Ways To Improve Your Body Image

Mirror Madness

Mirror Madness

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Selfconcept body image sexual identity

Cancer has the potential to influence development of self-concept, a key task, among young people (Rowland 1990). Alterations in physical appearance, including weight changes, hair loss, amputations, placement of catheters to facilitate treatment administration, scars and alterations in skin colouration and texture, not only make children and teens feel different from peers but also may represent frightening changes in the body with an adverse impact on self-esteem. Fears that the body will never return to its original appearance, of not being recognized by others or of being mistaken for an individual of the opposite sex, often lead to shame, social isolation, and regressive behaviours (Die-Trill and Stuber 1998). These sometimes sudden alterations in body image are often perceived by patients as a threat to their well-being, causing anxiety. Also, self-image and life outlook appear to be worse among survivors who perceive treatment-related physical limitation as being moderate to...

Body Image

Body image is clearly an important aspect of BDD, but has received little investigation. In one study, patients with BDD were less satisfied with their body image than control subjects and were more likely to feel that their body was unacceptable (Hardy 1982). Patients' views of their appearance may be based in abnormal sensory (perceptual) processing or in attitudinal cognitive-evaluative dissatisfaction. Preliminary empirical reports suggest that BDD patients may not have deficits in sensory processing, but to the contrary, may have unusually good discriminatory ability. In one report, BDD patients more accurately assessed facial proportions than control subjects or cosmetic surgery patients (Thomas and Goldberg 1995). Another study similarly found that BDD patients had a more accurate perception of nose size and shape than a control group (Jerome 1991). In a neuro-psychological study, individuals with BDD overfocused on minor and irrelevant stimuli (Deckersbach et al. 2000),...

Professional practice

Children and young people who experience repeated episodes ofhealth interventions or medical examinations, or who need intimate personal care, sometimes feel that their body is not under their own control. They can develop a learned compliance that leaves them more vulnerable to sexual abuse than other children (Westcott and Jones 1999). Sometimes their relationship with their body becomes so dissociated that they do not feel that it is worth looking after. This can lead to poor health choices, including indiscriminate sexual activity. Negative comments from others about weight or physical appearance can contribute to the development of poor body image or even, in more extreme cases, an eating disorder (CMEC Council of Ministers of Education Canada 2001). In any discussion of future relationships, care needs to be taken to avoid setting up limiting assumptions that reduce the child or young person's perceptions of the range of experiences and relationships that might be possible for...

Associated Neurological Findings

There are some potential distortions of body image that may accompany sensory loss helping to localize the sensory deficit to the cerebral cortex. Examples are anosodiaphora, which is a lack of concern over a profound loss of sensation or other neurological deficit anosognosia, which reflects a lack of awareness of a profound sensory or neurological deficit and asomatognosia, which represents loss of awareness of one half of the body. Additionally, the patient may manifest sensory neglect with a lack of orienting responses to unilateral stimuli. An aphasia and an increased susceptibility to distracting stimuli manifested as lack of attention or poor concentration are also signs localizing an accompanying sensory deficit to the cerebral cortex.

Sensory Syndromes Associated with Psychogenic Sensory Loss

A psychogenic sensory loss should be suspected in patients with sensory loss that demonstrates hyperesthesia for one modality in a given area and anesthesia for another in the same area, absolute loss of all cutaneous sensation, hyperesthesia that resolves with mild distraction, and sensory levels that correspond to the patient's body image rather than organic sensory levels. The examiner should look for abrupt midline changes, vibration asymmetry over a fixed bone that spans the midline, vibration asymmetry at a fixed midline point as the tuning fork is pivoted from one side to the other, and marked variation with repeated examination. The validity of determining a psychogenic sensory loss with these factors has been debated. y , y

Etiology and Pathophysiology

BDD's etiopathology is likely multifactorial, with neurobio-logical, evolutionary, sociocultural, and psychological factors playing a role. Family history data suggest that BDD is familial (K. A. Phillips, unpublished data). Neuropsychological studies indicate that the pathogenesis of BDD may involve executive dysfunction, implicating frontal-striatal pathology (Deckersbach et al. 2000 Hanes 1998). Rauch et al. (1998) hypothesized that BDD may involve dysfunction of the orbitofrontal system or the orbitofrontal-amygdalar axis, similar to OCD. Studies of this hypothesis are needed, as is investigation of the temporal and occipital lobes, which process facial images and, along with the parietal lobes, are involved in neurological disorders involving disturbed body image. Treatment data provide only indirect evidence about etiology but suggest a role for serotonin antagonism of the serotonin system can worsen BDD symptoms.

