Body Image Work

Preferred Provider WorkshopJanuary 26, 2013

Cara Faries, MA, LPCCastlewood Treatment Center for Eating Disorders

www.castlewoodtc.comCara.faries@castlewoodtc.com 636-779-1430

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.

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.

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

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

The Language of Fat

Feelings

Attitude

Thoughts

Listen, Stop and Explore the language!

Body Image involves perception, imagination, emotions, experiences

and physical sensations

Attunement and Psychological BoundariesPsychological 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.

ShameSelf Hate

PainPersons 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.

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.

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.

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

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

Triadic SelfVictim- 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.

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.

Identifying ShiftsTo gauge and measure clients movement towards esteem and worth we must evaluate:Physically: Clients movement towards resolving negative talk, beliefs, attitudesIntellectually: 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.

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?

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

Phase Three: Reclaiming Self Image

Continue Body Image/emotions journalWrite 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.