00:02One thing is for sure that in the last 20-25 years, if you look at the way the importance
00:13that people have started giving to how they look or the importance that they are forced,
00:18you know, I would say that maybe not everyone out of their free will gives importance to
00:24how they look.
00:24They are being forced by, you know, the popular impressions and whatever is happening to look
00:31into that direction.
00:32You know, I guess given a choice and given freedom and a space, many people may want to
00:39simply, you know, walk out of it or less in this.
00:44So, it has been a growing obsession, there has been, now almost every street corner has
00:51a slimming institute, a health club, a beauty institute, a plastic surgeon, various other
01:00things, you know, various other things that one can see, all which promise you that if
01:07you come to us, you will get a good body.
01:11And, why do you need a good body?
01:13Because they claim, and that is what we might use, once you have a good body, you will have
01:20a lot of goodness in your life, you will have a good partner, you will have a good profession,
01:25you will have a good confidence, you will have happiness, so that's how it goes on.
01:32So, the body or the appearance is not just appearance, it has become sort of a key to unlock a
01:41treasure
01:41of happiness which everyone is very, very keen to get.
01:51So, physical appearance has come to be overloaded with meaning.
01:55It always had a meaning, you know, like when two people, you know, when you see someone
02:01attracted, I mean many, many interesting researchers actually have seen that the babies who look
02:10good or who are cute, they are the ones, you know, that people who really want to pick
02:16up and play with and they tend to have nice experiences as growing up children.
02:20So, physical appearance always had some meaning, some connotation.
02:26You know, all cultures have talked about it, they have had elaborate, you know, the thesis
02:33on how to have a good physical appearance, in their art, in their sculpture you see glimpses
02:41of it, but in the present context it is becoming extremely overloaded with meaning.
02:48There's this image, there's this image that's created of a so-called designer body, you know,
02:53that it's no more a human body, it's more like a designer body, you know.
03:00The kind of nose, you know, your nose should be like this, the jawline should be like this,
03:05hair should be like this, your biceps should measure this inches, you know.
03:22So, there's this hypothetical image of designer bodies and there is a whole bunch of health products, beauty treatments,
03:33and obviously the surgeon's knife to help people achieve that.
03:38And, many people are in this circle, there are some who think that why they are in this circle,
03:45but there are some who don't think why they are in this circle.
03:47There are people who run in this circle and who have been running in this circle,
03:52who, you know, crawl on to see, you know, say every week, how much are they gaining,
03:57how much are they losing, and who get really distressed.
04:04One thing is to be concerned about how much you are gaining, but one thing,
04:10it's a totally different thing to be distressed about how much you are gaining.
04:14So, there are people who are very distressed.
04:16There are people who, they have a pimple on their face and they will be very, very distressed.
04:25As I said, it's always very normal and natural to be concerned about one's appearance and enhance it.
04:31It's a very basic human way of living.
04:35But, and given a choice, a large majority of people would say that why not?
04:41I would want a good skin, I would want, you know, thick hair, I would want attractive features,
04:47I would want a well toned body, why not?
04:50So, that's not what we are talking about, you know.
04:54But, we are talking, largely focusing on this segment of people.
04:58For some people, these concerns cross over into a sort of preoccupation.
05:03That appearance comes to be one major thing or theme in their life,
05:09and their life starts revolving around this idea that they should look beautiful
05:15and they would go to various lengths to do that.
05:20I remember the first, you know, case of disorder I had seen.
05:25And initially, I was not really so much, I mean, I was very open to people being concerned about their
05:32weight
05:33or about their appearance.
05:34But this one person whom I had, like, seen approximately 11 years ago,
05:42I called him Mr. K, he told me that he had taken, he had undergone two nose surgeries.
05:52He felt that his nose was very flat and it was not triangular and it was not in the way
05:59it should be,
06:00like, you know, my nose is also not like that, the way it should be, you know.
06:03So, he had undergone two different surgeries, but after each surgery, he ended up feeling even more horrible about his
06:12nose.
06:13He claimed that the surgeon had done a very horrible job, that the nose was not the way it should
06:20have been.
06:22The surgeon, on the other hand, mentioned that he had a good period of experience in this surgery
06:28and he had done his best, you know, to give this person the kind of nose that this person wanted.
06:36But, each time after surgery, this person had become more and more concerned about his nose.
06:45And interestingly, his image or his feeling about his nose was not constant.
06:52It would change on, at times, on a daily basis.
06:57You know, that one day he would get up and look in the mirror and say,
06:59it's not so bad, it's okay.
07:02But the second day when he would get up and have a look, he would say,
07:04that it's extremely horrible, how can I walk out with this nose?
07:08Apart from that, after these two nose drops, he was now considering the third one,
07:13he had really become concerned about some acne scars that had been there, you know, from his teenage.
07:22And he was now also seeking some kind of treatment for them.
07:27His surgeon now was very concerned because the surgeon had a sense that,
07:31if I go on giving this person treatments, then there may be a case that he may still be more
07:40and more dissatisfied with his appearance.
07:43And that's why the surgeon had a sort of psychological consultation.
07:49So that's the way in some people that these concerns can really blow up into.
07:55And we'll be talking more about them today.
