E174 | Looksmaxxing Uncovered: The Dark Side of Self-Improvement (w/ Dr. Rosy Blunstone)

Looksmaxxing is an online subculture that has moved from niche online forums into mainstream conversation, but what does it actually mean, and when does looksmaxxing become concerning, if not disturbing? 

In this episode, Alex is joined again by psychiatry and psychotherapy registrar Dr Rosy Blunstone to explore the world of looksmaxxing: from grooming, fitness and “softmaxxing” to more extreme practices such as bone smashing, steroid use, cosmetic surgery and dangerous medication misuse.

They discuss why looksmaxxing appears to resonate especially with young men, how dating apps and image-based social media may be shaping anxiety around attraction, and the links between looksmaxxing, rejection, loneliness, OCD, body dysmorphic disorder and incel culture.

Together, they ask what a healthier attitude toward appearance might look like, and why confidence, resilience, social connection and learning to tolerate rejection may matter far more than chasing physical perfection.

Watched the Channel 4 doc about Looksmaxxing here: https://youtu.be/KdfKZpsNMvE?si=VWYuNugKxZVWgZsS

Interviewed by Dr. Alex Curmi. Dr. Alex is a consultant psychiatrist and a UKCP registered psychotherapist in-training. Website: alexcurmitherapy.com

Check out The Thinking Mind Blog on Substack: https://thinkingmindblog.substack.com/

If you would like to invite Alex to speak at your organisation please email alexcurmitherapy@gmail.com with "Speaking Enquiry" in the subject line.

Alex is not currently taking on new psychotherapy clients, if you are interested in working with Alex for focused behaviour change coaching , you can email - alexcurmitherapy@gmail.com with "Coaching" in the subject line.

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Transcript

Alex: Today we're gonna be talking all about looksmaxing. the most extreme, things like bone smashing, taking drugs like testosterone and steroids, considering surgery. 

Rosy: I think this idea that we can somehow, um, remove ourselves from the responsibility to, be the leader here, and actually, if I'm just incredibly good-looking or optimized, I ascend. That's a word that they use. one of the things that seems to come up a lot is this fear of rejection, like almost pathological fear of rejection. And where has this come from in younger people who seem to be the demographic to which looksmaxing is most aligned, 

Alex: so many people live their life totally encumbered by fear, and there are things they really want to do, whether it's get into a relationship or just learn a new skill. And the only reason they're not doing it 

is because they're afraid of what other people will think, 

What, what do you think is like a sane attitude a young man should have about their appearance I've been [00:01:00] looksmaxing for about five years now.

Rosy: Yeah. 

Alex: can,​ 

 welcome back, everyone. Today we're gonna be talking all about looksmaxing. We're gonna hopefully discuss a sane definition of looksmaxing, what it involves, the benefits, the downsides, the clinical implications for you psychiatrists and therapists out there Psychological implications and maybe a few holistic alternatives.

Hopefully, we can separate fact from fiction and not overly sensationalize this topic, while at the same time treating it with the seriousness that I think it deserves. And I'm very happy to be joined in today's conversation with Dr. Rosie Blunstone, who is a registrar psychiatrist and psychotherapist.

Rosie, thanks so much for joining me again.

Rosy: Alex. Nice to see you.

Alex: We did a conversation last month, uh, about the manosphere, which people loved. I think this is one of these topics that's now emerging into the mainstream, and people t- are starting to understand [00:02:00] more. Following from that conversation, I said, you know, "Should we do a podcast about looksmaxing?" And you said, "What's that?"

So for you, it's also still emerging, and then we discussed it a bit and watched the Channel 4 documentary. W- what's been, like, your general impressions of this looksmaxing world so far?

Rosy: Yeah, it's de- it's certainly been an immersive research experience. Um, I think there, there were points of it that I absolutely-- I'd never heard that term before un- until you suggested it. Um, I had not seen the documentary. But interestingly, there are points about it that definitely come up in the manosphere conversation, um, and then possibly cause and effect.

But I certainly found that it's-- I'm a lot more aware of it and a lot more conscious of it in my day-to-day life since. Um, so even just being aware of some of the names that are linked with it, the word itself appears now to be something that I, I'm picking up [00:03:00] on a lot more. Um, but certainly I feel like I've been on a real journey from understanding, I suppose, the spectrum of what is involved, um, involving some really quite bizarre and terrifying things.

