Session 7: Comparison Making and Timeline of Muscle Dysmorphia Symptoms

CONTENT

 

1) Welcome, Review of Treatment Map, and Agenda-Setting

 

• Review goals/homework from previous sessions. 

• Topics today: (1) comparison making and (2) timeline of MD symptoms. 

 

 

 

2) Review of Goals/Homework from Previous Sessions (approx. 15 mins)

 

• Review goal to address checking/avoidance behaviour

Questions to ask client:

• What kind of checking/avoidance behaviour did you decide to address?

• How did you do that?

• What were you able to achieve? What are your main takeaways? 

• How will you continue to challenge that behaviour in the future? 

 
 

• Review goal to expand marginalised areas of life 

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Questions to ask client:

• What did you decide to do?

• What happened? Did you notice an impact on your mood? 

• How will you continue to work on this goal in the future? 

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3) Comparison Making (approx. 15 mins)

 

• Comparison making is a behaviour that often becomes frequent and biased in people with strong body dissatisfaction.

• Comparison making becomes problematic because it reinforces body dissatisfaction and overvaluation of shape. 
   

Questions to ask client:

• Who do you tend to compare yourself to?  

• Are there groups of people who you tend to avoid comparing yourself to? 

• Is the way you judge others different to the way you judge yourself (i.e., the level of scrutiny and attention to flaws)? 
   

• There are two types of biases related to comparison making that people with MD frequently engage in:  

(1) Subject bias – only comparing yourself to people who are larger and more muscular than yourself.

(2) Double standard bias (or assessment bias) – having a double standard where you judge yourself more harshly than you judge other people.  

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Questions to ask client:

• What role does social media play in your comparison making? 

 

 

 

4) Addressing Comparison Making (approx. 10 mins)

 

Challenging subject bias

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• Social media: Monitor mood and body dissatisfaction during periods/days where you do and do not check social media over the next week. You might also find it helpful to unfollow people who normally trigger feelings of body dissatisfaction for the entire week (or longer). 

• Behavioural experiment: Walk down a busy street and compare yourself with every third person who passes you (of your gender and approximate age). Notice what comparisons you make with them. You may discover that there is much more variation in body shape and size than you had previously noticed. 

 

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Challenging double standard bias

 

• Behavioural experiment. Go to a place where people are typically wearing little clothing (e.g., the gym, beach, pool, etc). Then select someone of your gender and approximate age who you view as reasonably large and muscular. Next, discretely scrutinise their body in the same way you would yours. You may discover that on first notice, you might judge someone very superficially and evaluate them as immediately more attractive and muscular, but if you scrutinise their body in the same way you do your own, you may realise that we all have flaws and perfection is indeed elusive.  

 

 

 

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5) Timeline of MD Symptoms (approx. 20 mins)

 

• Work with client to develop a timeline of their MD symptoms from adolescence to the current period. 

 

Questions to ask client:

• When was the last time you remember feeling happy and confident in your body?

• What was your body image like during high school? 

• When did your body image start to become worse? What was happening at that time? 

• When did you first begin dieting? What about going to the gym? 

• When were your muscle dysmorphia symptoms at their worst? What was happening at that time?  

• What do you think will happen to your muscle dysmorphia symptoms if you do not make any changes going forward? 
   

• It may be helpful to highlight:

(1) associations between life circumstances and the initial development of MD + (2) possible family influences on body image + (3) a need for control being linked with exacerbation of muscle dysmorphia symptoms during stressful life periods.

 

 

 

6) Setting Homework/Goals

 

• Carry out behavioural experiment to address subject and/or double standard bias. 

• Continue reducing checking behaviours or challenging avoidance behaviours.