07:58So they start suffering from what is known as the appearance anxiety,
08:02that you are very anxious about your appearance.
08:05or it's severe psychiatric, psychological disorder, which is called the body dysmorphic disorder.
08:15These people jettled up a preoccupation with mild or even imagined defects in their appearance.
08:24And their lives get structured around hiding or getting rid of these secrets.
08:31What happens is, all of us, if you were to look at her face or at her body,
08:35all of us will have one or two areas in which we don't like, or maybe more.
08:40We may not like her face, we may not like, you know, to bear her body fat is distributed on
08:44her body.
08:45We may not like, you know, say some marks on her body.
08:48We may not like, you know, we may want a few more hair at some places.
08:52We may not want a few more hair at some places and various things like that.
08:57So we all would have some kind of real defects and some kind of mild defects.
09:07If someone has a very real severe defect, you know, someone with a faceburn
09:13or someone with a weight like very very abnormal, then anxiety would be genuine.
09:25It will be warranted in that case.
09:28But, in quite a few cases, you know, where other people around the person may feel that,
09:36you know, that this is not really something to be so much concerned about.
09:40Or, yeah, it is there, it's not such a pity.
09:43But the person is really concerned about that, then it can be, it is a mild defect.
09:50In people who are concerned about their opinions, there can also be at times certain imaginary defects.
09:56Now, imaginary defects do not mean that they are delusional or they are imagining something to be grossly ugly.
10:03It's just that they, when they look at any feature or part of their body, they find it very repulsive.
10:11And they find it defective in some gross sense and they want to change it.
10:21People suffering from appearance anxiety focus exclusively on a few negatives.
10:27That's the problem of these people.
10:28Like, people who are more or less normal, they would feel that, yes, I have this one scar over there.
10:34Or, you know, I don't have, like, six-pack abs.
10:38Or, you know, I don't have this kind of a very smooth, lustrous skin.
10:43Or, after the age of 40, I am having some kind of dark circles over here.
10:49Or, you know, some changes in my face and, you know, my skin has started sagging.
10:55But they can still recall in their mind certain positives about their appearance, hold on to them.
11:02And they give them more or less kind of a confidence in their appearance.
11:09That, fine.
11:10But the normal or average person would say that, yeah, you know, few negatives and few positives.
11:15I am an okay person overall.
11:17I can, like, you know, I can go like this and deliver a talk.
11:20I can go like this and date.
11:22I can go like this to update functions.
11:26Or, you know, the person can think of certain very positive attributes about their personality.
11:33And say that, fine, even if I am not good looking, I am a very confident person.
11:38Or, my body language is in a certain way.
11:41I can carry myself off well.
11:43So on and so forth.
11:44But these people, almost their 95% attention is rests on your mind.
12:01I can definitely think of them.
12:08You know, I have a lot of them on the way they do.
12:11But with an approach to an emotional response to an emotional response, you know, I am not
12:11But it is certainly that I would say that when I am not going to push, that is a real
12:13reflection, you know, you know, and you know, you know, you know, like this.
12:16you know, that, oh, my nose is like this, my skin has started sagging, I have fat on my belly,
12:28I have fat here, I have fat there.
12:32They may have a hard time relaxing and concentrating on other activities as they start dwelling on their appearance concerns.
12:40So what happens is that they would do, they would get into these two kinds of things, obsessions and compulsions.
12:47Obsessions would mean that the idea that they have a defect in their body or in their appearance would keep
12:54on coming back to their mind.
12:56So even when they are, you know, they are going about their daily activities or they are reading something, they
13:01are meeting someone,
13:02they would still carry this idea back in their mind and at times they are very distressed because even if
13:07they want to push out this idea from their mind,
13:10this idea does not go away and it keeps coming back in that my body is like this, my body
13:16is like this, my body is like this.
13:19And because they get very distressed by this idea, so then they start spending a lot of time, you know,
13:27in dealing with this thought or in trying to do something about their body.
13:32So someone who feels that their skin is very horrible, they will start reading a lot on how to, you
13:38know, get rid of those blemishes,
13:41they may start taking various kinds of treatments for that and those things will assume a lot of priority in
13:48their life.
13:48The more severe the preoccupation, the greater the priority it would require and more the number of obsessions and these
13:58compulsions.
13:59And at times these thoughts about the appearance can be so hauntingly severe that they start doing poorly in various
14:06spheres of their life.
14:07In their students they would have a hard time studying, if they are working, if it is hard to work.
14:14In their relationships also they would be, they would be like very anxious about being rejected, you know.
14:21And it's a hard time for them to leave themselves loose and relax and enjoy the fun.
14:30So that's how it happens.
14:33Like one person I remember who would kind of say that, you know this college student,
14:43she was so concerned about her face and her acne that rather than paying attention to her GMAT classes,
14:52she completely took off for them and she went on and signed up for a whole one month laser treatment
14:57for these scars.
14:59Well this is the reason why she was so inclined.
14:59She is the only one person who is working on studying, her face as her face as her face as
14:59her face as her face as her face being made.
14:59And she's at her hand and she is amazing.
14:59She has really enjoyed her, don't you, but even though with those of her started to change her face or
14:59her face is also interesting to everything.
