Addressing Body Image Concerns Using Mirror Exposure

Who hasn’t experienced some form of self-criticism about their body image? We are all too familiar with examining ourselves in the mirror and zeroing in on whatever it is that we do not like. It’s a process so many of us unconsciously engage in…but what effect does it really have on us? Negative body image is associated with lower self-esteem, anxiety, depression, eating disorders, and body dysmorphic disorder. Concerns about our appearance can have a profound effect on social functioning and intimate relationships. People may avoid wearing certain clothes, being seen or touched, or going to places based on concerns about how they look. While everyone can relate to experiencing dissatisfaction with their appearance, few of us are aware that how we examine ourselves in the mirror plays a drastic role in what we see, think, and feel.

 

In today’s blogpost, we are going to talk about one specific intervention for addressing body image concerns: The mirror exposure. Please note that addressing negative body image is challenging and can call for a number of different interventions including but not limited to, examining underlying beliefs about what our bodies should look like as well as the degree to which we base our self-worth on how we look. If you have an individual therapist, I recommend bringing up your body image concerns in that supportive space. If you are looking to learn more on your own, I recommend a book like: The Body Image Workbook. Okay, now back to mirror exposures…

 

Let’s start by debunking a myth:

 

Is what you see in the mirror completely accurate?.... Not quite!

 

Have you ever looked like yourself in one mirror and totally different in another? The lighting, type of mirror, and glass quality all affect how your image is reflected. Beyond that, consider the size of your image in a full-length mirror. Does the image in the mirror reflect your true height and width? You can experiment with this by having someone mark the top of your head and your feet in the mirror and measure it. The short answer is no.

 

Am I advocating for no mirrors? Of course, not. They have their value, but taking the reflection you see in the mirror as capital “T” truth and then criticizing yourself can contribute to a variety of mental health concerns.

 

So, what IS body image?

 

When we think about body image most of us will think about…well…our bodies. However, it’s a bit more complex than that. Our body image is made up of perceptions, cognitions, feelings, and behaviors. Perceptions are what we become aware of by way of our senses (e.g. the sensation of my waistband pressing on my abdomen or the way I see myself in the mirror). Cognitions are thoughts, beliefs, and interpretations about our bodies (e.g. “I’m fat”). Feelings are the emotions we feel about our body which can be amplified by negative cognitions (e.g. disgust, shame, embarrassment, and/or guilt). Finally, behaviors are actions we take (e.g. restricting food/food groups, checking your stomach in the mirror repeatedly, and/or avoiding looking at yourself in the mirror). Each of these components impacts one another and can happen in any order.

 

How can behaviors reinforce the cycle?

 

If someone assumes they look “fat” and “disgusting,” they may avoid looking in the mirror. This avoidance strengthens those beliefs by leaving them unchecked. Now, let’s say you do the opposite…you check repeatedly whether you look fat and disgusting. Well…what you discover depends on the way you assess yourself. “Flaws,” that would otherwise go unnoticed, become prominent, when you seek them out. Furthermore, scrutinizing yourself in the mirror magnifies perceived defects. Consider the study that showed how people with spider phobias perceived spiders to be larger than they actually are in reality. This is because when looking at the spiders through the lens of fear, they focused on unpleasant characteristics and ignored things in the environment that provided a reference to size. Similarly, when people study themselves in the mirror, they fixate on perceived flaws, which, in turn, magnifies them. If you are looking for a flaw, you will find it. In other words, how you examine yourself in the mirror influences what you see.

 

Enter stage left…the mirror exposure:

 

Mirror exposures, sometimes called perceptual retraining, is an intervention that works to break the cycle of negative body image. We are looking to confront anxiety, disgust, shame, guilt…any uncomfortable feelings having to do with our body. We are also practicing looking at our bodies as a whole rather than focusing on the parts of our body we dislike.

 

How do we do this?

1. This practice is really tricky. If you are doing this on your own (versus with a therapist), it can help to record yourself so that you can play it back afterwards and give yourself feedback.

2. Stand in front of a full-length mirror and practice systematically describing your body using neutral, objective language. Go from head to toe or toe to head.

a. Examples of neutral descriptions include: Describe colors you see, shapes you see, textures, measurements using neutral, and objective terms (e.g. my forehead is about three fingers tall). Think about any description you might use to help someone build a model of your body.

b. Examples of non-neutral descriptions: Fat, ugly, gross…need I go on?

c. If you are unsure, ask yourself, does that description feel neutral to you?

