It’s not about the body: the hidden story behind your body image

Dr Beth Shelton
Welcome to Let’s Talk, a podcast from Butterfly Foundation. I’m your host, Beth Shelton, and this is my very first time as host. So first, let me introduce myself. I’m a psychologist with more than three decades of experience working with people with eating disorders, as well as their families and carers. I’ve also served in leadership roles, helping to build and improve the system of care.

Today’s episode is all about exploring a different way of understanding body image — one that moves beyond socially determined body and beauty ideals, but instead looks at what our relationship with our body might be trying to tell us about our own lives. I’m joined by clinical psychologist Natasha Hepworth, who is helping to lead new thinking in how we understand and work with our body image.

Together we’ll explore why there can be such a gap between thinking we should feel okay about our bodies and actually feeling that way, how body image struggles can sometimes be rooted in past experiences or unhealed emotional wounds, and why hating the body can actually be a coping strategy rather than a failure.

This episode is about a deeper, more compassionate framework — one that helps you understand not only why you might be unhappy with your body, but what might help you move forward in a way that feels safe and sustainable.
So Tash, to begin, what first drew you to working in the body image space, and what did you start to notice was missing in the way we traditionally approach it?

Dr Natasha Hepworth
Well, I’ll probably have to credit someone we’ve both worked with — Susan Paxton. She was my doctoral supervisor and pioneered a lot of work in the body image space. Being part of her research team and having her mentor me certainly sparked that interest. And then when I moved into a clinical role, I started to enjoy the opportunities to work alongside my clients to improve their body image.

But probably over the years what I found was that I was applying the skills and strategies that I had been taught in my training and at workshops, and they were giving some relief but not the lasting relief that people really wanted. My clients would often say things to me like, ‘I know that I’m worthy no matter what I look like, but I don’t feel that on a deeper level.’
So that sparked an interest in exploring how we could perhaps think about body image in a different way and add to the existing strategies that we have. I’m a big believer that we don’t want to throw the baby out with the bathwater — we’ve got really good strategies, but maybe we need something to supercharge them a little bit and help people who weren’t getting that deeper, longer-lasting change they were looking for.

Beth Shelton
Yeah, absolutely. There’s that gap, isn’t there — often between knowing that I want to change my body image, even knowing I should change my body image, but not being able to get into a place of real acceptance. Why do you think that gap is so hard to bridge, Tash?

Natasha Hepworth
I guess, apart from the fact that we live in a society that probably doesn’t actively encourage us to have body acceptance — one that kind of benefits and profits from us not liking our bodies — I think from a clinician’s perspective, part of the reason is that some of our really great treatments work perhaps more on a cognitive level, but are not necessarily addressing some of the factors and reasons that have contributed to people not liking their bodies.
So we perhaps need to add to our existing treatments and strategies by looking at how we can support people on an emotional and somatic level, and help them process difficult life experiences that have given rise to that negative body image, or the need to hate the body. We do part of the work on that level, but we need to go perhaps a bit deeper.

Beth Shelton
Wow, that’s a big phrase, Tash — the need to hate the body.

Natasha Hepworth
Yes.

Beth Shelton
That’s full on.

Natasha Hepworth
Absolutely. And I talk about that a lot with my clients, with people I supervise, and in my body image workshop as well. It might seem a bit odd and can almost be a little bit controversial, but I tend to frame negative body image as an expression or a symptom of something that is unhealed from the past. It doesn’t even have to be a huge trauma, but it might be something unhealed from the past.

And hating the body, or not liking the body, is sometimes a survival and adaptive response to those things from the past. So if people have been bullied or teased about their appearance, or have internalised weight stigma and shame, hating the body is actually a kind of smart thing, because it means you can make meaning from your situation. It’s like, ‘Oh, I know why these things are happening — they’re happening because I’m the problem, and specifically my body is the problem.’
And by hating the body, we can then almost feel a bit empowered to do something about it. Well, at least I can fix the body. I can change it — whether that be through diet, or I can change my hair colour, or I can try to mould myself into something that is more acceptable.

Beth Shelton
So it’s more of a coping strategy — a way of making sense of life and being able to do things — rather than, I don’t know, a cognitive pathology that someone has. Is that right?

