April 2018 – SACAC Counselling

Body Dysmorphic Disorder

Are you genuinely content with what you see in the mirror? We all have things we wish we could change, large nose, acne, discoloration of our skin, and the list goes on. Most of us are able to live with the flaw(s) in our lives and not allow it to become a nuisance in our everyday lives but someone with BDD it becomes the focal point of their life, overtaking every moment, thinking and figuring out solutions to their flaw.

When you suffer from body dysmorphic disorder (BDD), every imperfection that you feel will become an obsession. It debilitates your everyday life where your thoughts are controlled by concealing these imperfections, seek verbal approval on your physical attributes even though every compliment that someone gives you, will never be genuine to you, social isolation, and depression and anxiety usually forms due to the constant need for perfection. BDD afflicts men and women equally and usually begins in adolescence. It is usually characterized by a flaw that is imagined or hardly noticeable by the general population. It causes the individual to lose their quality of life because that one flaw is perceived as the main focal point of one’s life. People who tries to work on that flaw whether through excessive exercising or extreme cases, plastic surgery to fix the flaw, are still not satisfied with the result which causes them to have multiple visits with the plastic surgeon.

The difference between an eating disorder where you are preoccupied by your overall body shape and weight, BDD is focused on a specific part of the body. The obsession over your flaw affects your interpersonal, work, and family relationships.

Some of the most common symptoms of BDD include acne on your skin, size of your breasts, hair on your head, size, shape and symmetry of your face or body part. People with BDD portrays behaviors and obsessions such as checking their flaw in the mirror several times a day or on the other side, avoiding mirrors, wearing excessive makeup to hide or distract from the flaw, undergoing medical procedures often specifically plastic surgery to minimize the flaw but with non-satisfactory results. seeking verbal praise or reassurance from others, excessive exercising, and obsessive thoughts throughout the day that affects your work, school or social life. If this disorder is untreated it can lead to emotional problems such as anxiety and depression. Unfortunately, this disorder goes untreated or unnoticed by many specialist and clinicians since BDD individuals are able to hide their compulsions and obsessions very easily from the general public. They can also be misdiagnosed for a social phobia or depressive disorder.

What causes someone to have BDD? Researchers believe that it’s a combination of genetics and environmental factors. Factors that increases the chance of having BDD stems from childhood situations such as bullying, having low self-esteem, growing in a household where adult figures emphasizes the importance of physical beauty, and placing strong societal pressure of what is perceived to be beautiful. The treatment for BDD is therapy and medication. Cognitive Behavioral Therapy along with anti-depressants have worked greatly in treating this disorder. Cognitive Behavioral Therapy which focuses on recognizing irrational thought patterns and replace these negative/irrational thoughts with a positive one has been a great tool for people suffering from BDD. As clinicians we need to recognize this disorder especially with our adolescent clients and provide a safe environment for them to express their feelings on their self-worth and image.

References:

Phillips, Katherine, A Body Dysmorphic Disorder: recognizing and treating imagined ugliness. World Psychiatry. 2004 (Feb); 3(1): 12-17
What is Body Dysmorphic Disorder (BDD)? International OCD Foundation

Written by:
Meesha Chan
Clinical Therapist
SACAC Counselling

Bad Childhood Experiences

Do you have a hard time looking in the mirror because you never like what you see? Do you constantly find fault in yourself and tend to focus on your flaws rather than your assets? Are you a perfectionist? Are you seldom pleased with your performance, whether at work, at home, or in a relationship?

Whilst everyone suffers from time to time with self-critical thoughts, some people have such low self-esteem that they are never satisfied with their achievement, their physical appearance or their performance. Their inner critic is so strong and seems never to be tamed.

People with high self-esteem appreciate and accept themselves for who they are with both good qualities and the “bad ones”. They don’t need to impress others because they already know they have value.

Low self-esteem on the other hand is deeply rooted in one’s childhood. People who raised us (our parents, most of the time) have the most significant influence on how we feel about ourselves.

Negative parental behaviour and messages are damaging to our self-esteem. Parents who are neglectful, critical, unfair, provide harsh discipline and inappropriate limits are emotionally abusing their children, who most likely will reproduce the same pattern in the future with their own children.

Emotional abuse of a child is a pattern of a behaviour that affects their sense of self-worth; therefore, occasional negative attitudes or actions are not considered emotional abuse. Parents who emotionally abuse their children seldom do so intentionally and many do not realise that the way they are treating their children is harmful to them.

