. Do they all really look better than you? Or do they refuse to deprive themselves of involvement in life simply because they arent perfect? Will you really have the only imperfect body at the gym or the pool party? Think about other times in which youve accomplished things that you first felt insecure about until you gave yourself a little push, took them on, and mastered them. Didnt it feel good to prove to yourself that you could overcome obstacles and succeed? Remember those occasions and tell yourself you can do it again. When you are ruled by the Beauty Bound Distortion, how do you feel? Frustrated? Angry? Dejected? Imagine how you would feel if you stood up to I cant by saying, Oh yes I can. Imagine that you face your apprehension and do it anyway. How would you feel? More confident? More in control? Counter your Beauty Bound pessimism with motivating experiences. Apply the wisdom conveyed in the inspirational, not-just-for-children book The Little Engine That Could. Affirm to yourself, I think I can! I think I can!
Correcting Your Moody Mirror Distortions The final distortion is the Moody Mirror mistake, which involves emotional reasoning. It can happen in several ways. When you are feeling ugly, you take your negative emotion as proof that you are ugly. You search for any or all things about your looks that might justify your feelings. This distortion can also occur when youre in a bad mood or upset about something other than your appearance; your funky mood contagiously infects your Private Body Talk. Moody Mirror thinking triggers other mental mistakes, activating one distortion after another and carrying you from one criticism to another, in waves of feverish distress. Corrective thinking treats the spreading infection. The key is to understand that your bad mood came first, and you conveniently pointed to your looks to rationalize your distress. Other people with identical physical flaws do not necessarily feel as bad as you feel. An inferiority complex doesnt exist in the same genetic material that gave you a short stature or a receding hairline or extra cushioning on your butt. How often have you heard people belittle their own looks, while your impression of their
appearance was not as negative as theirs, and perhaps not negative at all? A friend may say to you, My hair looks terrible, yet objectively you can see that it looks fine. Or you hear a woman say, My hips are as big as a buffalos, and knowing how big buffalo hips really are, you ignore her comment as an exaggeration much larger than her hips. Youre not that person, so you can be unemotionally objective. You know that the individuals actual appearance isnt really the problemeven if your friends hair could look better or the womans hips could be smaller. The problem is what the person believes and feels. The following corrective thinking tactics can temper your Moody Mirror mistakes: Approach the Moody Mirror by thinking as an unbiased, objective observer would. Catch the distortion as soon as you notice your mood and before the discontent spreads. Like a snowball rolling down a hill, the farther it goes, the larger and more forceful it becomes. Stopping it is much easier at the top of the hill than near the bottom. Realize that obsessing over your physical imperfections doesnt fix whats wrong. The obsessing is whats wrong. Ask yourself this: Was something else already bothering me before I started worrying about or criticizing my body? Then say, Okay, my appearance isnt really the issue here. I need to accept that my day was really stressful and Im going to leave my looks out of this. Use a mental stop sign to halt your Private Body Talk. Listen to your New Inner V oice say, Im not feeling very attractive right now. This isnt a good time to contemplate my looks. Im just making myself feel worse. So Im going to stop this! Step away from this Private Body Talk (after a brief apology, of course, to your body for the false accusations). Then follow the Equal Time Rule, and compliment yourself. Suppose youve upset yourself by criticizing the way your hair looks. Then you begin to insult your weight. Stop right there! Mindfully catch yourself and say, Okay, Im at it again. Being discontent with my hair is no reason to pick on other things about my looks. Replace I am thoughts with I feel thoughts. For example, replace I am awful looking in this sweater with I feel less happy with this sweater than Id like to be. Fixating on feelings often intensifies them, like dwelling on a headaches sensations intensifies your pain. So mindfully notice your feelings, accept them, and then pull yourself out of the emotional quicksand and turn your attention to something that can create different feelings. Watch a funny video, visit your favorite Web site, listen to upbeat music, or take an invigorating walk. Your New Inner V oice obeys this variant of an old saying: If I cant say anything nice about myself, I wont say anything at all. Then shift gears!
for having a hard time. That only makes it worse. And you dont deserve worse! Accept that you are where you are. Dont judge it. Its a fact of life that people are more likely to behave in ways that are rewarded and rewarding than in ways that arent. Rewarding yourself for mindfully monitoring your body image experiences and for corrective thinking is crucial. Mentally recognize your efforts and commend your successes. Mindfully do something special to affirm yourself in your quest to improve your body image quality of life. Buy yourself some fresh flowers, treat yourself to a movie, or take an invigorating walk. In a later chapter (Step 8), Ill show you even more positive ways to promote your improvements.
Self-Defeating Self-DefensesWith Steps 4 and 5, you began changing the faulty mental assumptions and distortions that provoke and perpetuate your painful body image experiences. In Steps 6 and 7, youll learn how to change certain troubling behavior patterns. People engage in all kinds of efforts to manage their appearance and to deal with their disturbing Private Body Talk. From monitoring the ABC Sequence of your own body image experiences, youve probably observed that you try to avoid certain Activators that set off your discomfort. Among your Consequences, you may discover patterns of specific self-protective actions you take to manage your misery once its begun. Body image distress, whether actually experienced or merely expected, usually will set in motion behavior patterns for self-defense. These maneuvers are efforts to correct, conceal, or compensate for what you think is wrong with your looks. However, these habitual behavior patterns create their own problems. They stir up their own distress and then, paradoxically, are used to cope with the difficulties theyve caused. Unfortunately, these well-learned patterns reinforce your conviction that your looks are somehow defective. Put simply, your self-defenses are self-defeating. So why do you continue to do such things? The answer is self-protection: You want to avoid or escape feeling bad about your looks. You develop these behaviors to protect yourself, so that bad events either wont happen or, if they do, so that they wont be nearly as unpleasant as they might be. Psychologists call this learning by negative reinforcement. This is entirely different from learning by positive reinforcement , in which we do things because doing them rewards us with positive outcomes and pleasurable emotions. Thus, self-protective actions are motivated more by preventing discomfort and emotional pain than by providing pleasure. With these actions, you either try to hide (avoid, disguise, or flee) the problem or you compulsively seek ways to make it go away. These two patterns of behavioral selfdefensehiding and seekingare called Evasive Actions and Appearance-Preoccupied Rituals. Now, look back at your Body Image Coping self-test results in Step 1. Two of the scores are indicators of the extent to which you use these two self-defeating behavior patterns to deal with threats or challenges to your body image. How high were your Appearance Fixing scores and your Experiential Avoidance scores? Figure 6.1 shows how these self-protective patterns emerge in the flow of your body image
experiences. With your Appearance Assumptions setting the stage, events trigger your distorted Private Body Talk and your resultant body image discomfort or distress. To manage these negative thoughts and emotions, you engage in action to defend against or cope with these experiences. I want you to understand that such patterns of self-protection are really acts of self-rejection. You are rejecting the acceptability of your body, which worsens both your body image and your self-esteem. In Step 6, first youll discover your own Evasive Actions and then youll learn how free yourself from these self-defeating avoidant behaviors. In Step 7, youll identify your Appearance-Preoccupied Rituals and learn how to rid your life of these problematic patterns. So, lets get going with selfdiscoveries.
Wearing clothes of a style, color, or fabric that might reveal your flaws. Some physical activity that might call attention to your bodys appearancesuch as exercising, dancing, or playing certain recreational sports. Some normal activity in which somebody might see you when you are not fixed upsuch as going to the grocery with sweats on, or going out without makeup or with your hair not done. Some activity that might mess up your appearancefor example, an activity like swimming that would wet your hair or wash off your makeup. Paying attention to your bodyfor example, weighing yourself or viewing your mirror reflection or a photo of yourself. Allowing your partner to see you in the buff. Certain physical contactsuch as giving or receiving hugsthat might disclose to others how your body feels. Being photographed or videotaped. Eating heartily in the presence of othersfor fear theyll think youre fat.DO YOU AVOID CERTAIN PLACES?
Any place where your body is relatively exposedsuch as at the pool or beach, or dressing rooms and public showers.
Places where appearance is emphasizedsuch as dressy formal occasions or singles gatherings. Clothing stores where your appearance is on display to clerks or customers. Places with prominent mirrorssuch as department-store dressing rooms or exercise classes in mirrored rooms.DO YOU AVOID CERTAIN PEOPLE?
People who are good-looking in ways youd like to be. Good-looking members of the sex you are attracted to. People who do a lot of things to look goodfor example, people who diet, exercise regularly, or wear stylish clothing. Individuals who talk a lot about physical appearance. People who might comment on your appearanceusually a friend or relative whos inclined to make unwelcome comments about your weight, manner of dress, and so forth.DO YOU AVOID CERTAIN POSES?
Where or how you sit or stand during a social interactionfor instance, stances or profiles that might spotlight your disliked characteristics (e.g., body shape, posture, hair, or facial features). Gestures that you think make your defects more pronouncedsuch as smiling (and exposing disliked teeth, dimples, or wrinkles) or hand gestures (which show stubby fingers or chipped or bitten fingernails). Particular positions during sexual relationsnotably those that allow your partner to see the parts of your body that you dislike. Hiding Hiding is an Evasive Action in which people try to protect themselves against negative body image thoughts and feelings by using various grooming behaviors to conceal or camouflage what they dislike about their looks. Certain Appearance Assumptions that you uncovered in Step 4 can lead you to disguise what you despise. That is, if you assume that your unadorned appearance is unacceptable and will taint others impressions of you, youll probably want to hide what you really look like. The trappings of bodily adornment can act as mood-altering substances. People select clothing, jewelry, cosmetics, and hairstyles either to feel attractive (positive reinforcement) or to feel less unappealing and to shield their shortcomings from others (negative reinforcement). Of course, the
latter is a self-protective way of Grooming to Hide. How do people groom to hide? Well, the skinny guy wears long-sleeved shirts and long pants all year round to cloak his arms and legs. The heavy-hipped woman shrouds her shape with dark, loose-fitting shirts and slacks. The aging woman conceals her wrinkled face under layers of makeup. The balding fellow hides beneath his hat. The man with protruding ears veils them with his long hair. The woman with small breasts wears padded bras. The lady with dark hair growth on her face or arms bleaches it. And God forbid that her gray hair should show. She conceals it with hair-coloring. This list could go on and on. Now, think about your own physical characteristics that trouble you. What do you do to hide them so theyll be less apparent to others or for you to feel less concerned about them? Add these behaviors to your Self-Discovery Helpsheet: My Evasive Actions.
