"Body Image and Sexual Health" by Clinical Sexologist Dr. Martha Tara Lee of Eros Coaching for "Symposium - Sex and the Spine: All You Ever Wanted to Know about Sex and the Spine but Were Afraid to Ask" by NSpine as part of SpineWeek, at Marina Bay Sands Expo & Convention Centre on Mon 16 May 2016. Dr Martha Tara Lee is Founder and Clinical Sexologist of Eros Coaching since 2009. She is a certified sexologist with ACS (American College of Sexologists), as well as a certified sexuality educator with AASECT (American Association of Sexuality Educators, Counselors, and Therapists). Martha holds a Doctorate in Human Sexuality as well as Certificates in Sex Therapy, Practical Counselling and Life Coaching. She was recognised as one of ‘Top 50 Inspiring Women under 40′ by Her World Singapore in July 2010 and ‘Top 100 Inspiring Women by CozyCot Singapore in March 2011. Website: http://www.eroscoaching.com.

1. Body Image and
Sexual Health
Dr. Martha Tara Lee, D.H.S.
16 May 2016
Symposium: Sex and the Spine: All You Ever Wanted to Know about Sex and the Spine but were
Afraid to Ask

2. Agenda
• Definition of Body
Image
• Body image and
puberty
• Concepts relating to
sexuality
• Identify strategies for
intervention

3. Dr. Martha Tara Lee
Clinical Sexologist
• Doctorate in Human Sexuality
• Masters in Public Policy and
Management
• Bachelor of Arts (Comm)
• Certificate in Sex Therapy
• Certitificate in Practical
Counselling
• Cert in Life Coaching

4. “The picture of our
body which we form
in our mind, that is
to say the way in
which our body
appears to ourselves”
[Schilder 1935, cited in
Price, 1990]
Body Image

5. 1. How a person thinks and feels about his
or her own body
2. The way we see our body and the way we
think that others see our body
3. How you feel your body is esthetically and
how attractive you perceive yourself.
4. Society's standards may not always
correspond to our perception of our own
body.
Body Image

6. Different Aspects of Body Image

7. The Way We See Our Own Body
(Perceptual)
• Perceptual body image is the difference between
what you perceive your body to look like and what
your body actually looks like
• Our body image is not always an accurate reflection of
what our body actually looks like.

8. The Way We Feel About Our
Body’s Appearance (Affective)
Affective body image
refers to the amount of
satisfaction or
dissatisfaction we feel
about our general
appearance, our weight
or shape and even
about specific body
parts.

9. The Thoughts and Beliefs We Have
About Our Own Body (Cognitive)
The feelings that we have about
our body and its appearance are
often associated with certain
thoughts or beliefs.
When we feel dissatisfied with
some aspect of our body it is
usually because we believe that it
is not the right shape, size or color.

11. Nicholas James "Nick" Vujicic; born 4 December 1982 is
an Australian Christian evangelist and motivational
speaker born with Phocomelia, a rare disorder
characterised by the absence of legs and arms.

12. Sean Clinch Stephenson is an American therapist,
self-help author and motivational speaker.
Because he was born with osteogenesis
imperfecta, Stephenson stands three feet tall, has
fragile bones, and must use a wheelchair.

13. Bethany Meilani Hamilton-Dirks (born
February 8, 1990) is an American
professional surfer who survived a 2003
shark attack in which her left arm was
bitten off

14. All in the Mind
• The mental representation we
create of what we think we look
like.
• The avg. person receive at
least 14 messages a day
related to attractiveness from
the media.
• Body dissatisfaction and eating
disorders are common in
college females and
adolescents.

15. The Things We Do because
We are Dissatisfied with our
Body (Behavioral)
Often, feelings of
dissatisfaction with the
body can lead a
person to avoid doing
certain things that
might evoke those
concerns.

16. Puberty vs. Body Image
Why important?
• A person's opinions, thoughts,
and feelings about his or her
own body and physical
appearance.
• A healthy body image means
feeling pretty satisfied with the
way you look, appreciating
your body for its capabilities
and accepting its
imperfections.

17. • Body image is just one
part of your self-image.
• A change in your body
can be tough to deal with
emotionally!
Puberty vs. Body Image

18. If you’re uncomfortable with
your changing body… .
• May lead you to feel more
self-conscious.
• Some may not feel too
satisfied with their body or
appearance to begin with.
Thus puberty may add to such
insecurities.
• Their sexual identity is
developing and they become
increasingly concerned about
being attractive to others.
Puberty vs. Body Image

19. Big Bullies Don’t Rule
• Sometimes if people haven’t
caught up physically, peers
may tease them.
• Often, peers that put others
down do it because they aren’t
comfortable with their bodies.
• Bullying makes them feel
better, more powerful.
• Suggestion: To be comfortable
with who you are and get in
touch with your strengths.

20. The Definition of a Positive Body
Image
If you have a positive body
image you are happy about
the way you look and feel
good about your body. You
may realize that your looks
do not match what is
presented in the media, or
what family members might
say, but you carry yourself
with pride.

23. The Definition of a Negative
Body Image
People with a negative body image feel that their looks do not measure up to
what society, family, friends, and the media expect. There is a feeling of
inadequacy when they compare themselves to others, which they tend to do more
frequently than those with a positive body image.
Usually, people with a negative body image are not being realistic. When they look
in the mirror, they see parts of their body in a distorted, unreal way. They do not
see who/what they really are.

24. Sexual Health & Body Image
Teens who lack
knowledge about
sexual health and who
do not feel accepted
and supported by their
parents are more
likely to follow the
crowd.
By: The Emotional
Life

25. Sexual Health
According to the current working definition, sexual
health is:
“…a state of physical, emotional, mental
and social well-being in relation to
sexuality; it is not merely the absence of
disease, dysfunction or infirmity. Sexual
health requires a positive and
respectful approach to sexuality
and sexual relationships, as well
as the possibility of having
pleasurable and safe sexual
experiences, free of coercion,
discrimination and violence.”