3. Pacing: Spend a similar amount of time on each area.

a. Notice if you have urges to avoid certain areas on your body. If the urge is there, practice approaching and slowing down using the neutral descriptions.

b. Conversely, if you have the urge to spend extra time on a particular section of your body part (e.g. checking), practice pacing yourself in the same way you do for a part of your body you don’t check.

4. When you are finished, listen to the recording of yourself doing this practice and determine whether there were areas of difficulty.

5. If you avoided, checked, or used non-neutral language go back over these areas and practice confronting, pacing, and using neutral language.

6. Practice this daily. You can vary the exposure using different types of clothing.

 

Why is this helpful?

In case it’s not already clear, mirror exposures target the self-perpetuating cycle of negative body image by…

● Disrupting hyperfocus on perceived flaws by viewing your body more globally.

● Breaking the cycle of avoidance via confronting/exposing (avoidance reinforces negative thoughts/feelings).

● Teaching you to tolerate and accept (versus fight) difficult thoughts and emotions. If we stop fighting these things, over time they will die down. Keep in mind, however, this takes time! Measure your success by the fact that you are doing the mirror exposure practice versus by the presence of negative thoughts and feelings.

 

To conclude:

 

Body dissatisfaction takes place when a person has persistent negative thoughts and feelings about their body which, in turn, shapes behaviors such as the way you look (or don’t look) at yourself in a mirror. While this is an internal process it is heavily influenced by external factors - think messages in our culture, media, and

immediate environment that tell us what the ideal body “should” look like. Mirror exposure is one practice that can help you move towards a more positive body image. What IS a positive body image? Accepting, appreciating, and respecting your body. This does not mean you are never dissatisfied with aspects of your appearance, but it does mean that you practice acceptance with all of its limitations. Positive body image is a protective factor against developing eating disorders and is also associated with higher self-esteem, self-acceptance, and more adaptive living. While changing your relationship to your body is challenging, it is worthwhile if it can leave you feeling more flexible and free to live the life you want.

How to Live in Accordance With What Matters: A Crash Course on Acceptance and Commitment Therapy (ACT)

What the heck is ACT? If you find yourself thinking, “another type of behavioral therapy? Another acronym?!” I would get it. It’s true, as a therapist, I geek out on this stuff. But I wouldn’t write a blog post about it if I didn’t think it was really worth your time.  

So what is it? ACT is all about accepting what is out of your personal control and committing to action that enriches your life. What do you want to stand for in your life? What truly matters to you? Once you clarify your core values you can use them as guides to motivate and inspire behavioral change. 

How is this different from other types of therapy? We are often being sent messages about the need to control our emotional states. Think about the self-help section in a bookstore: You see titles like “How to Feel Less Stress” or “5 Ways To Find Happiness.” At some point, all of us probably received feedback about getting over an unpleasant emotional state. It’s what I like to call the wipe off your knees and keep going mentality. When we buy into this, we tell ourselves we’re not doing a good enough job– if we feel too much stress, anxiety, fear, shame, guilt, and not enough happiness or joy. When we internalize these messages we try to control our thoughts and feelings. In ACT, we believe that thoughts and feelings themselves are not pathological. We don’t need to chase them down and change them. Rather, the focus is on relating to them in a different way by accepting their presence, fully and without defense, and choosing what you will or won’t do based on your personal values. It sounds nice, but how do we actually put that into practice? In ACT, there are six core processes that can help guide you: defusion, self-as-context, presence, acceptance, values, and committed action. Each of these processes comes with a number of different skills. For this blog post, I will explain each step and scatter into some exercises.  

Defusion:

We get caught up in our thoughts; we take them as capital “T” truth and often see the world through the lens of a painful thought we have about ourselves, others, or the world. Defusion is about stepping back and detaching from inner thoughts or images. Instead of getting caught up in our thoughts, we let them come and go. We see thoughts for what they are– nothing more or less than words or pictures. We hold them lightly instead of clutching to them tightly. 

Exercise: Take a painful thought such as, “I’m unlovable” and get a bit of space from it by inserting one of the clauses below:

The Observing Self (also known as Self-as-context):

There are two elements of the mind: The thinking self and the observing self. The thinking self is the part of us that is always thinking– generating judgments, fantasies, beliefs, and so on. The observing self is less talked about in our culture. This is the part of us that is aware of whatever we’re thinking, feeling, sensing, or doing in any moment. Throughout life your body, thoughts, roles, and feelings all change but the “you” that’s able to notice or observe all those things never changes. 