Facing Avoidance Now, having identified the self-defeating, avoidant behavior patterns that are linked to your negative body image, its time to learn how to take control of them, instead of allowing them to continue to control you. There is a lot of substantial scientific proof that people can overcome their
anxieties by gradually exposing themselves to whatever they avoid because of anxiety. Of course, what is really avoided is an inner experience (i.e., thoughts and emotions) that they find uncomfortable or unacceptable. One very effective way to manage your Evasive Actions is to use an active strategy called Facing It. You have already acquired most of the skills you need to face down your Evasive Actions. Youve learned how to mindfully observe and accept your inner experiences, without judging them or reacting to them. Youve also cultivated your New Inner V oicean essential ally for Facing It. Now, Id like to teach you a few additional skills that can help you manage the tension or discomfort that is likely to come from Facing It.
When under stress, your breathing becomes irregular and leads to physical sensations that further undermine feelings of control or contentment. With deep, rhythmic diaphragmatic breathing , however, you can enhance experiences of relaxation and contentment. Lie down and, reclining comfortably in a quiet, private location, gently close your eyes. Take five slow, deep breaths. Preferably, inhale through your nose and exhale through your mouth. Breathe evenly from your diaphragm, which is the lowest part of your chest at the top of your abdomen. Breathe so that your stomach slowly rises and falls, while your chest moves only slightly. You can put one hand on your stomach and the other on your chest to verify this. Be mindful of the sensations caused by the air flowing in and flowing out of your body. Be aware of your abdomen rising and falling. Be aware of the sounds of the flow of your breathing. Engage in this exercise for about ten minutes, or longer if you wish. Practice diaphragmatic breathing a few times a day for several days. Mental Imagery When fretting about your appearance, its likely that you replay frustrating or upsetting situations in your mind. These mental images evoke negative emotions. Being able to shift your attention away from distressing images and to turn on pleasant ones cultivates inner serenity. With your eyes closed, allow your imagination to paint a pleasing picture of a landscape in your mind. Using your imagination, simply place yourself in a springtime scene, at the beach, in the mountains, or in the countrysidewhichever pleases you most. Begin to paint your mental picture vividly and then experience your pleasant scene as if you were really there . You hear the songs of birds, singing so sweetly . You see the colors of nature around you . You feel the soothing, gentle warmth of the sun . Against your skin you feel a soft breeze that caresses your body Mindfully enjoy your pleasant scene . For about ten minutes allow its details to unfold and envelop you in experiences of contentment and peacefulness. Building Your Ladder of Success for Facing It Heres what you need to do to get ready for Facing It: On the Evasive Actions you listed in your Self-Discovery Helpsheet: My Evasive Actions, above, review the practices, places, people, and poses that you avoid because of past experience or future expectation of discomfort. (Hold off on the Grooming to Hide items; well deal with those later.)
Make a simple judgment about each situation or activity that you avoid. This is a judgment that psychologists call self-efficacy. Self-efficacy is your degree of confidence that you could actually enter the situation or engage in the activity. For instance, suppose that you avoid going swimming at the community pool because you feel self-conscious in a swimsuit and have too many thoughts that you look unattractive with wet hair. Ask yourself, How confident am I that I could actually take a dip in the pool? Your answer is your level of self-efficacy for this activity. Assign each item on your Evasive Actions list a self-efficacy rating from 0 to 100. A rating of 0 means No way. Never in a zillion years would I be able to do that. A rating of 100 says Im 100 percent certain that I can do that. A 50 means there is a fifty-fifty chance that you could Face It. Write down your self-efficacy level in the margin next to each of the avoided practices, places, people, and poses. Next, you will design a Ladder of Success. Transcribe the items and their self-efficacy ratings to the following Helpsheet for Change: My Ladder of Success for Facing It. Put the hardest items (those with the lowest self-efficacy ratings) at the top of the ladder and the easiest ones (with the highest ratings) at the bottom. Make sure your list contains a reasonable range of ratings, though about half should be under 50 (that is, fairly difficult). If two or more items have the same numerical rating, decide which is a little more difficult and list it on a higher rung. If an activity or situation is very general, be more specific. For example, eating in front of others might become having hors doeuvres at Paddys Pub with my friends. Drop any item that isnt practically feasible. For instance, you cant go to the beach if its below freezing outdoors right now. If all or nearly all of your items are rated below 50, yours is a hard-to-do list. If most are rated above 50, its an easy-to-do list. Try to even out a lopsided list by adding a few more Evasive Actions, either easy or hard, or by modifying the existing ones to make them more or less difficult to do.
Youll Prepare for Facing It by writing down your strategy in advance. This first step is crucial, as it involves you in planning and rehearsing the remaining three steps. Decide exactly what youre going to do and when youre going to do it. Figure out how you will talk back to your Old Inner V oice of avoidance that says, No, I cant. Not now. Ill do it some other time. By anticipating which pessimistic thoughts are likely to run through your mind and how they might make you feel, you can decide how youll handle them. Finally, you can promise to reward yourself for your efforts at Facing It. Decide ahead of time what your reward will bea special treat, some affordable trinket, a cone of tasty frozen yogurt, or a relaxing moment with your favorite music. Having first spelled out this detailed plan using the Helpsheet for Change: My Ladder of Success for Facing It, rehearse it in your mind. Act The time has arrived to Face Itto carry out your plan. To warm up cold feet, give yourself the pep talk youve prepared, engage in a moment of Body-and-Mind Relaxation, or do whatever else will help you follow through. You can be mindfully aware of your inner experiences of anxiety and your impulses to avoid, and can accept these experiences without allowing them to control your actions. And off you go! As you begin confronting what youve so often avoided, encourage and commend yourself. Good for you! Cope When uncomfortable thoughts and feelings rise up, that should come as no surprise attack. You expected them, and you know how to accept them. Just draw upon the coping skills youve learned and roll with any discomfort. For example, you can use your New Inner V oice or elements of Bodyand-Mind Relaxation, such as calming imagery or breathing techniques. Reassure yourself that you can handle this. Remind yourself that you are handling it. Stay in the moment of what you are accomplishing. Enjoy There, you Faced It! But dont forget the deal. Facing It earns a reward. Applaud your accomplishment, dont criticize it. Never say Yes, but to yourself by saying Yes, I did it, but Just enjoy your success. Relish your reward. You deserve it. Preparing Your PACE Plans The My Plan for Facing It Helpsheet that follows this section is for developing your PACE plan of action for each item on your ladder. Make copies of this Helpsheet and fill them out as you climb each rung of your Facing It Ladder of Success. Develop your first plan. Start at the bottom rung of your ladder, with the activity or situation that youre reasonably confident you can face. Prepare by drafting your plan for Facing It.
Decide how you will Act. Specify the place, date, time, duration, and frequency of your action. For example, suppose your Evasive Action is I avoid standing anywhere that people are behind me and can see the shape of my rear. Your action plan might be Each day at work for the next five days, at 10 A.M. and at 4 P.M., Ill spend at least two minutes at the file cabinets where my coworkers can see me from behind. Now write down your plans to Cope. Remember, your goal is not to be totally free from discomfort while facing what you normally avoid. Your goal is just to carry out the activity, to accept any discomfort you feel as natural, and to comfort yourself. So, in my example, you must understand that when you stand at the file cabinet you will accept your self-consciousness rather than fight it and you will use pleasant imagery and particular corrective thinking to create other experiences of the situation. Whats the reward youll Enjoy afterwards?
Implementing Your PACE Plans Okay, youve prepared your plan by writing it out on the Helpsheet. Now what? After youve prepared your plan by scripting it, rehearse it. Mentally review exactly how you will act, cope, and enjoy. Visualize yourself carrying out each step of your plan. Then Ready Set Go! Execute your plan. Act Cope Enjoy! As you move up the ladder, if an item seems too hard to do, break it down into simpler steps. For example, the situation having my partner see me naked might begin with your partner seeing you in your underwear. Theres no need to get totally naked until youre ready. Focus on the current rung of your ladder. Dont worry about the rungs you havent prepared for yet. Youll handle those when you get there. Dont be like the guy who has trouble doing high school geometry because he starts worrying that hell never be able to learn college calculus. After each accomplishment, however small, make a note of what worked best and record the results on your Helpsheet. Onward and upward!
behaviors, think of a couple of situations in which you could conceivably not do these things. Select common everyday situations like walking around at the mall, going to class, or getting coffee at your local caf. Choose situations in which not engaging in your Grooming to Hide behavior is reasonably acceptable for anyone. Nobodys asking you to attend church services in your bathing suit.
more like a gamea game of challenge and skill rather than one of chance and risk. And in the end, youll be a winner! Speaking of winners, Id like tell you about Charlotte, who faced one of her Evasive Actions and enjoyed complete success. Since her adolescence, Charlotte had never left home without wearing layers of facial makeup. She was horrified that anyone seeing her might think she looked plain or homely. But applying her makeup every morning was taking up too much of her time. So, she constructed her plan for Facing It. She started with something she felt she could dogo outside, without makeup, to her mailbox to retrieve her mail. She did this every day for five days. Next, she went for a walk at a nearby park wearing less makeup than usual. Then, on five occasions wearing fewer and fewer cosmetics, she biked to a convenience store. Of course, she felt somewhat nervous and self-conscious each time. Charlotte accepted these familiar feelings and did not allow them to deter her. Her discomfort diminished as she followed through with her plan. She used her mental imagery skills and her New Inner V oice to calm herself when her anxiety became troublesome. Charlotte capitalized on her love of exercise and was mindful of how invigorating the walk and the bike ride felt. After each trip, she rewarded herself by listening to Mozart. Ultimately, Charlotte freed herself from the necessity of hiding behind a mask of cosmetics. It felt so good to be able to be herself!