Um, but also, uh, I guess exploring how this links with some of the stuff we've discussed before and our clinical practice and our, and, and our day-to-day lives, I mean, really. 

Alex: and I think I'm glad that you mentioned the word spectrum. I think one of the criticisms of the Louis Theroux manosphere documentary was perhaps that he didn't fully acknowledge that the manosphere stuff is a spectrum ranging from pretty reasonable and healthy to really unhealthy and dysfunctional.

And I think the first thing I would want to mention is looksmaxing is the same. So at the milder ending of looksmaxing, you've got things like grooming, fitness, style, um, people call this softmaxing, you know, self-care, stuff that most people should [00:04:00] probably engage with o- to some degree or another. But then it's the higher end that-- the, the harder end or hardmaxing that gets a lot of press, which involves, uh, maybe a lot more obsessional behavior, a lot more, uh, obsessiveness about how someone looks to the extent where it's getting in the way of your day-to-day life A lot of self-monitoring, but then at the most extreme, at the most extreme, like risky fringe practices, things like bone smashing, taking drugs like testosterone and steroids, considering surgery.

So really important firstly to acknowledge there is this spectrum.

Rosy: Yeah, absolutely. And as with all things, it's, it is quite complicated, and I think when you try and distill it down into just a headline or even just, I suppose, a tag on social media, you do have to be aware that you are talking about something that's really varied. Um, for different people who are involved in that world or adjacent to it, they may have different understandings of what they perceive to be, um, appropriate [00:05:00] or, um, within the remit of their understanding of looksmaxing.

And to understand that nuance, I think is, is important because what I don't think we fully understand is, is it a spectrum in which you can move from the softmaxing, which seems to be more around self-care, grooming, sort of optimization. That's a word that comes up a lot. Do you move through this spectrum and become a hardmaxer, or is that something that becomes-- is that an entry-level thing that you can just go straight in there?

I'm not sure we really know. And so I think that appreciating there is a spectrum and being able to, one, engage in that dialogue, even amongst ourselves or, um, in the media and things is important because you risk otherwise really understanding the nuance of what people are talking about if they're engaged in this world.

Alex: Yeah, absolutely. I mean, my intuition would be probably it's a gradual process. Obviously, looksmaxing is an online phenomena, and it's [00:06:00] typical of all the different dysfunctions we see online. It's a problem of thinking and rumination in the absence of action, real-world experimentation, and finding things out for yourself. I mean, the first elephant in the room we have to acknowledge when we're talking about looksmaxing is it seems to be for, for the purposes of dating and romantic attraction. It's like that's why guys seem to be interested in looksmaxing because they're interested in dating, and they feel like this is the path to, to a successful dating life.

And I guess the first question we have to ask is why? Why has this become a phenomena in the first place? Because historically, it hasn't really been the case that guys have ha- felt that they have to obsess over their looks specifically to have a successful dating app-- uh, dating life. There's always been a, a minority of guys who might be really interested in fitness or bodybuilding, but this seems new.

Do you have any [00:07:00] thoughts on, on why this has become so prevalent amongst young

men? 

Rosy: I, I I think you've slightly hit on it a bit in your question is I think the rise of dating apps and an online culture that is driven by and, um, obsessed with image. Um, I think we have a so- social media algorithms and platforms that are, are image-based. That is their purpose. Um, and that, um, will algorithmically, uh, push, um, more extreme and more provocative views.

Um, but-- And this is linked with the rising dating apps, which again, are by their very nature image-based. Um, and I think an understanding that the way in which these apps work, which again, not, not people are not always so aware of, um, it can be disappointing, um, if you're s- if you're somebody who perhaps in the real world doesn't feel that you would [00:08:00] struggle to date, but online you're struggling to make these connections.

And there may be lots of other reasons as well, work from home culture, increasing social isolation in terms of m- much more of a move online. Um, but I do think that when we try and make that link between looksmaxxing and dating, we gotta look at, well, what's changed so much about dating? And I guess we would historically have dated people that were in our social field and maybe our, our religious group, our, our cultural kind of, um, frame of reference, um, friends, colleagues, and that's changed, right?

I guess it's 

Alex: Yeah, I guess it's something like people our age can take for granted the fact that we had a pre-internet phase of our lives. So certainly a pre-dating app and pre-social media phase of our lives. So I'm in my mid-30s. Dating apps would have become a thing around the time I was, I guess, 24, [00:09:00] 25. So I had my whole life before having to deal with this on any level. And what we don't realize is for pe- people for whom this, this technology is native, they've never had that experience and they've never had that real world of experie- real world experience of what it's like to date someone purely through meeting them in real life. And so not only do you have the retreat online, but crucially you have the mistaking what happens online for reality.

