What Are Body Image Issues?
Body image refers to the thoughts, feelings, and perceptions you have about your own body. It’s not just about what you see in the mirror—it’s also about how you feel in your body, how you believe others perceive you, and how comfortable you are in your own skin.
When someone has negative body image, they may:
- Focus excessively on perceived flaws or imperfections
- Compare themselves unfavourably to others
- Feel uncomfortable, anxious, or ashamed about their appearance
- Avoid social situations, intimacy, or activities due to how they feel about their body
Body image issues can affect anyone—regardless of age, gender, weight, or shape—and are often influenced by societal pressures, trauma, past experiences, and internal beliefs.
The Impact of Body Image Issues
Negative body image can have far-reaching effects on mental, emotional, and physical health. It’s more than just “not liking what you see.” It can influence:
- Self-esteem and confidence – A constant inner critic can limit opportunities, relationships, and personal growth.
- Mental health – Negative body image is linked to anxiety, depression, eating disorders, and social withdrawal.
- Relationships – Struggles with intimacy, fear of judgment, and avoidance behaviours can put strain on relationships.
- Daily life – Avoiding certain clothes, activities, or public spaces can lead to isolation and reduced quality of life.
In many cases, body image issues are deeply rooted in past experiences, including bullying, criticism, trauma, or attachment wounds—not just in the present moment. This is why talking to a therapist can be a powerful step towards lasting change.
How Therapy Can Help
Therapy can address body image concerns at their roots—not just manage the symptoms. Here’s how three evidence-based approaches can make a difference:
1. Cognitive Behavioural Therapy (CBT)
CBT works by helping you identify and challenge unhelpful thought patterns about your body. You learn to:
- Recognise distorted thinking (“I’ll never be attractive unless I lose weight”)
- Replace it with more balanced, compassionate beliefs
- Build healthier habits that support your wellbeing rather than fuel the cycle of self-criticism
CBT focuses on the here-and-now, giving you practical tools to interrupt negative spirals and develop a kinder, more accepting relationship with your body.
2. Eye Movement Desensitisation and Reprocessing (EMDR)
For many people, body image struggles are connected to specific painful experiences—like being teased about weight in childhood, or a moment of humiliation in adolescence.
EMDR helps process these memories so they no longer carry the same emotional weight. Through guided sets of bilateral stimulation (eye movements, tapping, or sounds), EMDR:
- Reduces the distress linked to past experiences
- Strengthens positive, empowering beliefs about yourself
- Helps integrate new ways of seeing and feeling about your body
Because EMDR targets both the mind and the nervous system, it can lead to profound shifts in self-image and confidence.
3. Schema Therapy
Schema therapy combines elements of CBT, attachment theory, and parts work to address long-standing patterns formed early in life.
Many people with body image issues have schemas (deeply held beliefs) such as:
- “I’m not good enough”
- “I’m unlovable unless I look a certain way”
- “My worth depends on my appearance”
Schema therapy helps you:
- Recognise and understand where these beliefs come from
- Heal emotional wounds from the past
- Develop new, compassionate self-identities that go beyond appearance
This approach is particularly helpful for people who have struggled with body image for many years or who find themselves repeating the same patterns.
Improving Body Image, Improving Life
When you work on body image in therapy, the benefits go far beyond liking your reflection in the mirror. You may find that you:
- Feel freer to participate in life without fear of judgment
- Build stronger, more authentic relationships
- You can experience greater self-worth, self-compassion, and emotional resilience
- Improve your mental health and overall wellbeing
You are more than your appearance. Therapy can help you reconnect with your strengths, values, and the parts of yourself that have nothing to do with body shape or size.
If body image concerns are holding you back from living the life you want, you don’t have to face them alone. Evidence-based therapies like CBT, EMDR, and schema therapy can help you understand, heal, and create a more peaceful relationship with yourself.
Sherry-Lee Smith
Principal Psychologist/Accredited EMDR Consultant/Accredited Eating Disorder Clinician
Director of the Phoenix Holistic Health Centre
Upstairs Unit 4 / 131 Herdsman Parade
Wembley PERTH WA 6014
Sherry has also written the following articles which may interest you;
Alleva, J. M., Sherran, P., Webb, T., Martijn, C., & Miles, E. (2015) A meta-analystic review of stand-alone interventions to improve body image. PlosOne.
