Body Image WorkPreferred Provider WorkshopJanuary 26, 2013Cara Faries, MA, LPCCastlewood Treatment Center for Eating Disorderswww.castlewoodtc.comCara.firstname.lastname@example.org 636-779-1430
What is Body Image?How you see or picture yourself.How you feel others perceive you.What you believe about your physicalappearance.How you feel about your body.How you feel in your body.
Negative Body ImageNegative body image is the culmination ofmessages, roles, rules, experiences, feelingsand traumas, we attempt to accommodate andassimilate in order to maintain cognitive andemotional equilibrium. Society and mediareinforce negative body image and messages,but it does not create it.
How to conceptualize individualizedcase treatment?1) How does client see him or herself…2) How does client feel others see them…3) Overt and Covert messages received …4) Need to gather in- depth history about significantexperiences, traumas and relationships.5) Identify irrational beliefs, distortions, struggles.6) How does the client perpetuate negative body imagestruggles?All Psychological, experiential, emotional, and societalinfluences
What Function does Negative BodyImage Serve?• Externalized expression of self hate• Expression of overwhelming feelings: grief,anger, insecurity, loneliness, shame, etc..• Internalized beliefs that stem from negativemessages (peers, family, coaches, media)• Coping for unresolved experiences,attachments, traumas, secrets, and roles.• Re- enactment
Body Image involvesperception, imagination, emotions, experiencesand physical sensations
Attunement and PsychologicalBoundariesPsychological and physical boundaries develop early in life.Proper attunement and nurturing helps a child understand anddistinguish between what is inside and outside of themselves.Attunement builds and nurtures a strong sense of self,boundaries, and trust.
ShameSelf HatePainPersons who are deprived of touch and attunement, may nothave the sensory information s/he needs to distinguish clearand formed boundaries. This often leads to difficulty in gainingan accurate sense of his/her body shape and size.
Trauma and the Body“Trauma is stored in somatic memory….inPTSD, failure of declarative memory maylead to organization of the trauma on asomatosensory level (as visual images orphysical sensations) impervious tochange” -Bessel A. Van der Kolk, MD.
Body Memories-Phantom Pains-Unexplainable preoccupation of body part-Unexplained physical sensations-Sensations identical to trauma experiencedIt is imperative to connect the source of the body memory to thetraumatizing event. This gives the necessary context to separate bodyimage struggle from trauma.Working through body memories allows clients to release and resolvestuck and/dissociated trauma. This allows clients to free hate, shameand disownment projected onto body.
Trauma BondsStrong emotional ties that develop between twopersons where one person intermittently harasses,beats, threatens, abuses or intimidates the other.Imbalance of powerSporadic in NatureDenial/ Dissonance
Re- Enactment• Trauma shapes self image• Behavioral enactment and automaticrepetition of past.• Clients re-enact in many ways includingthrough negative self talk, disembodiment,and abuse towards parts of the body that holdthe trauma
Triadic SelfVictim- Feelings of helplessness andpowerlessness to change.Abuser- Internalized abuser. Engages inperpetuating messages, abuse, andsabotaging behaviors.Non-Protecting Bystander- Does notprotect or intervene.
Self Esteem, Self Awareness and SelfWorthA healthy body image can only occur when apersons feelings about his/her body is positive,confidant and self caring.This image is necessary:To care for the body.It empowers clients to hear and respond to physicalneeds.Define and assert boundaries.Respond to thoughts, feelings and attitudesappropriately.
Identifying ShiftsTo gauge and measure clients movement towardsesteem and worth we must evaluate:Physically: Clients movement towards resolvingnegative talk, beliefs, attitudesIntellectually: Combat cognitive distortions, andbehaviors that enable negative bodyimage.Emotionally: Resolution around unsolved traumas,roles, experiences, relationships, etc..Morally: Understanding how client thinks of themselvesasa person.
Phase Onez: Assessment-Messages received about body-Influential experiences-Mirror-Have client write down 3-5 words they use todescribe areas of struggle-Core beliefs they have about what it means to bea male/female in the world, their body, andrelationships.-Clothing choices, what do they mean?
Phase Two: Address and Correct What if I accepted my body the way it is? What risks wouldI take? What benefits would I experience? How would lifebe different? What secondary gains come from my perpetual strugglewith my body? Reality testing: Body tracing, String/tape work Letter from body to self about what it has been like toendure the years of hate and abuse? When I think…Then I feel…Then I believe…New positive selfstatement Emotions Journal 2 minute negative self talk exercise
Phase Three: Reclaiming Self ImageContinue Body Image/emotions journalWrite letter back to body from self, expressingawareness and compassion for what it has endured.Systematically decrease perpetuating behaviors: bodychecking, negative self talk, excessive wardrobe changes,etc..Body Tracing: representing all the body has gonethrough and endured. Include all injuries, areas of selfharm and areas that endured abuse.Body appreciation work.Boundaries and Assertiveness training.