WEBVTT - 202. Body dysmorphia 0:00:04.440 --> 0:00:09.280 Hello everybody, and welcome back to the Psychology of Your Twenties, 0:00:09.920 --> 0:00:12.280 the podcast where we talk through some of the big 0:00:12.520 --> 0:00:16.880 life changes and transitions of our twenties and what they 0:00:16.960 --> 0:00:18.720 mean for our psychology. 0:00:23.000 --> 0:00:27.000 Hello everybody, Welcome back to the show. Welcome back to 0:00:27.080 --> 0:00:31.040 the podcast. New listeners, old listeners. Wherever you are in 0:00:31.080 --> 0:00:33.639 the world, it is so great to have you here, 0:00:33.720 --> 0:00:36.880 back for another episode as we, of course break down 0:00:37.240 --> 0:00:42.160 the psychology of our twenties. Of your twenties. Before we begin, 0:00:42.440 --> 0:00:46.200 a brief trigger warning that this episode does deal with 0:00:46.240 --> 0:00:51.320 some fairly in depth discussions around weight loss, weight gain, appearance, 0:00:51.640 --> 0:00:55.320 and eating disorders. So please do just take a second 0:00:55.400 --> 0:00:58.800 to consider whether you are in a healthy mental space, 0:00:59.000 --> 0:01:02.440 a healthy mindset to be listening to this right now. 0:01:02.480 --> 0:01:06.000 This episode will still be here in a few days, 0:01:06.040 --> 0:01:08.839 in a week, in a few months, so you can 0:01:09.000 --> 0:01:11.640 always return to it when the time is right, when 0:01:11.640 --> 0:01:15.600 the time is better. Let's get into it today. We 0:01:15.640 --> 0:01:17.959 are going to be talking about a pretty vulnerable topic, 0:01:18.160 --> 0:01:21.800 one that has I think especially serious implications for our 0:01:21.840 --> 0:01:26.000 mental health, both in our twenties and beyond and even before, 0:01:26.520 --> 0:01:29.000 and it can also just be such a present and 0:01:29.240 --> 0:01:33.200 overwhelming shadow in our lives, our thoughts, our feelings, our 0:01:33.200 --> 0:01:38.840 opinions about our body do have this incredible capacity to 0:01:38.959 --> 0:01:42.880 really influence every other area of our daily life, of 0:01:42.920 --> 0:01:47.240 our existence, of our values, of our relationships, and yet 0:01:47.280 --> 0:01:48.960 we really do tend to kind of keep it out 0:01:49.000 --> 0:01:53.360 of the light of day. We really avoid discussing this 0:01:53.560 --> 0:01:56.880 openly because I think of, you know, well, shame and 0:01:56.920 --> 0:01:59.320 how hard it is to come out and say, you know, 0:01:59.360 --> 0:02:02.040 at the moment, I really dislike my body, I really 0:02:02.120 --> 0:02:05.040 hate some part of me, or I'm fixated on my 0:02:05.080 --> 0:02:07.720 appearance and I don't know how to stop it. I 0:02:07.760 --> 0:02:10.959 think it's also what it comes down to is embarrassment 0:02:11.040 --> 0:02:14.600 as well as shame, the sense that caring this much 0:02:14.639 --> 0:02:19.040 about your looks is somehow, you know, vapid or vain, 0:02:19.320 --> 0:02:22.119 when actually it goes so much deeper than what other 0:02:22.160 --> 0:02:25.760 people might want to label it. It is and can 0:02:25.800 --> 0:02:30.200 be very disordered, a very disordered pattern of thinking, and 0:02:30.240 --> 0:02:35.360 beyond that, something that is hugely and largely beyond our control. 0:02:35.880 --> 0:02:38.720 I've come to realize the more I also choose to 0:02:38.800 --> 0:02:43.360 speak more openly about this experience, how many of us 0:02:43.639 --> 0:02:47.720 are struggling with some form of negative and harsh thinking 0:02:48.160 --> 0:02:51.720 about our bodies, about our weight, about our appearance. But 0:02:51.919 --> 0:02:55.240 you wouldn't think that given how much we have trained 0:02:55.240 --> 0:02:59.919 ourselves in society has trained us to be silent about it. 0:03:00.200 --> 0:03:02.600 Beyond that, it hasn't just trained us to be silent, 0:03:02.680 --> 0:03:06.399 it's also trained us to view and treat our body 0:03:06.480 --> 0:03:09.440 like it is a constant, working progress rather than something 0:03:09.440 --> 0:03:12.840 that we can just be satisfied with as it is. 0:03:13.120 --> 0:03:17.440 So consider this your safe space. We're going