Ways To Improve Your Body Image

Mirror Madness

Mirror Madness

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Metaphors and Model Systems

The main problem with the theater metaphor is that to be conscious does not typically feel like sitting in a dark theater and looking at characters or events appearing on a faraway stage. Rather, my moment-to-moment consciousness feels like being immersed in the center of a multimodal world that is present for me all at once, though I may pay focal attention only to some feature of it. The phenomenal level includes the externalized sensory events, my own body image, and those events which I feel are going on inside my body or my mind (emotions, inner speech). All of these phenomenal contents are highly organized in characteristic ways. Therefore, we need a different kind of metaphor and a different conceptual framework in order to capture the level of phenomenal representation, or consciousness itself (but not necessarily its neuro-cognitive mechanisms). I think that the dreaming brain is an excellent source of both a model system and a metaphor of the phenomenal level of...

Classical anorexia nervosa postpubertal

Several near-synonyms have been used to describe the specific attitude detectable in the patient who systematically avoids fatness a 'disturbance of body image', (6) a 'weight phobia',(35) or a 'fear of fatness' 7 Magersucht, or seeking after thinness, was a term applied in the older German literature. The patient will express a sensitivity about certain parts of her body, especially her stomach, thighs, and hips. Not only is she likely to assert that fatness makes her unattractive, but she may add that it is a shameful condition betraying greed and social failure. These distorted attitudes generally amount to overvalued ideas rather than delusions. Occasionally, however, a patient may be frankly deluded, such as one young woman who believed that her low weight was due to thin bones and that fatness was still evident on the surface of her body.

Altered states of consciousnessnormal or abnormal

In many cultures altered states of consciousness are induced for religious and or therapeutic purposes and are sanctioned practices in institutionalized ritual activities. These temporarily modified waking states are associated with selectively focused attention, heightened suggestibility, various degrees of anaesthesia or analgesia, blurring of cause and effect distinction, altered time sense, body image changes, and illusional perceptions. The often intense emotional experiences are felt to be ineffable but also to have a special significance they are given a culture-congenial meaning and are interpreted according to the prevailing belief system. Behaviour in altered states of consciousness during rituals is culturally defined as not under voluntary control and is often not clearly remembered. Nevertheless, such behaviour follows culturally accepted patterns and social rules which are monitored by the officiating functionaries. In religious and therapeutic cult groups, altered...

Chapter References

Rosen, J.C., Reiter, J., and Orosan, P. (1995). Cognitive-behavioral body image therapy for body dysmorphic disorder. Journal of Consulting and Clinical Psychology,63, 263-9. 17. Rosen, J.C. and Ramirez, E. (1998). A comparison of eating disorders and body dysmorphic disorder on body image and psychological adjustment. Journal of Psychosomatic Research,44, 441-9.

Cognitive functioning and informed consent

Providing information and obtaining informed consent are routine aspects of preoperative care. For informed consent to be obtained, the relevant information must be provided by the surgeon to the patient. There must be evidence that the patient has understood the rationale, risks, and benefits of the surgery, the potential alternative treatments, and the risk of not proceeding with surgery. The decision about the surgery must be made voluntarily and without coercion. Patients may need this information to decide whether to choose more or less radical surgery, weighing the possibilities for cure against potential adverse effects of surgery. Breast surgery is an important example in which cosmetic and body image concerns of women have led to more conservative surgical approaches, especially in cases where there is little evidence that more aggressive surgery is associated with a higher cure rate.

Medium and longterm complications

These may occur in the longer term following disfiguring surgeries (for example, facial surgery, amputations, ostomies) or which require complicated postoperative regimens (such as organ transplantation). Sexual difficulties may result from procedures that compromise the neural input or functional integrity of genital structures, or that negatively impact on body image. Patients and their families should be informed about the possibility of adjustment problems with such surgeries and should

Assessment and treatment

An accident can lead to several important sources of threat, loss, or conflict. The most important accident-related variables associated with subsequent psychological problems include the objective severity of the accident, the presence and type of physical injury, and exposure to dead and mutilated bodies. The accident may represent a blow to the person's feelings of invulnerability and provoke conflictual feelings (e.g. self-blame, survivor guilt) or shame. Injury may threaten self-esteem and body image, or represent a loss of function. The person's immediate responses will be influenced by psychological issues such as fear of losing control. Secondary gains may influence the clinical response.