Managing adult sexual relationships

Growing up, I had few friends and little social interaction. CAH can affect your social life both through its impact on self-esteem, body image and confidence but also through the necessity, for some, for frequent hospital visits and in-patient stays simply to stay well and alive. Like any teenager, I had begun to have sexual feelings but was too scared and frightened to explore them. So, while my friends and peers seemed to be getting on with their lives and having boyfriends, I avoided the issue, shut off and suppressed feelings, got on with my schooling and then work. I felt isolated and lonely and lacked confidence around people - a very common experience for those with CAH (May, Boyle and Grant 1996). I wondered how anyone could love or want me, thought that I could not reciprocate and felt a failure -though more failed by society and doctors as surgery made me look worse than 'nature's mistakes'.

Depression and Behavioral Disorders

Although many healthcare providers may believe that high rates of depression or behavioral disorders are common in cancer survivors, there is little evidence that this is the case. While parents tend to see higher than average levels of somatic symptoms in children (e.g. headaches, stomachaches, toileting issues 39, 43 ), most research indicates no unusual levels of psychological symptoms in survivors during childhood and adolescence. Across a number of studies, overall rates of depression 42 ,behavioral disorders 41,43 and other general psychological symptoms 9, 31, 55 reported by children and their parents have been comparable to rates reported by children who have never had cancer. Similarly, survivors appear to have no more social anxiety, loneliness or body image concerns than do their never-ill peers 46 , and they may even have a more positive self-image than their peers 3,35 .

Peer support and support groups

Roberts et al. (1997) report results of a support group intervention designed to facilitate adjustment in young adults with cancer. Improvements in psychological well-being were observed. The group was facilitated by two young adults, one of each gender. Topics covered included anxiety about health and physical well-being, worries about fertility and raising children, relationship problems, financial concerns and body image. The authors noted that the group quickly developed cohesion and they Thus, participation in oncology camps, outdoor adventure programmes, cancer survivor day picnics and family retreats offers opportunities for life experiences that promote successful achievement of age-appropriate developmental tasks. For instance, a wilderness adventure programme provides adolescents undergoing therapy with extraordinary experiences that boost self-image and facilitate coping skills (Stevens et al. 2004). An eight-day adventure trip for 17 young adult survivors of childhood...

Physical Activity and HRQL

The beneficial effects of a healthy lifestyle and physical activity on perceived health status are well recognized, and medical societies support physical exercise as an important aspect of prevention and therapeutic measures 6 . A few review articles have pointed out that exercise benefits are not limited to somatic diseases, but also extend to mental health. A lot of studies support the use of physical activity as a means of improving HRQL through enhanced self-esteem, improved mood states, body image and stress responsiveness, reduced state and trait anxiety and depression 7-9 . Also the stage of change for regular exercise is associated with self-perceived quality of life 10 . Subjects who are least motivated to adopt regular exercise report the lowest levels of HRQL, suggesting that cognitive-motivational messages designed to emphasize the benefits associated with exercise may be helpful to move people along the stages of change.

The Female Athlete Triad

The problem usually begins with disordered eating, which includes a spectrum of abnormal and harmful eating patterns such as binging and purging, restrictive eating, fasting, and the use of diet pills or laxatives. The preoccupation with food, a distorted body image, and intense fear of becoming fat are often present as well. Some athletes will meet the Diagnostic and Statistical Manual of Mental Disorders, revised edition IV 95 , criteria for anorexia nervosa or bulimia, whereas other athletes may display similar behaviors without meeting full diagnostic criteria. A new classification of eating disorder not otherwise specified (ie, ED-NOS) allows for the identification of women who do not meet other classification criteria. This classification has been helpful in this population because the athlete's weight may seem adequate as a result of increased lean tissue mass however they are not consuming enough calories to meet their energy needs.