to discuss 0:03:17.840 --> 0:03:21.720 everything to do with this today, specifically the topic of 0:03:21.760 --> 0:03:25.800 body dysmorphia and what that actually means. I think we 0:03:25.880 --> 0:03:27.720 hear a lot of people talk about how you know 0:03:27.760 --> 0:03:31.160 they are dissatisfied with their appearance, with their weight. Is 0:03:31.200 --> 0:03:35.120 that always body dysmorphia? Or can we just have symptoms 0:03:35.120 --> 0:03:39.400 without a diagnosable condition. The other point that people mention 0:03:39.600 --> 0:03:42.920 is how it's really difficult to even be able to 0:03:42.920 --> 0:03:44.760 tell what we look like. How a lot of us 0:03:44.760 --> 0:03:49.040 are really struggling with just a genuine acknowledgment of our 0:03:49.080 --> 0:03:52.680 appearance and how other people see us. Is that body 0:03:52.720 --> 0:03:55.480 dysmorphia or is that something else? What is the actual 0:03:56.000 --> 0:04:02.640 I would say pathology and criteria behind BDD body dysmorphic disorder. 0:04:03.040 --> 0:04:05.480 So we're going to discuss all of that, including the 0:04:05.520 --> 0:04:09.680 origins of this condition, what makes us more susceptible, including 0:04:09.680 --> 0:04:13.320 the impact of toxic gym and diet culture, how it 0:04:13.400 --> 0:04:16.400 manifests the impact, but also some stories from you guys, 0:04:16.480 --> 0:04:20.040 the listeners, who were really vulnerable and open about their 0:04:20.080 --> 0:04:23.560 personal experiences. And I also just want to talk more 0:04:23.600 --> 0:04:27.520 generally about what it means to really dislike your body 0:04:27.560 --> 0:04:33.400 without having BDD, and why that is becoming increasingly more common, 0:04:33.720 --> 0:04:35.880 and what we can actually do about it. What are 0:04:35.880 --> 0:04:40.760 ways of interrupting this really negative belief system that our 0:04:40.800 --> 0:04:43.920 appearance is really at the core of our worth all 0:04:43.960 --> 0:04:47.200 matters more than it does. So we have so much 0:04:47.240 --> 0:04:50.000 to talk about, so much research, so much science, and 0:04:50.120 --> 0:04:54.440 of course so much psychology. So without further ado, let 0:04:54.520 --> 0:05:02.160 us get into it. Body dysmorphia is one of those 0:05:02.160 --> 0:05:04.800 conditions that I think we've all heard about, which is 0:05:04.880 --> 0:05:08.960 definitely enlargely misunderstood. So to start off with, I just 0:05:09.000 --> 0:05:13.160 want to get our kind of basics downpat what actually 0:05:13.279 --> 0:05:18.200 is BDD. So BDD body dysmorphic disorder is a mental 0:05:18.240 --> 0:05:23.120 health condition, and it's a lot more than feeling occasionally 0:05:23.800 --> 0:05:28.520 negative about your body. It is an entire pattern roundabout 0:05:28.800 --> 0:05:35.120 cycle maze, inescapable maze of negative emotions, negative perceptions, and 0:05:35.160 --> 0:05:39.200 negative feelings that are all directed towards your appearance. And 0:05:39.240 --> 0:05:42.960 what it really involves is an obsessive focus and shame 0:05:43.000 --> 0:05:47.960 and anxiety around some perceived flaw in our appearance. This 0:05:48.680 --> 0:05:52.440 often very small feature of us. It could be, you know, 0:05:52.600 --> 0:05:55.920 some feature of our face, our physique, muscle mass, our skin, 0:05:56.440 --> 0:05:58.560 combination of all of those things, our weight, our height, 0:05:59.200 --> 0:06:03.400 and this feature becomes a preoccupation, regardless of whether it 0:06:03.560 --> 0:06:08.480 is real or imagined, no matter how small it is. 0:06:09.040 --> 0:06:11.880 So when I say real or imagined, I mean that 0:06:12.360 --> 0:06:14.919 this thing that we really dislike about ourselves. You know, 0:06:14.960 --> 0:06:18.520 it could be so tiny and obscure that no one 0:06:18.560 --> 0:06:21.680 else would ever notice it. But for us, it feels 0:06:21.720 --> 0:06:24.960 like a huge part of who we are. It feels 0:06:25.080 --> 0:06:30.120 like we exist in the world, and as we are existing, 0:06:30.200 --> 0:06:35.080 this huge spotlight is highlighting to ourselves and everybody around us, 0:06:35.360 --> 