Body Image Psychologist

Transforming body-loathing into self-love

Sherry-Lee Smith – Psychologist, Perth WA

Body Image Psychologist

I recently returned to the gym after an extensive time of being away. This time away allowed me to  experience it with new eyes and a little more wisdom. Many of us living in a western society tend to see our body as who we are. We are bombarded by unrealistic ideals about what we should look like and who we should be, as if our body is the most important part of who we are. Guess what? You are not your body nor are you your mind. We tend to over identify with both of these things. Who you really are is the consciousness which can observe both the body and the mind;  the essence that uses the body and the mind as vehicles to fulfil a unique purpose. That is who you really are and what you are here for. This over identification with the body and the mind over our true selves perpetuates a living hell for people who suffer with body image issues. For many of the people I work with whether they come seeking help for eating disorders, compulsive exercise, weight loss difficulties, or body image issues, the gym environment can become a place of self-punishment, body-loathing and self-hatred. Many people on the process of recovery at some point or another want to avoid working out because it triggers their body image issues. However, avoidance isn’t the answer. You can use your triggers to work your way from body-loathing to self-love, taking your focus away from your body image and towards who you really are.

Practical tips to help you on your journey;

  • Refrain from comparing yourself to others. This only perpetuates the preoccupation with your body image and weight. Everyone is on their own journey. Try catching yourself when you compare yourself to others and move your focus of attention elsewhere.
  • Refrain from checking how your body looks. You can focus instead on perfecting your form rather than your body.
  • Engage mindfully in your exercise routine. Exercise can be used as an active meditation. Allow any outside thoughts to come but don’t get attached to them, especially the critical ones about your body. Let them go and refocus your attention on what you are doing.
  • Focus on health, fitness or achievement related goals rather than body image or weight goals. Small goals in these areas will get results faster and keep you motivated.
  • Take your focus away from how many calories you are burning. This only serves to reinforce the cycle the punishment and unhealthy preoccupation with food and weight.
  • Focus on the gift your body gives you. In between sets stop and close your eyes, focus on your heart and become aware of how your heart beats and the gift it is giving you by pumping blood around your body, keeping you alive and well. This act of gratitude towards the body shifts your focus from body-loathing to self-love. Love and appreciate everything it has to offer. Even if you don’t believe it at first, find something to be grateful for.
  • Find some time to contemplate your positive qualities and how you can use them to serve others. Focus on your strengths and the gifts you have to give the world.
  • Remember that the body is merely a vehicle. It deserves your love, respect and a healthy lifestyle but at the end on the day it’s really just a means to an end. It’s meant to help you accomplish something far more important than looking good. You are so much more than your body. Find the magnificence within you.

Sherry-Lee Smith is a psychologist who works in private practice in Mt Lawley, Perth WA. Sherry is available for consultations with eating disorders, body image issues (including body dysmorphia or muscle dysmorphia), weight loss difficulties, compulsive exercise as well as other mental health issues. If you would like further information about her services please click here.

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OCD – Factors that contribute to the development of OCD Part 3/6

Factors that contribute to the development of OCD

OCD is a complex neurobiological disorder. There are various factors thought to influence the development of OCD. It is most likely an interaction between biological, psychological and social factors. Some of the factors thought to contribute to the development of OCD are:

  • A genetic predisposition
  • Ineffective functioning in the frontal cortex area of the brain
  • Serotonin imbalances
  • Intrapsychic conflict – conflict occurring within the mind
  • Ambivalent sense of self – difficulty managing contradictory aspects of the self
  • Personality characteristics – see next section
  • Cognitive distortions/information processing errors – such as black and white thinking, perceiving things as more negative or less positive than they are, only paying attention to information that confirms a negative view, making guesses about the future and negative events, believing you know other people’s intentions
  • Traumatic events in early childhood
  • Stressful life events – such as the death of someone close, divorce, moving house, pregnancy etc.

Personality characteristics and thinking patterns commonly seen in people with OCD include;

  • Perfectionism/criticalness – belief towards themselves and other that mistakes are unacceptable and perfection is desirable
  • Excessive conscientiousness
  • Strong need for control and autonomy
  • Overemphasis of intellectual processes – thinking that the presence of a thought increases the likelihood that an event will happen
  • Rigidity
  • Inflated sense of responsibility and guilt – a belief that a person has the ability to cause or prevent negative outcomes
  • Intolerance of uncertainty – believing that it is possible and necessary to be certain that undesired events do not happen
  • Overestimation of danger – thinking danger is more likely to happen than it is

Sherry-Lee Smith Perth Psychologist Home Page


OCD – What is Obsessive Compulsive Disorder? Part 1/6

Obsessive compulsive disorder is a mental health issue which is distressing to sufferers and impairs their ability to function in daily life. OCD is characterised by persistent thoughts, ideas, images, doubts or impulses (obsessions) that are experienced as disturbing, along with repetitive behaviour or mental rituals (compulsions) aimed at reducing anxiety.