Let me offer an analogy. When youre tucked in bed and dozing off to sleep, has the question I wonder if I locked the door? ever crossed your mind? You may be 99.9 percent certain that you did. But the question lingers and you cant put it to rest. So, what do you do? Yes, you get out of bed and check whether the door is latched. It is. Now you can start counting sheep. The worrisome rumination in your mind is called an obsession. The checking behavior is a compulsion. Because acting on the compulsion quiets the obsession, the pattern is reinforced. The next time the preoccupying thought occurs, the stronger the urge is to act out the checking behavior. The principal aim of Checking Rituals is to seek and obtain relief from unsettling worries about your appearance. Checking Rituals are sometimes willful, deliberate attempts to avoid worrying. At other times, they are mindlessly automatic reactions, because theyve become well-practiced habits. Some signs of this pattern are listed below. To what extent does each example describe you? Place a check mark next to the descriptions that fit fairly well. You have intrusive thoughts that tell you to inspect your appearance. These thoughts are hard to dismiss until youve acted on them. If you pass a mirror (or other reflecting surface), you often reflexively check to make sure that your appearance is okay. You frequently visit the restroom with the conscious intent of checking your appearance, even though you have no good reason to believe that something is really wrong with your looks. If concerned about your weight, you frequently weigh yourself to find out if youve gained or lost any small amount. Whenever scales are available, its hard to resist weighing yourself. If concerned about your body weight or shape, you often pinch or squeeze areas of your body to try to determine how fat or thin they are. You routinely check out other peoples opinions about your looks to seek reassurance that you look fine. Trusted loved ones or friends are typically asked, Do you think I look okay? Are you sure? Are you really sure? In social situations, you repeatedly check how your appearance compares with what others look like, so that you can feel more certain that your appearance is acceptable. Now,based on the items in the checklist above, describe your own Checking Rituals. Write these down in the top section of the Self-Discovery Helpsheet: What Are My Appearance-Preoccupied Rituals? that you will find following the section Appearance Fixing, below. Add any Checking Rituals that you engage in that may not have been mentioned. In describing your personal pattern, be specific. Appearance Fixing Fixing Rituals, which usually coexist with Checking Rituals, involve elaborate and meticulous efforts to manage or modify your appearance. You must do a lot of things with a lot of precision to be
satisfied that you look okay. Special social situations may demand even more time and perfection in figuring out what to wear. If something doesnt appear (or feel) quite right, you may start your fixing all over again. How frustrating! Recall that your Appearance Fixing score on the Body Image Coping self-test in Step 1 offers a partial index for this behavior pattern. Heres a more specific checklist of some telltale signs of Appearance-Preoccupied Fixing Rituals. Think about each one and decide how often you become fixated on fixing. At home, getting out of the bathroom and getting dressed on time is a rare event. Friends or people in your household have remarked on the amount of time you spend on your appearance. Their comments may range from gentle kidding to irritation at having to wait for you to get ready. You primp and fuss with your clothes, hair, and/or makeup more than you think you should. Rationally, you know you look fine. Emotionally and behaviorally, you just cant leave well enough alone. Different situations demand that you change what youre wearing. Otherwise, you worry that your appearance might be inadequate or inappropriate. You purchase clothing or grooming products that you seldom wear or use. When you bought them, you were sure that they were what you needed to enhance your looks. Ultimately, they didnt fully meet your expectations. Before going out, you change clothes or redo your hair several times until youre satisfied that you look okay. When you see yourself in a mirror or other reflecting surface, you reflexively adjust some aspect of your appearancelike your hair, your tie, or your dresseven though nothing is really amiss. You regularly make significant modifications in your appearancefor example, changing hairstyles or hair colors or getting cosmetic makeovers. Gaining a couple of pounds or the experience of feeling fat compels you to go on a diet or to exercise more intensely for a few days. Now, based on your answers above and any other Fixing Rituals you engage in, write these down in the following Self-Discovery Helpsheet for Change: What Are My Appearance-Preoccupied Rituals? For both your Checking and Fixing Rituals, rate how often each behavior occurs.
Erasing RitualsLets be sure we keep things in proper perspective. Managing your physical appearance is definitely a good thing. We bathe, shave, do our hair, and clothe and adorn ourselves in ways that make us feel
comfortable and are esthetically pleasing. Only people with problems like severe depression or schizophrenia may completely neglect their physical hygiene and appearance. Later, in Step 8, well consider how these activities can represent positive ways in which we relate to our bodies. In contrast, when we are dealing with Appearance-Preoccupied Rituals, weve lost control and are really struggling not to feel bad about ourselves. Like Evasive Actions, we experience our rituals as what we must do to avoid thinking and feeling that something about our looks (and worth as a person) is flawed, wrong, inferior, unacceptable, imperfect, judged negatively by others, and so forth. Because checking and fixing temporarily calm our concerns, we keep doing them, despite the clear or partial realization that they are preoccupying and seem to have a life of their own. This reminds me of the story about the fellow who regularly went out into his front yard, surveyed the premises with his binoculars, then flapped his arms like a duck, turned in a circle, did a little dance, and spit three times over his left shoulder. A curious neighbor finally approached him to ask him what he was doing. Somewhat nervously, he replied that he was keeping the elephants away. Perplexed, the neighbor said, But there are no elephants around here. The fellow smiled proudly and said, I know. What I do really works! I hope you can see that Appearance-Preoccupied Rituals also fuel false assumptionsfor example, if you dont look perfect all the time, bad things will happen or people wont like you. To change these habitual patterns, you can either prevent yourself from initiating them or interrupt them once youve begun the ritual. I call this solution Erasing It. It derives from exposure and response (or ritual) prevention , a well-known and effective behavior therapy procedure. Several successful strategies exist for Erasing It. Ill describe each and illustrate its helpful use.
Obstructing Your Rituals Most Appearance-Preoccupied Rituals occur whenever the right opportunity arises. Given certain triggers, or Activators in your ABC Sequence, you carry out the behavior before you know it. Therefore, you may need to obstruct its opportunity to occur. You block its path. Think about one Appearance-Preoccupied Ritual for which you need certain tools or conditions to carry out the ritual. For example, you require a mirror for rituals in which you repeatedly scrutinize your looks. Compulsive weighing would be impossible without scales. How could you make trouble for your ritual by altering the environment? Developing this strategy is a challenge to your creativity. So be creative! This obstructive technique for change is usually a short-term, stopgap approach. You dont want to avoid one thing in order to avoid another. It can be helpful, especially at first, but note that youll want to use additional strategies to remove most rituals.