In other words, if my profile on my dating app isn't successful, that means that equals I am an unattractive person. And that's something that people like myself who have had some experience before dating app would-- we don't necessarily-- can still be difficult for people who are older because it's still, it's not particularly great for your self-esteem to feel like you can't get success on a dating app.

But at least you have that experience of what life was like before, so you, you, you're not fully equating your online 

success with [00:10:00] reality. 

Rosy: Reality. Yeah, totally. And I think that there's a really interesting point about having had a life before in which you've learned a bit about who you're attracted to and how, and also a-- maybe a bit about rejection.

And one of the things that seems to come up a lot is this fear of rejection, like almost pathological fear of rejection. And where has this come from in younger people who seem to be the demographic to which looksmaxing is most aligned, particularly young men? W- I, I'm not sure that I grew up with quite the same fear of reject-- It's not something you like or look forward to, but I don't think I was really quite so afraid, um, in the way that it seems that this community are. 

Alex: I,

I mean, I think there's something really important to say on this about the dynamics of fear and anxiety. So I think the fear of rejection on some level, obviously we [00:11:00] know is always there. People, as you say, don't like to feel rejected. But the way we deal with anxiety, I-- Before we had no choice.

Before technology, you either met people in person or you didn't meet them at all.

Rosy: you think is 

Alex: we know from the psychological literature that the best way to counteract anxiety, like you'll know this because of your cognitive behavioral work, is to slowly do the things that make you anxious and that makes you less anxious.

Uh, and the number one thing you can do to increase your anxiety is to let that anxiety inform your behavior and decision-making. So if you're interested in someone and you feel anxious about talking to them, the best thing you can do is to talk to them. The worst thing you can do is to retreat, to discuss it online with other people, and to form this, like, rumination and this narrative about perhaps why you could never date that person.

That will cause your anxiety. It'll th- make you feel safer in the moment because you, you're not having to [00:12:00] deal with the anxiety there and then. But in the long term, it unconsciously feeds your anxiety and makes it much, much larger. So I think the fear of rejection is always there, and this retreat into the online world just heightens it and heightens it.

Rosy: like- Yeah. And the thing is, is that we're not, um, in through this, we're not testing out any of these hypotheses. We're making assumptions, "This person would never be attracted to me," or, "I didn't get this role in life because I'm not s- as attractive as this other person." But we're not testing any of them out.

And, you know, that is the core of, as you say, cognitive behavioral therapy, is this idea of we have to-- how do we learn that things are different to our perceived impression of it or our assumption or hypothesis? How do we learn if we don't try, if we don't test it out? And I suppose this is the, the danger with this, the rumination and the, the, the, um, closing off of the conversation in an echo chamber that encourages it and amplifies [00:13:00] it more and more, is a sense of, well, don't put yourself in a position where you're potentially gonna learn that that person, it's not that they don't find you attractive, it's that they aren't homosexual or are they, you know, are not interested in a relationship or whatever it might be.

You're not gonna learn that. Instead, what you should do, and I'm not saying everyone says this, but for the purposes of, you know, is smash your face with a hammer a little bit, and that'll probably change things. Like that, the connection between the two is wild, um, and in no way really solves that underlying query that they have around what is attractiveness?

Am I attractive? And how am I gonna meet someone to be with in the future? 

Alex: Yeah, and, and to be honest, what I've also seen in my younger male coaching clients where we work on problems like this, like socializing and dating and forming relationships,

is, uh, a lot of young men feel it's just unacceptable now, or they're [00:14:00] worried at least that it's totally unacceptable to talk to someone that you're romantically interested in.

And it feels like we've thrown the baby out with the bathwater on-- a little bit on this. Like, yes, of course, the extremes of male behavior as a man, if you're disrespecting women, if you're acting misogynistically, if you're just prioritizing your own needs over a woman's needs, that's a terrible thing.