Natasha Hepworth
Yeah. I like that way of putting it — cognitive pathology. I tend to frame it as well as a way of making sense of things, and it’s easy to blame the body. Society almost hands that to us on a silver platter and says, ‘Yeah, actually it is your body that’s the problem.’

Especially if some of these past difficult experiences happen earlier in life, it’s hard to blame our caregivers, hard to blame peers, hard to blame school or whatever it might be. When we’re younger — in particular, kids and adolescents — it makes more sense for them to blame themselves and to internalise the idea that they, and their bodies, are the problem.

Beth Shelton
What sort of things do you hear from people, Tash, about the sorts of things that hurt in that way and might set up — I know it might be any sort of trauma in your life — but in terms of body image specifically, I guess that’s what I’m asking.

Natasha Hepworth
It’s a great question, Beth. I sort of divide it into two categories. One covers the more obvious things that might happen in life to create negative body image — being teased, bullied, and rejected about your appearance; perhaps living in a body that society doesn’t accept, or having characteristics or features that are not as accepted in society. So you internalise messages like, ‘My body is not good enough. It’s unsafe to live in the world the way that I look.’ Those are the more classic body image traumas, so to speak.

But not everybody is teased about their appearance growing up. So the other category sometimes has less direct links to body image. It might be something like feeling criticised a lot, or feeling like there are issues going on at home and you don’t feel supported, or there are just different interpersonal struggles going on. And again, there’s that idea of, ‘I can’t make sense of why these things are happening. Why am I getting criticised? Why am I getting in trouble?’ And when you are getting criticised, it doesn’t feel good in your body.

And then: ‘Oh, actually it doesn’t feel good in my body — maybe there’s something wrong with my body. Maybe that’s why.’ So sometimes it’s a misinterpretation of the sensations and emotions that are happening. And labelling it as, ‘I feel heavy in my stomach — maybe that heaviness is because I’m too big or my body is not right.’

That sense of overwhelming sensation can be really important, particularly for people who have sensory processing difficulties and can’t make sense of what’s going on in their body. Sometimes the way of making sense of it is to blame the body and say it’s the body that’s the problem.

Beth Shelton
It kind of makes me really sad — blaming the body. I get it, I absolutely get it, but it makes me sad that people have these experiences because the world is what it is, and also because things hurt and then we blame our bodies. That’s interesting, those two different ways of coming into that.

Tash, just before we go to talking about ways of working with this in a hopeful way — what are the sorts of things that people experience when they do get really stuck in the predicament of body image difficulties?

Natasha Hepworth
Well, sometimes I find that people have, on a cognitive level, done some really good challenging and reframing of their beliefs. They’ve got angry at and rejected diet culture, which is really good. But often where people get stuck is that they find it difficult to actually live in their body. Going into the body and being embodied is really, really difficult. So they can think about their body differently at an intellectual level, but they’re still living life separate from their body. They’re scared of their feelings. They can’t come in. They can’t make sense of their emotions.

I think really importantly, there’s often a sense of, ‘I can’t trust my body.’ So recovery can feel a bit cognitive and behavioural, but without that embodied sense of being able to live and exist in the body, experience the world through the body, and feel sensations and emotions and trust them.

Beth Shelton
I reckon our title is a sort of a problem as well as a good thing. It says it’s not about the body — but you are saying that it kind of is about the body. It’s about the body in a different way than being about my body’s appearance and what that does for me socially. It’s not about my body’s appearance — is that right? It’s more that what will start to heal things is connecting with my body in all the other wonderful ways that bodies give us information.

Natasha Hepworth
Exactly. I think that’s a good point. Sometimes I frame it as it’s about returning to the body, but in a way that is safe and grounded and embodied, yeah.

Beth Shelton
Can you describe a little bit for us, Tash, what that might mean — what the process might look like with somebody when working in this way?