Allow me to illustrate this point: Lois felt compelled to weigh herself almost every time she ate anything. She was ill at ease until she confirmed that she had not put on several pounds. So Lois applied masking tape to the weight-displaying window of her scale. She obstructed her rituals path. In this way, she weakened her compulsion to weigh herself. She combined this technique with the By Appointment Only strategy (discussed below), weighing herself only on Saturdays, when she changed the tape. Loiss innovative strategy helped her to change her preoccupying mental tape, as well. Delaying Your Rituals Another method for Erasing It is really simple. You learn to wait a while before commencing your ritual. This works quite well for Checking Rituals. Appearance checking is usually preceded by an inner urge to check. For example, you may have a gnawing feeling that you need to weigh yourself, inspect your hair or makeup, or seek reassurance about your looks. Your urge is typically narrated by your Private Body Talk that asks What if? and conjures up distressing scenarios. What if Ive gained weight and I look fat? What if my hair is out of place and looks really messy? What if my makeup is wearing thin and my big pores are showing? What if my husband thinks this outfit looks dumb on me and hes ashamed to be seen with me? Just be mindfully aware of these urges and mental whatifs. Accept that they occur and let your consciousness move away and focus on other things. Checking Rituals serve several self-protective purposes: They interrupt your preoccupied thoughts and your feelings of discomfort. Moreover, they offer a clear answer to your what-if? question. When you learn that you look fine, you feel relief. And, if something was slightly amiss, fixing it brings relief. So, youll want to detach the thoughts from the ritual. You are aware that you want engage in the checking behavior. You remind yourself that it isnt required that you do so. By postponing your checking even for a short time, you sap the power of your anxious urge. Instead of succumbing to the urge and letting it immediately dictate your actions, you become the decision maker. You take control of deciding when (or whether) to check on your looks. This usurps the urge that instigates your ritual, as well as the ritual itself. So, for example, you decide Ill delay checking for ten (or fifteen or thirty) minutes. Waiting it out will be uncomfortable for a while, so youll need to accept the discomfort and create mindful experiences to soothe yourself during your wait. You can learn from the following success story: Roger is a sales representative for a pharmaceutical firm. Hes on the road a lot, calling on doctors and clinics. During the course of a typical day, he checked his appearance often. Every time he stopped at a traffic light, he inspected his hair and face in the rearview mirror. At his office, he checked his appearance once or twice an hour, using a mirror he kept in his desk drawer or the one in the mens room. When Roger decided to delay his rituals, he put off checking his reflection in the rearview mirror until he reached his destination. Whenever he had the urge to check his appearance at the
office, he deferred checking for twenty minutes. At first the waiting troubled himwhat if he looked awful all that time? However, he just mindfully observed and accepted his worried thoughts. Next, he spent a few moments doing slow, diaphragmatic breathing and listening to his encouraging New Inner V oice. Then, he more easily shifted his attention to his work. Eventually, Roger kept his urge to check in check. Restricting Your Rituals Fixing Rituals can be exasperating for others. Each fixing episode usually continues until you are either momentarily content with its results or you run out of time. An alternative to allowing your ritual to run its course is to place specific limits on it. Here are three ways to weaken your rituals by placing specific limits on them:PLAYING BEAT THE CLOCK
Heres how you could tackle a Fixing Ritual in which you take too long readying your appearance to face the world. First establish how long your Fixing Ritual usually takes. Then make a fair estimate of how much time would be reasonable for you to take if you didnt get so compulsively caught up in it. For example, suppose your morning grooming regimen takes two hours. You know that if you were a bit more organized and less picky, you should be able to get ready in one hour. At first, set your initial goal generouslysay, to be ready in one hour and fifty minutes. Set your alarm clock or kitchen timer to this limit and play Beat the Clock. After a few days of success, lower the limitsay to one hour and forty minutesand play Beat the Clock for several more days. Continue in this fashion, shaving off ten minutes each time you change your limit, until youve reached the reasonable amount of time to groom that is your goal. Reward your progress by using the time saved to do something enjoyable. Then youll appreciate the change even more. Kyra liked her hair, but she insisted that it always had to look perfect. Her hair was the saving grace she relied on to make up for the physical features she disliked. Dreading a bad hair day, each morning Kyra would style and restyle her hair for about an hour, until her ride for work arrived. For two weeks, she played Beat the Clock by setting her timer for gradually shorter intervalsforty-five minutes, then thirty, and finally a reasonable twenty minutes. Her goal was to be finished with her hair, out of the bathroom, and enjoying her cranberry juice before the timer alarm went off. By making a challenging game of it, Kyra eliminated her morning preoccupation with her hair, which looks just as attractive as it did back in the days of one-hour fixing sessions. Now if she has a bad hair day, she sticks to her new abbreviated schedule anyway. She knows that the world wont come to an end.
This next method sets a limit on the number of times you engage in a ritual within a certain period. How does this work? Suppose that whenever you go out to dinner with a friend or loved one, your requests for reassurance that you look fine begin to sound like a broken record. The more you ask, the more insecure you feel, especially if you start to sense your companions annoyance. So, you set a quota and allow yourself only two reassurance requests during an entire evening. You can use your allocation whenever you wish, but having used up your ration, your requests are over. Over time the goal is to set your ration progressively lower until it reaches zero.BY APPOINTMENT ONLY
Heres the third method for restricting your rituals: An intense urge to practice a ritual usually dictates when your rituals will take place. So instead, put those rituals on a schedule. In effect, you make an appointment with yourself to carry out your ritual. Like any appointment, the one for your ritual should begin and end on time. Because youre permitted to have the ritual by appointment only, it cannot occur at unscheduled times. If you miss your appointment, you must wait for the rituals next scheduled occasion. Heres an example of an effective use of this strategy: Since adolescence, Ivans face has been prone to blackheads. Many times a day, he would get out his magnifying mirror and peruse his pores in search of blackheads and blemishes, squeezing and picking at them. Not only did these search-anddestroy missions take a lot of time, they took their toll on his complexion as well. To gain control, Ivan scheduled an appointment for his ritual, allowing it to take place only during ten-minute visits to the mirror at 7 A.M. and 7 P.M. Thus, he restricted his rituals duration and frequency. Much to his dermatologists relief, Ivan eventually reduced his unhealthy practice to once a week. Resisting by Rebellion This last strategy for Erasing It can be rather difficult, yet sometimes it is the most successful. You rebel against your ritual by resisting it cold turkey. You face the temptation and exercise restraint. You ride out your urge without performing the ritual. Controlling a ritual, despite the conditions being ripe for its occurrence, can greatly increase your self-confidence. You may want to try this approach first on weaker rituals. For stronger ones, youll probably graduate to this approach after successfully delaying, restricting, or obstructing your behavior
pattern. With mindful acceptance, Body-and-Mind Relaxation, and corrective thinking as your allies, you force yourself to remain in the situation where you experience the urge without performing your ritualthe longer the better. Often a gradual approach is most helpful. Schedule your rebellions for progressively longer periods. In this way, you build up your resistance. In other instances, it may be effective for you to remain in the situation until the urge to perform your appearance-preoccupied pattern has subsided. You mindfully observe the urge and its weakening. If you try this total rebellion against the ritual and dont succeed, give yourself the credit you deserve for trying. Never give yourself a hard time for having a hard time! Take inspiration from Jessica, who learned how to resist two self-defeating patterns: Whenever she was on a date, Jessica spent almost as much time in the restroom checking and fixing her appearance as she spent with her companion. She would end up stuck to the mirror the way a magnet sticks to a refrigerator, brushing her hair, freshening her makeup, and adjusting her clothes. But once Jessica made up her mind to end her appearance checking and fixing, she planned her resistance well. On several occasions when she was at a restaurant, she allowed herself to visit the restroom only to use the toilet, not to primp. When washing her hands, she made a point of looking down at the sink instead of up at the mirror. For her next step, Jessica required that, on each visit, she look at herself in the mirrorbut not fix anything. She progressed to longer and longer periods between checkups. Relying on her mindfulness and coping skills to get her through her initial discomfort, Jessica was finally able to break her pattern of checking and fixing.
Preparing and Executing Your Plans for Erasing It Start with the ritual at the bottomthe easiest one to eliminate. Write out your plan for Erasing It, using the Helpsheet for Change: My Plan for Erasing It. Youll want to make several copies of this Helpsheet to use for each ritual, or you can use your own notebook to write out your plan in this format. PACE yourself, just as you do when Facing It to manage your Evasive Actions. As you plan, anticipate and specify each stepPrepare, Act, Cope, and Enjoy. Visualize yourself carrying out your plan, coping effectively with any troubling thoughts or feelings, and affirming and enjoying your accomplishment. Youve made and rehearsed your plan for Erasing It. Now go for it!
One rung at a time, just keep climbing your ladder. When youve made headway with several Checking or Fixing Rituals, go ahead and begin Step 8 of this workbook. Continue to follow through on your Erasing It plans.
Achieving and Pleasing with Positive Physical Activities Bodies are much more than what they look like; they are instruments of action and sensation. People with a negative body image often neglect taking satisfaction from their bodies in ways that have nothing to do with appearance. Preoccupied with loathing, hiding, and repairing their looks, they also fail to find opportunities to enjoy their appearance. As stated above, Affirmative Actions are intended to improve your relationship with your body by doing special things to foster positive body image thoughts and feelings. These Affirmative Action opportunities fall into three categories of bodily experience: (1) physical health and fitness (i.e., feeling physically competent or healthy), (2) sensate experiences (i.e., your awareness of bodily sensations), and (3) physical appearance. Within each of these categories, there are two psychological experiences that enhance your relationship with your bodymastery and pleasure. Mastery produces gratifying feelings of accomplishment from reaching a set goal. For example, setting and achieving the goal of running two miles or swimming ten laps can provide a satisfying sense of mastery. Pleasure simply means having fun. It doesnt require reaching a goal, only enjoying an activity because it inherently feels good. For instance, getting a massage or relaxing in a hot tub brings about calming, soothing sensations. Some activities furnish both mastery and pleasure. For example, aerobic dance involves mastering new
moves and achieving improved fitness and also provides a pleasing, invigorating sense of bodily freedom.
The following Self-Discovery Helpsheet lists possible sources of physical mastery and
pleasure. Answer the survey questions to begin discovering potential ways to act affirmatively toward developing a more balanced, fulfilling relationship with your body. Next, review your answers to the survey so that you can obtain your Positive Physical Activities scores. Heres how to do it: Regardless of how often you engaged in the activities, circle those that you rated as 2 or 3 on either pleasure or mastery. Classify the circled activities as relating either to health and fitness, sensate experiences, or physical appearance. Beside each, write H for health and fitness, S for sensate experiences, or A for appearance. If you find that some fall into more than one category, you may mark them more than once, but think about which category the activity fits best. Many activities have the potential to create different experiences for different people. For example, although some people would regard getting a facial as an appearance activity, others might regard it as sensate because of the tactile pleasure enjoyed during the process. Similarly, an activity like lifting weights can cover lots of experiential groundenhancing feelings about appearance, promoting an awareness of being strong or fit, or evoking certain bodily sensations during the workout. Count the number of circled activities in each category. Omit any that arent feasible to do within the next month. For example, dont count sexual relations if youre not in a sexual relationship. Forget about rock climbing if your arm is in a cast. For activities that relate to multiple categories, only count them in one primary category. Enter these scores at the bottom of the SelfDiscovery Helpsheet. How many Health and Fitness Activities did you circle? How many Sensate Activities? And how many Appearance-Oriented Activities? Choose at least four activities from each of the three categories. If you have fewer than four, here are some ideas for coming up with more: Look for circled items that you can break down into more specific activities. For example, playing team sports lists multiple sports, so choose the ones you do. Wearing favorite casual clothes could be split into wearing my favorite jeans and wearing my red bow tie. If there are activities that you initially placed in multiple categories but counted only in one primary category, reassign a few to a secondary category that needs more activities. Finally, to expand the list, ask yourself, What have I done or considered doing that could lead me to feel physical mastery or pleasure? Write down these twelve activities (or more!) on the following Helpsheet for Change. Soon you will use your chosen activities to build a better relationship with your body. The next three sections of this chapter focus on the ways that you will use these activities for Affirmative Actions. By committing some of your quality time to these experiences, your relationship with your body has a very good chance to experience positive change. Having Good Times with Health and Fitness Activities Affirmative Actions for health and fitness nurture your experiences of physical competence and
well-being. Routine exercise can benefit your body image, as well as your overall mental health. Compared to couch potatoes, whose only workouts are with the remote control for the television set, regular exercisers typically feel better about their fitness, their health, and also their appearance. The most formidable obstacles to health and fitness activities pertain to motivation. Studies of peoples motives for exercise reveal these four basic reasons: (1) to be more attractive or to lose weight; (2) to improve physical competence, fitness, and health; (3) to improve mood and manage stress; and (4) to meet, socialize with, and have fun with others. Individuals with the first motive exercise to achieve a certain lookto look fit or slimmer or more muscular. Good health is incidental. Women are somewhat more likely than men to exercise primarily to manage their appearance and weight. Research has demonstrated that a negative body image is more prevalent among people who exercise for this reason. However, neither the mirror nor the scale measures your bodys capabilities.
