Year : 2022 | Volume
: 27 | Issue : 2 | Page : 136--137
Book Review: Izydorczyk, bernadetta (2022). body image in eating disorders: clinical diagnosis and integrative approach to psychological treatment. Oxon, UK: Routledge. pp. 157. £120 (Hard Cover). Doi: 10.4324/9781003251088
Fung Kei Cheng
Independent Researcher, Hong Kong, China
Dr. Fung Kei Cheng
Independent Researcher, Hong Kong
|How to cite this article:|
Cheng FK. Book Review: Izydorczyk, bernadetta (2022). body image in eating disorders: clinical diagnosis and integrative approach to psychological treatment. Oxon, UK: Routledge. pp. 157. £120 (Hard Cover). Doi: 10.4324/9781003251088.J Mental Health Hum Behav 2022;27:136-137
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Cheng FK. Book Review: Izydorczyk, bernadetta (2022). body image in eating disorders: clinical diagnosis and integrative approach to psychological treatment. Oxon, UK: Routledge. pp. 157. £120 (Hard Cover). Doi: 10.4324/9781003251088. J Mental Health Hum Behav [serial online] 2022 [cited 2023 Mar 26 ];27:136-137
Available from: https://www.jmhhb.org/text.asp?2022/27/2/136/367743
Among mental illnesses, eating disorders manifest abnormal eating behaviors, severely endangering both psychiatric and physiological conditions mostly connected to food, body shape, and weight. The monograph, Body Image in Eating Disorders: Clinical Diagnosis and Integrative Approach to Psychological Treatment, examines prevention, clinical diagnosis, and psychological treatment of distorted perception of body image in a wide range of unhealthy eating habits in Poles girls, women and men from premises of theoretical foundations and evidence-based clinical practices. It covers anorexia, bulimia, bigorexia, cachexia, orthorexia, and binge-eating disorders. Although these restrictive, compulsive anti-health eating behaviors are self-destructive, patients frequently pay great attention to their body image.
Body image is a mental response related to the interaction between the individual's internal world and social environment, simultaneously linking with emotional unease which shares with other people. It conjugates affective reactions with appearance and weight, cognitive dimensions and schema regarding one's own figure and impression, and behavioral aspects. Analyzing causes of aberrant body image among people with eating disorders, the book investigates dynamics between psychological and sociocultural body image profiles, family relationships, and personality structures. While Western esthetics dominate contemporary body image standards, becoming “cultural universalisation of body image” (p. 97), this sociocultural influence leads perception of body shape, involving internalized schema, bodily boundaries, and thoughts about the body. It also guides the construct of self-identity, including the body Self (mental level of bodily experiences), actual Self (how one perceives oneself), ideal Self (what a person would like to be), ought Self (what an individual should be), and mental Self (one's mental qualities that distinguish from that of other people), which associates with elements of personality structures in respect of neurotic and psychotic levels and borderline characteristics. In addition, harmful relationships, perfectionism and stress increase emotional uncertainties and tension of body image. All these factors help understand nonconstructive behaviors toward the body and eating, producing dissatisfaction with body image, fat phobia, and appearance-related fears.
The author has created a Big Five model (p. 137) to diagnose eating disorders; that is, agreeableness to interpersonal relationships, openness to new experience, conscientiousness to responsibilities, extraversion, and neuroticism toward difficulties. These gauges direct adequate treatments. Pathological personality structure, one of the dominate dimensions, offers diagnosis guidelines to examine distortion characteristics, pertaining to internal conflicts, perfectionism, and emotional disorders which produce distorted perceptions and negative attitudes towards body image, body satisfaction, and psychological functions. Such distortions come from low self-esteem, consequently, leading to self-hurting behaviors; for instance, restrictive eating, intensive physical activity, and compulsive purging.
In addition, Kernberg's structural and developmental model of personality organization is a functional approach based on the object relations theory. It assumes that personality is a system which continuously transforms self-representation and develops mature defense mechanisms. It investigates the relationship between mental disorder symptoms and specific personality structures. It also probes neurotic, psychotic, and personality disorders from the perspective of identity integration. Neurotic personality structure, mainly from a psychoanalytic view, explores ego, superego and Oedipal phases of personality development, which exerts pressure and causes the internalization of sociocultural factors affecting body image, together with identity hesitation and boundaries between internal and external worlds. The psychotic level discusses defense mechanisms, while borderline personality brings immaturity, chaos and impulsivity toward the body, self-mutilation, and low self-esteem. This model looks into the level of control over impulses, body image, and interpersonal relationships.
