Creating Space Around Body Image

Concerns about our bodies are common and part of being human. For some people, they remain occasional worries. For others, they begin to take up more attention, influence mood and shape everyday choices about food, movement, relationships and confidence.

In this episode of The Choice Space, Dr Lee David is joined by Joanna Silver, a psychologist specialising in eating disorders and body image difficulties, to explore why appearance-related distress can become so persistent – and what can genuinely help.

They discuss body image as something that exists on a continuum, from everyday dissatisfaction to more intense distress that narrows attention and reduces quality of life. Joanna explains how self-worth can become overly linked to weight or shape, why comparison often increases distress, and how cultural messages, family language and social media all shape how we relate to our bodies.

Rather than framing body image as something to fix or eliminate, the conversation approaches it as a relationship – one that can soften and become more balanced over time. They explore why change is rarely linear, how shame thrives when concerns stay hidden, and why curiosity and kindness are often more helpful than self-criticism.

The episode also includes a Choice Pause – a short, guided moment to help create space from comparison and reconnect with what matters in the present moment.

This is a compassionate, practical discussion about understanding body image distress and finding steadier ways to care for our bodies, even on difficult days.

Key moments

00:39 Why body image concerns are common and when they become more distressing
03:50 When self-worth becomes tied to appearance
07:12 How family, culture and language shape body image
09:16 Comparison, social media and increased distress
11:26 Signs body image concerns may be affecting daily life
15:27 Shame, secrecy and the value of talking
19:31 The Choice Pause creating space from comparison
22:04 Relating to body image as a relationship
28:47 Shifting focus from appearance to function
35:15 Body distress as a signal
40:34 Small steps towards a kinder relationship with the body 

About the Guest

Joanna Silver is a Counselling Psychologist who specialises in working with people affected by Eating Disorders, Body Dysmorphic Disorder and body image problems.  She works as the Lead Psychological Therapist at Orri, a treatment centre for people with Eating Disorders.  I am passionate about bringing compassionate, evidence-based conversations about mental health and body image into the public space.  

You can connect with Joanna via Linked in

Beat eating disorders charity

About the host

Dr Lee David is a GP, CBT therapist and author specialising in mental health and wellbeing. Lee has written many books on CBT, mindfulness and teen wellbeing, and speaks regularly at conferences and in the media. Away from work she enjoys running, hiking, singing in a choir and spending time outdoors with her family. You can find Lee through her website and on Instagram, TikTok (@dr.lee.david), Facebook and LinkedIn.  You can find more about her books, wellbeing courses and therapy here:  https://linktr.ee/dr.lee.david 

Transcript

Joanna (00:00)
first of all, one thing is to say that this is not my fault. No one chooses to have body image distress. My second thing is just to notice and to be curious. and if there are particular times that you feel more distressed about your body image.
to notice and observe without judgement. And the third thing, is each day to notice one thing that you're grateful for or one thing that your body has done for you.

Lee (00:39)
Welcome to the Choice Space podcast. I'm Dr Lee GP, CBT therapist and author. Today we're talking about body image, how we experience our bodies, how much space worrying about our bodies can take up and how this can influence the way we think, feel and behave in our day-to-day lives.

Body image difficulties and concerns are really common. And for some people, they may show up as self-criticism or comparison with others. For others, they can affect our confidence, relationships, our food, how we move, and how freely we feel able to live our life. These concerns can affect people of any age and at any weight.

Today, I'm delighted to be joined by Joanna Silver, a counselling psychologist who works with people experiencing eating disorders, and body image difficulties. Joanna is the lead psychological therapist at Orri, a specialist treatment centre for eating disorders. Joanna, welcome.

Could you start by introducing yourself and your role and the kind of work that you do around body image?

Joanna (01:49)
Thank you for having me, Lee. So as you said, I'm Joanna and I'm the Lead Psychological Therapist at Orri And in terms of my role, I see clients on a one-to-one basis, whether it's eating disorders or body image worries. I do several groups, including a body image group, a relationships group and a relationship

with food group. And really important part of my work is supporting parents and loved ones whose family members or friends are going through treatment.