Physical exercise is most psychologically rewarding when done for the right reasons. Becoming physically competent and fit is certainly a good reason. Physical competence and fitness reflect what your body can doits athletic abilities, flexibility, coordination, strength, stamina, and endurance. This mastery component of exercise represents the second motivation listed above. This is certainly a
healthy reason to exercise, unless taken to the extreme. Compulsive exercisers pursuit of physical mastery can become dangerously consuming, or even addictive, as they push themselves harder and harder to achieve ever-more rigorous feats of physical mastery. Driven to achieve perfect control over their bodies, ultimately they come to feel that their bodies control them. Illness, injury, and other interferences with exercise are exasperating and barely tolerated. They exercise more but with less enjoyment. By contrast, regular physical activity done in sensible moderation can benefit your emotional life and your body image. As for the other motives, exercise also can be a pleasurable way to socialize with others and it is an effective tool for managing stress. One scholarly summary of research pointed to the positive effects of physical activity training on body image (Martin and Lichtenberger 2002). Moreover, these body image benefits dont necessarily require substantial improvements in fitness per se; nor do they require reductions in weight. For example, in 1994, psychologists at the University of South Florida (Fisher and Thompson) discovered that a program of aerobic activity and weight training fostered body image improvements. In 1995, Sherri Hensley-Crosson and I evaluated the effects of regular participation in an aerobic dance class. Not only did the exercisers enhance their cardiovascular fitness, they also developed a more satisfying body image than did their sedentary peers. In 2001, Pamela Williams and I investigated the effects of circuit weight training. When compared with a control group, those who did weight training had greater body image satisfaction, less physical self-consciousness, and improved feelings of physical competence. All of these studies showed body image improvements after several weeks. To get more out of exercise, you should shift your attention away from issues of appearance or weight control and focus more on the satisfying experiences of physical mastery and pleasure. Learn how exercise can help you improve mood, manage stress, and enjoy the company of others. One excellent reason to be physically active is that you can have such good times working out with others. This week, set aside time for one or two of the Health and Fitness Activities you selected. Im not asking you to run a marathon or to start training for the Olympics. Of course, before embarking on an exercise program, especially if youve been inactive for a while or have any health problems, consult your physician about your plans. Dont be so demanding or judgmental of your physical competence that you take all the fun out of exercise. As a Nike slogan says, Just Do It! While you engage in these activities, monitor your feelings of mastery and pleasure. On the Helpsheet that follows, rate your experiences. Each week, do just one or two of these activities, including the new ones, and record your experiences. Having Good Times with Sensate Activities Your body has millions of highly specialized cells that enable you to experience it and the world around you. You can take in the visual beauty of a colorful sunset or a babys smile. You can sense the essence of fragrant flowers. You can savor your favorite flavor. You can experience the symphonic sounds of an orchestra or the melody of a distant songbird. You can feel your body move rhythmically to music. You can feel your skin luxuriate in the suns gentle warmth and the coolness of a soft breeze. You can be soothed by the caring touch of a loved one. If youre like most people, you take for granted such wonderful, sensate experiences. With all these riches that your body endows you, why dwell unappreciatively on what your body looks like?
Each week from now on, create opportunities to enjoy at least two of the Sensate Activities from your Positive Physical Activities Helpsheet. Schedule them and then carry them out. Mindfully immerse yourself in the pleasurable feelings that will arise. Let your sensate pleasure fill your consciousness. As enjoyable as these experiences may be, dont always schedule the same ones (like having sex!). Expand your sensory horizons to include activities such as bubble baths, head rubs (do it yourself if necessary), or body massages (with a little help from a friend). Use the Helpsheet to record the enjoyment you harvest each time. You need not rate mastery, of course. Sensate activities are treats of pleasure, not achievement. Having Good Times with Appearance-Oriented Activities In Steps 6 and 7, you began chiseling away at the various self-protective behaviors you use to manage your looks. You realize now that your Evasive Actions and Appearance-Preoccupied Rituals have undermined your body image. Many of these problematic patterns of behavior pertain to appearance management or grooming. But grooming doesnt have to create problems. It can enhance your feelings of mastery and pleasure. Whether your grooming affirms a positive body image or
perpetuates a negative one depends on which type of groomer you are. There are three basic types: 1. The individual who Grooms to Hide and repeatedly checks and fixes her or his appearance is called the Insatiable Groomer . You will recognize this appearance-preoccupied pattern from Step 7. Primping, preening, fussing, and fretting are incessant. Satisfaction is fleeting. 2. A second pattern also seldom brings good times. Gloomy Groomers have given up on their looks. They mostly neglect their appearance, believing either that nothing could ever improve their looks or that they lack the ability to do so. Gloomy Groomers often fear doing anything to call attention to their body and invite self-consciousness. Therefore, they cling to a restricted range of safe looks. Some rationalize their pattern by thinking that grooming is somehow bad self-absorbed or provocative. Consider Norma, whos worn the same aqua eye shadow, pink lipstick, and thick black mascara for about twenty years. Shes pulled her hair into a ponytail for nearly as long. She always wears loose-fitting, ankle-length dresses, usually of solid black or dark gray. Norma doesnt care for her appearance. Shes unwilling to attempt even simple grooming changes that would allow her to enjoy her looks more. To her, enjoying her looks would seem vain. Besides, she hasnt a clue of what she would do. 3. The first two types of grooming are clearly self-defeating. Insatiable Groomers stir up trouble. Gloomy Groomers want to leave bad enough alone. Both types have an inflexible relationship with their bodys appearance. The third type of groomer has the best attitude. This Flexible Groomer is neither preoccupied with compulsive grooming nor neglectful of appearance. The Flexible Groomer has adaptively discovered a happy medium between unhappy extremes. My own research findings confirm the advantages of being a Flexible Groomer. For example, we found that women who are versatile in their use of facial makeup feel more in control socially than women who are rigid in their use of cosmetics (Cash, Rissi, and Chapman 1985). Further, women who always wear lots of makeup, no matter what situation theyre in, underestimate their unadorned attractiveness (Cash et al. 1989). Their makeup is more a mask of self-imposed concealment than an optional and enjoyable adornment. Flexible grooming offers you choices and the affirming experience that you are acceptable with a variety of looks. It provides opportunities for pleasure and playfulness.
As a Flexible Groomer, Kristins basic goal is to enhance her appearance in ways that express her individuality. She uses cosmetics in moderation, and she isnt reluctant to explore a new look from time to time. When selecting clothing colors and styles, Kristin wears what delights her eye rather than conforming to the dictates of fashion or what best camouflages the thighs shes not so fond of. About once a year, she changes her hairstyle, simply because she experiences this as a refreshing change. Kristin doesnt depend on other peoples compliments to enjoy her appearance. In fact, only a few friends know where her beloved butterfly tattoo is located. She doesnt aspire to be a flawless beauty; neither does she try to neutralize her looks. A Flexible Groomer like Kristin isnt afraid to look less than perfect or afraid to experiment. Becoming a Flexible Groomer is possible through two parallel paths of action: First, keep using the lessons from Steps 6 and 7 to lessen your self-defensive grooming. Keep on Facing It and Erasing It! Second, carry out Affirmative Actions that provide positive appearance-oriented experiences. Learn to use the mood-altering tools of adornmentlike clothing styles, fabrics, colors, cosmetics, hairstyles, jewelry, and fragrancesto enjoy your appearance. Dont work at it! Play at it! Flexible Grooming is fun. Deriving enjoyment from your grooming activities doesnt mean you are a vain person. It just
means you accept the body thats yours. What could be bad about that? Creating mastery experiences might involve figuring out how to put your clothes together to achieve a certain style you like and always thought you could never even attempt. It might involve learning how to apply makeup more effectively or how to do your hair in an easier-to-manage style. Be mindful of your motives, though. Mastery at concealing defects or at emulating a movie star is not healthy mastery. Examine the Appearance-Oriented Activities that you listed on your Positive Physical Activities Helpsheet. Carry out a couple of these activities each week. Remember to record your experiences on the following Helpsheet. Enjoy the good times!
you preserve the gains youve achieved and for handling any unforeseen challenges that may arise in the months and years ahead. So please keep reading!