Obsessions stimulate anxiety and are intrusive, unwanted and distressing. They are often experienced as irrational to the person experiencing them.

Common obsessions include;

  • Fear of contamination (by dirt, germs, bodily waste, chemicals or other substances)
  • Fear of illness, harm or death (to the self or significant others)
  • Aggressive obsessions (fear of hurting the self or others, violence, fear of being responsible for something terrible happening)
  • Sexual obsessions (“forbidden” sexual thoughts, such as incest or involving children, homosexuality or aggressive sexual behaviour)
  • Religious or moral obsessions (worry about thinking or saying something blasphemous, being consumed with always doing the right thing)
  • Number obsessions (safe numbers, bad numbers etc.)
  • Symmetry or exactness obsessions (alignment, perfection etc.)

Compulsions are repetitive behaviour or mental rituals that an individual feels compelled to perform in response to experiencing an obsession. The purpose of the compulsions is to alleviate or reduce the anxiety and distress created by the preceding obsession. The more successful the compulsion is at reducing the anxiety the more powerful and difficult to resist it becomes.

Common compulsions include;

  • Checking (things are locked, turned off, that somebody isn’t hurt or sick, something bad hasn’t happened, that a mistake hasn’t been made)
  • Repeating (rereading or rewriting, repeating activities)
  • Counting (counting and recounting)
  • Symmetry, ordering or arranging (straightening or arranging items)
  • Washing or cleaning
  • Touching
  • Excessive prayer
  • Avoidance of objects, substances or situations
  • Repetitive reassurance seeking

Obsessive-compulsive related disorders include body dysmorphic disorder (body image related obsessions and compulsions), hoarding disorder, trichotillomania (hair pulling disorder), excoriation (skin picking) disorder, and body-focused repetitive behaviour disorder (including nail biting, lip biting and cheek chewing).

OCD is a common mental health issue that impairs the functioning of a large number of people. The life time prevalence for OCD is estimated to be 2-3% of the population. However, some researchers argue this is an underestimate and that many cases of OCD go undiagnosed and untreated. People who suffer from OCD tend to experience impairment in several areas of life including occupational performance, academic achievement, and social functioning. The severity of OCD symptoms tends to wax and wane over time relative to the amount of stress a person experiences, even when the person has engaged in treatment. It can be a chronic and debilitating condition if not treated. Sometimes OCD symptoms can also change over time. For example the subject of obsessions may differ or the compulsions used to reduce anxiety may change.

Most people who suffer from OCD recognise that their fears and rituals are irrational and excessive. Because they have this level of insight they are more often than not distressed by their own thoughts and behaviour. Nonetheless, they feel almost powerless to stop them.

The onset of OCD is usually gradual and tends to manifest during adolescence or early adulthood. However, childhood onset or later life onset is not uncommon. Stressful life experiences such as family illness, death of a significant other, marital problems, divorce, sexual difficulties, or pregnancy often precipitate the onset of OCD.

Sherry-Lee Smith Perth Psychologist Home Page

Articles, Body Image and Body Dysmorphic Disorder

Body Image and Body Dysmorphic Disorder

Registered Psychologist

Perth, Western Australia

Body Image

Body image can be defined as the thoughts and feelings a person has as a result of the perception they hold of their physical self. When you have a healthy body image you value who you are as a person and are comfortable and happy with the way you look. If your self-worth is determined by the way you look you may have an unhealthy body image. If you think your body is unattractive or not good enough and you are fixated on trying to change or hide it you probably have a negative body image.

The social environment in which you live can have a significant influence on the development of a negative or unhealthy body image. The people you surround yourself with and the media you are exposed to impact on how you think and feel about your appearance. You have a higher risk of developing a negative body image when you live in an ‘appearance orientated environment’. This means that if you spend most of your time in the company of people who focus on appearance you are more likely to think negatively about the way you look. Receiving negative feedback from those around you about your appearance also puts you at an increased risk of developing an unhealthy body image. Furthermore, exposure to unrealistic and unattainable body images through the media creates the erroneous perception that you will only find love, happiness and success by living up to the ideal body image.

Body image concerns can create a great deal of distress for many people. When these concerns impair a person’s ability to function in everyday life there is a possibility that they have developed a psychological disorder such as an eating disorder or body dysmorphic disorder.

Body Dysmorphic Disorder or Body Dysmorphia

Body Dysmorphic Disorder (BDD) is relatively common, yet often under-recognised or misdiagnosed. People who suffer from body dysmorphia judge their sense of self primarily by their appearance. They often experience shame and embarrassment around the way they look. These individuals may experience low self-esteem and feelings of being unlovable or unworthy as well as a sensitivity to rejection. Feelings of defectiveness related to their appearance are also common.

