Imagine being trapped in a never-ending cycle of self-criticism and doubt, where your body’s reflection is your worst enemy. This is the reality for people struggling with body dysmorphia, which is more than just a negative body image but a complex web of tangled emotions about disliking your appearance.
Seeing women with “perfect” bodies on social media, triggers feelings of inadequacy in Khethi Motha from Pretoria.
“What triggers body dysmorphia for me is seeing how some women on social media have perfect bodies, and seeing how I sometimes get treated differently than my smaller-bodied friends when we’re out or feel like an outcast in my friend group because I’m the ‘biggest’ one in the group.
“Sometimes I put on an outfit and feel like my body ruins it, making me feel horrible about myself again.”
Khethi Motha
For Motha, body dysmorphia makes her feel like she isn’t attractive, and if she looked a certain way, she would be more attractive and treated better. She has learned ways to cope.
She says, “I try wearing clothes that I wouldn’t usually wear, trying to look at my body in the mirror every day, and instead of being negative, I try to say positive things and be thankful that I have a fully able and healthy body.”
Comments from friends and family hurt
Reflecting on her journey with body dysmorphia, Afika Nobaza from Centurion in Gauteng says she tries to do internal work by accepting her body.
“Body dysmorphia for me was caused by comments by family members, friends, colleagues, and, 5% of the time, social media comments. It makes me feel the need to hide or wear clothing that will hide my body. I need to cover up or get surgery to ‘fix the problem’,” she shares.
Nobaza says clothes will never be designed to her desire; hence, she tries to feel good in her own body and not make clothes the reason she feels good.
“Going to the gym and eating healthy are only external motivations, and I do feel good. However, I have considered surgery but I can’t afford that right now. So I have a whole lot of work to do internally and to understand that there are certain things that I can’t change, and that’s okay,” Nobaza admits.
Clinical psychologist Palesa Chele from Gauteng defines body dysmorphic disorder (BDD) as a psychiatric condition marked by relentless preoccupations with one or more perceived defects or flaws in a person’s physical appearance.
According to her, perhaps a person will read this and begin to wonder if they may have BDD; however, she explains that when speaking about a psychiatric condition, they are specifically referring to psychopathology. Therefore, they must be able to demonstrate that the person’s experience causes clinically significant distress.
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Society’s standards of beauty
“Over the ages, socio-cultural and political standards of beauty have continued to exert psychological strain on people, which often manifests as self-esteem challenges. Most people may experience insecurities about their physical appearance, yet they remain able to go on with their day with enjoyment and minimal distress.”
“Conversely, a person living with BDD is unable to enjoy the occasion as they routinely get up to go to the bathroom to check their face. Or, they are so internally distracted that they are incapable of attending to the task at hand due to them being constantly plagued with intrusive thoughts and questions related to the defect of concern.”
For a person living with BDD, Chele notes that their experience of the defect is severally overwhelming and results in them intermittently performing a series of repetitive behaviours. This includes mirror checking, excessive grooming, skin picking, reassurance seeking, and/or mental acts, such as comparing their appearance with that of others as a result of their defect.
“BDD occurs when there is an interaction between biologically predisposing factors, such as a person with an underlying biologically anxious personality structure, and concurrent environmental stressors, such as childhood abuse, peer teasing, and peer victimisation.”
Clinical psychologist Palesa Chele
“The research on BDD has indicated that adults with the condition report high levels of childhood maltreatment and some form of emotional, physical, or psychological abuse. However, this does not hold truth for all persons living with the condition, and it is important to note that some people may present with BDD despite not having experienced adverse childhood living conditions.”
Therapy can help with self-image
Chele suggests cognitive behavioural therapy as an efficacious therapeutic treatment modality for BDD, as it focuses on empowering mental healthcare users (MHCUs) with flexible thinking patterns.
Ultimately, through CBT and MHCUs, she says people can minimise self-defeating, ruminative thought patterns and build a more realistic appreciation of their bodies.
“I also recommend accepting oneself without judgement as fundamental to cultivating a fully integrated and healthy self-image. This is achieved through a variety of approaches, including psychotherapy, where one is guided through the processes of recognising and challenging one’s negative thought patterns around one’s body.
“Furthermore, engaging in activities of healthy self-care, as well as acknowledging the very nature of beauty standards as idealistic and ever-changing, helps to foster acceptance of one’s self,” she advises.
Additionally, Chele underlines that there is no health without mental health and advises people to consult their local mental healthcare practitioner for an accurate assessment, diagnosis, and appropriate treatment options should they have any questions or concerns.
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