Motivation and emotion/Book/2023/Positive body image development

Overview


Imagine a 30 year old woman that battles a deeply ingrained negative body image. Throughout her life, societal beauty ideals have fueled feelings of inadequacy and self-doubt. The woman experiences many daily troubles due to her negative body image, including not seeing her friends and family due to her fear of judgement, never trying clothes on instore, trying to remain invisible when completing tasks which require social interactions and the development of depression due to her dissatisfaction. Seeking change, she draws insight from friends and self-help resources to cultivate a positive body image. The woman incorporates afirmations and mindfulness into her daily routine, however due to years of body dissatisfaction she decides that professional help is needed. During this journey, she challenges her inner-self critic, confronts insecurities and experiences vulnerability. The woman describes this journey as turbulent, with much distress as well as great progress. She has identified that whilst engaging in therapy a few work-related issues have hindered her progress, she is fearful that she will fall back into old habits. This journey can be seen in Figure 1.

This scenario demonstrates the turbulent journey to a positive body image. With deep-rooted negative ideations of body image it is imperative to seek appropriate treatment.

Positive body image has emerged as an important factor towards the development of self-acceptance and self-love. Through movements such as the "body positivity movement", the importance of embracing diverse body shapes, sizes, and appearances has acquired much attention in modern-day society. Challenging personal beliefs and engaging in a positive relationship with one's body contributes to well-being and plays a crucial role in combating mental health issues. Despite this, a survey conducted by The Butterfly Foundation (2023) among 1,600 young Australians, aged 12-18, revealed that 45% of individuals are dissatisfied with their body image. Frederick and colleagues (2012) further identified that approximately 20% to 40% of women and 10% to 30% of men experience dissatisfaction with their body image. While research on body dissatisfaction is more extensive than that of positive body image, gaining an understanding of the prevalence of body dissatisfaction in society provides greater insights into the crucial need for education regarding positive body image and its development for individuals throughout the lifespan. This chapter defines positive body image and the strategies involved in its development.


 * What is positive body image?
 * How does a positive body image develop?
 * What psychological theories relate to positive body image development?
 * What are effective approaches to fostering the development of a positive body image?
 * How does a positive body image affect mental health and well-being?

Body image
Body image is an individual's perspective, thoughts, feelings, and attitudes toward their own body. It includes how someone perceives their physical characteristics, including; size, form, and features, as well as the feelings and ideas connected to this perception. Social interactions, cultural norms and personal experiences can all have an impact on body image. It significantly influences ones self-worth, self-esteem and well-being (Frederick et al., 2022). Body image can fluctuate throughout the lifespan, through different life experiences and various timelines an individual’s body image varies from positive and negative ideations.

Positive body image
Positive body image is characterised by the valuing and centring of the distinctive strengths and functionalities of the body, even in cases of imperfection or misalignment with societal beauty norms. It involves embracing one's body in its current state, fostering a sense of ease and self-assuredness that radiates externally. Additionally, positive body image entails adopting a constructive and safeguarding perspective when processing external cues related to the body (Gillen & Markey, 2023). Body appreciation, body acceptance, a broad conception of beauty, inner positivity, and the ability to remain stable and flexible in the face of stressors are crucial components of positive body image (Tylak & Wood-Barcalow, 2015).

Table 1.

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How does a positive body image develop?
Positive body image develops through self-acceptance, supportive environments, and through focusing on well-being over appearance (Brazier, 2023). Embracing one's self-worth, enhancing self-esteem and receiving positive feedback from social settings contributes to how an individual views themselves both on a personal and social level. Challenging unrealistic beauty ideals, practicing self-care, and shifting focus from appearance to purpose, play pivotal roles in influencing positive body image development (Tylka, 2011). Exposure to diverse role models that represent body positivity and mindfulness practices that foster self-compassion, emphasise that each individual possesses unique qualities that are appreciated within society. Recognizing the diversity of beauty and building resilience against societal pressures, further contribute to this ongoing journey toward a positive body image. Developing a positive body image may be a lengthy process, however through the use of positive affirmations and engaging in activities that promote health and well-being the development of a positive body image becomes attainable.

Examples of positive affirmations:

"I am worthy, just the way I am"

"I am strong, confident and comfortable in my own skin"

"I choose to be kind and respect my body"

Positive body image can also emerge through therapeutic interventions, which will be explored in greater detail within this chapter.