Natasha Hepworth
Yeah, well, first of all, I start with all of my clients by building an understanding together — a shared understanding of all the different things in their life that have perhaps contributed to them needing to hate the body, or it being adaptive to hate the body. So we create this joint understanding and formulation together. And in that, we’re talking about how it actually makes a lot of sense that they perhaps blamed their body, and how, when they did, it gave them a sense of agency. Building that understanding first, I think, helps to approach it through a compassionate lens and can also help normalise why it’s so difficult to shift body image.

I also start to introduce the idea — both to my clients and to the clinicians I work with — that the aim or the goals of body image work might be a little different from what they traditionally have been. So they might not actually be, at least not at first, to improve body image. What they might be about instead is being curious when you have a bad body image moment.
I think we’re very quick to respond when someone says, ‘I don’t like the way my body looks’ — very quick to reframe that and use cognitive restructuring or logic to move away from it. But I actually think that when we have a bad body image moment, we want to pause and be curious about what it is trying to tell us. We might actually miss some really important information about echoes from the past that haven’t been healed.

So the initial positioning I take with people is: first, our goals might be different — rather than immediately trying to improve and fix the body image, we might want to slow down, pause, and be curious about what the bad body image moment is telling us about what’s going on. Then we can lean into that a little bit and ask: what is behind that? What is this trying to communicate? Is it shining a light on something that is unhealed — messaging, echoes of shame from the past that you’ve picked up about your body? That’s sort of where I start.

Beth Shelton
That’s a big change — a radical change in a way. If you’ve spent five, ten, twenty, fifty years pushing away bad feelings about your body and telling yourself you shouldn’t have them, it’s a big thing to then turn around and say, ‘Okay, this approach is saying it’s a kind of doorway.’ Do we need to more accept the experience and sort of go into it?

Natasha Hepworth
You’re right, it is a totally different way of thinking about it, and one that almost doesn’t sell itself to people. They’re like, ‘What? You’re telling me I have to lean in and feel this a little bit more?’ But yes, it is about leaning into it a little bit more with — I always use this term — curiosity. I say it’s your body image best friend, so to speak, and just be a little bit curious about what it might be trying to tell you about what is happening in your body, rather than about your body externally.
Because when we have a bad body image moment, we’re often focused on the external. But I think being curious about what might actually be happening inside the body right now is key. Am I perhaps feeling shame? Am I feeling unsafe? Something like that.

Beth Shelton
Tash, can I ask you — I know that you talk about using something called parts work in your work. Without getting too technical, what is it and how does it change the conversation around body image?

Natasha Hepworth
Well, parts work is used in lots of different psychological interventions, but it’s this way of thinking about the fact that as human beings, we all have different sides to ourselves. We might have a side that presents one way at work and another way when spending time with family and friends — a side that’s more emotional and a side that’s more logical. In parts work, we also think about the idea that we might have coping modes or protective parts that come in to help us cope with difficult situations. We might also have a critical mode.

I think parts work can be helpful in so many different areas, but in body image it can be really helpful because we can start to see that we might have a side of us that is hurting — a side that has experienced challenges in life and internalised negative beliefs about ourselves, the world, or other people. That hurting part might also hold shame and anxiety, and we develop different ways to protect it.

I talk about this idea that one of those ways is to have a body critic — a body critic part. And that’s what I mean when I say that the body critic hates the body, and that can be a functional thing. But we can also have a body fixer — the part that comes in and tries to fix the body.

And I also talk about this a lot in my body image workshop: we want to build up the body coach — the part that can work with these other parts to see if they can have more of a working alliance together, to help them come up with new ways to support that hurting part and be curious about what that hurting part really needs. Maybe it’s not hating the body that it needs anymore. Maybe it’s not trying to fix the body. Maybe we can meet that hurting part’s emotional needs in a different way.

Beth Shelton
What a lovely way to put that. So it’s an opportunity to get to know a new part of yourself, and then learn how you might be able to support and care for that part with all the knowledge and wisdom you’ve already gained in your life. And that’s the way forward to helping your body image, rather than just trying to stop doing the behaviours.

Natasha Hepworth
Absolutely, yeah. We can get to know these parts, understand their function, and understand how they’re trying to help and how they have helped in the past. Often people will say to me, ‘Hating my body and trying to fix it has actually really helped me in the past.’ But we’re always curious about: is it helping you now? Is it helping you have your emotional needs met now, in the here and now?