But

It would be a mistake to d- to totally throw out the idea of men approaching women in general, because men have been the romantic protagonists for forever culturally. You know, it is men who tend to approach women. And so the weird thing about looksmaxing is it's almost like a reversal of this dynamic,

Rosy: Um, 

Alex: impression I get from my research is there's this almost unconscious fantasy that if I can looksmax, and, you know, I've [00:15:00] been looksmaxing for about five years now. Just jo- just kidding. But if you can, if you can looksmax, women will approach you

uh, the-- and your dating life will be solved that way Um, and that removes the, the burden or the onus to have to do any of the hard work, to have to deal with rejection, to have to take that social risk. That's the 

impression I 

Rosy: emotion thing- Yeah, agreed. And I couldn't say if that's true or not, but I c- I, I struggle to imagine that it is. And so then the basis on which you're doing all of these things feels flawed because I think, as you've already said, historically, I think people recognize men as the romantic protagonist.

Um, I think that the underlying anxiety that you're speaking of, that men are saying, "Well, we're worried about approaching, um, women in a romantic way," speaks to a wider anxiety that we have around what it is to interact with people we don't know socially, um, what is and isn't acceptable. I think [00:16:00] we've, we've somehow lost, um, those, those common rules that we used to just take for granted that you would just-- Uh, people just used to ask if you wanted a drink at the bar.

I mean, it really was that simple, I think. It was-- I mean, I was younger, but, um, but it feels now that there's, there's a lot more nuance and rules that m- understandably make people very anxious because you don't want to get it wrong. And I suppose it goes back to that idea of, well, what's so bad about getting it wrong?

What, um, and what are we not learning by not trying? Um, but also, yes, I think this idea that we can somehow, um, remove ourselves from the responsibility to, uh, t-to be the leader here, and actually, if I'm just incredibly good-looking or optimized, I ascend. That's a word that they use. And, and therefore, through that, things are easier, not just romantically, although that app- that is [00:17:00] really at the crux of this.

But it is linked, I believe, with some other views around sort of social status and, um, the halo effect a little bit, I think. But, but the romantic relationship part is, is the crux of it. 

Alex: Something I'd like to ask you, Rosie, is-- 'cause s- some women, uh, seem to be aware of this and some aren't. So for any women out there who don't know,

men generally speaking,

like 95% of men, find the prospect of, uh, approaching a woman romantically, even in a totally respectful way, truly terrifying. And there will be men who might have served in the military, who might be pilots, who might be firemen, who might have very dangerous, risky jobs, and they can do that, but they, they might find the prospect of talking to a woman very, very difficult.

Is that something you're aware of? 'Cause I think a lot of women, um, because they might be, uh, o- occasionally approached by the 5% of guys who just don't have an [00:18:00] issue with it, get the impression that men find it easy. Is this something that you're aware of?

Rosy: No. Genuinely, no. Um, it wouldn't-- it would not have occurred to me, um, in sort of, I suppose, personal life that it would be something that consumed a man, um, outside of the 5%, as you say. Um, I think that professionally it wouldn't surprise me to hear that, but then I, I'm obviously spending a lot of time with people who are very anxious and/or, you know, depressed.

Uh, but I am surprised that it's as, as, uh, significant as you say it is.

Alex: Yeah, and there's powerful, you know, evolutionary reasons for this. Like the

potential danger of approaching a woman you don't know in hunter-gatherer times was very high, because if you didn't know them, that meant they belonged to an, a different tribe than you, which means you didn't know who that woman was [00:19:00] associated with.

You didn't know of what men that woman might be associated with, and therefore the danger of competing with that man, the danger of getting into a fight or an altercation. Uh, but also the, you know, the rejection from a woman has these powerful evolutionary implications. Obviously not really, not now, not in the age of modernity and contraception and things like that.

But in hunter-gatherer times, it's effectively a statement about your viability as a man.

So there are reasons why, obviously, this is a fear that we still have to contend with, but that's the problem with this online culture. Being able to retreat online means you don't have to go through this, in my opinion, very important almost rite of passage of learning how to, uh, assert yourself romantically with women in a way that is also respectful, in a way that is also kind and thoughtful, the, the wonderful balance that we need to strike.

And men [00:20:00] are almost being deprived of this crucial rite of

passage, I

think. 

Rosy: Yeah, absolutely. And while understanding that there are, um, evolutionary background to why we may or may not be justified in feeling this way, we also have to unpin that, um, wider sort of idea about my viability as a potential mate with the reality of the culture and the time in which we live. Like, yes, of course it-- your brain may well say, "Oh, what does this mean about me more broadly as a person?"

But that's where the experience, the maturity comes in that says, "It says nothing about me as a person and my future. It's this person just isn't interested in me just now," And that's okay. 

