According to recent surveys, in Italy the majority of boys between the ages of 14 and 17 consider being overweight as the most frequent cause of teasing and humiliation, while an international survey reveals that 6 out of 10 girls avoid go to the doctor and / or play sports because they do not want to show themselves or undress in front of other people; only 3%, in fact, think they look good and, as mentioned above, the biggest concern is weight.
The size of some parts of the body, for ex. breasts (if too big it is considered showy and vulgar, if too small it is inadequate and not very feminine); male complexes, on the other hand, mainly concern the physical structure such as height and presence of muscles, considered virile attributes, while a thin or weighted physique often causes inferiority complexes.
Teenagers in the mirror see themselves as ugly, fat and full of defects : on the one hand they would like to be accepted as they are as they hate discrimination and have no prejudices towards the different, on the other they do everything to homologate and equal their peers or the current models of reference, such as actors, singers, TV characters with perfect physique.
This is an attitude typical of their age and of the difficult moment of life and development they are going through, characterized by uncertainty, fears, rebellion and ambivalence between autonomy and security.
Since childhood we tend to evaluate our image on the basis of two criteria, self-observation and external judgments; all this is misrepresented in puberty, when the comparison with peers and the comments of others take on a predominant role, coming to blur and deform one’s real image, already difficult to define at this age as the body is subject to change continue.
The resulting condition of psychological distress can be very strong and have repercussions on daily life, social relationships, academic and / or sports performance. In most cases, fortunately, we are dealing with fleeting moods, linked to the natural evolutionary phase; sometimes, however, they can lead to deeper disorders, such as eating disorders or dysmorphophobia , a disorder frequently diagnosed around the age of 30 but which has its roots in adolescence, even if it is not always recognized: it is estimated that in Italy from one to three million people suffer from it, both men and women (we will see this later).
The causes of the problem of disliking can be various, the main ones concern:
- low self-esteem (children still lack the ability to consider others’ judgments with balance without being influenced, their strengths / weaknesses are not known)
- desire for homologation (we want to be similar to the peer group, who does not adhere to certain aesthetic standards are cut off)
- comparison with the models proposed by the media (magazines, web and TV spread very precise physical stereotypes but actually unattainable, distorted or in any case very distant from the real world, instilling the belief that only the beautiful and thin can be successful in life or, perhaps , have the right to be loved)
- “Social mania” (all adolescents use at least one or more social networks, where they expose themselves with “selfies” and, in turn, look at their peers; this continuous confrontation is a sort of implicit competition to be the most admired).
Adolescents afflicted with complexes risk withdrawing into themselves, becoming grumpy, irritable, aggressive and suffering at a more or less serious level of anxiety and / or depressive symptoms ; they can spend a lot of time taking care of their image in order to appear “perfect” (makeup, gym, hairstyle, copying the look of the stars, etc. in an obsessive way) or, in some cases, on the contrary, almost to compensate for their weaknesses they assume arrogant and presumptuous attitudes.
As for parents (but also applies to other reference figures such as teachers, coaches, etc.), suggestions on how to behave and deal with the discomfort of children can be useful: first of all, it is good to transmit the message that in life one is loved and appreciated for how we are “as people” and certainly not for our external appearance, for this it is necessary to set a good example, not giving too much value to appearances; then, however, it is important not to deny the evidence or trivialize any physical imperfection, but to encourage them to reduce the problem and help them find strategies to better cope with the weak points, which we all have (eg enhancing the best sides). Finally, we should “train” them to disappointments and to consider the essential concept that we cannot please everyone!
As previously mentioned, these discomforts generally take on a marginal role and resolve themselves spontaneously in a short time, with the natural evolution of the subject; in some cases, however, this does not happen and there is a real psychological disorder , which can affect both adolescents and adults, called Dysmorphophobia or Body Dysformism Disorder, recognized as a pathology in all respects over 100 years ago by the German psychopathologist Emil Kraepelin and, later, deepened by the Frenchman Pierre Janet.
It is characterized by a distorted view of one’s physical appearance and by an exaggerated attention to one’s image: the subject is worried about the whole of his appearance, or about one or more specific defects, often totally imaginary (or, if indeed present, magnifies them by fixing on a small anomaly until it becomes, in his eyes, a real deformity).
He feels ugly, abnormal, he is afraid of being made fun of and ridiculed, he is convinced that he cannot please anyone, he is ashamed to expose himself among others, believing that his alleged defect is enormous and, all this, becomes for him an obsessive thought that constantly torments him, so much so as to condition him in his daily life.
Often, in fact, these individuals feel so anxious and vulnerable that they avoid social situations, isolate themselves, give up friends or romantic relationships, for fear of being criticized, of arousing gossip, etc. (they can also develop, over time, further problems such as real Personality Disorders , eg. Antisocial and Avoidant).
They spend hours staring at the mirror to find confirmation of their “defective” appearance (eg. A mole, a wrinkle, hair, etc.), but also to look for tricks to hide and / or mitigate the imperfection, developing similar repetitive actions to the typical “rituals” of Obsessive-Compulsive Disorder (from which, however, this problem differs clearly).
Some, however, are not even able to sustain the sight of their own body and, therefore, implement avoidance mechanisms , not looking in the mirror or on other reflective surfaces, such as shop windows.
Often, they constantly seek confirmation from friends and / or family about the severity of their physical defect and, the fact that others minimize, only increases their anxiety, sense of inadequacy and the feeling of not being understood by anyone.
The causes are still poorly understood, among the mechanisms involved it has been hypothesized the existence of an alteration in the transduction / processing of visual stimuli that would lead to an incorrect assessment of one’s appearance, regardless of the interference of psychological factors. This relationship, however, remains to be verified.
Brain “imaging” studies have also highlighted activation anomalies in the brain areas responsible for processing verbal and non-verbal memory, and defects in the transmission of nerve stimuli between these areas and the prefrontal cerebral cortex, similar to those found in the Disorder Obsessive Compulsive (that Dysmorphophobia has a biological basis and that it is related to OCD, also on this front and not only on that of clinical manifestations, is demonstrated by the fact that the disorder tends to recur in several members of the same family and in families where there are one or more people with OCD present).
From a strictly psychological point of view, there seem to be predisposing factors for low self-esteem , personal dissatisfaction and trauma related to “negative” romantic relationships in adulthood; also in this case, the more or less determining role of the current aesthetic standards, unreal and exaggerated, continually promoted by the media (eg extreme thinness, eternal youth, etc.) should be emphasized.
As for the treatment of this disorder , therapy is always unsuccessful if the approach is exclusively of a surgical / aesthetic type, as it is not the correction of the (presumed) physical defect that solves the problem; on the contrary, often the subject will see himself as more horrible than before or, at most, will shift the attention to another critical part of the body.
The best results are obtained with an appropriate path of psychotherapy , possibly of a cognitive-behavioral type , which seems to be particularly useful for modifying the distorted perception of oneself, reducing control / ritual behaviors, recovering a positive relationship with one’s own image and also to re-establish a good relationship with others.
Furthermore, pharmacological support is also often required: serotonergic antidepressants are effective in reducing symptoms in at least 50% of cases.
