Tuesday night I attended a presentation of four psychologists titled "Body Image Issues for Gays and Lesbians." At the panel, sponsored by the civil rights organization Equality Forum, I learned quite a bit about Body Dysmorphic Disorder (BDD) - and its applications to those in and beyond the gay community.Taken from Wikipedia: "BDD is a mental disorder in which the affected person is excessively concerned about and preoccupied by an imagined or minor defect in his or her physical features. The sufferer may complain of several specific features or a single feature, or a vague feature or general appearance, causing psychological distress that impairs important functioning or social aspects of life."
Panelists used the example of men in the gay community who have a preoccupation with big and lean muscles, one which drives them to spend countless hours in the gym.
Also from Wiki: "Most people wish that they could change or improve some aspect of their physical appearance; but people suffering from BDD, generally of normal or even highly attractive appearance, believe that they are so unspeakably hideous that they are unable to interact with others or function normally for fear of ridicule and humiliation about their appearance."
Panelist Elan Cohen described many of his male clients with BDD as having "ideal" body types (ripped abs, huge arms and chest, etc) who still believe themselves to be fat. Another therapist, Carly Schulman, mentioned that 90% of her BDD clients - mainly women who believed themselves to be fat - weren't actually overweight.
BDD should not be taken lightly as it seems to go hand-in-hand with depression, OCD, anxiety, and eating disorders. The panelists spoke of the frequent need to medicate clients with BDD.
So how do you recognize this condition? Some signs include:
- Compulsive mirror-checking or obsession with one's reflection
- Reassurance-seeking from loved ones
- Social withdrawal
- Frequent referencing of celebrities the person wishes to resemble
- Obsession with plastic surgery
Two unique signs came from Dr. Petros Levounis, who compared the disease to that of an addicted gambler, and offered the following:
- Someone who makes a promise or an agreement to do (or not do) a certain behavior - i.e. "Today is my day off from the gym." - and then still does it, may be suffering from BDD.
- Someone who lies to his/her family or friends about eating or exercise behaviors may be affected as well.
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As a trainer, what concerns me is that there seems to be a fine line between encouraging people to take interest in adopting healthy behaviors and feeling proud of their body's resulting physicality, and pushing them to the point where they are obsessed over these habits and their accompanying aesthetics...where things like BDD enter the picture. Unfortunately, our culture likes to emphasize feeling proud about the body more than adopting healthy behaviors. Just think to the widely-accepted "If you got it, flaunt it" mantra. The media feeds us images of men and women with "perfect" bodies in magazines, advertisements, movies, and on TV. And because we dwell on these nicely-packaged finished products, we spend less time exploring and becoming excited about the other part of the equation, which is adopting healthy behaviors.
This leaves me wondering, Is BDD specific to active people who workout in the gym? Or does it occur evenly across populations of those who seek exercise outside the gym (like outdoor runners, bike commuters, or those practicing yoga)? We try to keep the addicted gambler from the casino, the alcoholic out of the bar...should we be trying to keep the person with BDD out of the gym?
Two friends of mine - one a sociologist and the other a psychologist - weren't sure, and agree that I may have stumbled upon a dissertation topic. Yikes!
Any thoughts?
2 comments:
I think a gym is a setting that invites comparisons whether in the locker room where I'm sure confident people bare it all and invite scrutiny or in the gym proper where you pretty much see it all. If a body-dysmorphic person chooses the wrong place to work out wouldn't that have a lot to do with reinforcing the b-d syndrome? In a gym whose membership is more low key and representative of the population at large (fewer body-builders, serious athletes, etc) it seems b-d would be less prevalent. The gym is also a closed-in environment where you share space, sometimes compete for it so you're in up-close contact on a regular basis. Comparisons are easier to make than if you engage in activities in the great outdoors where you don't have to rub elbows with those perfect bodies you covet. Just some rambling thoughts...
As much as I agree that the images in a gym - and being surrounded by others reaching for that "ultimate" body type - certainly can help perpetuate the negative habits and thoughts by someone with BDD, I think that it has more to do with the people themselves rather than their surroundings.
People suffering from BDD often see physical imperfections that don't exist, and are consumed with these obsessive thoughts, day in and day out. As has been proven with other addictions - you mentioned gambling, but there's smoking, or obsessive habits related with OCD - one addiction or bad habit can just be replaced with another. An alcoholic might be able to go sober, but that obsessive, addictive aspect of their personality still exists (hence, 'once an alcoholic, always an alcoholic.' or anorexic, etc). So whether in the gym or at home alone or out on the pavement, people with BDD are going to be scrutinizing themselves and obsessively working out, regardless of who else is around or what they look like.
That said, though, a workout like the one Cathy mentioned, where it's one on one with a trainer, outdoors in the fresh air, or in a more comfortable, low-key environment, certainly can't hurt. It could be a great way to attack BDD where it really lies - in the mind - while still encouraging healthy habits.
But yeah - definitely a great dissertation topic!
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