Yeah. Right. 

Alex: Yeah, it's totally okay. It's something I learned with, you know, making a podcast, putting stuff online. What you'll notice is some people will like what you put out, some people won't. Most people will actually be indifferent, [00:21:00] but that's totally okay because- Success in life isn't based on never failing or never getting rejected.

It's on trying enough so that you can find enough of the people that vibe with you or who like you, who will like your podcast or your content, or who would go on a date, um, with you so you can make a-- you can have a viable life. You know? It's not about having a 10 on 10 success rate, and that, that's the-- I almost feel sad about young men in this predicament because again, they're being deprived of this very 

important 

Rosy: Yeah. And I wonder at which point it, it becomes okay to then approach somebody. Y- wh- when-- how optimized do you need to be to be able to then face that rejection? Um, and I fear that that goalpost will, will perpetually be moving. You know, um, uh, oh, well, the reason why, um, they rejected me was because, to use an example, my, my hunter eyes were not optimized or, you know, m- the, the, the, um, amount of [00:22:00] inches between my clavicles was a problem.

Y- they-- and so I, I need to 

Alex: are 

these things-- These are things 

you've

actually 

Rosy: Yeah. This is what comes up in the conversation. And so, uh, y- again, this point of, uh, I have to fix this thing before I'm acceptable, l- we lose that opportunity of thinking about, well, actually, perhaps that it's nothing to do with that. It's, it's, it could be all these other things, some of which are related to me, some of which may not be.

Um, I, for, for example, we absolutely cannot know what another person is thinking unless we ask them.

Alex: Yeah. , So we watched a Channel 4 documentary about looksmaxxing, which I would recommend. So that is called "The Toxic World of Perfect Looks Untold with Ben Zand," and that's on YouTube, and I'll put a, a link to that in the description. What did you think of the documentary, 

Rosie?

Rosy: Um, was [00:23:00] astounded by the-- Yeah, didn't know anything 

about it. 

Um, I had no idea that people would be taking medications like Furosemide, um, which actually, since continuing my journey of research, I've realized is, is one of many medications, um, that, um, people are, are thinking about taking with seemingly some understanding of the consequences and side effects.

But, but perhaps not completely because there is a pseudoscience that is very associated with this field in which people share a lot of information back and forward about, "Oh, well, you can balance this side effect with that," et cetera, et cetera. But these are not medical people. Um, there is no monitoring in the same way.

So it starts off with a young man talking about that, but it, it actually journeys through to showing, um, uh, somebody who hides their face, I believe, but has undergone, um, leg lengthening surgery. [00:24:00] Um, and so I think, you know, a-a-and there's lots of other bits that stand out in it, but the, the, the pain and disfigurement that this person must be going through to... 

Alex: surgery. 

Rosy: To attain what I understood was a relatively minor adjustment in their height based on this belief that it would change their life meaningfully was astounding and sad, actually. 

Alex: Yeah. and you mentioned the drug furosemide. So for those who don't know, that's a diuretic. That's the kind of drug prescribed for things like heart failure and other related things. And was the idea that-- So, so furosemide will, uh, cause fluid to leave your body, and was the idea that their, their face would look better because there's less fluid in it to get like, I guess, like a Timothée Chalamet-type look?

Is that the 

idea? 

Rosy: believe it was to do with cheekbones, [00:25:00] showing y-your cheekbones because you were carrying less fluid. Um, and the young man who's talking about it, you can really see, I think, in that documentary that this has taken a hold in his life in a way that is far beyond the expectation of, "I want to optimize my appearance," and has gone into a realm of really quite dangerous practice that I think even he feels a bit unsure about.

Um- 

Alex: I guess the crucial thing for, for non,

uh, healthcare people to understand is that it's not just a

practice.

It is a practice that is based on a set of beliefs, and at the extreme end, a whole underlying philosophy about the way the world works, some of which we've kind of described already. But if I can make it concrete,

at the extreme end of something like looksmaxxing, you get this belief system that Basically, men, well all people exist in a [00:26:00] hierarchy of social value, social, sexual, and romantic value that is based in large part on your looks, and it's almost like a caste system.

And in keeping with, you know, one of the things that underlies a lot of psychological difficulties is a sense of rigidity, and in keeping with that, it's very, very rigid.

A man might come to the conclusion that they're a six on 10 in terms of, let's say, sexual value, and they feel like they're rigidly at that point.