Lee (02:19)
Great, so really loads of experience in your working life about people with both eating disorders and body image concerns. In your experience, what are the concerns that people tend to experience around their body image?

Joanna (02:34)
So I think in society there's something called normalised body discontent, which is when people may feel that they don't like aspects of their body, but it doesn't interfere in such a way that they're unable to function. But for some people there is a real preoccupation with body image to the point that it stops them living their life. So it may cause them to try and change their body weight or shape.

It may cause them to isolate more. Some people are unable to work, go to school, and it can consume every part of their mind. So I guess I see people on a real continuum that I think what is most important to think about is the distress that the body can cause people at different stages in their life.

Lee (03:24)
That's really interesting. it sounds like lots of us may experience some element of concern about our bodies and it's normal to compare ourselves at times to others and perhaps feel a bit negatively about our bodies. But for some people, how much room, how much emphasis, how much time is spent thinking about those and the intensity emotions that come can be much greater. Is that right?

Joanna (03:50)
Yeah, that is right. it's about the distress. So some people may say, I don't like particular aspects of my body, but overall I'm good enough and there's more to me than my appearance. But for some people, I think what is important to note is that their whole worth is related to their body or their shape or their weight. And therefore it becomes really important. And they feel that if I don't like my body or my body is not good enough. I'm not good enough as a person. I sometimes explain it to my clients in terms of eggs and baskets and it's never a good idea to put all your eggs in one basket, especially if it's a flimsy basket. This was an idea from Christopher Fairburn who does what we call CBT-e, Enhanced Cognitive Behaviour Therapy for Eating Disorders.

and what I encourage my clients to do is put their eggs in more baskets. So it's absolutely okay and can be a good thing to care somewhat about your appearance in your body and take pride in it. But when it becomes a be-all and end-all, that's when it can become the same way that if someone puts their whole self-worth in terms of their job, can be very difficult when they retire.
or in terms of a relationship. So it's not about eradicating necessarily the basket, but about creating more baskets for the eggs.

Lee (05:19)
I love the idea of lots of eggs and lots of baskets! what I'm hearing there is caring about our physical can be a sign in ourselves and can be quite a positive thing. But if we're really defining ourselves around

a certain appearance and being very rigid about that and if I don't live up to that, then somehow I'm as person lacking in some way, then that feels like that's just a real over emphasis about that relationship. Appearance just matters than needs to, because we're ignoring other qualities, I guess, that we might be great at certain things, we might have lots of skills, we might be really kind and lovely. But,
the brain is saying, well, no, unless you look a certain way, none of those things matter.

Joanna (06:01)
Exactly, and I think it comes down to the idea of worth. We're all worth so much more than our bodies and often people will equate the way that their body looks with their moral value. So body looks one way or the other doesn't mean that you're a better person or a worse person and I think that we see quite a lot of this, the equation of particular body types with virtues.

or particular eating style with virtue. So sometimes people will say, she's a very clean eater, which implies that people who don't eat in that way are dirty eaters. I think what can happen when one's relationship with the body becomes a source of distress.

Lee (06:46)
Yeah, and it's interesting, isn't it? The language we use around the body and also around food is very weighted. It's very judgmental. quite black and white. we talk about good food and bad food as well, really commonly. 

These ideas about the body having such a great importance about our worth, about representing something really fundamental about us as a person, where do you think those ideas come from?

Joanna (07:12)
think a lot of the ideas have been without meaning to passed down the generations. So often some of the people that I see will remark that, you know, parents may have said things like, you can never be slim enough, a second on the lips, a lifetime on the hips, all these kinds of phrases, which of course were never meant to have any mal intent, but they can really, really send the message that
food is of moral significance or there is a good way of behaving or a bad way of behaving. So a lot of the work that I do and the work that I do with families is to think about the scripts, to think about the messages. And this is really not about blame. And it may be that parents have not necessarily had the time to reflect on the messages.

So without meaning to, a lot of these messages can be passed down through the generations and just accepted without thought. And then also in wider society, there can be particular messages. So, there could be a certain body type or a certain way of eating that can be really applauded on social media. And the thing is with social media, that anyone can say anything, anyone can be a wellness warrior. It is not regulated. And people can internalise those messages as having real meaning. There is a good way to be and there is a bad way to be.