Physical Activity and HRQL in Obesity

Score Activity

The negative effects of obesity on HRQL are clearly demonstrated. Both physical and mental components of HRQL are remarkably impaired when compared with population norms, particularly in subjects seeking treatment 21 and in those with psychological or psychiatric distress 22,23 .Also in subjects where obesity is superimposed on other chronic illnesses, a further deleterious impact is observed 24 , limited to physical components. Behavior therapy produces a systematic improvement in all scales of HRQL, largely outweighing the effects on body weight and resulting in a significant change in self-perceived health status 25 . Several uncontrolled studies have consistently demonstrated that physical exercise can positively influence the quality of life in obese adolescents, at risk of psychological distress for the stigma of obesity. Walker et al. investigated the change in body image, self-esteem, and worries in 57 obese adolescents attending a residential, weight-loss camp 26 . Obese...

Psychosocial development in young people with CF

Growing up with a chronic illness such as CF has both a physical and emotional toll on young people's psycho-social development. The growth and pubertal delay common in CF has been shown to have a negative effect on young people's self-esteem and body image and other people's perception of their age and development (Sawyer etal. 1995). This is further complicated by the other obvious physical markers of CF, such as surgical scars, the visibility of permanent intravenous access ports and body habitus such as a barrel-shaped chest. These can all interfere with young people's development of peer and romantic relationships, and perception of physical attractiveness and self-worth (Sawyer 2000 Sawyer etal. 1995). The urinary incontinence experienced by many women with CF has also been shown to affect young women's social life and intimate relationships negatively (Nixon et al. 2003). Emotionally, growing up with a life-limiting condition has been shown to influence some young people into...

Management of Established Problems 16351 Management and Rehabilitation

Guidance needs to be provided for the female who can expect, or has developed, breast hypoplasia from irradiation. Development of a positive body image is an especially difficult task for adolescent females who expect normal development. A female teenager who has the potential for unequal breast development is particularly at risk for developing a negative body image, with accompanying lowered self-esteem. The

Self Control Strategies and Goals of Self Control

Critical in the development of self-control and the use of self-control strategies is the concept of choice, or decisional control that is, What is the goal for which the person wishes to develop and exercise self-control Several schools of thought are now beginning to integrate the traditional change model of self-control with an acceptance model of self-control. For example, a person who dislikes his or her body image may make a choice to learn self-control strategies involving an assertive change mode of control such as exercising more and developing healthier eating habits. Or such individuals may choose to learn self-control strategies involving meditation and cognitive instructions of self-acceptance to honor their bodies as they are. Depending on the person and the circumstances, either self-control goal may be healthy and bring about a sense of control and well-being.

Anorexia Nervosa

Anorexia nervosa is a psychophysiological disorder especially prevalent among young women and characterized by refusal to eat or maintain normal body weight, intense fear of becoming obese, a disturbed body image in which the emaciated patient feels overweight, and absence of any physical illness accounting for extreme weight loss. The term anorexia is actually a misnomer, because genuine loss of appetite is rare and usually occurs only late in the illness. Most anorectics are actually obsessed with food and constantly deny natural hunger.

Culture And Health

Some health-related practices are dramatically culture-bound, such as infanticide and malnutrition in girl children because of boy preference in several Asian countries. Mothers in West Papua do not take ferum tablets due to the fear of having large babies, since they have to deliver their babies by themselves in the hut in the back yard outside their homes. Certain mental illnesses, such as amok (sudden frenzy), koro (fear of penis constriction), and taijin-kyofusho (fear of being looked at) are thought to be culture-specific rather than universal. Anorexia Nervosa (self-starvation and distorted body image) is mainly confined to Western countries, but more recently it has been showing up in Asian locations.