And not only that, but that is influenced primarily by their looks, nothing to do with personality, character, ability to assert yourself, ability to take risks. And then it all becomes about what intervention can I do

to improve my sexual value? At the even more extreme end, you have, I guess, incel culture or what's called black pill or what's called doom pill, which is the sense that 

I actually have no hope.

There's nothing I can do. So incel, for people who don't know, stands for [00:27:00] involuntary celibate. Uh, and so people who identify as incels feel

Rosy: they're, they're 

Alex: they're stuck at a low level of sexual value, and there's absolutely nothing that they can do to break out of it. This obviously then tends to breed a lot of low self-esteem, depression, suicidal ideation in extreme cases, and then also worryingly a kind of resentment towards who they perceive to be more attractive men and a resentment towards women, which can also be a problem.

So it's like you start off with the behaviors. You see someone taking a drug that they shouldn't take

or doing something like bone smashing, which is, for people who don't know, taking a hammer to your face in the belief that it will somehow, uh, reshape your facial structure to become more masculine. No evidence for that, by the way, as far as I can tell, so definitely don't do that.

Starts off-- You start off learning about these interventions, but then when you actually listen to the people involved, there's this whole underlying philosophy and all this, this whole belief system attached. [00:28:00] Very 

important to understand 

that, I 

Rosy: Agreed and I think that you've hit on a point about the community that is built around this. So one is that these rankings, um, that may well start as, uh, your own personal sense of your attractiveness, but is reinforced, my understanding, by engagement with the community in which people will rank you back.

People will give you ratings, and those ratings can be adjusted based on recommendations you may well receive from them in these forums. So there is a kind of perpetuation of this idea of you-- have you tried this? Have you tried that? If you try these things, that will-- you will move up your ranking based by, uh, as an objective observer, somebody you don't know in this forum.

And that also brings you in, A, to a, a sort of a mindset around compulse-- compulsion to check and to-- for reassurance-seeking, and all of these worrying behaviors that we can start to see as we move towards the more obsessive [00:29:00] end of the spectrum. But also worryingly too, the community in and of itself fulfills something in terms of that, again, social isolation and the increasing loneliness that we're seeing in, particularly in young men, um, that people are feeling that it's giving them a sense perhaps of you're not on your own here.

Here's, here's a blueprint for what you can do to fix this, which is dangerous because actually the recommendations are, in and of themselves are-- can be very dangerous. Um, and then yes, at a very, very extreme end, the, the, the, um, the sort of the nihilistic views that can go with incel culture, which I know some of the looksmaxxers are very keen to dissociate themselves from, but I believe the term itself actually originated in that space.

Alex: And again, I do see, I do see the incel thing primarily as a way-- It's really occupying a victim role. I talked about this on another, another podcast recently. I think it was the podcast I did about "Taxi Driver." [00:30:00] So

Robert De Niro is kind of someone in "Taxi Driver" who would have been an incel if the movie was made in 2026 instead of 1976.

Actually, Robert De Niro in that movie actually tries to go on a date with someone. It doesn't go well, but he's giving it his best shot, which is good.

Um, And it is the-- I, again, I-- Similar to looksmaxing, but perhaps to an even higher degree, it's a way of avoiding responsibility. So rather than take responsibility for, for the fact that I am a man, I have sexual and romantic needs, and I wanna do the things I have to do, uh, to meet them, and that might involve facing rejection, et cetera, I'm going to declare that I am involuntarily ce- involuntarily celibate, that there's nothing I can do.

And of course, by doing that, you're totally externalizing responsibility from yourself and onto the world. To be clear, um, there's a lot of hate that gets directed at incels, and my dominant feeling actually is a lot of... I think we should have [00:31:00] largely sympathy and compassion because

Rosy: in the beginning 

Alex: the-- again, these are people who grew up in an online world,

and, uh, a lot of the, the, the people we're talking about, they're, they were kind of guinea pigs for smartphones, the internet, and technology.

We di- we kind of unleashed this technology on a generation of people without having Uh, any understanding of how it would affect people psychologically. We didn't really put any safeguards in terms of making sure people are meeting up socially. You know, a lot of people feel very isolated. So it's easy to judge from the outside if you don't have this problem, but you would be surprised what it's like

Don't think you're so different from them is what I'm saying. Like, your 

circumstances 

can change 

Rosy: psychology 

very well. I think that's 

so important. And I think that is why it's so important that we have these conversations as professionals and as people who actually we, we deal in compassion and we deal-- our, our profession is about that understanding. And if [00:32:00] you are not prepared for there to be complexity and nuance in human behavior and, you know, trends, et cetera, then, then you're missing the point.

