TABLE 6-5 Four Phases of Body Image Crisis

Age Group Development of Body Image Developmental Disturbance in Body Image

Infant and toddler
  • Becomes aware of body boundaries and separateness of own external body from others through sensory stimulation.
  • Explores external body parts; handles and controls the environment and body through play, bathing, and eating.
  • Experiences pain, shame, fear, and pleasure. Feels doubt or power in mastery of motor skills and strives for autonomy. Learns who one is in relation to the world.
Infant
  • Inadequeate somatosensory stimulation —> impaired development, increased anxiety level, poor foundation for reality testing.
  • Continues to see external objects as extension of self —> unrealistic, distorted perceptions of significant persons, inability to form normal attachments to others (possessive, engulfing, autistic, withdrawn).
Toddler
  • If body fails to meet parental expectations —> shameful, self-deprecating feelings.
  • Failure to master environement and control own body —> helplessness, inadequacy, and doubt.

Preschool and school age
  • Experiences praise, blame, derogation, or criticism for body, its part, or use (pleasure, pain, doubt, or guilt).
  • Explores genitals—discovers anatomical differences between sexes with joy, pride, or shame.
  • Begins awareness of sexual identity.
  • Differentiates self as a body and self as a mind.
  • Beginning of self-concept; of self as man or woman.
  • Learns mastery of the body (to do, to protect self, to protect others) and environment (run, skip, skate, swim); feels pleasure, competence, worth, or inadequacy.
Preschool
  • Distortion of body image of genital area due to conflict over pleasure versus punishment.
  • If body build does not conform to sex-typed expectations and sex role identification —> body image confusion.
School age
  • Physical impairments (speech, poor vision, poor hearing) —> feelings of inadequacy and inferiority.
  • Overly self-conscious about, and excessive focus on, body changes in puberty.

Adolescent
  • Physical self is of more concern than at any other time except old age.
  • Forced body awareness due to physical changes (new senses, proportions, features); feelings of pleasure, power, confidence, or helplessness, pain, inadequacy, doubt, and guilt.
  • Adult body proportions emerge.
  • Anxiety over ideal self versus emerging/emerged physical self; body is compared competitively with same-sex peers.
  • Use of body (adolescents’ values and attitudes) to relate with opposite sex.
  • Body image crucial for self-concept formation, status achievement, and adequate social relations.
  • Physical changes need to be integrated into evolving body image (strong, competent, powerful, or weak and helpless).
Growth and changes may produce distorted view of self —> overemphasis on defects with compensations; inflated ideas of body ability, beauty, perfection; preoccupation with body appearance or body processes, women more likely than men to see body fatter than it is; egocentrism.

Early Adulthood
  • Learns to accept own body without undue preoccupation with its functions or control of these functions.
  • Stability of body image.

Middle age
  • New challenges due to differential rates of aging in various body parts.
  • Body not functioning as well, unresolved fears, misconceptions, and experiences in relation to body image persist and become recognized.
  • Less dependable, less likable body —> regression to adolescent behavior and dress due to denial of aging, defeat, depression, self-pity, egocentrism due to fear of loss of sexual identity, withdrawal to early old age.
  • Women more likely to judge themselves uglier than do men or younger and older women.

Old age
  • Accelerated physical decline with influence on selfconcept and lifestyle.
  • Can accept self and personality as a whole; continued emphasis on physical self, with increased emphasis on inner, emotional self.
  • Ill health —> fear of invalidism, hypochondriasis.
  • Denial related to feelings of threatened incapacity and fear of declining functions.
  • Despair over loss of beauty, strength, and youthfulness, with self-disgust about body projection of criticism onto others.
  • Regression.
  • Isolation (separation of affect and thought) leads to less intense response to death, disease, aging.
  • Compartmentalization (focus on one thing at a time) causes narrowing of consciousness, resistance, rigidity, repetitiveness.
  • Resurgence of egocentrism.