26. Body Image and Spinal Cord
Injuries

27. Body Image
Van der Velde (1985) suggests that
body image should consider :
• There are multiple & innumerable
body images present, since we are
not able to view the entire self at
any one time.
• Body images incorporate our
interpretations of others appraisals
& evaluations, as well as their
reactions to our appearance.
• Formation of body image includes
the perceptions of the physical
appearance of others.
• Body image is important in its
necessity for the interactions with
others. Any contact with others,
requires an image of self to be
projected.

28. Body Image Model [Price,1990]
Environment
(Real ,symbolic, external)
BODY IDEAL
Coping strategies Environment
Social support network
Environment BODY REALITY BODY PRESENTATION
Self image
Environment

29. Assessment
• Body reality, body ideal, body presentation
• Coping strategies
• Support networks

30. Care Intervention Modes
• Preventive care
• Harm reduction?
• Supportive care
• Patient education/
patient counselling
• Liaison with social
support network &
other agencies
www.pulitzercenter.org

31. Evaluation
• Body reality
• Body ideal
• Body presentation
• Coping strategies
• Social support network
Body image problem
resolved or if not,
reassess

32. Stages of Altered Body Image
• Impact
• Retreat
• Acknowledgement
• Reconstruction
[ Lee,1970]

33. Principles of Grief Counselling
[ Worden,1991]
1. Help “ survivor” to actualise the “loss”
2. Help the “survivor” to identify & express feelings
3. Assist “living” without the “deceased”
4. Facilitate emotional relocation of the “deceased”
5. Provide time to grieve
6. Interpret “ normal” behaviour
7. Allow for individual differences
8. Provide continuing support
9. Examine defence & coping styles
10. Identify pathology & refer

34. Some Body Image & Sexuality
Issues
• Loss of energy/ fatigue
• Loss of control
• Isolation
• Feeling dirty
• Sexual
dysfunction/distress
• Fertility
• Pregnancy
• Menopause

35. Sexuality
Sexuality is interwoven with every aspect of human
existence, and in its broadest sense, sexuality is
defined as a desire for contact, warmth, tenderness,
or love. Humans express and live their sexuality in
their daily lives.
Sexuality is not limited to an act of seduction or of
intercourse but encompasses every area of our
lives: the way we relate to others, our friends, our
family, and our work. It is evident in what we believe,
how we behave and the way we look.
[Poorman,1988]

36. Sexual self concept Sexual function
Sexual role relationships
[Woods, 1984]

37. Useful Areas to Explore
1. In what ways (if any) has your illness/ surgery
changed the way you see yourself?
2. How has illness/ surgery interfered with being mother/
father /wife/ husband/ partner/ friend?
3. Some people who have had this type of illness/
surgery find that they have a few problems in their
sexual relationships. Is this something you have
encountered? If so, it is OK to talk to me about it.
4. In what ways would you like things to change?
[ Adapted from Woods, N. F (1984)Sexuality in Health & Illness. St Louis: Mosby]

39. PLISSIT Model
Permission to self – Pleasure; to use vibrator, Ask
for certain kinds of touch, caress.
Limited Information – Changes in sexual response
with pregnancy, menopause, aging. Impact of
medication(s) on sexual function.
Specific Suggestions – HRT benefits and risks, use
of lubricants; Positions.
Intensive Therapy – Refer to specialists for couple
therapy, resolution of long-standing problems.

40. Tips to Improve Your Body
Image
1. Understand your body
2. Self-care: Keeping yourself well-groomed
and neat
3. Do exercises that make you feel better
about your body
4. Grooming: Wear clothes that make you
feel attractive
5. Non-verbal communication: Walk tall and
straight and smile whenever you can
6. Body image is more about your mind
than your body
7. Realize that few people are as critical of
your body as you are
8. Know that you are special

41. Do what you can, let go of the rest
Scar Tissue Remediation
Scar remediation works on
both internal and external
scars and is a simple
process that uses castor oil
and a number of different
strokes to gently work with
the tissue over the scar and
surrounding area.

42. “Remember
that your
body image
is not about
how you
look, but
how you
feel.”

43. References
Geise ,L,A & Terrell,L (1996) Sexual health issues in inflammatory bowel disease. Gastroenterology Nursing Vol
19 No 1 pp 7-12
Kane, S (2001) Caring for women with inflammatory bowel disease Journal of Gender Specific Medicine Vol 4 No
1 pp 54-59
Lee,J,M (1970) Emotional reactions to trauma.Nursing Clinics of North
America.Vol 5 pp 577-587
Price,B (1990) A model for body image care. Journal of Advanced Nursing Vol 15 pp 585 – 593
Van de Velde,C,D ( 1985) Body images of ones’ self & others. Development & clinical significance.American
Journal of Psychiatry. Vol. 142 pp 527 – 537
Annon, J (1971) The PLISSIT model: A proposed conceptual scheme for the behavioural treatment of sexual
problems. Journal of Sex Education & Therapy. Vol 2 pp 1-15
Tomlinson,J (2000) ABC of sexual health: Taking a sexual history. London: BMJ
British Association of Sexual & RelationshipTherapy.020854432707
www.basrt.org.uk
SPOD : 02076078851.286 Camden Road.London N7 OBJ
Fpa: 02078375432 : www.fpa.org.uk ( sex ware products)

44. Thank you!
Dr. Martha Tara Lee, D.H.S.
Clinical Sexologist
Eros Coaching Pte Ltd
Website: www.eroscoaching.com
Email: drmarthalee@eroscoaching.com