0:06:40.360 this feature that we really don't like. Even when others 0:06:40.640 --> 0:06:43.360 say that we look amazing, they compliment us, they say 0:06:43.360 --> 0:06:46.359 we look lovely, They reassure us that no one is 0:06:46.440 --> 0:06:49.560 noticing this floor that we are focused on. We can't 0:06:49.560 --> 0:06:53.000 believe them. There is a part of us that is 0:06:53.240 --> 0:06:58.000 quite honestly delusional and constantly tells us that all these 0:06:58.040 --> 0:07:00.880 other people must be lying, just can't see it, they 0:07:00.960 --> 0:07:05.040 must be blind in some way. And so we continue 0:07:05.520 --> 0:07:08.720 to have this like hyper focus on this floor, and 0:07:08.760 --> 0:07:12.480 we normally resort to repetitive behaviors in order to kind 0:07:12.480 --> 0:07:16.239 of self soothe or regain some control over this aspect 0:07:16.240 --> 0:07:19.760 of our appearance that is causing mental tension. So these 0:07:19.800 --> 0:07:23.720 behaviors are things like always checking ourselves in the mirror, 0:07:23.760 --> 0:07:28.679 constant mirror checking, constant grooming and touching or skin picking, 0:07:28.800 --> 0:07:32.000 only choosing clothes that will hide this feature or a 0:07:32.040 --> 0:07:36.800 part of yourself. So these are actually called BDD safety behaviors, 0:07:36.800 --> 0:07:39.960 and they're one step above avoidance, whereby they make us 0:07:39.960 --> 0:07:43.680 feel like we have control over what part of us 0:07:43.760 --> 0:07:46.160 is being made visible to others, and therefore we can 0:07:46.200 --> 0:07:50.960 control the judgments that we assume people are making about 0:07:51.040 --> 0:07:54.360 us based on this feature. So it's not just that 0:07:54.440 --> 0:07:57.200 we have a fixation on this floor. It's not just 0:07:57.240 --> 0:08:01.880 that we have this personal spotlight. It's also that in 0:08:01.960 --> 0:08:04.920 order to be meeting the criteria of BDD, you have 0:08:04.960 --> 0:08:08.440 to become obsessed with how you can fix it. In 0:08:08.560 --> 0:08:11.480 our minds, if the floor was to disappear or suddenly 0:08:11.520 --> 0:08:14.880 go away, so would all of our mental distress. And 0:08:14.920 --> 0:08:17.880 so we are always searching or coming up with a 0:08:17.920 --> 0:08:21.160 plan to erase this part of us, whether that is 0:08:21.240 --> 0:08:28.920 through excessive exercise, intense skincare routines, or cosmetic surgery. So 0:08:29.560 --> 0:08:33.480 cosmetic surgery has a really important kind of place in 0:08:33.520 --> 0:08:35.840 this discussion, now that I've kind of brought it up, 0:08:36.360 --> 0:08:38.640 what I found was really interesting when I was really 0:08:38.640 --> 0:08:42.360 digging into this research is that whilst only about I 0:08:42.360 --> 0:08:46.199 would say three to five percent of the general population 0:08:46.320 --> 0:08:51.400 has BDD, and that's even quite a generous statistic, it's 0:08:51.440 --> 0:08:55.280 probably sitting at around three point five amongst people who 0:08:55.320 --> 0:09:00.480 pursue cosmetic interventions, not just surgery but fillers and actions, 0:09:01.200 --> 0:09:05.719 non invasive procedures, that prevalence of BDD in that population 0:09:05.920 --> 0:09:09.520 rises to almost twenty five percent. So, depending on how 0:09:09.559 --> 0:09:11.760 you feel about cosmetic surgery, you may think that this 0:09:11.800 --> 0:09:14.680 could provide some relief to people with BDD. It's almost 0:09:14.679 --> 0:09:18.040 like a treatment, right, you know, if they're experiencing so 0:09:18.200 --> 0:09:21.160 much shame, associated with their appearance. Here is this fix. 0:09:21.840 --> 0:09:24.680 But on the other hand, this is a multi billion 0:09:24.679 --> 0:09:29.040 dollar industry that makes its money on exacerbating and preying 0:09:29.040 --> 0:09:32.480 on these insecurities and the purported ability to kind of 0:09:33.200 --> 0:09:37.920 fix them. We have to remember BDD is a mental disorder, 0:09:38.520 --> 0:09:42.600 not a physical disorder. The problem is with cosmetic intervention 0:09:42.800 --> 0:09:46.119 is that it actually often makes people with body dysmorphic 0:09:46.160 --> 0:09:51.079 disorder feel worse or actually just the same. After the procedure. 