Beth Shelton
And there’s hope in that direction.

Natasha Hepworth
Yes, absolutely. We can build that up together. I say to my clients, I might be a bit of your assistant coach, and we can try to build up that body coach to maybe quieten that critic a little bit if it’s being too harsh about the body, and to try to find perhaps more adaptive ways in the here and now to feel safe and to feel good about yourself as a person.

Beth Shelton
For clinicians who feel stuck with traditional approaches and want to better support their clients who are experiencing body image concerns — where would you suggest they start? And how can they work towards what you’re saying — that body image isn’t just a separate thing from all other therapeutic and healing work? It’s a part of who you are and how you are. How do they start incorporating that into their work?

Natasha Hepworth
Well, I always recommend two books that I think are wonderful. They’re actually written for people with lived experience, but I think they’re just as valuable for clinicians. The first is called Body Image Inside Out. I’ve had a blank on the author just now, but I can send you the link and you can put it in the show notes. It’s a really wonderful book that starts to explore this idea that maybe the goal is not to get rid of bad body image, and to look a little at what it might be trying to communicate. They talk about that from a parts perspective, which is really good.

The other book I think is lovely is Befriending Your Body by Ann Saffi Biasetti. A lot of the work in there is about taking a self-compassionate approach to body image, which is really lovely. And in my workshop, Body Image Reimagined, I talk a lot about this different framework for conceptualising body image, and we have a whole section on parts work for body image as well.

Beth Shelton
So you’re doing your workshops — you’ve sort of become a thing, haven’t you! You’ve done them in Brisbane, you’ve done them in Melbourne. Do you do an online one as well?

Natasha Hepworth
Yes, I ran it online last year as well and I’m going to do another online one again. Yeah.

Beth Shelton
I’ll just tell you, I’ve had some lovely feedback from people who found it really helpful — the reframing and understanding.
I really like the fact that you chose two resources that are both for people with lived experience and can also be good for people working in helping professions. So is there anything else you would like people with lived experience of body image difficulties to take away from this conversation, especially if they’re feeling stuck and feel that their relationship with their body is something they just can’t change?

Natasha Hepworth
Well, I think it’s to know that they’re not alone. And that’s why I like those two books as well, because when I was reading through them I thought, oh, this is actually helpful for me too, and my own relationship with my body. But I think it’s about keeping in mind that they’re not doing something wrong if they’re having a bad body image moment. Because a lot of my wonderful clients will say to me, ‘I don’t think I’m doing well because I don’t always have a perfect relationship with my body.’ It’s a bit sad, but I think the reality is that it’s normal not to always have that, and that we can develop a different relationship with our body.

Two important things — which again are really tough and require hard work. Sometimes, to heal that relationship with the body, we have to do something that I label as healing the original wound. Whether it be in treatment, we want to look at some of those challenging, maybe traumatic early life experiences that led to the need to hate the body. Doing some work around that can be really helpful in getting relief, because you’re trying to get to it on that emotional and somatic level and rewire how those experiences are stored and encoded in your body. So I think that’s really important.

And the other thing is around that idea of returning to the body — that the goal is to come back into the body, to feel safe enough to come back into the body. I think that’s a really important shift that needs to happen in the body image space: we have to include the body more in body image work.

Beth Shelton
I’m just asking about the title again. What is it? It’s not about the body — or it is about the body. It’s kind of both, isn’t it?

Natasha Hepworth
Initially it’s not about the body, and then it’s about returning back to the body — but in a safe and embodied way where we can really make decisions from the body in a way that trusts it. But that is scary at first. Even thinking about coming into the body — that’s often the place where we’ve experienced challenging sensations, trauma, difficult emotions.

So I think first what we have to do is create a sense of safety — we have to learn how to come into the body safely before we can then come into any distress that we hold there. So for people with lived experience, perhaps that’s something they can bring to their own treatment — saying to their professionals, ‘Can you teach me a way to come into my body that feels safe enough for me?’

