Altered Reality of The Human Body
Hritika Ahuja
MIRROR MIRROR ON THE WALL! WHO IS THE PRETTIEST OF THEM ALL?” “OH! NOT ME? NOT ME! STOP SHOWING ME MY CROOKED NOSE OR MY FRIZZY CURLS. I TRY AND TRY AND NEVER EVER LOOK LIKE ANY OF THOSE GIRLS!”

The altered reality of the human body is what we see in that mirror in front of us and remember the deeply embedded definition of beauty that was taught to us and realise that we look nothing like it. Since time immemorial, beings like us have believed that the ‘other side is greener’. The ones with less melanin sit sunbathing to get a nice tan and a wheat complexion. The ones with more melanin are surrounded by fake products that they rub into their pores as part of their routine. The ones who are tall are called ‘giraffes’ and the ones who are short are called ‘pygmies.’ The ones that weight heavy on the weigh scale are mocked for having an ‘eating problem’ and the skinnier ones are termed as ‘anorexic’ (honestly, slurs worse than these are used). Women who don’t use make-up are judged as ‘ungroomed’ and men who wear make-up are ridiculed to ‘be extra-groomed’. Finally, the ones with hair, teeth, eyes, nose, ears, lips, face, arms, hips, chest, stomach, legs, body hair, genitalia, muscles, nerves, blood, bones, brain and soul are judged all the time!
And let me tell you, this phenomenon isn’t just a way of life, or human nature, or a stroll in our typical socio-cultural garden. A setting like this has led to the rise of a mental health condition named ‘Body Dysmorphic Disorder’. And that’s what I call altered reality. We usually believe the other side to be greener but when some of us look into the mirror we find the other side to be ‘uglier’ of all things and tell ourselves ‘that’s me!’.

As per the American Psychological Association (APA, 2000), BDD is a disorder characterized by excessive preoccupation with an imagined defect in physical appearance or markedly excessive concern with a slight physical anomaly. The preoccupation is typically accompanied by frequent checking of the defect. BDD is classified in DSM–IV–TR1 as a somatoform disorder, but because it shares features with obsessive- compulsive disorder, such as obsessions with appearance and associated compulsions (e.g., mirror- checking), it has been reclassified in DSM–5 under a category labelled obsessive-compulsive and related disorders.
Causes??? God Knows!
Our smartest minds have still not figured out the causes of body dysmorphia but research shows it to be a trigger from a synthesis of problems, such as heredity, malfunctioning of serotonin in the brain, negative evaluations or experiences about your body or self-image, socio-cultural or environmental factors like childhood maltreatment, forms of abuse or trauma, and I would like to add the over-bearing pressure of the paparazzi, media, and social networking sites, etc.
Why don’t we know the cause behind conditions like these? Is it too obvious for us to actually notice it? Dug a little deeper and realised that the sense and concept of body image has been distorted for aeons.

Women have been taught what being a ‘lady’ should look like with charm and grace. On the other hand, can men really have body confidence issues? Who cares! An example is the torment Chinese women underwent for as long as 8 centuries to have perfect feet. The custom of feet-binding or lotus-feet meant methodically fracturing and reshaping feet arches so she could wear tiny lotus shoes. Petite feet brought women a higher chance at marriage since it was a status quo of the gentry.

Parallelly, in Europe corsets were worn by women in order to maintain an ‘hourglass figure’. Narrower waists meant ‘appropriate bodies’. Egyptians and Romans were martinets in the subject of the ‘No Body Hair’ Policy. Egyptian men and women cleaned all their body hair as a part of hygiene. While Romans viewed body hair for women as a class issue.