Eating Disorders

Both BDD and eating disorders are characterized by disturbed body image, preoccupation with perceived appearance flaws, and performance of repetitive behaviors such as mirror checking and body measuring, and they have a similar age at onset. However, patients with eating disorders tend to dislike their weight and overall body size, whereas those with BDD dislike more specific body parts, often facial features (although this distinction is not always applicable). These disorders also differ in terms of sex ratio and are not as highly comorbid with each other as with many other disorders (Phillips and Diaz 1997). Family history and treatment data do not strongly support the hypothesis that these disorders are the same or closely related (Phillips et al. 1993). Rosen and Ramirez (1998) found that BDD and eating disorders were characterized by similarly low levels of self-esteem and by equally severe body image symptoms and disturbance. However, patients with eating disorders reported...

The way ahead

Regaining ownership of one's body is a very important component of ensuring that self-esteem and improved body image are restored as well as a means of avoiding the 'medicalization' of sexual function. Parents, carers and professionals need to remember that the growing child and teenager is a sexual being and will want to have similar experiences to their peers. To be told that an 'oversized clitoris is unimportant and has been removed reduced' despite the fact that it is the most innervated part of the woman's body (Baskin etal. 1999 Crouch etal. 2004 O'Connell etal. 1998) and essential for sexual pleasure is at least insensitive and at worst highly damaging. If the same was said about a man's penis there would be total outrage

Detection Screening

The patient should be assessed for level of functioning and participation in normal daily activities, such as school and after school activities. Normal growth and development parameters should be incorporated into this assessment, as developmental stages may influence the patient's participation in some activities. Another influence on level of functioning or decreased participation in activities could be the lack of adjustment to body image changes. There is no current method of completely preventing the development of late musculoskeletal effects from surgery or radiotherapy. The patient who has experienced an amputation or a significant growth deficit due to radiotherapy may or may not have incorporated this long-term effect into a new, positive body image. Many other factors contribute to general growth and development, such as nutritional deficits, other tissue damage and hormonal influences. The examiner should not rush to attribute the entire problem to the cytotoxic treatment...


The psychological adaptations to the long-term sequelae of treatment also need attention. Novotny 44 observed that one's body image is composed of fluctuating physical, psychological, and social aspects. A positive adjustment to changes in body image requires discarding the previously-held perception of one's body and incorporating the changes into a new perception. If the previous body image cannot be put aside so that the changes can be integrated and accepted, a negative body image may result. Medical personnel can assist patients and their families in making a positive adaptation to changes in body image. Strategies for promoting acceptance of treatment-related body image changes must be individualized to each situation 44 . The initial approach should begin with facilitating open, honest communication within the family about their previous experiences, current and anticipated concerns and their educational needs. This information can then serve as the foundation on which to...


Finally, the evaluative performance aspect of sex with a partner often creates sexual performance anxiety for the man, a factor that may contribute to IE. Such anxiety typically stems from the man's lack of confidence to perform adequately, to appear and feel attractive (body image), to satisfy his partner sexually, and to experience an overall sense of self-efficacy 91,92 . The impact of this anxiety on men's sexual response varies depending on the individual and the situation, but in some men it may interfere with the ability to respond adequately. With respect to IE, anxiety surrounding the inability to ejaculate may draw the man's attention away from erotic cues that normally serve to enhance arousal. Apfelbaum,

The frontal cortex

However, although not all mental rotation studies report premotor activation (Jordan et al., 2001), there is stronger evidence that premotor areas are involved in mental rotation. This makes sense from a functional neuroanatomy perspective because there are strong functional and anatomical connections between posterior parietal and premotor cortex in humans. The parietal cortex (SPL and IPS) serves as an essential node generating information (transformation from retinotopic to body centered coordinates) which is projected to the dorsal premotor cortex for further processing. The dorsal premotor cortex is strongly involved in learning, storing, and controlling of sensorimotor associations (Hanakawa et al., 2002) thus, sensory cues are linked to motor programs in this area. This area is also activated during tool use (e.g., the tool as part of the body image), action observation (Buccino et al., 2004), and during planning of motor processes (Binkofski et al., 1999). In addition, parts...