Individuals with body dysmorphia have a preoccupation with a perceived defect in their appearance. This obsession commonly focuses on one or multiple body parts that the person finds ugly or ‘not right’ in some way. Often these worries centre on facial features, skin or hair, however any body part can be the focus, as well as overall appearance or build. Over time this preoccupation can change from one body part to another. Sometimes a person with body dysmorphia has a general perception of themselves as unattractive or ugly. A person with body dysmorphia will find these obsessions distressing and the thoughts are likely to impair their daily functioning.

BDD is an obsessive-compulsive related disorder. When a person with body dysmorphia experiences these preoccupations they will engage in compulsive behaviour aimed at reducing their anxiety over their physical appearance. This behaviour is directed at disguising, improving and examining the defect and may include;

  • Comparing their appearance to others
  • Mirror checking
  • Excessive grooming (hair cutting, make-up application, shaving, hair styling etc.)
  • Seeking reassurance from others about their appearance or attempting to convince others of the defects ugliness
  • Skin picking
  • Dieting
  • Excessive exercising
  • Steroid use
  • Camouflaging (with a hat, clothes, make-up, sunglasses etc.)
  • Pursuing dermatological treatment or cosmetic surgery

The compulsive behaviour seen in people with body dysmorphia is time-consuming, distressing and difficult to control. Unfortunately the behaviour that is aimed at reducing anxiety inevitably increases anxiety in the long term (even if the anxiety is temporarily reduced).

Age of onset

Body Dysmorphic Disorder usually starts in adolescence, although it can begin as early as childhood. Adolescence is a time when many young people have appearance concerns. However when body dysmorphic symptoms are seen in these age groups it should not automatically be dismissed as a normal adolescent concern. Due to the embarrassment and shame experienced by sufferers, BDD often remains undiagnosed until 10-15 years after onset.

Factors that contribute to the development of body dysmorphia

There are various theories regarding what causes BDD. Some theories focus on individual or social factors, while others focus on biological causes. Factors that contribute the development of body dysmorphic may include;

  • A genetic predisposition or vulnerability in neurobiological functioning
  • Individual and personality factors – such as shyness, a tendency to be self-critical, insecurity, perfectionism or an anxious temperament
  • Negative early life experiences or childhood adversity – for example teasing or bullying (either about appearance or competence), poor peer relationships, social isolation, lack of support in the family or childhood abuse
  • Traumatic experiences – such as physical or sexual assault

How medical treatment or counselling/psychotherapy can help

BDD can be more persistent and therefore more difficult to treat than other psychological disorders. However, those who engage in treatment fare better than those who don’t. When patients are persistent with treatment symptoms can improve.

The use of a group of anti-depressants called serotonin re-uptake inhibitors (SRIs) appear to be helpful in treating body dysmorphia. However, higher doses usually need to be used than those found to be effective with depression. Often patients don’t see improvements for at least 8-16 weeks, which is much longer than responses for depression. Generally it is recommended that patients stay on medication for a minimum of 1 year.

Psychological treatment can also help people with body dysmorphia in the following ways;

  • Developing an understanding of how and why body dysmorphia occurs
  • Developing an understanding of the factors that maintain body dysmorphia
  • Identifying and challenging unhelpful thinking
  • Addressing past trauma/s
  • Addressing compulsive behaviours through behavioural exercises
  • Improving social skills
  • Identifying and addressing the impact of body dysmorphia
  • Developing an alternative view of the self
  • Addressing socio-cultural factors of body dysmorphia
  • Treating co-occurring mental health issues

Tips to help with body image issues or body dysmorphia

  • Set health related goals rather than goals focused on appearance
  • Avoid negative self-talk
  • Avoid comparing yourself to others, especially celebrities and other people in the media
  • Focus on your positive qualities and skills
  • Limit your exposure to relationships and media that focus on appearance (studies show people tend to feel worse about their appearance after reading magazines that focus on appearance)
  • Spend time with people who have a healthy relationship with their body
  • Focus on improving yourself in ways that don’t involve appearance
  • Question your media defined ideas of beauty and try to focus on the beauty you see in people you admire
  • Remember there is no right or wrong in regards to your appearance
  • Give yourself a break from the mirror
  • Define yourself in ways other than your appearance

If you are experiencing any difficulties with body image issues and would like help please contact Sherry-Lee Smith on 042 135 1020 or via email on the contact page.

Sherry-Lee Smith

Registered Psychologist


Mt Lawley Counselling Centre

13 Alvan St

Mt Lawley,

Perth, Western Australia 6050