0:09:51.559 --> 0:09:54.920 They may even become more preoccupied with the perceived floor 0:09:54.960 --> 0:09:58.600 because it has just changed, it hasn't gone away, and 0:09:58.800 --> 0:10:02.200 they can seek further medic procedures, leading to at times 0:10:02.200 --> 0:10:05.440 an addiction. So something that really fascinated me about this 0:10:05.520 --> 0:10:10.480 kind of interaction between body dysmorphic disorder and cosmetic surgery 0:10:11.160 --> 0:10:14.160 is the study that said that, yes, a lot of 0:10:14.160 --> 0:10:17.400 people who pursue cosmetic surgery would actually make the criteria 0:10:17.440 --> 0:10:20.280 for this mental condition, but more so, they are actually 0:10:20.320 --> 0:10:22.679 also the people that are most likely to take legal 0:10:22.720 --> 0:10:26.760 action against surgeons because even when the surgeon in their 0:10:26.800 --> 0:10:30.400 mind has fixed this flaw, you know, it's it hasn't 0:10:30.440 --> 0:10:34.000 gone away, just because it's you know, physical form has 0:10:34.120 --> 0:10:38.320 changed this feature of us is once again a preoccupation 0:10:39.040 --> 0:10:42.320 that it's coming from something that is kind of mentally 0:10:42.360 --> 0:10:46.080 disturbed or mentally I don't like to say broken. Mentally 0:10:46.120 --> 0:10:49.520 different is probably a better way mentally disordered, right, It's 0:10:49.559 --> 0:10:52.560 just not an accurate reflection of what we actually look like. 0:10:52.600 --> 0:10:55.560 It's not an accurate reflection of our physical forms, So 0:10:55.600 --> 0:10:59.160 it doesn't actually matter if that feature of us changes. 0:10:59.760 --> 0:11:03.280 So obviously not everybody with BDD is going to seek 0:11:03.280 --> 0:11:06.480 out cosmetic surgery, but I think it does really reveal 0:11:06.559 --> 0:11:10.240 to us how hard it is to control such a 0:11:10.360 --> 0:11:14.679 loud and persistent thoughts about our body, and why it 0:11:14.760 --> 0:11:17.480 does seem that drastic measures will be the only solution 0:11:18.320 --> 0:11:21.360 to silence them. This is often why as well BDD 0:11:21.760 --> 0:11:27.160 is compared to parallel disorders like OCD and eating disorders. 0:11:27.320 --> 0:11:29.640 I feel like that one might have come to mind 0:11:29.679 --> 0:11:33.680 for you almost immediately, And these disorders in particular have 0:11:33.720 --> 0:11:38.600 a high chromobility. With BDD, that means that often not often, 0:11:38.640 --> 0:11:41.520 but you know, it's not uncommon for people to have 0:11:41.559 --> 0:11:44.079 a dual diagnosis. So for these two things to be 0:11:44.440 --> 0:11:46.840 occurring at the same time, for somebody to have BDD 0:11:46.960 --> 0:11:51.679 and an eating disorder or OCD and BDD. So the 0:11:51.679 --> 0:11:56.360 comparison to OCD really emerges because of the excessive sixuation 0:11:56.480 --> 0:12:00.600 which results in compulsive behaviors, which really kind of follows 0:12:00.640 --> 0:12:04.640 a similar format to how OCD manifests. However, with you know, 0:12:04.679 --> 0:12:08.840 body dysmorphia, it's really solely based on an obsession and 0:12:08.880 --> 0:12:11.960 a compulsion to do with appearance. So the link to 0:12:12.040 --> 0:12:16.320 eating disorders is also quite a common one. If someone 0:12:16.559 --> 0:12:22.000 is that disgusted i would say, almost tormented by their appearance. 0:12:22.880 --> 0:12:27.040 Sometimes this can really manifest in disordered eating habits, you know, 0:12:27.160 --> 0:12:31.920 wanting to control this aspect of yourself through whatever behavior 0:12:32.240 --> 0:12:35.920 or means necessary. But it's also important to remember that 0:12:35.960 --> 0:12:39.080 a lot of people with BEDD do actually just have 0:12:39.160 --> 0:12:43.520 quite normal eating patterns, like you can have BDD without 0:12:43.600 --> 0:12:48.479 abnormal eating. It's also interesting because people who are experiencing 0:12:48.559 --> 0:12:52.520 anorexia or binge eating disorder or bolimia, yes, they may 0:12:52.559 --> 0:12:55.280 