Afterword: From This Day Forward: Preserving Your Positive Body Image for LifeCan you believe it? Youve completed the final step of your program for an improved, more accepting and satisfying body image. In saying farewell, however, I want to leave you with some thoughts about faring well in your body image future. How can you progress even further and preserve your positive changes?
TroubleshootingAlthough you cannot foresee every body image difficulty on the horizon, many problems can be anticipated. A forward-looking solution makes strength available by using the power of prevention. Take a little time to constructively look for trouble. What events and situations still evoke your negative body image emotions? What do these troublesome triggers have in common? For example, do they involve reactions of certain people? Do they entail others seeing particular parts of your body? Are they situations that spotlight your weight or body shape? Do they pertain to how your
clothes look? Whenever you expect to enter one of your risky situations, dont start contemplating how to avoid it. Thats the Beauty-Bound Distortion that leads to Evasive Actions. Relying on skills youve developed in this program, here are two ways to ready and steady yourself: The first strategy is to apply what youve learned in Steps 3 and 6. Create a Ladder of Success that breaks down the situation into elements that are progressively more difficult for you. Then, practice accepting and neutralizing your anticipated discomfort with mindfulness and Body-andMind Relaxation while visualizing these elements or events one at a time. The second strategy uses what you learned in Step 6. Youll PACE yourself. Prepare for the anticipated situation. Imagine being in the situation. Mentally rehearse how you want to deal with the worst-case scenario. Picture yourself handling it effectively. Act on your plan for confronting the situation. Cope as planned. Your New Inner V oice can support you through this tough time and will help to keep your Private Body Talk from becoming overloaded with mental mistakes. Stop, Look, and Listen! Your goal is simply to survive the situation, not to feel totally wonderful. Enjoy the fact that you stood up to adversity. Reward your courage.
The Inattentive People Your spouse or romantic partner may sometimes be inattentive to your looksnot critical, but not complimentary either. Gosh, you look so nice! are words they seldom, if ever, express. As a result, you become insecure about what your partner privately thinks about your appearance. So, what can you do? First, recognize your own mental mistakes. Are you committing the Mind Misreading Distortion and projecting your own negative thoughts into the other persons head? What factual proof do you have that the person has a negative opinion of your looks? What other explanations might exist to account for the persons inattentiveness? Consider these possibilities: Understand that some people never give compliments to anybody about anything. Obviously, the deficiency is theirs, not yours. Some people are totally appearance blindoblivious to how others look and to how they themselves look. They dont comment on your appearance simply because it never crosses their mind to do so. No news isnt bad news. Thats just the way these people areapathetic about appearances. Another reason for their inattentiveness could be that theyve grown accustomed to your face (and all other aspects of your looks). They take your appearance for granted, assets and all. If their silence and your uncertainty compel you to ask, Do you find me attractive? they usually reply, Sure. You know I do. Familiarity doesnt breed contempt; it breeds complacency about many things. One final reason that a particular person doesnt comment favorably on your appearance might be the can of worms explanation. A negative body image can lead some people to be vocally critical of their own looks and to engage in the Appearance-Preoccupied Ritual of excessive reassurance seeking. If the topic of your appearance is a well-worn subject, its no wonder that this other person might be reluctant to reopen such a can of worms. As you can see, there are abundant reasons that certain people may not compliment your looks. If you want strokes from these folks, your best chances are to go with the Golden Rule; so, do unto others. Behavioral scientists call this the norm of reciprocity, which means that inattentiveness begets inattentiveness and that compliments beget compliments. Give sincere positive feedback when you notice that they look especially nice. If they reciprocate your compliment, accept it and tell them you appreciate it. If they dont, pay them compliments anyway. After all, being positive is its own reward. The best solution to this concern is not to depend on strokes from others in order to appreciate your looks. Punch your own ticket! The Insensitive People Do particular friends, loved ones, or acquaintances seem intent on making insensitive remarks that stir up your body image distress? Their comments can come in various forms:
Friendly teasing: You know I only kid you about your fuzzy hair because were good friends. If I didnt like you, I wouldnt kid you that way! Caring concerns: Its because I care about you that I can be honest about how terrible you look in shorts. Helpful advice: I dont mean to hassle you about how chunky youve become. Im just worried about your health. I only want whats best for you. Short of buying them all a one-way airfare to a faraway place, how can you handle such insensitive people? Before I tell you, I want to alert you to recognize three common but definitely unproductive approaches: With the passive, or unassertive, approach, you dont want to cause trouble so you hide your hurt or annoyance and quietly sustain the insultsmaybe even believing you deserve them. With an aggressive approach, you blow your cool and retaliate with hostile threats or insults. In the passive-aggressive, or indirect, approach, you sulk or become cranky or oppositional without ever telling the offender why youre acting this way. The best way to deal with insensitive people is to take a rational, assertive course of action. Assertiveness is made easier if you better understand the other person, which can help to neutralize his or her unwelcome words. Ask yourself, Where could this person be coming from? Perhaps these people truly are trying to be friendly, or caring, or helpful. On the other hand, maybe they act insensitively because of their own body image insecurities. For example, parents who struggle with their own weight may shift their weight-watching burden onto their children. So they pass their misery along by nagging, Why dont you go on a diet? or At your weight, you shouldnt be eating pie. There are other plausible motives for insensitivity. Jealous partners or friends may worry that if you look too good, youll have opportunities for other relationships. Their jabs at your appearance may be unconscious controlling efforts to diminish your self-confidence and prevent the possibility of losing you. Furthermore, did you ever stop to consider that critical people may be envious of you or your looks? You may be the focus of their own Unfair-to-Compare Distortions, and your appearance may cause them to feel unattractive. Or, perhaps because you intimidate them in some other way, they try to even the score by pointing out your physical imperfections. After gaining some insight into possible motives for their insensitivity, make a plan for thoughtful assertive communication. Rational assertion has six sensible steps that you can remember easily with the acronym RIGHTS: 1. Review the situation in advance. Identify what the problem is, how you feel about it, and how youre going to approach the offending person about it. Know exactly what you want to accomplish with assertive action. Because you want to be prepared and confident when you talk with the person, plan your words, write them down, and even practice them beforehand. 2. Initiate conversation with the person at a time and place thats mutually convenient. Dont just sit around and wait until youre offended again. Its preferable to talk without time pressures or distractions. 3. Get specific about the problem. Calmly and confidently tell the person the particular remarks or
behaviors you find objectionable. Stay focused on the facts. Be descriptive without being accusatory. For instance, you might say something like Recently, youve often mentioned that you think I ought to lose weight. I want to talk with you about your comments and how I feel about them. Dont take the passive path, meekly mumbling, Im really sorry to bring this up. Its probably petty and Im just being overly sensitive, but . Dont exaggerate or use aggressive, inflammatory words eitherfor example, You are always bitching at me about being fat! Dont stray off course into other issueslike Im really fed up with your insults about my weight and your total lack of consideration of me. Youve never really been in my corner when I needed you. Like last year when you . 4. How you feel is an essential aspect of what you will communicate. Use I statements to express how the objectionable behavior feels to you. For instance, When you make jokes about my being so short, I feel hurt. Casting blame about how the person makes you feel will put him or her on the defensive. Keep the focus on your feelings, without tossing in opinionated conclusions. The statement I felt embarrassed when we were at the beach and you criticized how I looked in my swimsuit properly expresses an emotion. The proclamation I feel you are a rude and insensitive scoundrel who takes great pleasure in humiliating me is an opinion. The person can toss aside your opinion with Youre wrong! Its much harder to dismiss or ignore your feelings. 5. Target the change you want. Offer a specific solution by stating what it is you want from the other person. For example, Im asking that from now on you stop calling me Jelly Butt in front of our children. Thats more precisely targeted than I wish youd stop being so damned hateful. 6. Secure an agreement from the person. Mention the inherent advantages to each of you that cooperation with your request would bring. Propose a win-win solution: If you stop asking me whether Ive lost weight, Ill take less time getting dressed before we go out, and I know Ill be more fun to be with. To negotiate change, offer positive consequences: If you promise to refrain from criticizing my appearance today, Ill give you a back rub tonight. Of course, sometimes serious sanctions are called forwhen the unwanted behavior is long-standing or when the offender has been unresponsive to previous requests for change. Under these circumstances, you may need to stipulate punitive outcomes for noncompliance with your assertive request: I do want you to know in advance that if you make your usual jokes about my hair loss tonight, I will leave the party without you. Of course, whatever consequences you propose, positive or negative, must be ones that you are committed to follow through on. By following the six steps of rational assertivenessyour RIGHTS, you take charge of how insensitive people affect your body image. If following these steps doesnt work at first, refine it and try again. You have a right to assert yourself and be treated with respect! But dont expect miracles. Most people dont change overnight, and some wont change at all.
certain self-defeating attitudes can cause progress to stagnate. Do you have any of the following five stagnating attitudes that could impede your improvements? The Now Is Forever attitude is a nasty notion that goes something like this: Now that Ive completed this workbook and I like my looks better, Ill never have to work on my body image again. This is like the attitude of some of the students Ive taught, who think, Now that Ive taken the final exam, I can forget everything Ive learned. What youve learned in this program will continue to be useful only if you mindfully continue to use it. The Good Things Never Last attitude espouses the opposite extreme. For example, some people become apprehensive when good things happenif they are promoted at work or if they find themselves falling in love. Because they now have something valuable to lose, they start to worry and search for signs that their job or their romance may not be secure. Their actions then slowly sabotage their success and happiness, and they conclude, I knew it all along. Good things never last. But, its actually the case that their attitude sets a self-fulfilling prophecy in motion. With mindful efforts, good things surely do last. The My Best Isnt Good Enough attitude is a form of self-blaming used to explain unattained changes or an episode of body image distress. Should you have a perfectly positive, problemfree body image now that youve completed this workbook? Absolutely not! Learning new skills well enough to make them a natural part of your life takes time and practice. Furthermore, perfection is a mythan unreasonable standard to judge yourself against whether or not youve done your best. Improvement builds on itself and on sustained effort, which is good enough. Tough times mean tough times, and thats all they mean. They are not an ultimate proof of your abilities or your character. The Some Things Will Never Change attitude is similar to the notion that your best is never enough. Both attitudes can cause what psychologists call learned helplessness. This happens when people give up because they decide that they have no control over events. If you resolve that some facet of your body image is unalterable, then youll throw up your hands and do nothing to change it. So, obviously, nothing will change. On the other hand, if you put your pessimism on hold, set your goal, and work toward it, change has a real chance. Have you ever achieved things you once believed you couldnt? The Bad Is Good attitude justifies and perpetuates your lack of body acceptance. The notion here is that hating your body is crucial to your making desired body changes. So you insist on body loathing to motivate you to lift weights or lose weight. Beating yourself up is more likely to undermine your efforts to change your body in satisfying ways.