Patients who do not respond

There are no evidence-based guidelines for the treatment of patients who do not respond to cognitive-behaviour therapy. There are various logical alternatives including adding an antidepressant drug (fluoxetine 60 mg being an appropriate choice (l9i) and switching to interpersonal psychotherapy (29 (see Chapter.6.3.3) since both are treatments for bulimia nervosa in their own right. Modifying cognitive-behaviour therapy is also an option. For example, components of the treatment may be intensified (for example, by adding exposure with response prevention procedures (12> or more emphasis on body image(17> ) or cognitive-behaviour therapy may be broadened to address more general issues such as self-esteem, mood regulation, and interpersonal functioning.

The Central Theoretical Problem on the Functional Level of Description

This answer to the functionalist question posed above immediately leads to testable hypotheses, because it makes the step from functional to neural correlates possible. If, e.g., it is really true that the constant activity of that part of the neuromatrix of the spatial model of one's own body, which is independent of external input, becomes the center of experiential space by forming an invariant background of bodily awareness, then this constitutes an empirical hypothesis. Of course, as a philosopher I should now definitely step back and refrain from any dilettante, amateurish speculation. However, let me draw my readers' attention to the fact that new results concerning research on pain experience in phantom limbs may point to the existence of a genetically determined neuromatrix, the input-independent activation pattern of which could form the functional basis of the most invariant partitions in the phenomenal body image (''phylomatrix of the body-schema'' see Melzack 1989, 1990,...

Mental phenomena in health and cultural variation

It is important to recognize the effect of culture on subjective experience, the expression of psychological symptoms, and their manifestation in behaviour. In some cultures the very expression of subjective experience and emotion is discouraged and censored, in others feelings tend to be somatized, and in yet others the subjective experience of the individual tends to be subjugated to the sense of well being of the immediate social group. There are specific culture-bound expressions of subjective distress concerning body image in those who suffer from anxiety disorders. For delusions of passivity, although the psychopathological form remains relatively constant, the description of content will vary according to culture for example, 'the djinn made me do it', 'my thoughts are controlled by the television'. Similarly, for possession state, although the psychopathological description remains similar, the actual cultural expression is very different for a member of a fundamentalist sect...

Female Sexual Dysfunction and Colorectal Surgery

After CRS, sexual dysfunction in women may be attributed to disorders of desire, arousal, orgasm, and or pain. Sexual desire has been shown to maintain or improve in 76 to 80 of women after CRS and is often accompanied by increased frequency in sexual activity and sexual satisfaction.13,14 Such an improvement may be expected, because general health is likely to improve after surgery. However, previous studies have demonstrated that up to 78 of women complain of decreased or complete loss of libido after surgery.15 Factors such as impaired body image, concerns of partner negative reaction, fear of stool leakage, and use of a stoma are known to adversely impact sexual function, and may account for these findings. Among these factors, the negative impact of a stoma has been specifically addressed by several studies. Gloeckner and Starling16 conducted an interview with 40 subjects with a permanent stoma (24 men, 16 women) and found that 60 of the patients had impaired sexuality after...

Delusional disorder somatic subtype monosymptomatic hypochondriacal psychosis

Modern society, especially in developed countries, is preoccupied with health concerns. While much of this is positive, there is no doubt that many people worry excessively about health matters and a proportion of these show pathological self-concern. This can shade into hypochondriasis, in which there is a persistent conviction of illness in the absence of objective evidence of its existence, with misinterpretation of bodily sensations as disease and with inability to accept reassurances. In many cases the individual shows some degree of body image disturbance, sometimes of extreme degree.(5 55> Usually we think of hypochondriasis as referring to physical complaints, but nowadays it seems that an increasing number of affected people are also prepared to complain in psychological terms. Hypochondriasis is common and may be a personality trait, but it can also be an accompaniment to many psychiatric illnesses, both non-delusional and delusional. It is the presenting feature of the...