find that this has resulted from initial feelings of like 0:12:55.880 --> 0:13:00.920 extreme dissatisfaction and fixation with some perceived flaw. But also 0:13:01.200 --> 0:13:04.960 another component of this is that sometimes there is you know, 0:13:05.040 --> 0:13:10.120 behaviors like restricting food or excessive exercising or purging can 0:13:10.160 --> 0:13:14.080 also emerge simply from a place of control, not just 0:13:14.600 --> 0:13:18.959 bodily modification, which is why I think BDD is really 0:13:18.960 --> 0:13:23.600 deserving of its own separate diagnosis. All right, so let's 0:13:23.640 --> 0:13:26.440 talk about risk factors here. There are obviously some people 0:13:26.920 --> 0:13:30.000 who are a lot more susceptible to this than others, 0:13:30.080 --> 0:13:33.520 like most mental health conditions, And when we talk about 0:13:33.559 --> 0:13:36.360 mental health conditions and we talk about who's at risk, 0:13:36.920 --> 0:13:39.760 the biggest thing it mostly comes down to, or always 0:13:39.800 --> 0:13:44.640 comes back to in some sense, is family history. If 0:13:44.640 --> 0:13:50.200 someone in your close or your immediate family has endured BDD, 0:13:50.960 --> 0:13:54.480 your chances go up quite a bit. This, You know, 0:13:54.720 --> 0:14:00.480 it comes down to genetic predisposition, but also exposure and 0:14:00.559 --> 0:14:04.240 life experiences. You know, if that individual with BDD was 0:14:04.280 --> 0:14:08.840 a parent, their own experience with this condition is going 0:14:08.840 --> 0:14:12.000 to influence how they raise you and how they parent you, 0:14:12.600 --> 0:14:15.080 as much as they may try for it not to. 0:14:15.800 --> 0:14:19.160 You know, if this kind of condition goes untreated, it 0:14:19.240 --> 0:14:22.520 does have the impact of bleeding into all these other 0:14:22.680 --> 0:14:27.640 aspects of our lives, including our relationships. So, for example, 0:14:27.680 --> 0:14:30.840 I heard from someone who spoke about how their mother 0:14:30.960 --> 0:14:34.120 was obsessed with slimness for all her life. She would 0:14:34.240 --> 0:14:38.240 endure these like drastic diets. She got multiple surgeries in 0:14:38.440 --> 0:14:42.080 the pursuit of this small body, this small physique. She 0:14:42.120 --> 0:14:44.960 would always comment on her weight to others. She really 0:14:44.960 --> 0:14:49.200 never seemed happy regardless of the results, So definitely meeting 0:14:49.240 --> 0:14:52.520 the criteria for BDD here and as a child, this 0:14:52.560 --> 0:14:55.880 person spoke about how her mother really implanted a lot 0:14:55.920 --> 0:14:59.760 of those beliefs in her through the way that she, 0:15:00.560 --> 0:15:03.640 you know, controlled her as a parent. She would, you know, 0:15:03.720 --> 0:15:07.240 control her food. For example, she would choose flattering clothes 0:15:07.320 --> 0:15:09.920 and colors for her and tell her these are the 0:15:09.960 --> 0:15:12.360 colors that you should wear, or you can't wear those things, 0:15:12.840 --> 0:15:16.000 they make you look fat. She was constantly commenting on 0:15:16.040 --> 0:15:20.200 her skin, especially as she hit puberty and developed acne. 0:15:20.200 --> 0:15:22.720 And this person said to me, you know, two years ago, 0:15:23.240 --> 0:15:25.760 I got the same diagnosis that my mum had gotten. 0:15:26.120 --> 0:15:28.320 And sometimes I think how much of it was genetic 0:15:28.760 --> 0:15:31.720 and how much of it was environmental? And was my 0:15:32.320 --> 0:15:36.840 you know, the environment of my upbringing. Because in those situations, 0:15:37.560 --> 0:15:39.840 how are you meant to develop a healthy sense of 0:15:39.880 --> 0:15:43.080 self esteem? How are you meant to detach your appearance 0:15:43.600 --> 0:15:48.280 from your self worth? When that kind of preoccupation is 0:15:48.400 --> 0:15:50.640 being passed down to you by the person in your 0:15:50.640 --> 0:15:52.640 life that matters the most to you as a child, 0:15:53.120 --> 0:15:56.960 which is your caregiver. This kind of example, and I 0:15:57.000 --> 0:16:01.480 don't like to say example, this person's experienceerience, Yeah, they're 0:16:01.640 --> 0:16:06.040 very much personal experience. Really demonstrates to me as well 0:16:06.160 --> 0:16:10.280 how negative life experiences also play a really crucial role, 0:16:10.680 --> 0:16:17.280 especially experiences like childhood bullying, like neglect, like teasing, like abuse. 