Lee (08:41)
I'm wondering if the influence of social media has really exaggerated that role of comparison as others, because there are so many images available to compare ourselves to that I think weren't as available in the past. And in fact, a lot of those images are not actually even real images of people. They can be generated by computer or by AI.

And yet there's that sense of, I'm not living up to this. And if then we're linking that, if I can't live up to that, then I'm not a good person. It's a really hard space to be in, isn't it?

Joanna (09:16)
It is really hard and I think a lot of the people who are vulnerable are not equipped to know how to interpret the images. And I think even if, know, cognitively and logically, you might know that they're not real, or you may know that this is just a highlights reel. Somehow it's very easy to get seduced into the power of it and to look at it and to think, okay, this body means a perfect life. 

And it's It's difficult, you this is not just children, even adults who are very, very intelligent. It's powerful stuff. And I think that has always been there. And I think body image distress has been there way before social media. But it's just exacerbated it. It's something that makes it very difficult to escape from. And it's just fed to us without us even realizing it.

And often to my clients who will often compare themselves to others and most of the time when people are comparing themselves to others, they come off worse. And I will say to my clients, which is compare and despair.

if you compare yourself to other people, you're much more likely to despair, to think worse about yourself. And when it comes to it's so unfair all made differently. We've all got different genetics. We've all got different heights. We've all got different build. So it's a very unfair comparison when you do start comparing eating habits and bodies.

Lee (10:48)
Yeah, and It's not just about diet. It's around so many different influences that may be genetics. There's things about our microbiome. There's things about how we move our bodies, but also about families.

How do you see distress around body image when it's becoming more significant? Talk us through how we might spot that, know, what are people thinking, feeling, doing that might be different if somebody's range of I'm a bit concerned but you know what I can see that this part of my body I'm not so keen on but this part's okay so on okay I'll get on with my life kind of thing. would we be looking for if someone had more impact of body image concerns?

Joanna (11:26)
So we may see the person becoming more isolated. And often this can be a real contrast to how they were before. They may not be wanting to talk to people. They may be avoiding foods, so declining social events. They may be becoming more irritable when the mind is preoccupied and thinking a lot about the body. It's very hard to concentrate on anything else.

so their concentration levels may go down. Often people will say, sometimes my clients, parents will say that he or she has lost their spark. Just that indefinable, know, it might be difficult to define what that is, but their zest for life seems to have gone. Their interests seem to narrow. I think that that's important to say that the more people focus on the body,

the more life shrinks and it can become a very vicious circle as people's hobbies, interests, relationships with others close down, the body becomes more and more and more important and it's very difficult to get out of that vicious cycle. So I think it's important for anyone listening, if they're worried about someone for signs, it's always better to think and with yourself, is there a problem to perhaps ask for help than to ignore it and hope it will go away? And I think with body image problems and with eating disorders, the sooner that we start to explore in a really gentle way, the better. People can change their relationship with bodies and people can change their relationship with eating at any time. I really believe that it is never too late.

That being said, it can be much easier to do so before the patterns of thinking become really entrenched.

Lee (13:16)
Yeah, so there's good evidence, I think early recognition and then early action really does make a it just has that impact on people's lives earlier in their has got to be a good thing and possibly also improves treatment outcomes do have earlier treatment, So what it sounds like you're saying is that if people do have concerns, that that is something significant in itself. And I think if that's something that's going through people's minds, then it's worth actually going have a conversation. Maybe someone could go and visit their GP and start talking it through, because we sometimes do need to have that third party involved to try and pick apart what's going on.

Joanna (13:54)
Mm-hmm.
Yes, think that's really important. No concern is too small. And sometimes, as you said, just talking it through with someone can be very helpful. And I think sometimes there can be perceptions about the type of people who do have body image worries. 

