Helping A Client With Negative Body Image

Nov 24, 2022

People come in all shapes and sizes, but our culture tends to only value bodies that fit a very limited mold. Almost everyone has had the painful experience of feeling like their body doesn’t measure up. Almost everyone is somewhere along a journey of coming to terms with the unique way their body looks and functions. As a therapist, you can play an extremely important role in helping your clients on this journey.

Healing body image is often a part of my work as a sex therapist and a couples therapist. There are all sorts of ways that negative body image can hurt a relationship. Think about it: if you don’t love your body, how can you be comfortable being naked in front of another person, being touched in places or seen in positions that activate your insecurities? If you’re always worrying that your appearance is turning your partner off, how can you relax into an experience of pleasure? 

Self-consciousness and negative self-talk can block arousal and make it difficult to experience an orgasm, or even pleasure. Body shame can also get in the way of having an honest conversation with your partner about your particular body insecurities, meaning you never get a chance to check your assumptions and experience a different perspective. Very often, the first step to more satisfying sexual experiences with a partner is building body love and body acceptance.

The way you feel about your body will naturally shape your way of experiencing the world in a fundamental way, in all spheres, not just sex. For that reason, I think building a better relationship with their body is one of the most meaningful projects you could possibly take on. Working with body acceptance and body image issues from a body positive perspective is a powerful opportunity for therapists to make profound differences in the lives of their clients. 

So, if healing negative body image is a part of your treatment plan, where can you start? Here’s how I tackle this challenge: 

  • Often, I start by asking people to talk with me about what they love about their body. 
  • If they can’t think of anything (which is not uncommon), I shift the focus to function, not aesthetics. From the perspective of function, it’s hard not to see how incredible your body is. Think of the zillions of magical and automatic functions every body does every single second! If your client can take a moment to appreciate the wonder of all the work their body does every moment, that can be a seed that sprouts into a more nurturing, grateful, appreciative relationship with their body.
  • When a client expresses hatred for their body, I might say:
    • “Your body is absolutely beautiful just exactly as it is. You don’t have to change it in order to love it or find it beautiful.”
    • “This is a belief system, you know. Other cultures view this differently than ours”.
    • “I’ve never known anyone to change anything about themselves by hating themselves into it.” That last one is important if you have a client who is trying to motivate themselves to create or stick with a lifestyle change while also struggling with negative body image–a difficult balancing act, and one that will benefit from your support. (For more on this topic, see my last post.) 

I advise you to be very cautious about body compliments that might come across as judgments. The urge to compliment a client who has been struggling with body hatred is understandable, but it is important to choose compliments carefully, in order to avoid falling into the same body-negative tropes that are hurting your client and us all. For instance, if a client said to me, “Do you notice I lost weight? I think I’m looking a little better,” I would respond with “I’ve always thought you are beautiful, and you know, I’m the wrong person to ask about weight loss because I just don’t see people that way.”

If you want to learn more about body positivity, or are searching for something on the topic for your client to watch, I recommend the film “Embrace.” It’s an excellent documentary and a real education in body acceptance and body politics. I have frequently encouraged clients to watch it when I think a fat-phobic belief system is part of what is standing in their way.

Originally published on Psychology Today.

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