0:16:18.240 --> 0:16:22.280 So I actually have a story about this that is 0:16:22.280 --> 0:16:24.720 from my own life that I've never really shared before 0:16:25.080 --> 0:16:26.960 on the show. You know, it never really came up, 0:16:27.440 --> 0:16:30.720 but it is one of my earliest and most lucid 0:16:30.840 --> 0:16:34.560 memories from childhood. It's also one of those moments that 0:16:34.600 --> 0:16:37.520 really goes to show how, you know, passing words can 0:16:37.560 --> 0:16:41.560 really leave quite a lifelong mark. So when I was 0:16:41.720 --> 0:16:44.760 around seven, six or seven years old, I used to 0:16:44.800 --> 0:16:47.320 always go to out of after school hours care Like 0:16:47.760 --> 0:16:49.640 I don't know if that's a thing everywhere in the world, 0:16:49.720 --> 0:16:52.240 but you know, both my parents were working, and so 0:16:53.200 --> 0:16:55.160 I like stayed at the school a little bit longer 0:16:55.480 --> 0:16:57.920 with like other kids whose parents were also working or 0:16:57.920 --> 0:17:01.360 also had things to do. And we were watching this 0:17:01.520 --> 0:17:04.440 movie with a bunch of other kids called the little princess, 0:17:05.080 --> 0:17:08.320 and this boy turns to me and he goes, you know, 0:17:09.359 --> 0:17:13.480 you would look just like her if you weren't so fat. 0:17:14.080 --> 0:17:19.760 I have never been able to shake those words, even 0:17:19.800 --> 0:17:22.679 to this day. They have left such an imprint on me. 0:17:23.200 --> 0:17:25.960 It was like the first time that I ever felt 0:17:26.040 --> 0:17:29.560 shame about my body. And I think when I was 0:17:29.560 --> 0:17:33.520 a teenager. Now as an adult, my whole life, my 0:17:33.680 --> 0:17:37.320 weight has been a point of fixation for me. There 0:17:37.320 --> 0:17:39.600 has never been a period of my life where I've 0:17:39.600 --> 0:17:43.120 been satisfied with how I look or how I weigh, 0:17:43.359 --> 0:17:46.320 how I feel in my body, and I often wonder 0:17:46.960 --> 0:17:49.880 whether that would have been different if that hadn't happened, 0:17:50.200 --> 0:17:53.919 because it was almost like this new you know, It 0:17:53.960 --> 0:17:56.359 was almost like that was the beginning, Like I became 0:17:56.480 --> 0:17:59.720 conscious of everything that I could change that I didn't 0:17:59.760 --> 0:18:03.160 like myself, and the fact that people could observe these 0:18:03.200 --> 0:18:06.000 things that I didn't like about myself and could make 0:18:06.080 --> 0:18:10.560 judgments or mean comments to me about my appearance, and 0:18:10.640 --> 0:18:13.959 it mattered. It's also really interesting to me how that 0:18:14.040 --> 0:18:16.040 continues to come up as a problem for me in 0:18:16.040 --> 0:18:19.240 my life. I posted like this random video on my 0:18:19.320 --> 0:18:21.800 Instagram a few weeks ago. If you follow me over there, 0:18:21.840 --> 0:18:24.000 I think you'll know which one it is. And it 0:18:24.080 --> 0:18:26.760 reached an audience that I basically like didn't intend it 0:18:26.760 --> 0:18:29.520 to like. It went semi viral, and the audience was 0:18:30.119 --> 0:18:34.520 you know, men in their like thirties and forties who 0:18:34.560 --> 0:18:37.040 didn't you didn't agree with what I was saying. And 0:18:37.080 --> 0:18:40.320 as always goes with those situations, if like a middle 0:18:40.320 --> 0:18:42.720 aged man doesn't agree with what you're saying, the first 0:18:42.720 --> 0:18:45.280 thing they're going to resort to doing is making a 0:18:45.320 --> 0:18:49.680 comment about your weight or your appearance. And oh my gosh, 0:18:49.720 --> 0:18:52.160 did I not get hundreds of them? And they were awful, 0:18:52.240 --> 0:18:55.920 And the only thing I could think of was, oh 0:18:55.920 --> 0:18:57.720 my god, this is just like this all over again. 