And sometimes people feel that, actually, if I don't look a certain way, maybe I'm just making this up, or I should just be getting on with it. We see this a lot, specifically, with eating disorders. There's a misconception out there that to have an eating disorder, you perhaps need to look very underweight. And people who are normal weight or overweight sometimes can feel this real sense of shame in saying that I'm struggling. And I think it's so important to emphasize that if you are struggling and if you are distressed, that really matters. Your pain is valid. You do not need to look a particular way to get help.

Lee (14:52)
I think that's so important to emphasize and and in fact, I some types of eating disorder, like for example, maybe binge eating disorder, that it's much more common to not be underweight. It would be more common to be either normal weight or overweight.

we've done a few episodes around shame, and I think body image can trigger a lot of shame. And one of the antidotes to shame is to bring it out the dark, is to start having these conversations and to recognize that people are not gonna judge me, they're going to actually be very caring, and I'm not the only person who experiences this. Do you find that that is helpful?

Joanna (15:27)
Yes, and I find that a lot of people, as I said, I do a body image group, which is a really lovely group, and people often will come very anxious and very nervous because it's such a personal thing. talking about the body needs to be handled with real sensitivity. A lot of the shame can almost be what I call a double shame, that people having these intense feelings of disgust and shame towards them.

and at the same time feeling shame for feeling shame. People will often say, I know that there more important things in the world. You only need to look at the newspaper. I know that it's not important and yet it's interfering with my life and it's taking over my thoughts and that's really difficult. There can be a lot of shame in saying this matters to me.

And yes, we know that eating disorders and body image worries and disordered eating, they thrive in secrecy and shame. So the more that we're talking about this, the better.

Lee (16:29)
Yeah, absolutely. It comes up in lots of areas actually where people say, I know there's people worse off than me. And it's kind of like you can say, hello, your inner critics visiting and really trying to help and trying to help you to move on. But actually that's like that is with done with such a critical tone of, well, you shouldn't be making a fuss then. And actually, I don't think it's competitive. We can care about people in the world.

Joanna (16:40)
Mmm.

Lee (16:53)
And we can also be worthy of care about ourselves and our own struggles, have validity. It doesn't feel like either or situation. It feels to me like there's room for both of those things to matter.

Joanna (17:05)
Yes, and I think that's a lot of the work that I do, whether it's about body image or about relationships with food, is about two ideas can be true at the same time. It can be very easy to think in terms of black and lot of this work is about the grey. And it's really difficult. People are really suffering with their body image. And I think it's important that we validate that.

Give people support, if people are suffering, people are suffering. As you said, it's not a competition in terms of who is suffering the most. There's room to hold it all.

Lee (17:41)
Yeah, definitely. recently, we've been seeing a lot more emphasis on things like the GLP-1 treatments for and for struggling with their weight. And in fact, we've done an episode around this and how it's important to recognise when it's important for people's health to look at a structured approach to weight loss as a healthy choice, but what we don't want is for it to be around body image or driven by shame or a trigger in some way for a sense of insecurity negative feelings. So I'm just wondering if that is something that you'd that issue has come up.

Joanna (18:18)
Yes, it has come up and I know there's a lot of conversations about it and I think again it's important not to be black and white about them. I think sometimes we hear that they're the best things or the most terrible things and I think as with all things in medicine it's important to balance the risks and the benefits and for some people who are in bigger bodies they can be extremely helpful and can have real health benefits and I think it's important to say that. 

I think the worry I've seen is when they're misused, so when people who do not meet the criteria will take them in order to improve their relationship with their And whilst these drugs can change one's body, the relationship with body image is very different and it can be quite worrying if someone is is scared to get off them and is scared of their own hunger or can't trust themselves to eat in an intuitive way. So I think, yes, I think it's important to take it very much on a case by case basis, but as you said, they're designed for health and not to improve your relationship with your body.

Lee (19:31)
This is the choice pause, a short two to three minute tool you'll hear in every episode. Each time it offers something a little different to help you pause, notice and choose your next step. Today's pause is creating space from comparison.

This pause is drawn from my book, 10 minutes to better body image. A step by step guide for teens using CBT and mindfulness. And I've linked to that in the show notes.

Take a slow breath in and a longer breath out. Let your shoulders drop just a little.

when a thought about how we look shows up. when we see an image online or notice someone else's appearance and compare it to our own, it can quickly trigger worries about our own body.

