Individual CBT can allow a therapist to study Jake's view of himself and the premium he placed on the aesthetic value of his body. Many schemas are laid down in the early years of living and those that act maladaptively can integrate later experience within this maladaptive context. They may work to create such ramifications as feelings of social anxiety, shame and poor self-esteem.
Rather than focus on the functional aspects of the body, the body can be viewed from an aesthetic perspective and self-criticism can act as part of a campaign to judge the self by impossibly high standards. The number of self-aspects in which a patient engages and the extent to which they compartmentalise cognitive aspects of the self can profoundly influence feelings of self-worth in the presence of a given social context. CBT often works to separate the self from the disease, which in many cases is the paramount issue since the disease can come to represent the self in an aesthetic context. Working with patients to re-emphasise aspects of the self that are not dependent on the body and to help them to realise that others often do not base their judgement of the patient on their body and specifically, their skin disease, can be a crucial aspect of the therapeutic process.
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