0:18:57.800 --> 0:18:59.760 It brought me right back to that version of me 0:18:59.800 --> 0:19:03.520 who was first really made aware that her body wasn't 0:19:03.520 --> 0:19:06.399 just there to climb and to run and to play 0:19:06.920 --> 0:19:09.600 and to giggle and to eat yummy foods like it 0:19:09.720 --> 0:19:14.680 was there to be judged. Those early life experiences might 0:19:14.760 --> 0:19:18.080 seem very far in the past, but they definitely linger, 0:19:18.600 --> 0:19:22.399 especially since BDD typically starts, you know, in our early 0:19:22.480 --> 0:19:25.720 teen years when everything is so formative, but also when 0:19:25.920 --> 0:19:29.399 those childhood experiences and memories are a lot more fresh 0:19:29.480 --> 0:19:32.919 and we are a lot more impressionable. So there are 0:19:32.920 --> 0:19:38.360 some other risk factors, including personality traits like perfectionism. If 0:19:38.400 --> 0:19:42.240 we are, of course preoccupied with being flawless in every 0:19:42.280 --> 0:19:45.399 other area of our life, of course our appearance is 0:19:45.440 --> 0:19:47.439 going to come into that. You know, the existence of 0:19:47.480 --> 0:19:50.880 even a tiny perceived floor, a bad skin day, stretch 0:19:50.920 --> 0:19:54.479 marks a facial feature that can really disrupt our whole 0:19:54.760 --> 0:19:59.320 identity and be quite distressing. I will say something that 0:19:59.400 --> 0:20:02.800 is not a fact to hear is gender. So with 0:20:03.280 --> 0:20:07.040 eating disorders, for example, there is you know, typically a 0:20:07.160 --> 0:20:11.680 much higher prevalence amongst women. It's normally around three times 0:20:12.119 --> 0:20:13.960 the rates that we would see in men for things 0:20:14.040 --> 0:20:18.840 like anorexia and bolimia. But for BDD men and women, 0:20:18.920 --> 0:20:23.520 people of all genders are influenced the same, It just 0:20:23.640 --> 0:20:28.400 expresses itself quite differently. One area that this is really 0:20:28.480 --> 0:20:31.159 evident to me is when it comes to weight. Women 0:20:31.280 --> 0:20:35.040 typically want to be thinner, whereas men want more muscle. 0:20:35.280 --> 0:20:40.000 They're preoccupied with gaining weight. Obviously this isn't always the case, 0:20:40.119 --> 0:20:42.439 but I do think that it's a distinction that we 0:20:42.480 --> 0:20:45.040 can really see when we just look around ourselves, when 0:20:45.080 --> 0:20:48.919 we just compare what our male friends versus our female 0:20:48.960 --> 0:20:53.240 friends complain about when it comes to their size. So 0:20:53.320 --> 0:20:56.600 in the DSM there is even a specifier around this 0:20:56.640 --> 0:21:01.840 particular kind of BDD that results from muscles dysmorphia, whereby 0:21:02.119 --> 0:21:05.840 somebody is really engrossed with the idea that their body 0:21:05.840 --> 0:21:09.080 build is too small. They are not muscular enough to 0:21:09.119 --> 0:21:11.679 be seen as I don't know, manly, or to be 0:21:11.760 --> 0:21:16.040 seen as big enough, or worthy enough, or like strong enough, 0:21:16.600 --> 0:21:19.280 whatever it is. This, in my mind can also be 0:21:19.320 --> 0:21:22.280 really attributed to, I would say, a rise in toxic 0:21:22.359 --> 0:21:26.280 gym culture and this idea of big erexia. Now, this 0:21:26.359 --> 0:21:28.800 is a term that I learned from a recent article 0:21:28.840 --> 0:21:32.719 by the Guardian and they talk about like how you know, 0:21:32.760 --> 0:21:35.120 we all know what anorexia is. This is a play 0:21:35.160 --> 0:21:39.880 on words, and anorexia is typically associated with the pursuit 0:21:39.960 --> 0:21:44.120 of smallness and thinness, whereas big erexia is this pursuit 0:21:44.160 --> 0:21:47.439 of being as huge as possible. And in this article 0:21:47.480 --> 0:21:50.200 they spoke to some you know, guys and some women 0:21:50.240 --> 0:21:53.199 as well, but mainly men about the lengths that they 0:21:53.200 --> 0:21:57.240 are willing to go to to achieve this, and how 0:21:57.359 --> 0:21:59.440 no matter how many people say, wow, like you are 0:21:59.480 --> 0:22:02.600 so huge, huge, You're massive, Like every time they look 