Contact the present moment

Our judgmental, problem-solving minds constantly pull our attention away from the present. Why? We want to avoid suffering and we yearn for orientation– to know where we are in our life journey. But instead of orienting ourselves, we end up ruminating about what’s happened in the past or worry about what will happen in the future. Both of these “thinking self” processes are associated with depression and anxiety. Contacting the present moment is about mindfulness, defined as “paying attention in a particular way, on purpose, in the present moment, and non-judgmentally” (Jon Kabat-Zinn). 

Exercise: Try this simple 6-minute meditation

Acceptance: 

When we try to avoid uncomfortable thoughts and feelings, we demonize natural human experiences. Our efforts, energy, and attention are spent trying to control unwanted inner experiences and we feel even worse when they show up. Avoidance is not workable as a long-term solution. As we say in ACT:

If you don’t want it, you’ve already got it.

If you aren’t willing to be anxious, you will feel even more anxious.

If you aren’t willing to feel pain, you will feel even more pain.

If you keep doing what you’re doing, you’ll keep getting what you’re getting.

The goal of acceptance is a willingness to make room for uncomfortable feelings, sensations, urges, and emotions. Instead of struggling against them, we open up to them and let them be. This does not mean you have to like it or want it (anxiety IS uncomfortable), but it’s about allowing yourself to have it. In fact, the wisdom of pain is that it tells us what matters most. For example, I might feel pain if a friend is upset with me or I might feel anxiety after a social interaction. What those uncomfortable emotions tell me is that I don’t want to hurt my friends or that I care about how I’m perceived in social situations because connection matters to me. Values and vulnerabilities are two sides of the same coin; the more we pursue our values the more vulnerable we will feel.   

Exercise:  Say “Yes”

Consider a painful thought or memory that you often struggle with or avoid altogether. Put a 1-minute timer on. Close your eyes and adopt a “no” stance towards that thought or memory as in: “No, that’s not good. That needs to change; that is unacceptable.” Allow yourself to struggle against it as you normally do. When the timer goes off, note any observations of what that experience was like: What emotion did you feel? How did you hold your body (tense, relaxed)? What happened in your mind (did your thoughts speed up? Slow down?) Next, put the timer on again for 1 minute. This time, take that same thought or memory but instead adopt a “yes” stance towards it as in: “yes, I am willing to allow that to be there, just as it is. I do not need to change it.” Afterward, observe or describe how these experiences were different. 

Values 

In ACT, we define values as qualities of being. For example: Being a loving, caring, attentive, curious, and supportive partner. 

Values are not goals. Goals can be met, checked off a list, or completed.  Values are what we live by and we continuously commit and recommit to them. I can meet my goal of getting married but I’m never done being a loving partner. Love is ongoing. It matters before and after you get a partner. 

The more in touch we are with what truly matters, the easier it is to take a step in the right direction. 

Exercise: Attend your own funeral

Close your eyes and take a few deep breaths to calm your mind. Picture witnessing your own funeral. Think about where it would be and visualize a clear picture of your funeral service in your mind. Imagine that a loved one is saying a few words about what you stood for in your life; about what you cared about. Write out what you would want to hear in your eulogy about how you lived your life. Notice if certain thoughts or judgments come up. Defuse from them. This is not a prediction of your life but rather a reflection on the meaning you would most like to create; the purpose you would most like to reveal about the time you spent on this planet. 

Committed Action

Take effective action towards upholding your values. Value-guided action gives rise to a wide range of thoughts and feelings– both pleasurable and painful. Committed action means doing what it takes even if it brings on pain and discomfort. Maybe I’m terrified to open up fully in a relationship; to be vulnerable. I could choose to avoid that feeling by saying no to dates, being hypercritical of someone I meet, or closing myself off from someone emotionally, but that won’t help me get to where I want to go (having a close, connected, intimate relationship). Instead, what do I do? Committed action often encompasses all other act processes: Download the dating app (action), defuse from self-critical thoughts, accept the anxiety you feel, observe fear and shift towards curiosity and openness (values), show up fully present, with the intention of getting to know someone. 

Putting it all together:

One quick way to put it all together yourself. If you find that you’re in a situation and struggling with your inner world, ask yourself these questions: 

  1. What is the story I am telling myself in this moment? (e.g. the story of no one likes me) 
  2. How do I react when I buy into that story? (e.g. get quiet, retreat, internally criticize everything I do)
  3. Who or what is important to me right now? (e.g. getting to know someone, connecting, being present)
  4. What are some actionable steps towards that? (e.g. find someone approachable, sit and ask them questions, listen intently) 

Now you try!