And when that happens, your attention can often turn inward, and becomes focused on just our appearance.  The body may tense. You might notice feelings like anxiety, agitation or unease. At moments like this, it can help to gently pause, offer yourself some kindness and gently return to what matters.

Take another slow breath.
Let your senses bring you back to the moment.
Notice your feet on the ground.
stretch your arms wide.
or give yourself a brief hug.
See if you can notice sensations from within your body rather than looking at your body from the outside.

It may help to say something kind to yourself, such as, this is difficult, I'm comparing, and it feels really upsetting.  I don't need to judge my body. I can accept my body as it is today.

Take another slow breath.  and now bring your attention back to what feels most important in the here and now.

That might be the conversation you are in. The task in front of you.  
moving your body in a way that helps release tension. perhaps a short walk or doing something that feels useful or absorbing.

Take a final slow breath.  And carry this sense of acceptance with you as you continue with your day.  

along with a reminder that you can have some choice about where your attention rests and about what activities you put most energy into today.

Lee (22:02)
in the idea of a relationship with our body when you think about relationships they're really complicated. If you think about family relationships and dynamics, then we get into real patterns that can be difficult of that relationship with body being something quite similar actually and I'm wondering do you approach it from a relationship perspective?

Joanna (22:04)
Mm.
we are all in our bodies for our entire life and sometimes people come to see me and they're in such a real battle of hate with their body which is sad to see and I think sometimes they can be almost a perfectionist desire to love the body.

And that can sometimes be unrealistic. Most of us don't love every aspect of our bodies. And actually that can feel quite scary and quite daunting. If you come in and you're in a battle, the thought of getting to a place of love can feel, I don't know how I'm going to get there, so I can't even try. So what I try and do is, as you said, see it as a relationship. YOU may not get to the place of love in your body.

but you may get to the place of accepting your body, of appreciating your body. And as you said, I like the analogy with families. It may be a little bit of an up and down journey. I think often the people who I see are really scared to fail and to make a mistake and to have a bad day. And I think it's important to normalise that with many different things, not just with eating or body image.

that there are good days and they're bad days and recovery is never linear. And what is more important is to think with curiosity. I wonder why my body image was particularly bad that day. And actually you may uncover with someone that the reason was that they were very anxious and they projected their feelings onto their body. Or they were with a new group of people and they didn't feel comfortable. So I think approaching it as a relationship

with ups and downs and a relationship that can grow in time can be a nice non-threatening way to look at it. And actually it's quite interesting often the people who I see think that they know what their body looks like but actually don't and sometimes people have a very difficult relationship with the mirror so sometimes the people who I see will either mirror check a lot

some kinds of people who I see will look in the mirror for hours and hours and hours. And it becomes totally distorted, as well as physically exhausting.

And the more you look at yourself, the less you know what you look like. And I often say to my clients, if we had the most beautiful person in the world and we zoomed into his or her features for hours and hours and hours, it would become very distorted. We then often have other people who avoid their bodies. And sometimes people would do that because they used to check.

and they found it so distressing that they think, actually, I'm going to give myself a break. I'm never going to look at myself again. So that's understandable. The problem with that is it sends a message to the brain that the way you look is so hideous that you actually can't look at yourself. It's so unbearable. And also another problem with that is that people don't get to know themselves. You know, thinking about the relationship, it becomes a very avoidant relationship.

So what I encourage people to do is first of all, understand their relationship with the mirror and therefore with their body and to work in a gentle and collaborative way to get to know their body. And one way that I recommend people can do this, depending on where they're at, is just to spend a couple of minutes

Some people are not able to look at the whole of themselves, know, maybe looking at their face or maybe even starting looking at their nails and describing themselves in a very neutral way. No judgment. Don't need to like it. I have got brown hair. I have got blue eyes just to build that knowledge. And then in time, depending how that's going, expanding on that.

actually you may not know what you look like and a lot of people have got a very distorted image that may be a very old image that isn't updated.