Disorders of awareness of the body

Dislike of the body and distortion of body image are subjectively different experiences but often occur together, for example in anorexia nervosa or with gross obesity. In dysmorphophobia the primary symptom is the patient's belief that he or she is unattractive. Sufferers believe themselves to have a physical defect, such as the size of their nose or breasts, that is noticeable to other people, but objectively their appearance lies within normal limits. The dissatisfaction with their appearance, the extent to which they feel others are aware of disfigurement, the distress this causes, and the consequences in suicidal or other self-destructive behaviour are out of proportion to the significance of the abnormality, even if such an abnormality were present. The content disorder of dysmorphophobia takes the psychopathological form of an overvalued idea in which the degree of concern and consequent distress is clearly out of proportion and comes to dominate the whole of life. The...

Pharmacological Aspects

The effects of LSD may be observed for 8 hours. The specific acute effects of a drug like LSD include euphoria, depersonalization, enhanced awareness of sensory input, alterations in the perception of time or space or body image, and to some extent, minor stimulant effects. Sometimes the dreamlike quality of the experience produces relaxation, good humor, and a sense of wonder or euphoria.

The Partial Seizures

These arise in the sensory cortex, the patient describing paraesthesia or tingling in an extremity or on the face sometimes associated with a sensation of distortion of body image. A 'march' similar to the Jacksonian motor seizure may occur. Motor symptoms occur concurrently - the limb appears weak without involuntary movement.

Benefits Of Activity

The psychological benefits of exercise are equally important for the obese individual with Type 2 diabetes. Reductions in anxiety levels, improved body image and higher self-esteem promote greater self-efficacy and help the individual to cope with stressful situations which often result in overeating and relapses (71,72).

Treatment of obesity

Reduction of as little as 5 to 15 per cent. (21) This recommendation is based on two facts. First, most obese people are able to lose only 7 to 15 per cent of initial weight, even with state-of-the-art treatment. Second, such weight losses often produce significant improvements in hypertension, hypercholesterolaemia, type II diabetes, depression, and body image dissatisfaction.*23) Obese people must be helped to appreciate the medical benefits of modest weight losses and to eschew the frequently unattainable weight losses demanded by cosmetic concerns. Realistic treatment expectations are critical to long-term weight management.

The patient less so

Freezing attacks and walking problems, even though it's no longer the case. My body is cured but my mind is still sick''. Curiously, this difficulty in looking ahead, and the restrictions that it causes, can persist long after the operation. f) The altered body image. After the operation, a small number of patients had the impression that their body had been ''dehumanised'' because of the metallic device inserted in their brain ''I'm an electronic doll'' said one ''I feel like a 'Robocop''' said another ''I'm under remote control'', said yet another. This impression of a body transformed into a machine that no longer belongs to the person and is dependent on a device worthy of a science fiction story is very different from the impression of an altered body attacked from within that some patients experience before neurosurgery, when they suffer periods of dyskinesia or freezing. ''I feel I'm forced to live like a prisoner in an alien body that's out of control'', said one patient.

Cancer Cachexia

Weight loss and malnutrition are problematic causes of symptom distress in cancer patients. Anorexia, weight loss and the associated fatigue as well as changes in body image can contribute to depression and decreased social interactions 59, 60 . It is especially relevant in relation to cancer patients to keep in mind that poor intake is rarely the most important cause of cancer-induced weight loss. Patients fed intravenously generally still lose weight, despite intake of adequate or even supraphysiologic calories. CCS is a metabolic syndrome that affects intermediary metabolism and substrate utilization, not just appetite. Therefore, particularly in patients with primary GI tract malignancies, it is rarely appropriate to undertake specialized nutrition support for anorexia or even GI obstruction unless there is a plan in place to treat the obstruction and the underlying cancer.

Female Athlete Triad

The Female Athlete Triad is found among female athletes trying to balance the pressures of body image and physical performance. The triad (Figure 15-1), marked by inadequate food intake, menstrual abnormalities, and bone loss, can be fatal if left untreated. Therefore, a healthy relationship between food, body image, and performance must be established.

Anorexia Nervosa

This disorder is characterized by 1) a body weight that is below normal (ie, < 85 of expected body weight) 2) intense fears of weight gain despite being underweight 3) body image disturbance resulting in the misperception of one's weight or shape, undue self-evaluation based upon weight, or denial of the seriousness of the current low weight and 4) in post-menarchal females, the absence of at least three consecutive menstrual cycles. The diagnosis of anorexia nervosa requires all four criteria.