Beth Shelton
Do you reckon there are other ways people can use? A lot of people do practices like meditation, yoga — so many people are involved in various forms of breath practice or movement practice or whatever. Do you think those are also resources that people can draw on in order to say yes to their body and learn to trust it?

Natasha Hepworth
100%. I think some of those somatic and embodied strategies and interventions are so important here. I hear a lot of people say that when they do something like yoga — not that it has to be that — they really for the first time come into their body in a way that feels safe and that they can trust. Dance is another — and you would know a lot about that. Dance can be a very embodied practice.

I think when it comes to safe embodiment, people probably have more resources available to them than they realise, but in Western society we don’t always value them as much or recognise that they’re right at our fingertips.

Beth Shelton
It’s interesting. I suppose for me personally, I really experience a lot of interest and curiosity and pleasure — even relief — in going inside my body and going, ‘What’s there now?’ And sort of breathing into it. And while yes, it can be hard because there are pains and sufferings in there, this is also kind of life in all its messy glory. And it’s kind of like a place you can go that’s yours. It can be like that too, I think, perhaps.

Natasha Hepworth
Yeah, that’s so well said, Beth. I love that — ‘all its messy glory.’ And my tip for clinicians is that if we are going to support our clients and sit alongside them to safely return to the body, we have to know how to do that too. We have to have some kind of embodied practice — it doesn’t have to be yoga or dance or anything like that — but we have to have a sense of whether we ourselves can come into our body, because it’s also hard for us. We live in the same society and are subjected to the same pressures that our clients are.

Beth Shelton
The idea that our body is our life partner just came into me — that our body is always there with us and is a partner. So it’s like having a good relationship with that partner.

Natasha Hepworth
That’s such a nice way of putting it, Beth. Yeah, I love that.

Beth Shelton
Tash, is there anything else you’d like to tell us about before we finish today?

Natasha Hepworth
I guess just what I said before — that it is a different way of thinking about it, and sometimes it can take a little bit of time, both for us as clinicians and perhaps for someone with a lived experience, to come around to it. And don’t be surprised if your initial response — either as a clinician or as someone with lived experience — is, ‘No thank you, I do not want to lean into that with curiosity. I want to stay away from that.’ That’s okay, but just keep in mind that we’re trying to lean into it in a way that is safe. It doesn’t have to feel distressing and overwhelming — it’s in a way that feels manageable for you.

And I really have seen my clients get those lasting changes that they wanted. I’ve really seen it. So it’s possible and there is hope. And yes, it’s hard work, and I was about to say maybe it takes longer — but I actually disagree with that. I think we slow down to then go faster. At first it feels a bit painfully slow, and then I just see my clients kind of take off after that, and it’s so wonderful to watch.

Beth Shelton
And then what does that look like, Tash, when people are getting freed of body image difficulties?

Natasha Hepworth
I think it’s that they are no longer frightened about having maybe a shaky moment with negative body image — that their body coach is well developed enough so that they can be curious about what’s going on and support that hurting part of themselves to have emotional needs met in a way that’s really adaptive.

And I guess it also means I become redundant — and I like that. I want to become redundant. I kind of want my clients to be able to carry with them the wonderful work that we’ve done in our relationship, but not to feel that they need that all the time.

Beth Shelton
Absolutely. A beautiful encapsulation. Tash, thank you. Thank you so much for joining me for my first episode hosting Let’s Talk. It’s been wonderful to have a really deep and revealing discussion with you and gain your insights into other ways we can go with our body image.

If you’re concerned about an eating disorder for yourself or someone you care about, please reach out to the Butterfly National Helpline at 1800 33 4673 — that’s 1800 ED HOPE — for a free, confidential conversation with one of our specialist counsellors. Alternatively, you can chat online by visiting butterfly.org.au and following the prompts at the top of the page.

To find out more about today’s episode, check out the helpful links in the show notes and on the Butterfly website. Just head to butterfly.org.au/podcast and click through to this episode.

Let’s Talk is produced for Butterfly Foundation by Beth Shelton and Sam Blacker from the Podcast Butler, with the support of the Waratah Education Foundation. Our executive producer is Camilla Becket, with support from Melissa Wilton. Thank you for listening. Go gently, go well, and see you next month.