MetamorphosesOne thing that never changes is the fact that things will always change. Your body certainly has changed during your life, and it will continue to change. Some years ago, I went to my twenty-fifth high-school reunion. Many of us hadnt seen one another since graduation. Our reacquainting conversations often touched on how our current looks matched our recollections of each other, aided
by circulating copies of our yellowed yearbook. Wow, you look just the same! was typically reserved for average- or better-looking classmates. You look terrific; you really do! was seemingly remarked to those whose attractiveness had improved over time. So how have you been? may have been the socially sensitive equivalent of the aging process hasnt been too kind to you, has it? The former basketball team captain and hottie to most girls in the class was now a paraplegic, his body forever altered in the Vietnam War. The prettiest cheerleader, whose body had been ravaged by a potentially deadly disease, felt obliged to explain her appearance repeatedly during the course of the reunion. More than a few of the guys had substantial scalp to show for the quarter century that had passed. Hair today, gone tomorrow, was a favorite quip. And then there was the woman with gray hair who warned us not to call her Grandma. Classmates whod added inches to their love handles groaned about how they had grown over the years. Some women displayed photos taken during pregnancy and sought reassurances that they were no longer as big as a beached whale. Some smooth faces had weathered with a few wrinkles. And speaking of faces, where was Larry? We wondered if his cystic acne, about which hed been so terribly teased, had scarred his life. Time truly transforms everyonepsychologically and physically. With good nutrition, proper exercise, and other healthful practices, we can exert some control over the extent and rate of unwanted physical changes. But we can never look like kids again. This reality, however, doesnt seem to stop many of us from trying. We search for and buy fountain-of-youth products. We chase the promises of take it off fast and forever diets. We hire cosmetic surgeons to erase time with a scalpel, laser, or needle. What would happen if we devoted half of the effort we invest in trying to turn back the clock or have the perfect body to physical self-acceptance? The answer is profoundly simple: We would live happier lives.
Psychological Association. Thompson, J. K., and L. Smolak (eds.). 2001. Body Image, Eating Disorders, and Obesity in Youth: Assessment, Prevention, and Treatment. Washington, DC: American Psychological Association. For those readers who are particularly science-minded, take a look at Body Image: An International Journal of Research (T. F. Cash, editor-in-chief), published quarterly by Elsevier and accessible by ScienceDirect subscribers (www.sciencedirect.com). You can also visit the journals website: www.elsevier.com/locate/bodyimage. Body Image Measures for Researchers Most of the books listed above include chapters that identify assessments of various aspects of body image functioning. Moreover, scientists who need validated body image assessments for their research may wish to consult these websites: www.body-images.com (website of T. F. Cash) www.bodyimagedisturbance.org (website of J. K. Thompson)
Finding PractitionersTo find practitioners, the following two websites are particularly useful. Additional websites are listed below for specific problem areas. The Academy of Cognitive Therapy lists practitioners at www.academyofct.org. The Association of Behavioral and Cognitive Therapies lists practitioners at www.abct.org.
Heal Your Suffering, and Reclaim Your Life. Oakland, CA: New Harbinger Publications. Kalodner, C. R. 2003. Too Fat or Too Thin? A Reference Guide to Eating Disorders. New York: Guilford Press. Lock, J., D. le Grange, W. S. Agras, and C. Dare. 2001. Treatment Manual for Anorexia Nervosa: A Family-Based Approach. New York: Guilford Press. (This book is particularly recommended for practitioners.) McCabe, R. E., T. L. McFarlane, and M. P. Olmstead. 2003. The Overcoming Bulimia Workbook: Your Comprehensive Step-by-Step Guide to Recovery. Oakland, CA: New Harbinger Publications. Websites These sites offer listings of therapists and treatment facilities specializing in eating disorders, as well as links to professional eating disorder associations and conferences: An excellent website for publications (books, DVDs, newsletters, free articles) and other resources on eating disorders is www.bulimia.com (also www.gurze.com). Another highly informative resource is the Something Fishy website on eating disorders at www.something-fishy.com.
Websites Here is a partial list of websites from programs that specialize in the treatment of BDD and related disorders: BDD Central at www.bddcentral.com is a valuable website. In addition to educational information, it gives treatment referral resources. BDD Treatment Programme www.veale.co.uk/bdd.html at the Priory Hospital North London, UK:
Bio-Behavioral Institute in Great Neck, New York: >www.bio-behavioral.com/bdd.asp Body Dysmorphic Disorder Clinic and Research Unit at Massachusetts General Hospital and Harvard Medical School: www.massgeneral.org/bdd Body Image Program at Butler Hospital (Providence, Rhode www.bodyimageprogram.com (or http://www.butler.org/body.cfm?id=123) Island):
Compulsive and Impulsive Disorders Program at Mount Sinai School of Medicine (New York, NY): www.mssm.edu/psychiatry/ciadp
New Harbinger, the publisher of this workbook, has a number of informative resources on mindfulness and acceptance, titles listed below. Visit the publishers website at www.newharbinger.com: Alpers. S. 2003. Eating Mindfully. Oakland, CA: New Harbinger Publications. Brantley, J. 2003. Calming Your Anxious Mind. Oakland, CA: New Harbinger Publications. Brantley, J., and W. Millstine. 2005. Five Good Minutes. Oakland, CA: New Harbinger Publications. Hayes, S., and S. Smith. 2005. Get Out of Your Mind and Into Your Life. Oakland, CA: New Harbinger Publications. McKay, M., and C. Sutker. 2007. Leave Your Mind Behind. Oakland, CA: New Harbinger Publications. McQuaid, J., and P. Carmona. 2004. Peaceful Mind. Oakland, CA: New Harbinger Publications. Spradlin, S. 2003. Dont Let Your Emotions Run Your Life. Oakland, CA: New Harbinger Publications.
Facets of the workbook are valuable for addressing the body image difficulties that accompany a range of other presenting problemssocial anxiety, depression, sexual dysfunctions, and basic selfesteem issues, for example. Of course, the program should never be the sole treatment for these clients. In clinical practice, your thorough assessment of each clients functioning and primary complaints is essential. You must have an accurate understanding of the functional significance of the clients body image in relation to other aspects of his or her psychosocial problems. However, you can effectively integrate this program with the proper treatments of these problems. Of course, simply telling a client to Read this book wont be helpful. Good clinical care necessitates meaningfully integrating the workbook into the clients broader treatment plan and providing problem-solving guidance and support. Moreover, as one who believes strongly in science-based practice, I encourage you to collect data on your clients targeted changes resulting from the therapeutic procedures that you use. I sincerely hope that you will find The Body Image Workbook to be an efficient, effective, and valuable resource in your clinical practice or treatment program. Helping clients who struggle with a broad range of body image difficulties makes an significant contribution to the quality of their lives.
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Harvard University Press. Noles, S. W., T. F. Cash, and B. A. Winstead. 1985. Body image, physical attractiveness, and depression. Journal of Consulting and Clinical Psychology 53:88-94. Nye, S., and T. F. Cash. 2006. Outcomes of manualized cognitive-behavioral body image therapy with eating disordered women treated in a private clinical practice. Eating Disorders: The Journal of Treatment and Prevention 14:31-40. Olivardia, R. 2002. Body image and muscularity. In Body Image: A Handbook of Theory, Research, and Clinical Practice, edited by T. F. Cash and T. Pruzinsky. New York: Guilford Press. Partridge, J. 2006. Changing Faces: The Challenge of Facial Disfigurement. 5th ed. London: Changing Faces. Pennebaker, J. W. 1997. Writing about emotional experiences as a therapeutic process. Psychological Science 8:162-166. . 2004. Writing to Heal: A Guided Journal for Recovering from Trauma and Emotional Upheaval. Oakland, CA: New Harbinger Publications. Pennebaker, J. W., and C. K Chung. 2007. Expressive writing, emotional upheavals, and health. In Foundations of Health Psychology, edited by H. S. Friedman and R. C. Silver. New York: Oxford University Press. Phillips, K. A. 2002. Body image and body dysmorphic disorder. In Body Image: A Handbook of Theory, Research, and Clinical Practice, edited by T. F. Cash and T. Pruzinsky. New York: Guilford Press. . 2005. The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder. Rev. ed. New York: Oxford University Press. Polivy, J., and P. Herman. 1983. Breaking the Diet Habit. New York: Basic Books. . 1992. Undieting: A program to help people stop dieting. International Journal of Eating Disorders 11:261-268. Pope, H. G., Jr., K. A. Phillips, and R. Olivardia. 2000. The Adonis Complex: The Secret Crisis of Male Body Obsession. New York: Free Press. Powell, M. R., and B. Hendricks. 1999. Body schema, gender, and other correlates in nonclinical populations. Genetic, Social, and General Psychology Monographs 125:333-412. Pruzinsky, T., and M. Edgerton. 1990. Body-image change in cosmetic plastic surgery. In Body Images: Development, Deviance, and Change, edited byF. Cash and T. Pruzinsky. New York: Guilford Press.