Sociocultural theory
The sociocultural theory delves into the miscellaneous dynamics between societal and cultural influences on individual development. In relation to positive body image development and overall self-worth, this framework emphasises the impact of cultural norms, media and societal expectations. Based on the fundamental concepts developed by Lev Vygotsky (1978), the sociocultural approach identifies the crucial role of cultural norms, values, and practices in shaping individuals' cognitive abilities and understanding of the world (Cherry, 2022)

Within the realm of positive body image development, the sociocultural theory suggests that individuals engage in comparisons with others within their social and cultural settings. Individuals may compare their bodies to societal beauty standards, influencing the perception of their own bodies, which contributes to either a positive or negative body image perception (Rodgers et al., 2023). The theory highlights that societal ideals of beauty, often displayed in the media, can play a crucial role in either fostering or hindering the development of positive body image (Aparicio-Martinez et al., 2019).

Reflect: Take some time to reflect upon your personal experience using social media and how it has influenced your own view of body image.

Self-compassion theory
Self-compassion theory is a psychological framework that emphasizes treating oneself with kindness, particularly during difficult life events. The theory explores the impact of cultivating self-compassion in buffering against negative body image and fostering body appreciation (Neff, 2003). An instrumental tool in assessing self-compassion is the Self-Compassion Scale (SCS), is a widely used 26-item measure that identifies trait levels of general tendency to respond self-compassionately in the face of personal inadequacy, failure, or external life challenges (Neff, 2023). The theory originates from the positive emotions that arise when expressing compassion for others and the innate inclination to aid individuals during challenging circumstances. These positive emotions and the impulse to aid can be extended inwardly towards oneself. Self-compassion is comprised of three elements, which are displayed in Table 2.

Table 2.

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A study conducted by Wasylkiw et al. (2012) examined the relationship between self-compassion and body image amongst university women. 142 participants completed various messure indicating their self-esteem, self-compassion and body image. Those who identified high levels of self-compassion indicated minimal cocncerns in regards to body image, thus increasing self-esteem.



Cognitive behavioural theory
Cognitive behavioural theory (CBT) developed by Aaron Beck in the 1960's, plays a significant role in fostering positive body image development. This psychological approach focuses on identifying and modifying negative thought patterns and behaviours, which are often at the core of body dissatisfaction (Southam-Gerow et al., 2011). The cognitive behavioural theory focuses on the interplay between cognition (thoughts) and behaviour (actions). It emphasises that thoughts have the ability to influence emotions and behaviours, this can be seen in Figure 2. Automatic thoughts can cause negative impacts on an individual’s overall well-being, by challenging these thoughts cognitions and actions towards a positive body image will be enhanced (Early & Grady, 2016). The theory suggests that thoughts are changeable, which has a significant influence on how you see yourself, others and the future. CBT offers a comprehensive and effective framework for fostering positive body development and improving body image.

Cognitive-behavioural approaches
Cognitive-behavioral approaches focus on restructuring negative thought patterns related to body image. Offering strategies to challenge distorted beliefs and replace them with more adaptive perspectives.


 * Recognise Negative Thoughts - Individuals learn to identify automatic negative thoughts regarding their bodies, gaining awareness of their impact on emotions and actions.
 * Challenging Negative Thoughts - Critically examine the negative thoughts before addressing them. This requires assessing the evidence supporting the negative approach to.
 * Reconstructing Beliefs - Guided introspection prompts individuals to question and reframe negative thoughts. Gathering evidence to counter irrational thoughts, fosters a more balanced viewpoint.
 * CBT Homework - Therapists will often provide homework to be completed between sessions. This allows the client time for reflection whilst at home and ensures that the treatment (CBT) is consistent. (American Psychological Association, 2017).

Cassone and collgeagues (2016), analysed the effectiveness of a 6-week CBT group intervention, promoting the development of a positive body image. 52 women aged 17-54 years old completed self-report measures. The findings indicate advantages for individuals experiencing body dissatisfaction, especially those who report elevated levels of body shame.



Mindfulness-based interventions
Mindfulness, defined by the APA (2022), is the awareness of an individuals mental state and surroundings. Mindfulness-based interventions enhance awareness of bodily sensations, thoughts, and emotions, and offer a transformative approach to cultivating a positive body image. These interventions emphasise the non-judgmental observation of one's body, thereby reducing concerns centred around appearance. Mindfulness practices incorporate qualities such as openness, nonjudgment, friendliness, curiosity, acceptance, compassion, and kindness (Hofmann, 2018). These practices are designed to foster a state of mindfulness, which can manifest through formal practices like breathing exercises, sitting meditations, walking meditations, and body scanning, or through informal practices, such as incorporating mindfulness into daily life (Zhang et al., 2021). Directing attention to emotions during mindfulness practice can cultivate self-trust and confidence in one's perception of the world, eliminating the need for external validation. In this way, the habitual question of "How do I look?" becomes unnecessary, as individuals become accustomed to how they truly feel, fostering a more authentic and positive relationship with their bodies (Blakeslee, 2021). Mindfulness-based interventions, emerge as an empowering strategy for promoting positive body image by encouraging self-awareness and self-acceptance.