Lee (26:15)
Yeah, I think that's such a useful And what always strikes me when I've done that with people is the tendency is to drop into the language that we're talking about earlier, which is really critical. And so maybe they're describing parts of their features, maybe their nose, and then they can start using really negative language. instead of just saying, I've got a bump on one part of my nose or...
narrow at the top and wider at the bottom, they can really start being quite critical in the language. so it's almost noticing that habit where the critic jumps in and starts taking over the narrative and saying, this is really bad and actually pausing and coming back to how do I describe this in a really neutral, not good, not bad, but just that very neutral way, which it doesn't seem to come naturally to us, I don't think.

Joanna (27:04)
And I think it's important to say that the critic may be trying to protect the person. The critic may have been going for years and years and just thinking of some of my clients who may have had a history of bullying, example. And the critic may be designed to say, if you change your appearance, you won't get bullied.

And I think it's important to approach the critic with kindness and compassion and understand why it's there and gently tell it, I know you're trying to protect me, but I'm OK now. And I think so much of improving our relationship with our bodies is about thinking about the tone of our voice and the way that we speak to ourselves. We cannot beat ourselves up or anger ourselves into improving our relationships with our bodies.

Lee (27:53)
I definitely agree about that befriending the critic and giving that critic a big hug and saying, thank you so much. You're trying to protect me. I think we're going to try and find a way to protect me that supports us all and maybe doesn't lean into being so critical. So just going to put a little boundary around how much influence that voice has. So love the work you've talked about there for redeveloping our relationship with the mirror

It sounds like there's something about if we're on a seesaw, we might be over checking and spending hours and hours checking, we might be avoiding completely and we're looking for that middle part of the seesaw where we're able to cope with the mirror, maybe not getting too drawn into it, but not equally having to avoid it, which can be triggering in its own right. Are there any other ways that you would begin to work with people that help to improve our relationship with the body? What other strategies might you use?

Joanna (28:47)
what we sometimes do in a body image group is to think about the function of our bodies. A lot of what we've been talking about is thinking of the body as an aesthetic object, what it looks like, and to think about what the body can do, whether it's now we're able to talk or whether it's the body can allow me to hug people who I love or my body can allow me to horse ride. And just to think about what can the body do for us, what might I be grateful for, can slowly and gradually turn that shift away from what the body looks like to what the body can do. That is one thing that can be quite powerful. 

Another thing is to think about looking after the body. So is there any way, and sometimes for some people it feels quite counterintuitive, but whether it's putting on some nice moisturiser.

whether it's putting on some perfume. All these things can in time, bit by bit change the relationship between the body being, this is what's wrong with it, to actually, I'm going to look after you. And I think sometimes these ideas can feel a little bit daunting, but bit by bit, they can really help. Another thing which we've noticed a lot that people do is,

Often people's moods will be projected onto the body. So sometimes if people are having, say a bad day at work or say we've got a child who's feeling quite anxious about his or her parents getting divorced, they might find on those days that they're feeling more fat or they're feeling more ugly or they're feeling more bloated. Or even throughout the days, people's relationship with their bodies can change.

And we know scientifically that the body doesn't change that much in a day. But what that information can do is actually tell us that that person, the way they feel about their body is information. It may be information that you're not feeling okay or information that you're feeling anxious or information that you're feeling sad. So just asking people when they're noticing 
body discomfort or body distress to pause, to take a moment and think what might be going on here.

Lee (31:07)
there's quite a few things there you've said that I think are really powerful. So to start with, there's moving from my body is an object, my body something to look at and that is its primary purpose to actually my body lets me do things and it might be that I can draw, it might be I can run, it might be all kinds of different movements and social interactions, I can talk.

Joanna (31:10)
Mm-hmm.

Lee (31:31)
As you said, I can hug people. And so actually the body is an incredible that allows us to live our lives in such varied ways. And that feels like it goes back to the eggs in the basket instead of it just being an appearance related basket, but actually, this basket is really fun and this basket is full of energy and this basket is full of doing things that I care about

Joanna (31:38)
Mmm.

Lee (31:51)
And all of these things do involve our bodies, don't they?

Joanna (31:52)
Mm-hmm.