Um, there-- we have to be prepared to understand that there, there will be an element whereby we, we don't understand and we have to be curious. Um, and as, as we said before in the " Manosphere" podcast, that there's certain things that we can absolutely say this is wrong. Um, but we m- but we m- we, we maintain a sense of curiosity because through learning and understanding, that's hopefully how we help people.

Because ultimately there's a sense that while grooming and self-care in and of themselves is unlikely to cross our professional s- sphere in, in that way, what we're talking about is the possibility that people can become really very unwell, um, through engaging with these ideas. And, and it's only through our professional curiosity, um, and, and as you say, our compassion, that we are going to be able to help people, [00:33:00] um, and, and offer anything by way of a counter, a counterargument.

Alex: We can get psychiatric here for a second. So I guess the two psychiatric conditions which seem to lend themself, lend themselves most to looksmaxing as far as I can tell are OCD, obsessive compulsive disorder, and BDD, body dysmorphic disorder. For people who don't know, so these, these,

Rosy: these conditions 

Alex: conditions have very specific cycles.

So with OCD, what happens is people get intrusive thoughts which they may not necessarily identify with. That's called ego dystonic. They might be ego dystonic thoughts, um, that create a lot of anxiety, so that's the obsessional part, and then they have to do compulsions to ameliorate that. That's the compulsive part.

So in terms of looksmaxing, you can imagine a young man getting a lot of intrusive thoughts that, uh, they're ugly and not good-looking in a kind of global way, that there are problems with their appearance. Uh, they may get these thoughts all the time, [00:34:00] and that causes compulsions which could be

checking, checking their appearance in the mirror, doing their online rating and comparing themselves to other people Uh, becoming obsessed with looksmaxing influencers and how, how they look and trying to move their appearance more towards them.

And then again, on the extreme end, um, these more serious risk-taking behaviors like taking medications and things like that. Then we've got body dysmorphic disorder, very close to, um, OCD. Body dysmorphic disorder, the main difference is it tends to be focused very much on a body part with a very, again, rigid, fixed belief that one particular body part is importantly wrong in some way.

So it'll be something like my eyes are too far apart, or my ears are too large, or my nose is too small, and all of the anxiety becomes fixed on that, and solving that problem feels to that person, is perceived by that person [00:35:00] to be the solution to their problems. So these are the kinds of things as psychiatrists we're gonna be looking on, on the lookout for, um, when we're thinking about looksmaxing, and that's something, you know, if you know someone who, who might be falling into this trap, these are the kinds of patterns you want to be on the

lookout 

Rosy: Yeah, Yeah, absolutely. And I think that we historically have not always been particularly good at, um, picking up these difficulties. Um, I think there is a general sense that they are underdiagnosed. Um, and I think while we don't actually know the prevalence of looksmaxing itself, um, we, we actually genuinely don't know how common a lot of this is.

I think there's a, there's a sense that its influence is likely to push people who may already have a, a predisposition in terms of an anxious mindset or even an obsessive compulsive, um, disorder, may, may push them in that direction and/or those with a body dysmorphic disorder, could be attracted to that space.

[00:36:00] And, and likewise the other way around, that a, a, a body dysmorphic mindset could, could evolve from this, sort of perpetual conversation around, um, focusing on areas of your body to optimize or to improve in some way.

Alex: And something I want to mention both about OCD and BDD is for, for both, you would expect a certain level of impairment. And again, what that's gonna look like, w- what would be typical for OCD to be spending hours and hours checking, hours and hours doing things to reduce those intrusive thoughts.

Typically for BDD, it's going to be spending time by yourself, not only withdrawing romantically, but even withdrawing socially from friends and family because you feel , the issue with your appearance is too d- bad for, for you to be looked at by anyone.

Camouflaging, wearing caps or wearing masks, things like that. Again, checking online. So it really does get quite extreme when we're

thinking about 

these specific 

Rosy: Yeah, and that's usually the context in which people are, [00:37:00] are, coming to us. So normally at the point at which the impact is so significant, their distress is so significant that somebody can no longer continue because perhaps they might not be able to leave the house until they've taken a number of selfies in which they've reassured 

Alex: Yeah, exactly. Yeah. 

