I can't remember a time in which I wasn't obsessed with my appearance. There is a harsh, vindictive little critic who sits on my shoulder and breathes his bile into my ear incessantly... He tells me I'm grossly overweight, unattractive, and undesirable. He turns my head towards every reflective surface and excoriates every lump, bump, crease and curve, imagined or otherwise... I no longer feel I have any concept of what I actually look like.
The other huge problem about body dysmorphia is the normalisation and misuse of the term. You only have to look at gossip magazines covers to see celebrities mouthing about their muffin tops, slamming their cellulite and loathing their legs; thats human nature, its natural. Its not necessarily right, and we all do it far too often, but it's something innate in all of us.
The focus on size and shape seems to suggests eating disorder is a physical illness, which it is not. By 'calorie loading' this is simply ignoring the underlying causes of anorexia - it may put on the weight, yes. However it does little to address the key factors or triggers linked to his eating disorder.
If having experienced trauma or acute vulnerability ourselves, are we prepared to accept and share that part of ourselves in the work that we do with our patients? It is my view that in order to offer people the best possible chance of recovery we have to offer them something more intimate than clinical expertise.