Self-compassion based interventions
Self-compassion-based interventions, drawing inspiration from self-compassion theories, are designed to equip individuals with the tools to treat themselves with kindness, mindfulness, and understanding, ultimately fostering self-acceptance and reducing self-criticism. Compassion-focused therapy (CFT) developed by Gilbert and Irons (2004), integrates principles from evolutionary psychology, cognitive-behavioural therapy, and Buddhist philosophy. Originally crafted for clinical groups characterized by pronounced shame and self-critique (Gilbert & Proctor, 2006), CFT aims to heighten awareness and comprehension of automatic emotional reactions that have evolved over time, often rooted in early childhood experiences and subsequently reinforced. The key principles of CFT involve cultivating internal warmth and empathy toward oneself, empowering individuals to prioritize personal welfare, fostering awareness of individual needs, developing the capacity to endure personal challenges, and mitigating inclinations toward self-criticism. Research findings have consistently demonstrated the efficacy of CFT in increasing self-compassion across individuals with various psychological conditions, affirming the intervention's effectiveness in promoting a more compassionate and nurturing relationship with oneself (Leaviss & Uttely, 2015).


 * Compassion Images - Clients identify their ideal vision of compassion from others, describing visual and auditory cues, and associating descriptive words. Clients then role-play as compassionate individuals, embodying this image through expressions, tone, posture, and words. Clients are encouraged to envision these compassionate images during times when self-criticism might arise.

Carter et al (2023), conducted a study to analyse the effects of compassion-focused therapy on obese individuals experiencing weight shaming. 55 participants underwent a 12-session compassion-based group intervention. The findings identified that CFT had a positive impact on increasing self-compassion, reducing external shame and reducing self-criticism. 66% of participants identified a decrease in depressive symptoms.

{Which intervention involves homework:} + Cognitive-behavioural therapy - Self-compassion based interventions - Mindfulness-based interventions

{Many individuals struggle with a positive body image:} + True - False

How does a positive body image affect mental health and well-being?
Mental health and overall well-being are influenced by a multitude of factors. However, the development of a positive body image stands out as a significant contributor to enhanced mental health and well-being. Through self-acceptance, fostering a strong sense of value/contentment in oneself and having a positive self-perception influence how individuals view their bodies. Having an overall positive self-perception influences not only how people view their bodies but also their sense of identity and confidence. Confidence within oneself, enables individuals to engage in fulfilling activities and cognitive thoughts that promote positive development within other realms irrespective of body image. A positive body image serves as a crucial mechanism in mitigating anxiety, depression and body dysmorphia, often associated with body dissatisfaction, by eliminating negative self-perceptions and fostering self-compassion, individuals experience a notable reduction in emotional distress (Soares et al., 2020). The development of a stronger sense of self-worth and self-love is based on the practises of positive body image. Individuals with a positive body image are inclined to appreciate their intrinsic value beyond physical appearance, therefore experiencing elevated self-esteem (Pop, 2016). Self-esteem is characterised by positive or negative attitudes toward oneself and serves as an affective evaluation of self (Zeigler-Hill, 2013). Those with a positive body image demonstrate resilience against societal beauty standards and media pressures. This resilience is characterised by a strong ability to resist internalising unrealistic ideals and commit to maintaining an authentic sense of worth and confidence (O’Brien, 2021).

Conclusion
A positive body image encompasses personal body appreciation, body acceptance, an understanding of the broad conception of beauty, inner positivity and the ability to remain stable and flexible when faced with stressors. Through positive body image, self-esteem increases, creating a positive environment that fosters mental and physical health. The development of positive body image is influenced by many factors however, through personal interventions and psychological approaches an individual’s journey towards body positivity begins.

Psychological theories that delve into the development of a positive body image are; the sociocultural theory which explores how societal and cultural factors shape individual development, the self-compassion theory which emphasises the importance of self-kindness, common humanity and mindfulness and the cognitive-behavioural theory which identifies that thoughts influence behaviours and emotions. Insights into the theories related to positive body image, ensures the ability to identify ways in which external and internal factors foster or hinder its development. Effective approaches towards positive body image development reviewed include cognitive-behavioural therapy, mindfulness-based interventions and self-compassion based interventions. Recognizing the strategies and approaches that resonate most effectively with each individual is crucial when fostering a positive body image.

The prevalence of media and social media use in today’s society places an invisible beauty standard of which men, women and others feel the need to conform to. Constant exposure to the “perfect body” whether that be thin, curvy, muscular, athletic etc… encourages disordered perceptions of oneself, causing a greater prevalence of body dissatisfaction. However, the importance of positive body image development aims to mitigate the negative effects of societal and cultural beauty norms. Embracing and accepting one's body without judgment, while recognizing its unique strengths, promotes inclusivity and an appreciation for diverse physical attributes.