Children exposed to emotional abuse lack a strong sense of self, view themselves as unlovable and “less” than others. They may not be able to fulfil their true potential in life. Also, they may accept poor treatment from family, friends and romantic partners.

Adults who have been seriously hurt in their childhood, battle with feelings of hopelessness and “out-of-control” emotions.

Some embrace change, choose to deal with the childhood baggage and move on, others choose to stick to the security of the familiar victimhood that became their comfort zone.

The difference between adults holding onto being a victim and others choosing to improve their lives is control. You have no control over your bad childhood but your present is controlled by your own choices despite the pull of your past.

It takes patience, courage, and perseverance to liberate yourself from victimhood and change your life from victim to conqueror. Which one are you?

Written by:
Sanaa Lundgren
MS (Counselling), MS (PolSci)
Collaborative Family Practitioner (SMC)
SACAC Counselling

Fear

Afraid of yourself, afraid of others … Fears can be so useful and yet so useless. Fear Life is not easy.

Even those who give the impression that everything smiles on them, who fly from success to success… even them are going through difficult times. Do not be fooled by appearances!

Fear of not pleasing, afraid that ‘the wind is turning’, fear of death, fear of being rejected, fear of the couple relationship – or loneliness – fear of being different until the ultimate fear, … so many fears!

Fear is eternal. No reason to be afraid.

Through the ages, the causes of fear have changed a number of times. What scared our ancestors in the Middle Ages has little to do with our fears today. Since fear is not a fixed emotion and what causes fear is not dictated by an eternal law, why are we not capable to overcome it? Because fear is rooted in us, more precisely in our reptilian brain, since the dawn of time; because fear is what allowed the human species to survive, to develop and finally to conquer the world. Fear is therefore essential to our survival. But then why can we be diminished or totally paralyzed by fear? Does not fear make us weaker, more fragile, more unfit to face the challenges of life? That is true. But as the philosopher Nietzsche said, ‘that which does not kill us makes us stronger’. We must learn to overcome our fears, to use them as a spur to push us to forward. On the contrary, let us look at the fears of today in the face to discover that they are only the foam of our civilization at a time, therefore transient, and thus can be dissipated like a ghost of smoke. Nevertheless we must accept that some fears are very deeply rooted in us and that getting rid of it alone is often not easy. It is in this type of situation that one should not hesitate to ask the help of a therapist.

Written by: Saveria Cristofari
Counsellor & Psychotherapist SACAC Counselling

Ways to Manage Sibling Fighting

With the Easter holidays upon us, many families get the chance to spend time together as a family. It provides the opportunity to connect and make memories together. At the same time however, the amount of time spent together can increase the likelihood of sibling fighting occurring. After all, all siblings will do some fighting, just as conflict is part of every human relationship. Managing siblings’ conflicting needs and desires can be exhausting for parents. How can parents manage sibling fighting so they can enjoy each other’s company over this holiday period and beyond?

Family Rules

Consider holding a family meeting where family rules are discussed and drawn up. Allow all members to contribute. Rules may include speaking nicely to each other and no hitting. Positively reinforce examples of children following the rules and interacting nicely with each other.

Family Routines

Routines help children feel safe and secure, which helps them to regulate their emotions and subsequently get along better with everyone. It also reduces power struggles between parent and child. Consider which routines may be helpful to maintain in the holidays, such as bedtime, and which ones might be able to become more flexible.

Build Positive Relationships with each Child

Children who have positive relationships with their parents tend to have happier relationships with their siblings. If siblings feel their needs are met and trust that there is enough love to go around, their feelings of rivalry towards each other reduces. Relationships can be built by regular 1:1 time with each child and using emotion coaching to express empathy for their experiences.

Teach Conflict Resolution

Children need to learn the skills of how to resolve problems with others. If siblings are found in the middle of a heated fight, place each child in a separate space in the room if required and model calming strategies such as deep breathing. When they are ready bring them together, perhaps putting an arm around each one, and give each child a chance to speak. Coach each child to tell the other how they feel and what they want. Importantly, resist taking sides. Describe the problem without judgement and ask the children to come up with a variety of solutions e.g. taking turns, trading objects, creating space between them, teamwork to clean up. Come to an agreement and help them implement it. Over time, as maturity increases and lots of practice continues to occur, parents may be able to step back and let siblings use these skills to work out the problem for themselves.

Written by: Dr Thea Longman Registered Clinical Psychologist SACAC Counselling