0:22:02.600 --> 0:22:04.680 in the mirror, they do not see that. They see 0:22:04.720 --> 0:22:09.119 themselves as tiny. And this one man in this article 0:22:09.240 --> 0:22:13.080 was talking about how he would like eat the only 0:22:13.119 --> 0:22:15.920 thing he would eat would be like chicken breasts and 0:22:17.280 --> 0:22:21.800 protein sources. And he was like, I looked amazing, Like 0:22:21.880 --> 0:22:24.879 in my mind, I looked so huge, but I was 0:22:25.040 --> 0:22:28.159 so unhealthy, and like his kidneys started failing and his 0:22:28.320 --> 0:22:31.880 livers started failing. And I think that that really comes 0:22:31.920 --> 0:22:35.240 down to this crucial point, which is that this obsession 0:22:35.240 --> 0:22:39.000 with a muscular body is largely ignored because it's seen 0:22:39.040 --> 0:22:43.840 as healthy or a worthwhile bodily pursuit. Because you know, 0:22:43.880 --> 0:22:47.560 what's unhealthy about strength, and what's unhealthy about spending time 0:22:47.560 --> 0:22:50.679 in the gym, what's unhealthy with fueling your body in 0:22:50.720 --> 0:22:54.919 this opt optimal way, what's unhealthy about protein? And I 0:22:54.960 --> 0:22:58.880 think a lot of people experiencing this, witnessing this would 0:22:58.920 --> 0:23:02.959 be quick to highlight how easy it is for this 0:23:03.000 --> 0:23:08.440 to tip into very unhealthy and maladaptive terrain. How this 0:23:08.520 --> 0:23:12.360 is just another version of an unrealistic or an extreme 0:23:12.560 --> 0:23:17.119 expectation for our body image that is promoted by certain 0:23:17.200 --> 0:23:21.600 in groups and certain cultures and certain aspects of society. 0:23:22.119 --> 0:23:25.119 So this distinction, this general distinction is I think between 0:23:25.240 --> 0:23:28.199 weight loss and weight gain for different genders is essentially 0:23:28.240 --> 0:23:30.879 a reflection of what society expects from men and women, 0:23:31.040 --> 0:23:34.800 you know, the beauty ideals that each gender is very 0:23:34.920 --> 0:23:38.120 much forced to endure. And we can't ignore that component, 0:23:38.160 --> 0:23:42.560 the influence of our social conditioning and how we have 0:23:42.680 --> 0:23:47.040 been taught to hate our bodies, not instinctially but through 0:23:47.160 --> 0:23:50.960 external influence. So BDD, I think, is what I would 0:23:50.960 --> 0:23:53.520 call a modern day disorder because it really has arisen 0:23:54.240 --> 0:23:57.879 mainly in the last one hundred years, probably even twenty 0:23:57.880 --> 0:24:01.679 to fifty years specifically, and it's really emerged, as some 0:24:01.720 --> 0:24:04.560 researchers would say, from the fact that we now have 0:24:04.840 --> 0:24:08.760 more comparison points than ever to judge ourselves based on, 0:24:09.240 --> 0:24:13.479 and we are increasingly being exposed to this messaging around 0:24:13.480 --> 0:24:16.320 what we should look like and what is not desirable. 0:24:17.080 --> 0:24:20.840 This is because things like TV, advertising, social media, they 0:24:20.840 --> 0:24:23.080 have made us more aware of the social norms around 0:24:23.119 --> 0:24:28.200 attraction and what society sees as beautiful or not. Secondly, 0:24:28.240 --> 0:24:31.000 they've exposed us to what other people look like, meaning, 0:24:31.040 --> 0:24:33.439 of course, more opportunities to come up short and compare. 0:24:34.000 --> 0:24:37.840 And finally, you know, the media uses looks and appearance 0:24:38.040 --> 0:24:41.479 as something through which they can influence and sell us things, 0:24:41.760 --> 0:24:45.040 And so let's be honest, they benefit from us not 0:24:45.200 --> 0:24:49.920 feeling great. They benefit from us seeing a beautiful person 0:24:50.080 --> 0:24:53.359 on TV and wanting whatever skincare product that they're using, 0:24:53.920 --> 0:24:57.520 or seeing you know, a huge, huge guy on some 0:24:57.680 --> 0:25:01.919 superhero movie and admiring not just this plotline and this 0:25:02.040 --> 0:25:04.919 narrative around him being a hero, but the fact that 0:25:04.960 --> 0:25:07.760 he looks so great and the fact that we could 0:25:07.840 --> 0:25:09.919