When discussing body image, there are many terms, diagnoses, and beliefs that someone may hear or have experience with. When it comes to gender dysphoria and body dysmorphia, it's common that these terms are incorrectly combined, causing harm and undermining the reality of how powerful and difficult it can be to experience gender dysphoria and body dysmorphia [2].  Centers for Discovery notes that, “unlike gender dysphoria, body dysmorphia doesn’t respond to the changes we make to our bodies. Individuals with body dysmorphia and eating disorders like anorexia don’t actually feel better about their body when they use eating disorder behaviors, even if their body is physically transformed. Healing body dysmorphia is more than a physical process. It involves deep and long-term therapy, where one is encouraged to challenge their own thoughts. Whereas gender-affirming actions, like hormone replacement therapy or wearing different clothing, for example, have been shown to improve gender dysphoria” [2]. 

As discussed above, body dysmorphia is its own diagnosis, called Body Dysmorphic Disorder (BDD),  and is classified as an anxiety disorder, “that causes individuals suffering to worry about and have a preoccupation with a perceived flaw in their outer appearance” [2]. Often, individuals with body dysmorphia experience distorted self-perceptions and feel deep shame about existing and living in their own body. You might feel disconnected from your body, feel unfamiliar with your reflection, and feel fearful of your appearance. This may come with frequent body checking, examining your appearance in the mirror, comparing your body to others bodies, isolation from social events, and avoiding being in photos. You might feel that lying underneath these behaviors is a fear of being visible or seen by others, harboring feelings of shame and anxiety. At Grounded Wellbeing, we align with attachment and internal family systems theories, and view this part of ourselves as a potential exile, which are the vulnerable parts of ourselves that hold onto shame, trauma, and  drive negative self-talk. We tend to make our exile behavior as a way to avoid the painful emotions and feelings that come with it. Often, but not always, body dysmorphia is the underlying part of us that triggers disordered eating or eating disorders which acts as protectors. These protectors, labeled as either firefighters or managers, respond with behaviors to avoid the emotional pain our exiles might bring. For example, “one of your parts may have witnessed you be shamed for gaining weight while growing up. This part decided it is not safe to gain weight and therefore took on the role of obsessive calorie counting and encourages you to restrict nutrition intake to keep you safe from feeling shame” [3].

The goal of this work is not to “get rid” of these parts, but to grow compassion and understanding of why they exist. In our work together, we can explore these parts, listen to them, understand them, and work to transform our relationship with them.