Ramirez, E. M., and J. C. Rosen. 2001. A comparison of weight control and weight control plus body image therapy for obese men and women. Journal of Consulting and Clinical Psychology 69:440-446. Rieves, L., and T. F. Cash. 1996. Reported social developmental factors associated with womens body-image attitudes. Journal of Social Behavior and Personality 11:63-78. Roberts, A., T. F. Cash, A. Feingold, and B. T. Johnson. 2006. Are black-white differences in females body dissatisfaction decreasing? A meta-analytic review. Journal of Consulting and Clinical Psychology 74:1121-1131. Rodin, J., L. R. Silberstein, and R. H. Striegel-Moore. 1985. Women and weight: A normative discontent. In Nebraska Symposium on Motivation: Psychology and Gender, edited byT. B. Sonderegger. Lincoln: University of Nebraska Press. Rosen, J. C., P. Orosan, and J. Reiter. 1995. Cognitive behavior therapy for negative body image in obese women. Behavior Therapy 26:25-42. Rosen, J. C., J. Reiter, and P. Orosan. 1995. Cognitive-behavioral body-image therapy for body dysmorphic disorder. Journal of Consulting and Clinical Psychology 63:263-269. Rosen, J. C., E. Saltzberg, and D. Srebnik. 1989. Cognitive behavior therapy for negative body image. Behavior Therapy 20:393-404. Rucker, C. E., and T. F. Cash. 1992. Body images, body size perceptions, and eating behaviors among African American and white college women. International Journal of Eating Disorders 12:291 300. Rudiger, J. A., T. F. Cash, M. Roehrig, and J. K. Thompson. 2007. Day-to-day body-image states: Prospective predictors of intra-individual level and variability. Body Image: An International Journal of Research 4:1-9. Rumsey, N. 2002. Body image and congenital conditions with visible differences. In Body Image: A Handbook of Theory, Research, and Clinical Practice, edited by T. F. Cash and T. Pruzinsky. New York: Guilford Press. Rumsey, N., and D. Harcourt. 2004. Body image and disfigurement: Issues and interventions. Body Image: An International Journal of Research 1:83-97. . 2005. The Psychology of Appearance. Berkshire, England: Open University Press. Sarwer, D. B., T. Pruzinsky, T. F. Cash, R. M. Goldwyn, J. A. Persing, and L. A. Whitaker (eds.). 2006. Psychological Aspects of Reconstructive and Cosmetic Plastic Surgery: Clinical, Empirical, and Ethical Perspectives. Philadelphia: Lippincott, Williams & Wilkins. Sarwer, D. B., J. K. Thompson, and T. F. Cash. 2005. Obesity and body image in adulthood. Psychiatric Clinics of North America 28:69-87.
Sarwer, D. B., T. A. Wadden, and G. Foster. 1998. Assessment of body image dissatisfaction in obese women: Specificity, severity and clinical significance. Journal of Consulting and Clinical Psychology 66:651-654. Schwartz, M. B., and K. D. Brownell. 2002. Obesity and body image. In Body Image: A Handbook of Theory, Research, and Clinical Practice, edited by T. F. Cash and T. Pruzinsky. New York: Guilford Press. . 2004. Obesity and body image. Body Image: An International Journal of Research 1:4356. Segal, Z. V., J. M. G. Williams, and J. D. Teasdale. 2002. Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse. New York: Guilford Press. Shontz, F. C. 1990. Body image and physical disability. In Body Images: Development, Deviance, and Change, edited by T. F. Cash and T. Pruzinsky. New York: Guilford Press. Smolak, L. 2002. Body image development in children. In Body Image: A Handbook of Theory, Research, and Clinical Practice, edited by T. F. Cash and T. Pruzinsky. New York: Guilford Press. Stice, E. 2002. Body image and bulimia nervosa. In Body Image: A Handbook of Theory, Research, and Clinical Practice, edited by T. F. Cash and T. Pruzinsky. New York: Guilford Press. . 2002. Risk and maintenance factors for eating pathology: A meta-analytic review. Psychological Bulletin 128:825-848. Strachan, M. D., and T. F. Cash. 2002. Self-help for a negative body image: A comparison of components of a cognitive-behavioral program. Behavior Therapy 33:235-251. Striegel-Moore, R. H., and D. L. Franko. 2002. Body image issues among girls and women. In Body Image: A Handbook of Theory, Research, and Clinical Practice, edited by T. F. Cash and T. Pruzinsky. New York: Guilford Press. Tantleff-Dunn, S., and J. L. Gokee. 2002. Interpersonal influences on body image development. In Body Image: A Handbook of Theory, Research, and Clinical Practice, edited by T. F. Cash and T. Pruzinsky. New York: Guilford Press. Thompson, J. K. (ed.). 1996. Body Image, Eating Disorders, and Obesity: An Integrative Guide for Assessment and Treatment. Washington, DC: American Psychological Association. . 2004. Handbook of Eating Disorders and Obesity. Hoboken, NJ: Wiley. Thompson, J. K., and G. Cafri (eds.) 2007. The Muscular Ideal: Psychological, Social, and Medical Perspectives. Washington, DC: American Psychological Association. Thompson, J. K., L. J. Heinberg, M. Altabe, and S. Tantleff-Dunn. 1999. Exacting Beauty: Theory,
Assessment, and Treatment of Body Image Disturbance. Washington, DC: American Psychological Association. Thompson, J. K., and L. Smolak (eds.). 2001. Body Image, Eating Disorders, and Obesity in Youth: Assessment, Prevention, and Treatment. Washington, DC: American Psychological Association. Tiggemann, M. 2002. Media influences on body image development. In Body Image: A Handbook of Theory, Research, and Clinical Practice, edited by T. F. Cash and T. Pruzinsky. New York: Guilford Press. . 2004. Body image across the adult life span: Stability and change. Body Image: An International Journal of Research 1:29-41. Tucker, K. L., D. M. Martz, L. A. Curtin, and B. G. Bazzini. 2007. Examining fat talk experimentally in a female dyad: How are women influenced by another womans body presentation style? Body Image: An International Journal of Research 4:157-164. Veale, D. 2004. Advances in a cognitive behavioural model of body dysmorphic disorder. Body Image: An International Journal of Research 1:113-125. Wertheim, E. H., S. J. Paxton, and S. Blaney. 2004. Risk factors for the development of body image disturbances. In Handbook of Eating Disorders and Obesity, edited byJ. K. Thompson. Hoboken, NJ: Wiley. Westmoreland-Corson, P., and A. E. Andersen. 2002. Body image issues among boys and men. In Body Image: A Handbook of Theory, Research, and Clinical Practice, edited by T. F. Cash and T. Pruzinsky. New York: Guilford Press. Whitbourne, S. K., and K. M. Skultety. 2002. Body image development: Adulthood and aging. In Body Image: A Handbook of Theory, Research, and Clinical Practice, edited by T. F. Cash and T. Pruzinsky. New York: Guilford Press. Wiederman, M. W. 2002. Body image and sexual functioning. In Body Image: A Handbook of Theory, Research, and Clinical Practice, edited byT. F. Cash and T. Pruzinsky. New York: Guilford Press. Wilhelm, S. 2006. Feeling Good about the Way You Look. New York: Guilford Press. Williams, E. F., T. F. Cash, and M. T. Santos. 2004. Positive and negative body image: Precursors, correlates, and consequences. Poster presented at the Conference of the Association for Advancement of Behavior Therapy, New Orleans. Williams, P., and T. F. Cash. 2001. Effects of a circuit weight training program on the body images of college students. International Journal of Eating Disorders 30:75-82. Williamson, D. A., T. M. Stewart, M. A. White, and E. York-Crowe. 2002. An informationprocessing perspective on body image. In Body Image: A Handbook of Theory, Research, and
Clinical Practice, edited by T. F. Cash and T. Pruzinsky. New York: Guilford Press. Winzelberg, A. J., L. Abascal, and C. B. Taylor. 2002. Psychoeducational approaches to the prevention and change of negative body image. In Body Image: A Handbook of Theory, Research, and Clinical Practice, edited byT. F. Cash and T. Pruzinsky. New York: Guilford Press. Yamamiya, Y., T. F. Cash, S. E. Melnyk, H. D. Posavac, and S. S. Posavac. 2005. Womens exposure to thin-and-beautiful media images: Body image effects of media-ideal internalization and impact-education interventions. Body Image: An International Journal of Research 2:74-80. Yamamiya, Y., T. F. Cash, and J. K. Thompson. 2006. Sexual experiences among college women: The differential effects of general versus contextual body images. Sex Roles 55:421-427.
Thomas F. Cash, Ph.D., is a true pioneer in the psychology of physical appearance. He is professor emeritus of psychology at Old Dominion University in Norfolk, VA. He is the founding editor-in-chief of Body Image: An International Journal of Research and has published six books and more than 200 scholarly articles on topics related to body image and human appearance, including What Do You See When You Look in the Mirror? and The Body Image Handbook. Dr. Cashs professional website is located at www.body-images.com. He currently resides in Naples, FL.