Ancient Indian medicinal study made available the luxury of plastic surgery to people with slight bodily imperfections even without anaesthetics. Skin grafting, nose reconstruction, rhinoplasty, etc were performed by the first-ever surgeon and physician named Sushruta whose books are the premise for many modern medical procedures.
Men have culturally been excluded from body confidence issues but also are secretly attributed to a list of physical features, the presence of which make a man macho-like or super-heroic. Men are equally as bound to fitting perfect body images as women. Body hair, facial hair, muscular curves, jawlines along with other mental attributes like bravery are the reasons men face body confidence problems. Many men also face a condition, included under BDD as per DSM-V, known as Penile Dysmorphic Disorder. Herein, men are severely anxious about the size and length of their genitalia which causes depression, distorted perception, reduced sexual function and lack of confidence. More, recently, male celebrities like Robert Pattinson, Chris Pratt have spoken of their struggle to fit the physical standards of the industry.


Signs and Symptoms of BDD: • Fixation and thoughts about appearance. • Mirror-checking. • Their belief is very strong even if evidence does not support it (this is also called Overvalued Ideation) • Covering up the “afflicted area.” (e.g. hats, scarves, make-up) • Reassurance- seeking. • Repeated unnecessary plastic surgery • Compulsive skin picking. • Avoiding social situations, public places, work, school, etc. • Keeping the obsessions and compulsions secret due to feelings of shame. • Emotional problems, such as feelings of disgust, depression, anxiety, low self-esteem, etc. As per studies, the prevalence rate of BDD is 0.7%-2.4% of the general population. Body image issues, however, are considered to arise in adolescence and can drastically affect one’s perception due to changes in looks as per old age/maturity. Body dysmorphia is commonly misdiagnosed with other similar disorders like: obsessive-compulsive disorder, social anxiety disorder (social phobia), major depressive disorder, eating disorder, etc.
Who to Blame in the 21st Century for Body Dissatisfaction?
Media is the answer. Celebrities face it. Commoners like us face it. Mass media and social media have altered how we look at ourselves and others. They have altered reality with not much positive impact on body concepts. Magazines, fashion houses, and digital media publications have endorsed a perfect body under the sham of expensive diets, model stories, luxury body care treatments, make-up revolutions, etc. Victoria’s Secret is that their models are starved, parched, and then photoshopped before you envy their delicate lingerie-look on the cover.

An ulterior agenda of trends and sales led by modern media negatively impacts susceptible viewers/readers and hampers their self-perception. Social media greatly affects the mental health and emotional wellbeing of teenagers and young adults. How many self-deprecating memes do we relate to in the entire day? How many of us dread opening the selfie camera unless it’s for a filter?

Snapchat Dysmorphia
Wait, what’s that? You associate Snapchat only with cute/funny filters. There’s a new-founded, dangerous correlation between these filters and our very precious lives. In August 2018, JAMA2 Facial Plastic Surgery reported a phenomenon where people were conflicted about their digital self-portraits that were filtered and airbrushed and their real physical selves. This led them to seek plastic surgeries that altered their physical features to their looks in Snapchat/Instagram selfies.
Designed by Hritika Ahuja©
Dr. Tijion Esho, a British physician known for performing cosmetic procedures, coined the term Snapchat Dysmorphia when he observed patients walking in with heavily filtered and digital but unreal images of themselves. The norm until now was to look like one’s celebrity but people’s distorted perception due to their selfies was alarming and delusional in plain sight. Shirley Cramer, chief executive of RSPH , said “Social media has been described as more addictive than cigarettes and alcohol, and is now so entrenched in the lives of young people that it is no longer possible to ignore it when talking about young people’s mental health issues,” she said.
Apps like Instagram and Snapchat have been declared as the most dangerous apps for young people’s mental health.
Treatments for Body Dysmorphia
The misdiagnosis of body dysmorphia can hamper the treatment provided. Another hindrance here is that most people don’t like talking about having shown significant symptoms of this disorder. In either case, care-giving gets thwarted. There is no cure to body dysmorphia but a combination of certain methods can help a patient improve and stabilise. They are:
Most commonly, Cognitive Behavioural Therapy (CBT, Aaron T. Beck) is involved and found to be effective over a few weeks. CBT is a form of psychotherapy that aims at identifying and modifying the client’s maladaptive thought processes and problematic behaviours through cognitive restructuring and behavioural techniques to achieve change. (American Psychological Association, 2000) A specific method of CBT known as ERP (Exposure and Response Prevention) is used. For example, urging yourself you go out without covering a perceived flaw and resist the urge to seek reassurance or hide your perceived flaw.
Antidepressants in the form of Selective Serotonin Reuptake Inhibitors (SSRIs) are prescribed that help reduce BDD and OCD symptoms. These are prescribed since the partial cause of BDD can be the serotonin imbalance in the brain. However, potential side-effects must be discussed with the doctor before consumption.
Other medical suggestions: Avoid alcohol and drugs during ongoing medication, indulge in physical activity, etc.
How We Can Fix This as A Society The edifice of our body concepts is deeply rooted in how we are treated or taught as children. In Asian countries, family and relatives very often show their concerns for a little baby weighing more and less. We have all spent a few years wondering what all those aunts wanted us to look like. Peers, friends, foes often hide their own insecurities by mocking others for healthy, skinny, hairy, short, and tall bodies. Confidence levels drop and by the time we are teenagers, we’re anxious, nervous, and least confident of our bodies and believe nobody will ever love us. Body image is that easy to scar and that difficult to fix. As a society, we need to stop judgement at every level. Only then will people develop positive body images. We can:

