In my private practice, I increasingly encounter individuals whose relentless pursuit of professional achievement has become inextricably linked with body perfectionism. This intricate interweaving of external success and physical ideals manifests in the use of the body as both a canvas for expressing unconscious conflicts and a defensive structure against deeper psychological pain.

The hunger for achievement and body perfectionism often stem from a common root: a deep-seated need for validation that arises from inconsistent or inadequate caregiving in childhood. The resulting unmet needs may drive the individual to seek independence in adulthood. These individuals continuously strive to prove their worth and competence but seek autonomy to keep anxiety at bay.

Your Body Isn't a Project

Building on Freud's (1923b) foundational concept that 'the ego is first and foremost a bodily ego', British psychoanalyst Alessandra Lemma's influential work helps us understand how the body can be used as a project to be perfected rather than lived in. Her development of the 'body ego' concept illuminates how early experiences of being seen or inadequately mirrored by primary caregivers shape our fundamental relationship with our body. When these early maternal relationships don't provide a secure enough base for development, individuals may continue to use their bodies as concrete defensive structures rather than developing more sophisticated psychological capacities for containment and symbolisation.

From Control to Connection

When integrated with contemporary psychoanalytic thinking about embodiment, John Bowlby's attachment theory offers crucial insights into the transformation of the body-achievement complex. When early caregiving has been compromised, children develop ways of using their bodies to manage anxiety and distress. This helps explain why high-achieving individuals in adulthood often express their psychological distress through a disturbed relationship with their body, alternating between rigid control and comfort-seeking behaviours.

Bowbly's concept of the 'secure base' takes on new meaning when considered alongside Gallese's concept of 'intercorporeity' (as cited in Lemma, 2014) - the profound bodily resonance between therapist and client that can facilitate psychological growth and create an opportunity to work through early ruptures and maladaptive relational patterns.

The Body and Psychological Development

Research findings from object relations and attachment studies demonstrate how early relational patterns become encoded in body image and self-representation. Studies of (m)other-infant interaction reveal that these patterns establish themselves through minute bodily exchanges - gaze, touch, holding - creating templates for later relationships with both self and others. This research helps us understand how early disturbances of the (m)other-infant relationship can lead to difficulties in body image and self-regulation. It's important to note that our exposure to cultural ideals of physical perfection from the beauty and fashion industry has the potential to become entangled with early attachment experiences.

Embodied Experience in the Therapeutic Space

The therapeutic environment offers what Lemma (2020) terms' embodied emotional scaffolding' - a containing space where the client's early experiences can be worked through at a somatic level via the therapist's receptiveness to the client's embodied experience. The unconscious bodily attunement between therapist and client is key to healing these patterns.

Working with the Body in Mind

In therapy, a gradual transformation over time can take place, from experiencing the body as a defensive structure to developing a 'containing skin'. In other words, the therapeutic relationship can allow for the individual to develop a psychological capacity to hold and integrate different aspects of their self-experience. In practice, this requires careful attention to:

1. The therapist's awareness of their own bodily responses as a source of understanding
2. The role of shame and early experiences of being seen/unseen
3. The body's function as both defender against and repository of traumatic experience
4. The importance of working with implicit, body-based memories alongside verbal narrative

Embodied Hope

Transitioning from using the body as a project of perfection to experiencing it as a home for authentic self-expression requires more than behavioural change or cognitive restructuring. Through the therapeutic relationship, clients can begin to inhabit their bodies differently, moving beyond the constraints of early relational patterns and cultural ideals of perfection.

New experiences created in the therapeutic relationship can lead to the client feeling seen and understood. These experiences become particularly important for high-achieving clients as the therapeutic process helps to reshape old patterns. The aim is not to attain perfection but to encourage embodied integration - embracing the body as both vulnerable and resilient, imperfect yet complete.

References:

Bowlby, J., & Holmes, J. (2005). A secure base: Clinical applications of attachment theory. Routledge.

Freud, S. (1923b). The ego and the id. In Standard Edition (Vol. 19, pp. 3-63).

Lemma, A. (2009). Being seen or being watched? A psychoanalytic perspective on body dysmorphia. International Journal of Psychoanalysis, 90 (4), 753-771.

Lemma, A. (2010). Under the skin: A psychoanalytic study of body modification. Routledge

Lemma, A. (2014). Minding the body: The body in psychoanalysis and beyond. Routledge.

Lemma, A. (2020). The aesthetic link: The patient's use of the analyst's body and the body of the consulting room. Psychoanalytic Perspectives, 17 (1), 57-73.