The book, therefore, proposes an integrative method to treating such mental disorders, including psychodynamic, psychodrama, cognitive behavioral techniques, and art therapy. This multifactorial approach combines psychological, sociocultural and family indicators, together with medical, psychotherapeutic, and dietary measures. It empowers patients to cope with the inner experience of obsessive slimness and reduces the feeling of confusion and ambiguity against a healthy body and diet. It focuses on sensory awareness; however, psychoeducation is a structured, informative intervention containing emotional, motivational, and knowledgeable drives, which should also be a crucial and effective agent to illuminate key functions of food and nutrition and physical exercise/movement therapy for these psychiatric illnesses. Thus, dietitians and nutritionists can play a significant role in explaining the balance of diet and body image. Equally critical, peer support group is prominent for psychotherapy, from which patients share experience in dealing with eating disorders and group members underpin one another and realize they are not alone. The integrative model could have considered these complementary parts to enhance the efficacy of therapy.
Psychodrama, based on psychoanalytic theories, works with symbols through verbal and nonverbal techniques. It also serves as training in experiencing bodily stimuli and emotions, leading to appropriate responses and restoring interoceptive awareness. As a result, it creates inner peace and emotional soothing and achieves a sense of security, from which patients with eating disorders are able to listen to their bodies and observe themselves. With calming behaviors, patients weaken their psychological mechanisms, negative emotions and self-harming ideations toward their own bodies. Rectifying perceptions of body image through psychodrama benefits anyone who suffers from poor eating habits and distorted perceptions of personal appearance.
Furthermore, religion and spirituality offer resources to tackle mental illnesses such as eating disorders, soothe stress on negative body image, and increase self-worth to face societal standards of body shape. They can sustain cultivating positive eating behaviors which favour body image concerns because of respectful and appreciative relationships with body satisfaction. This review suggests a detailed discussion on these aspects, resulting in enriching discourse on those connections with changing perceptions of physical appearance.
A healthy body image is self-acceptance of one's the natural body shape, size and appearance, with little strain about weight, food, and calories. It also reflects self-compassion, self-esteem, and self-confidence. Meditation can be an alternative intervention to foster inner calm that strengthens such characteristics. This practice has been proved to decrease worries and increase the sensitivity of physical and emotional experiences, resulting in self-recognition and wellness. If the book could have probed how meditation, as part of therapy, can contribute to rectify poor eating habits, it would show a fuller picture of treatment.
Body mass index presents a ratio of height and weight, providing a reference for health and an appropriate figure. The book limits Polish research. Noticeably, this anthropometric measurement encompasses ethnic, regional, gender, and age differences due to variations of body fat distribution, biochemical features, genetics, and lifestyle. Future studies are recommended to look into these factors.
Body changes challenge the body image of pregnant, postpartum, and breastfeeding women. Gestational weight gain produces peripartum body image disturbance, which increases negative body image and decreases body satisfaction during pregnancy. It may predict the onset of prenatal depression and postpartum weight regulation, including destructive dieting behaviors. In contrast, women who undertake breastfeeding may have awareness and appreciation of body functionality but less maladaptive weight control plans during lactation. The book would expectedly dig into the constructive psycho-physical dialog between perceived body image, health, diet, and weight control behaviors of this population.
Directing modern beauty standards, Western-oriented esthetics affect body image much, which leans toward thinness, attractiveness, and sex appeal. Nevertheless, symmetry, proportion, and harmony are also chief forms; and anthropological findings hint at diversified esthetics, which is worthwhile exploring distinct views of appearance management that benefits neurotic dimensions involving a sense of identity and intrapsychic conflict, representing sophisticated esthetic ideals, creativity and strong self-presentation. This monograph should have delved into the philosophy of esthetics and its intersubjectivity, it could become more inspiring.
Despite room for improvement in expanding those topics proposed earlier, the reviewed book exhibits an overview of the narrative, diagnosis and therapy for eating disorders and inverse body image, providing human service experts with a reference, such as doctors, nurses, teachers, social workers, psychologists, psychotherapists, psychiatrists, occupational therapists, and mental health professionals. Moreover, it gives insight into this mental problem to students in the field of medical, psychological, pedagogical, and people who are interested in understanding eating disorders suffered by children, adolescents, and adults.
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Conflicts of interest
There are no conflicts of interest.