They do. And I think it's important to say that for some people, like we were saying before, talking about this can always bring more shame. I should feel more grateful. And I think, like you were saying before, we can hold both in mind so people can feel grateful for what their body can do and still feel distress because the way that they feel about their body is causing them sadness. So it doesn't need to be either or.

Lee (32:18)
Yeah, that's really true. I think it's just about noticing as you're critic getting involved in the gratitude.

and just keeping it contained. Sometimes other words can help with that, I found. So appreciation can be lighter. just I can appreciate my body and I can care about all the things that matter in the world at the same time.

Joanna (32:39)
Yeah, I think language is really important. And I think with every person who I see the language has slightly different connotations. As we said before, we've all got messages from generations and generations that we're not even aware of. Therefore, I think it's very important to use the language that makes sense to that person. So if people are listening to this podcast and the language doesn't resonate, I would really encourage people to use words that have meaning for them.

Lee (33:06)
Yeah, that's absolutely true. making our own language just working out what feels, what lands in a way that feels positive and supportive,

Joanna (33:15)
in terms of these suggestions, some things may be helpful for some people and not for others. And I would really encourage people to try things, but if they're not finding it helpful, that doesn't mean that they're not doing it right. There are plenty of other things to try. So I like to think of it as a toolbox, a toolbox for managing body distress. And that gives them options. But if...

If some things don't feel helpful, just bin the idea and try something else and make it personal to you.

Lee (33:46)
So there's no one size fits all and that way you can't feel like you're not doing well enough. Because I think people who have a loud critic can be quite tough on themselves and maybe expect themselves to change things that actually are really quite hard to work through. And sometimes may really benefit from having someone like yourself, some external support and some strategies that are really tailored to the individual. Because

Joanna (33:50)
Hmm

Lee (34:08)
seeking the right support feels really fundamental sometimes, doesn't it?

Joanna (34:12)
It does. again, support can come in many shapes and sizes. So for some people, professional support is important. The GP is always a very, very good first port of call. And then there's the BEAT charity, which has fantastic resources. It has message boards that are monitored. It has support groups. So there is a lot of help out there. Other people may find it helpful just to talk to a trusted friend or
to engage in something like an art class, There is no one right way to get help.

Lee (34:45)
Yeah, the charity BEAT is really incredible. And I will put a link to that in the show notes. if people are having concerns, and having a recognition that actually there's some really good information here and I relate to that. That's a huge first step, rather than feeling isolated and not feeling sure what's happening.

Joanna (34:49)
Mm-hmm.
Yes, definitely can be the start and sometimes it can be, a journey. So, realising that it can take time, there can be blips in the road, but that is okay, that can be part of the process.

Lee (35:15)
The other thing you said, which I think is so powerful is the idea that when you're having body distress and it's coming out as I feel fat today, I feel ugly today, I'm feeling unattractive, to recognise that that's a signal of distress so that we don't have to buy into what the words are saying. It's not so much that the words are accurate, but the distress is very real and that maybe trying to find a way to pause

Joanna (35:31)
Mm-hmm.

Lee (35:40)
to regulate that distress before we then think about what to do next. So I think our instinct is to fix it by trying to do something about the thought, which is, well, I need to control, I need to change my appearance, I need to do something about my body, when actually it's representing a deeper level of distress, which may be around lots of things in life. I'm stressed, I'm being bullied, things are difficult at work.

really tired at the moment. so pausing and just giving space for those emotions and being kind to ourselves also feels really important.

Joanna (36:12)
Yeah, I think sometimes it can feel easier to say, I am fat and therefore the solution is I need to deal with that. Than actually I'm really confused or I'm really stressed, can be more messy and less tangible. So as you said, it can be seen as a bit If you're feeling that, what else might be going on? And sometimes just asking someone who you trust, know, telling them,

about you've noticed that these feelings emerge at certain times and perhaps they can ask you some open questions if you come to them with those I think one of the most common things that I get asked by parents is what what do I say if my child or if my partner says I'm fat? How do I navigate that? And I often say that it's not generally very helpful to get into an argument of

You're fat, you're not fat, you're fat. What can be more helpful is let's agree that you are distressed and let's work together to manage the distress.

