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When does body image become a problem during sex?

6.3.2024

Translation: Patrik Stainbrook

Often, we’re (too) hard on ourselves. Sex therapist Dania Schiftan reveals when our body image is most susceptible to negative thoughts, how it affects our sex life and how we can come to terms with what we see in the mirror.

How you perceive yourself determines how you go through life. And while some self-doubt and a negative body image can perhaps still be hidden or covered up quite well in everyday life, it’s a different story in our most intimate moments. We’re literally naked, vulnerable. Talking with sex therapist Dania Schiftan, I want to find out how strongly our body perception influences our sex life.

Dania, what is body image in psychology?
Dania Schiftan, sexologist and psychotherapist: Body image is the subjective view I have of my body. An inner image of what I look like, what this look feels like to me and what I think of it.

What influences this image?
Our body image is shaped by our life story and by the environment we grew up in. We collect good and bad experiences with our bodies. As early as childhood, we receive feedback on how we are, storing this information. As teenagers and young adults, we have our own first experiences with physicality and sexuality. We see, compare, perceive and then either realise that we’re okay or that something is «wrong» with us.

Can there even be such a thing as healthy body image if the concept is so subjective?
Yes, it certainly exists. A healthy body image is realistic and, at best, I accept myself as I am. We know, for example, that people with eating disorders have a very unrealistic body image. They often perceive themselves as taller, wider and fatter than they really are. And this doesn’t just refer to supposed problem areas, but also to the length of your own nose, for example.

Our body is the linchpin of sexuality. How strongly is it influenced by our body image?
It depends on the person. If you have a negative image of yourself, you may worry far too much about what the other person thinks. Is my chest too small, my hips too wide or my nose too long? If I constantly worry about whether I look good or doubt that I’m attractive and this slows me down around other people, it’ll naturally also affect my sexuality. I can’t freely enjoy myself. But there are also people to whom this doesn’t apply at all. They live their sexuality independently of their body image. They feel themselves, get into it and experience pleasure with all their senses.

At the risk of bringing up a cliché, it seems to me that this tends to be a more female topic. Are there really differences between the sexes when it comes to self-perception?
True, it’s mostly women who have these thoughts, stuck in their heads more instead of enjoying sex. But there are also men who have a difficult relationship with their penis, for example. As many men still wrongly assume that size is what really matters, many find their penis too small and worry about it. The following applies to everyone – if you think too much, you enjoy less.

Why is that?
When we have negative thoughts such as worries, doubts or even fears, our nervous system switches to fight-flight-freeze mode. However, you can’t fully live your sexuality in any of these three states. If you’re tense and don’t feel comfortable in your own body at the moment, it’ll be difficult to perceive beautiful sensations. When I’m ashamed of my body, it’s difficult to imagine that another person finds me beautiful and desirable.

How does such an inner conflict affect a relationship?
It can lead to problems. During therapy sessions, men tell me that they constantly compliment their partners and tell them how beautiful they are and that they find them attractive. However, the information isn’t received because it isn’t believed. If I don’t like my own body, it’s hard for me to imagine that someone else is crazy about it.

To what extent could it be helpful to try and help your sexual partner overcome insecurities? Or, more importantly, should you do it at all? Isn’t this more of an ego problem that can simply be overcome with some positive encouragement?
That’s the core problem. If I don’t feel okay the way I am, my partner will be able to tell me a thousand times – I won’t believe them. Of course, a loving partner can help build a positive body image. When I’m told that I’m beautiful, attractive and desirable, it’s empowering and helpful. But it’s more important to feel this within myself. A healthy, positive body image isn’t dependent on the judgment of a partner. When I feel comfortable in my own skin, I really know I’m okay the way I am!

Are there stages of life in which humans have a particularly vulnerable body image?
The younger you are, the more vulnerable you are. At a young age, we search for our own identity. We’re still in the process of finding out who and how we are. At the same time, we’re forced to cope with the environment that surrounds us in this phase of life. Peer groups play an important role here.

In what way?
As teenagers and young adults, we all have our own first experiences with sexuality. We encounter naked people who aren’t family members and are also confronted with images of bodies in films, television and certain naughty magazines. Trauma in this phase goes particularly deep. Positive experiences of acceptance and good experiences help us develop a positive body image. Of course, we may also encounter changes throughout our lives that influence it.

Could you give us an example?
Impactful experiences such as illnesses or accidents, but also pregnancies and giving birth, change our bodies and can, under certain circumstances, mean a kind of shock to our body image.

Can the body positivity movement help us here or should it be treated with caution?
Broadly, it’s a good idea to learn to love yourself as you are. For some people, however, this sounds so unrealistic that they can’t imagine ever loving their body. It puts them under pressure to achieve this goal, causing more stress. In this case, it’s helpful to take a step back and strive for a neutral acceptance of your own body. This is the more realistic goal for many people with a previously negative body image.

Let’s say I’m unhappy with my body and this feeling restricts me in bed. What can I do from a therapeutic perspective to change this?
A first step could be to become aware of your negative thoughts. What exactly do I think about my body? Do my negative thoughts affect a specific part of my body? Why do I think that way? What childhood or adult experiences led to this image? When we find answers to these questions, we can then take a closer look. Often, we don’t reject our whole body. It’s only when we deal with this that we realise what we find beautiful about ourselves and accept it.

Is there a specific exercise you can give us to end on?
Sure! Look in the mirror at the part of your body you want to make friends with. Pay attention to your body’s signals – your breathing, any present tension. The more you relax and breathe calmly as you approach a perceived problem area, the more likely you are to be loving to yourself and the more likely you are to have a positive experience with yourself. Your brain can only allow positive thoughts in such an atmosphere. Step by step, you’ll learn to think differently about your chest, stomach or thighs, and one day, your mind will have changed.

Dania Schiftan works in her Zurich practice as a sexologist and psychotherapist. As an author, she’s written two books about sex and the female orgasm, including a Spiegel bestseller. Schiftan is a regular guest in Swiss daily newspapers and on radio stations. Her podcast Release reaches more than 50,000 listeners a month and repeatedly makes it into the podcast charts on iTunes and Spotify. She gives presentations, runs workshops and works as a psychologist at Parship. You can find out more about her and her job in our interview:

Sex therapist Dania Schiftan
Source: Mirjam Kluka

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A trip to the sexologist
by Natalie Hemengül

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Natalie Hemengül

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Natalie.Hemenguel@digitecgalaxus.ch

As a massive Disney fan, I see the world through rose-tinted glasses. I worship series from the 90s and consider mermaids a religion. When I’m not dancing in glitter rain, I’m either hanging out at pyjama parties or sitting at my make-up table. P.S. I love you, bacon, garlic and onions.

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When does body image become a problem during sex?

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