Castlewood and EDCMO therapist Cara Faries shares information about the treatment of body image and body dysmorphia.

1. Body Image Work
Preferred Provider Workshop
January 26, 2013
Cara Faries, MA, LPC
Castlewood Treatment Center for Eating Disorders
www.castlewoodtc.com
Cara.faries@castlewoodtc.com 636-779-1430

2. What is Body Image?
How you see or picture yourself.
How you feel others perceive you.
What you believe about your physical
appearance.
How you feel about your body.
How you feel in your body.

3. Negative Body Image
Negative body image is the culmination of
messages, roles, rules, experiences, feelings
and traumas, we attempt to accommodate and
assimilate in order to maintain cognitive and
emotional equilibrium. Society and media
reinforce negative body image and messages,
but it does not create it.

4. How to conceptualize individualized
case 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 significant
experiences, traumas and relationships.
5) Identify irrational beliefs, distortions, struggles.
6) How does the client perpetuate negative body image
struggles?
All Psychological, experiential, emotional, and societal
influences

5. What Function does Negative Body
Image Serve?
• Externalized expression of self hate
• Expression of overwhelming feelings: grief,
anger, insecurity, loneliness, shame, etc..
• Internalized beliefs that stem from negative
messages (peers, family, coaches, media)
• Coping for unresolved experiences,
attachments, traumas, secrets, and roles.
• Re- enactment

6. The Language of Fat
Feelings
Attitude
Thoughts

7. Listen, Stop and Explore the language!

8. Body Image involves
perception, imagination, emotions, experiences
and physical sensations

9. Attunement and Psychological
Boundaries
Psychological and physical boundaries develop early in life.
Proper attunement and nurturing helps a child understand and
distinguish between what is inside and outside of themselves.
Attunement builds and nurtures a strong sense of self,
boundaries, and trust.

10. Shame
Self Hate
Pain
Persons who are deprived of touch and attunement, may not
have the sensory information s/he needs to distinguish clear
and formed boundaries. This often leads to difficulty in gaining
an accurate sense of his/her body shape and size.

11. Trauma and the Body
“Trauma is stored in somatic memory….in
PTSD, failure of declarative memory may
lead to organization of the trauma on a
somatosensory level (as visual images or
physical sensations) impervious to
change” -Bessel A. Van der Kolk, MD.

12. Body Memories
-Phantom Pains
-Unexplainable preoccupation of body part
-Unexplained physical sensations
-Sensations identical to trauma experienced
It is imperative to connect the source of the body memory to the
traumatizing event. This gives the necessary context to separate body
image struggle from trauma.
Working through body memories allows clients to release and resolve
stuck and/dissociated trauma. This allows clients to free hate, shame
and disownment projected onto body.

13. Trauma Bonds
Strong emotional ties that develop between two
persons where one person intermittently harasses,
beats, threatens, abuses or intimidates the other.
Imbalance of power
Sporadic in Nature
Denial/ Dissonance

14. Re- Enactment
• Trauma shapes self image
• Behavioral enactment and automatic
repetition of past.
• Clients re-enact in many ways including
through negative self talk, disembodiment,
and abuse towards parts of the body that hold
the trauma

15. Triadic Self
Victim- Feelings of helplessness and
powerlessness to change.
Abuser- Internalized abuser. Engages in
perpetuating messages, abuse, and
sabotaging behaviors.
Non-Protecting Bystander- Does not
protect or intervene.

16. Self Esteem, Self Awareness and Self
Worth
A healthy body image can only occur when a
persons 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 physical
needs.
Define and assert boundaries.
Respond to thoughts, feelings and attitudes
appropriately.

17. Identifying Shifts
To gauge and measure clients movement towards
esteem and worth we must evaluate:
Physically: Clients movement towards resolving
negative talk, beliefs, attitudes
Intellectually: Combat cognitive distortions, and
behaviors that enable negative body
image.
Emotionally: Resolution around unsolved traumas,
roles, experiences, relationships, etc..
Morally: Understanding how client thinks of themselves
as
a person.

18. Phase Onez: Assessment
-Messages received about body
-Influential experiences
-Mirror
-Have client write down 3-5 words they use to
describe areas of struggle
-Core beliefs they have about what it means to be
a male/female in the world, their body, and
relationships.
-Clothing choices, what do they mean?

19. Phase Two: Address and Correct
 What if I accepted my body the way it is? What risks would
I take? What benefits would I experience? How would life
be different?
 What secondary gains come from my perpetual struggle
with my body?
 Reality testing: Body tracing, String/tape work
 Letter from body to self about what it has been like to
endure the years of hate and abuse?
 When I think…Then I feel…Then I believe…New positive self
statement
 Emotions Journal
 2 minute negative self talk exercise

20. Phase Three: Reclaiming Self Image
Continue Body Image/emotions journal
Write letter back to body from self, expressing
awareness and compassion for what it has endured.
Systematically decrease perpetuating behaviors: body
checking, negative self talk, excessive wardrobe changes,
etc..
Body Tracing: representing all the body has gone
through and endured. Include all injuries, areas of self
harm and areas that endured abuse.
Body appreciation work.
Boundaries and Assertiveness training.