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Family Health Magazine - ADOLESCENT HEALTH

Self-Esteem, Body Image and the Modern Girl
Issues that affect adolescent girls

As humans develop and mature, they go through many stages of how they view themselves. Young children are happy when rewarded with smiles for discovering their noses and toes. As they become more active, children are proud to show others their skills. In adolescence, there is often intense self-examination with agonizing over body image and social interactions. By adulthood, most people have a sense of where they fit in the world. Adults who feel worthwhile have a positive self-esteem developed through childhood and adolescence.

How is self-esteem fostered?

Self-esteem can be thought of as the price tag we attach to ourselves. It is a vital part of our makeup. Our level of self-esteem determines the direction and satisfactions in life. It has a major impact on physical and mental well-being.

Children inherit their temperaments and personalities, but these can be moulded to build on their strengths. Bonding between mother and baby begins during pregnancy. Positive self-esteem begins with this attachment of the baby to its mother and is strengthened by the nurturing of parents through childhood. Parents who show pride in their child help that child feel secure and loved. The resulting self-worth helps the child form human ties and meaningful relationships.

Teens from troubled homes are more likely to experience lowered self-esteem. For emotional security, children need support and love. If they are neglected or abused, they do not have that security. Without the closeness of parents or in poor socio-economic conditions, it is difficult for them to develop emotional strengths. They may become withdrawn, and feel rejected or depressed. Add the trials and tribulations of adolescence and major trouble looms. In spite of such problems, most children develop values and aspirations that make parents proud.

General development

At no time is self-esteem more fragile than adolescence, especially in girls. Dramatic changes happen as they develop and become young women. These are:

Five principles to foster positive self-esteem in teenage girls

  • Develop good communications
  • Understand teen behaviour patterns
  • Provide appropriate boundaries
  • Monitor school performance
  • Encourage positive body image
  • improving ability to think in abstract terms
  • increasing awareness and insight
  • adjusting to body changes
  • separating from parents
  • coping with peer groups
  • making decisions about sexual issues
  • forming intimate relationship
  • planning for the future

A girl who does not cope well with these tasks can feel a failure. Low self-esteem can lead to depression, suicide attempts, pregnancy, substance abuse, eating disorders, rebellion and violence.

The teenager’s mind in adolescence

What happens to a girl’s psyche in adolescence? The seven-to-10-year old is a bundle of fun and energy, curious and interested in everything. She is as much at home baking pies as she is helping dad fix the car. She is uninhibited and not terribly concerned with her looks.

With adolescence, everything changes. Many girls abandon the tomboy traits that culture dictates are not socially acceptable and adopt others that are. This “false self” is encouraged by a culture with an unrealistic demand for beauty, thin body, physical perfection and sophistication. Girls who fear they lack these traits lose confidence and self-esteem, and are easy targets for physical and mental problems.

If a girl has a strong sense of her own worth, she is more likely to remain true to what she believes to be important. She risks rejection and isolation from those around her, but is more likely to emerge from adolescence with inner strength and positive self-esteem.

Body image changes

Body image and weight are important to most women. It is not just how they look, it is how they think they look and how they think others see them - their mental picture of themselves. As well known author Alice Miller wrote “to lose confidence in one's body, is to lose confidence in oneself.”

To determine the importance women place on their body image Psychology Today did a survey in 1997. Of the first 4,000 respondents, 3,452 were female and 89 per cent were dissatisfied with their bodies. These figures speak for themselves. The average weight of women has increased over the last 30 years, yet cultural demands for thinness are becoming more stringent and fashion models becoming thinner. It is normal for young girls to gain weight in adolescence, but our culture tells them their bodies are wrong. Psychological development of girls is slower than physical and they do not have the insight they need to protect themselves. They judge themselves against unreasonable role models and find themselves wanting.

Fear of being fat and dieting to lose weight are disturbing traits among some nine-year-olds. Images on TV, movies, videos and magazines tell them they must conform to unrealistic ideals. Such relentless pressure to be thin is a major factor in the current epidemic of eating disorders. Dieting 15-year-olds are eight times more likely to develop eating disorders than non-dieting 15-year-olds.

When communities were more stable and people in the neighbourhood knew one another, girls were recognized for their qualities. With today’s mobile population, often this is not the case. Appearance may be the only measure used. A girl’s body is her personal billboard and thinness the passport to social success. Girls who have been nurtured to feel secure and significant will have the inner confidence to face the world.

Family issues in adolescence

As toddlers, children want to separate from parents physically. As adolescents they want also to separate emotionally, while remaining connected to the family. To do this they need a safe and secure environment. Today’s families are under increasing pressure from single parenthood, financial and environmental stresses, illness and especially divorce.