Bajwa, T., & Chandola, R (2023). Effect of body image on mental health. European Chemical Bulletin. May, 6101-6106.
Bloomgarden, A., & Calogero, R. M. (2008). A randomised experimental test of the efficacy of EMDR treatment on negative body image in eating disorder in patients. Eating Disorders, (16), pp 418-427.
Brewerton, T. D. (2018). An overview of trauma-informed care and practice for eating disorders. Journal of Aggression, Maltreatment and Trauma, 1-18.
Cash, T. F., & Labarge, A. S. (1996). Development of the appearance schemas inventory: A new cognitive body-image assessment. Cognitive Therapy and Research, 20, 37–50.
Cash, T. F., & Pruzinsky, T. (2002). Body image: A handbook of theory, research, and clinical practice. Guilford Press.Duarte, C., Pinto‐Gouveia, J., Ferreira, C., & Batista, D. (2015). Body image as a source of shame: A new measure for the assessment of the multifaceted nature of body image shame. Clinical Psychology & Psychotherapy, 22(6), 656–666.
Edwards, D. J. A. (2022). Using Schema Modes for Case Conceptualisation in Schema Therapy: An applied clinical approach. Frontiers in Psychology.
Fuller-Tysziewicz, M., & Mussap, A. (2011). Examining the dissociative basis for body image disturbances. International Journal of Psychological Studies, 3(2), pp 3-13.
Malcolm, A., Pikoos, T. D., Grace, S. A. Castle, D. J. Rossell, S. L. (2021). Childhood maltreatment and trauma is common and sever in body dysmorphic disorder. Comprehensive Psychiatry, 109, pp 1-7.
Park, L. E. (2007). Appearance-based rejection sensitivity: Implications for mental and physical health, affect, and motivation. Personality and Social Psychology Bulletin, 33(4), 490–504.
Pouladi, H., Rajabi, S., Jamshidi, F., Pakizeh, A., & Talbot, D. (2024). Efficacy of EMDR in Body Dysmorphic Disorder and Associated Cognitive-Emotional Features. Journal of EMDR Practice and Research, 18 (2), pp 82-99.
Pugh, M., Waller, G., & Esposito, M. (2018). Childhood trauma, dissociation, and the internal eating disorder ‘voice’. Child Abuse and Neglect, 86, pp 197-205.
Rodges, R. F., Laveway, K., Campos, P. & Berbert de Carvalho, P. H. (2023). Body image as a global mental health concern. Cambridge Prisms: Global Mental Health 10, (9), 1-8.
Rossi, E., Cassioli, E., Cecci. L., Arganini, F., Martelli, M., Alberta Redaelli, C., Anselmetti, S., Bertelli, S., Fernandez, I, Ricca, V., Castellini, G. (2024). Eye movement desensitisation and reprocessing as add-on treatment to enhanced cognitive behavioural therapy for patients with anorexia nervosa reporting childhood maltreatment: A quasi-experimental multicentre study. European Eating Disorders Review. 32, pp 322-337.
Scheffers, M., van Busschbach, J. T., Bosscher, R. J. Aeters, L., Wiesma, D., & Schoevers, R. A. (2017). Body image in patients with mental disorders: Characteristics, associations with diagnosis and treatment outcome. Chapter 3. in Scheffers, W. J. (2018). Body experience in patients with mental disorders. [Thesis fully internal (DIV), University of Groningen]. Rijksuniversiteit Groningen.
Simpson, S, & Smith, E. (2020). Schema Therapy For Eating Disorders: Theory and Practice for Individual and Group Settings. Routledge: London.
Smolak, L., & Murnen, S. K. (2008). A meta-analytic examination of the relationship between body dissatisfaction and eating disorder. International Journal of Eating Disorders, 41(1), 1– 16.
Verdi, P., & Nicholls, J. (2019). Assessing trauma-driven eating disorders: A road map through the maze. In Trauma-Informed Approaches to Eating Disorders, Seubert, A., & Verdi, P. (Eds). Spinger Publishing: New York.