1. Unlearn the societal definition of perfection. Realise that everybody is different and can do wonders. 2. Make a list of physical attributes that you love about yourself and keep it in mind. 3. Appreciate the amazing things your body can do. You could have a few extra pounds, but a very flexible body. Flaunt the flexibility. 4. Don’t believe in rate cards. Don’t rate or get rated. 5. Be critical of what you see on Social Media and be a magnet for body-positive trends and content. 6. Compliments are like wildfire. Compliment others and they will pass it on creating a positive atmosphere. 7. Engage yourself in talking and helping others believe in themselves and in turn, you will believe too. Very often we are better at solving someone else’s problem than our own. 8. Write down body-positive statements and have them around your house as a reminder. 9. Analyse or adore yourself as a whole with not just physical but also mental and emotional attributes.
10. Meditate every day for 15 minutes and repeat to yourself, “I am beautiful the way I am.”
11. Invest your time in doing two things that are good for your body daily instead of criticism.
12. DO NOT BODY SHAME. Not yourself and not anyone else. Don’t believe in fake beauty standards and don’t compare.
13. Don’t look at a 10-year challenge. Fitting in jeans from 2004 isn’t an achievement worth-chasing.
14. Surround yourself with a squad of people that support and compliment each other fearlessly.
15. Wear clothes you are comfortable in, no matter what.
16. Be empathetic and approachable. Be alert for signs of negative body image in your friends and talk to them.
17. Go out not just for clubbing but to pamper your bodies for self-care.
18. Set health goals for yourself and your friends. Try Yoga.
19. Don’t shy away from seeking professional help. Join a group discussion on matters like these.
20. Research and try relaxation techniques.

So here we are, with another condition that someone we know or don’t know deals with. Our world is riddled with agony, anger, regret and other negative feelings. Amidst all that we have been fed to adore another’s body, criticise our own, and believe that perfection exists. This falsely altered reality is affecting lives to come. Let’s see what the true reality of the human body is: We are beautiful, irrespective of our unique bodies. Just like the Indian Philosophy that considers the body to be a sacred garment of the soul, we must love and respect ourselves. Let’s wake up from that slumber of social media and orthodox mindsets and be body positive. Let’s stay yards away from fake pretence and pull that ‘body-insecure’ friend closer and sort it out. Let’s not be ashamed of body dysmorphia and seek help. Let’s judge nobody. You love your eyes or freckles or curls the most? Flaunt that!
Spread the word. BDD organizations and helplines- https://www.itv.com/thismorning/articles/body- dysmorphic-disorder-helplines
References:
https://www.medicalnewstoday.com/articles/309254#diagnosis
https://bdd.iocdf.org/professionals/diagnosis/
https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/body- dysmorphic-disorder-bdd/treatment
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https://www.psycom.net/body-dysmorphic-disorder/
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Further Reading: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181960/