The turbulence of adolescence, when coupled with divorce, can be devastating. Teens need to talk, resolve conflicts within themselves and make choices. They need to be lifted when down and praised for their achievements. They thrive on reassurance. Divorcing parents are busy with their own problems and may not have time for their teens. Important relationships are cut and teens may be left stranded. Trust is lost. They feel their parents have broken the rules, so they can too. Their pain may be expressed as depression if they blame themselves. If they blame parents, they are liable to be angry and rebellious and this means trouble.

Many teens prefer that their parents stay together even if unhappy. Some children, because of their genetic makeup, will thrive in adversity while others struggle in the best environment. Painful experiences such as divorce can be a chance for personal growth and inner strength.

Peer relationships

The self-esteem of adolescents depends on making and keeping friendships. They “hang tight” with their peers and rely on them for guidance and information. Peer groups can be a positive or negative force. The need for acceptance often compels girls to strive to meet the expectations of peers. The right make-up, designer clothes, pop music and, of course, the right body shape are important. Adolescence may be when girls begin to smoke, drink, experiment with drugs and become sexually active. While experimentation is normal, continued involvement is hazardous to their health and interferes with the normal progress of their adolescence. They need to be encouraged to pursue interests that will develop the unique aspects of their personalities.

Sexuality issues

Good self-esteem enables teens to express their sexuality in healthy ways and to be equals in their relationships. Low self-esteem increases the chance of premature sexual activity. This creates a risk of both sexually transmitted diseases and pregnancy, along with emotional pain, guilt and loss of self-respect and even lower self-esteem.

Sexual abuse of adolescent girls is a reality. It interferes with their sexuality and causes psychological problems by undermining their mood, identity and self-esteem. Uncharacteristic out of control behaviour or sudden withdrawal should raise the suspicion of rape. Sexual abuse of adolescent girls leaves deep scars that are difficult to eradicate. The trouble is they often tell no one so the emotional scars never heal.

How can we foster positive self-esteem in adolescent girls?

How can parents help adolescent girls preserve and promote their personal worth? Our time is the greatest gift. Of all the things we can do for daughters, listening to them is the most important and meaningful. Both parents and children reap the benefits.

Adolescents can resolve psychological pain by thinking and talking. They do not solve problems by starving, violence, running away or substance abuse. If we do not talk with them, they become vulnerable to the world of the media. They identify with a solitary world where images, reinforced by sound, take the place of words. Human interaction is lost and imagination withers, as its work is done for it by bombarding images. Communities are bound together by conversation so everyone loses when adolescents are not part of this interaction.

For teens who find it difficult to express thoughts and feelings, isolation can be particularly damaging. Conversation is the way we learn about ourselves and others. As parents, we must be there to ensure a strong support system through the network of family, religious and social groups. All these promote a sense of belonging and security.

Parents wish to raise healthy teens, but sometimes wonder how. If they know the developmental changes occurring, they can understand why girls think and behave the way they do. They can accept that every pimple shines like a beacon of light, hair growth on legs takes on the dimension of a forest, and simple conversations with mom and dad are as loud as a public broadcast. Teens want distance yet closeness.

Teens read deep mean ing into casual remarks, they exaggerate, and they keep secrets. Their emotions are up and down, and behaviour unpredictable. Most of their thinking is focused on themselves. All of this is simply normal development. Books such as Reviving Ophelia by Mary Pipher, Ph.D., Kids Are Worth It by Barbara Coloroso and Now I Know Why Tigers Eat Their Young by Dr. Peter Marshall are helpful to parents.

A girl’s positive body image can be fostered through healthy eating habits, emphasising what should be eaten instead of what should not. Acne cannot be dismissed. Small blemishes that may seem insignificant to an adult assume vital importance for a teen. Regular exercise, promotion of friendships, and above all, a girl accepting herself for the way she is, should be encouraged.


Adolescents need and want boundaries but will never say so. Because they take risks, they test the limits of both the boundaries and parents. This is part of the power struggle as become independent. Without consequences when boundaries are crossed, teens learn disregard for authority and disrespect for parents.

At the same time, teens need room to manoeuvre within the boundaries. Those who believe they have some control over their lives are more inclined to act responsibly. Psychologists have found that strict but loving homes produce the best balance.

School issues and self-esteem

Eighty per cent of adolescents adapt well to their psychological world. However, low self-esteem associated with school failure and misconduct must be investigated. It may indicate an underlying psychiatric disturbance. In adolescent girls, 20 per cent suffer psychiatric illness, of which depression, anxiety disorders, drug and alcohol abuse are the most common. Realistic expectations for school performance should be set so teens can experience success. Otherwise they lose interest and career hopes fade into the distance.

Good self-esteem is fostered through school performance, and the nurturing of talents in sport, music, reading and other leisure activities. It is strengthened by parent’s encouragement of individuality, even if this means some pretty unusual choices such as clothing. A sense of security and significance are central to self-esteem. If we can instill these in our children through love, understanding, support and guidance, we will have done our job well. The rest is up to them.

FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
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