Lee (37:15)
Yeah, so that's a real reframe in how to approach. So really just making room for the fact that there's this thought and the belief around someone's appearance and it might be weight, it could be something related to the shape of the body as well. There's the key is that there's distress and I'm here to sit with you and I care about you.

I care about your difficult feelings and I know I can't just take them away but I'm here to sit with you with them. we often want to remove distress someone we care about feels upset, we want to make them feel better. But I don't know that that's possible. And so sometimes being with someone when they're distressed actually helps them to slowly regulate and settle down. But it can feel counterintuitive, can't it?

Joanna (37:46)
Mm-hmm.

It can, it can be very difficult to tolerate someone else's distress. And as you said, generally people want to help others, but just by sitting there and bearing the distress sends a really important message, which is that I can, I can be next to you. And I think often the people who I see are what we call distress intolerant. So they have beliefs such as

I can't manage being sad or I absolutely can't be angry. I have to remove that. And actually as a loved one, being able to sit next to them, and of course it's difficult, but I can bear this. I know you're sad and yet I can sit there and I can see you sad. It sends a very important message that these are difficult emotions, but they are manageable.

Lee (38:45)
Yeah, so that feels like such a compassionate way forward and building the relationship with a person to create that sense of connection and support and I think connection with others again is another way that counters feelings of shame. I think when we can feel connected to others, we start to co-regulate a little bit and then our emotions slowly start to settle but it doesn't happen immediately and I think we may need to let go of any idea of if I do this they're going to feel better but very much, this is going to be a difficult time. Maybe a this too shall pass sometimes helps where we know that as the emotion settles, we might see our bodies in a different way. So it's almost sometimes looking at as a temporary a snowstorm, but then the sun's going to come out again.

Joanna (39:18)
Mmm.
I think sometimes when people are in the depths it's difficult to remember that it can pass so just reminding them and it doesn't need to be all or nothing in terms of connecting with people. It's about thinking what you're able to manage at that moment so it may be that if you're really struggling with your body that you don't feel able to go out to a loud party and yet you may be able to

see a really good friend or even if that feels difficult you might be able to speak to someone on the phone so I think it's very important not to get into black or white and to just think about little moments of connection sometimes if you're able to.

Lee (40:08)
Okay, fantastic. That's been such an interesting conversation. To finish, we always do the choice space takeaway, we like to think about small choices that people can make that are may help them move forwards in a way that feels helpful. So what would be one or two small steps that somebody might try if concerns about their appearance or the body are taking up a lot of space in their life at the moment?

Joanna (40:34)
first of all, one thing is to say that this is not my fault. No one chooses to have body image distress. My second thing is just to notice and to be curious. just to notice if there are particular times that you feel more distressed about your body image.

and to notice and observe without judgement. And the third thing, is perhaps each day to notice one thing that you're grateful for or one thing that your body has done for you.

Lee (41:06)
And I think I'm going to add step out of too much thinking about our bodies and actually to step into being present and doing feel meaningful and powerful to us. So planning to reduce time thinking about or focusing on or looking at our bodies and replace it with time doing something that we care about, something interesting, something motivating.

Joanna (41:19)
Mmm.

Lee (41:29)
And it might be starting with something really small if we're a bit stuck or feeling a bit low or we've lost a lot of confidence, but it doesn't matter. It just could be five minutes of doing something that actually reduces that attention on the body and brings it to something where your body's actually working for you and helping you to do something that you really love.

Joanna (41:47)
Yeah, I think that's great and I think small steps.

Lee (41:52)
thank you so much for joining me, Joanna. It's been such a helpful and interesting conversation.

Joanna (41:57)
Thank you so much for having me, Lee.

Lee (42:00)
Thanks for listening to the Choice Space podcast. I hope this conversation has offered a little more room to pause, breathe and find your own way forward. We've linked all the ways that you can connect with Joanna in the show notes and I've also put a link in to the BEAT charity for eating disorders in the UK. If today's episode has been helpful please download, follow and share with somebody else who might value that space as well.

I'd love to have you with me for the next episode. Until then, take care and keep making space for what matters most. This episode was edited by Elle Dixon.