Rosy: are, you know, not asymmetrical.

Um, but, but just with an awareness, as we've been saying before about sort of spectrums, if we're talking about from a general public perspective, um, it may well be that there are indicators well before somebody reaches that sort of level, um, in terms of their distress and their level of functioning. Uh, but from a psychiatric perspective, certainly yes, to make a diagnosis and to be starting to think about treatment and intervention, it usually is that somebody is-- ha-has already had quite a significant impact on their life and a level of distress in which they can no longer function as they'd like.

Alex: Yeah, I think it's a good point. I think similar to what we mentioned at the beginning, it's unlikely you're gonna go from zero to having a condition. It's probably gonna be a gradual process where this happens. And it's important to understand that [00:38:00] these are all ultimately coping strategies. These are ways of coping with difficulties.

Like a lot of psychiatric conditions are like this, but eventually the coping strategy becomes the problem. Um, so like a little bit of checking, a little bit of obsessionality might actually be useful to help you, but then it just come- becomes out of control. It becomes like a monster, and it starts to dominate your life.

And a lot of, uh, psychotherapeutic intervention is to help you realize, "Okay, this coping strategy actually has become a problem in and of itself, and I need a much better coping strategy." Um, getting back to, to dating itself, because obviously, again, dating is the, the elephant in the room in the background for all this.

What, what do you think is like a sane attitude a young man should have about their appearance in the context of other things that could make them attractive to, to women? Like, like what are the other things

men should be thinking 

about? 

Rosy: So I, I, I genuinely think that, that [00:39:00] most young women are really appreciative of, uh, young men who are interested in them, respectful of them. I would say can make them laugh, but I know that a sense of humor isn't, you know, sort of always universal. I think genuinely a, a, an, an interest in forming a connection with somebody else, um, that i- that is based on a real interest in, in them as a person and perhaps not on the just trying to get them into bed, um, is, is, is- obvious to somebody.

If you are being, in a respectful way, trying to spend time with somebody, learn about them, and, uh, s- align your interests in some way and find those connections, I think that speaks volumes, and I think people really respect it. Genuineness comes across, and I think that in any way, trying to deceive somebody, um, by, uh, perhaps, uh, putting on a front, pretending to be something that you're [00:40:00] not, um, or I, I-- even if that is in an attempt to overcome your own insecurity, I, I do think it is relatively easy to see through.

Um, I, I think it is a mistake to think that, um, all people perceive attractiveness as the prerequisite for dating. I, I do not think that that is true. I do, however, think that there is a certain amount of, um, confidence that can come with, um, people looking at perhaps, um, say for instance, if they're having real problems with their skin, would that be something that some treatment might be helpful for?

If they're having real difficulties with their weight, would some exercise or some, um, a, a change in diet be helpful? But I think that this is more linked truly with a sense of your own self-esteem, your own self-worth, and your confidence to then build that genuine connection with somebody else, rather than a sense that I have to be attractive in order to [00:41:00] be interesting or inter- of interest to somebody else.

I, I, I really don't think that's the case. Um, but I, but I do think that the insecurity that can underline that mindset can in and of itself be a barrier. Yeah. 

Alex: I think that is worth mentioning. So the, the low end of looksmaxing actually can be nice to improve confidence and a sense of agency. Like, you know, if you're really out of shape, you go on a diet, lose some weight, do some exercise, you know, that can actually give you a sense of, you know, I can have a little bit more control over my appearance, and that can make me feel more confident.

But it's really important to do the other things as well, to be able to show generosity, curiosity about people, interest in them as a person, respectfulness, and all of those things that you mentioned are really social skills. They're not inherent characteristics. They're things you can really only learn how to do by talking to people.

Um, and importantly, they're not static. Like, you might be terrible at this today, you might be [00:42:00] amazing at this in two years, depending on the behaviors you choose or don't choose. So it's a-- that's a, it's a vastly different picture you're portraying than the one I think that a lot 

of people who are into 

looksmaxing 

tend to believe. 

Rosy: legacy potentially- Yeah, 

absolutely. Um, and it's gonna change and look different at different ages of your life. Of course it is. And, and that's okay too. Uh, I, I, I genuinely think that some of those, um, really core, um, values and traits of, of, of kindness and connection and, um, I guess sort of curi- human curiosity, it, it, it's not something you can teach.

You have to learn that, and you learn it, as you say, through, through speaking with other people, perhaps watching other people and learning, um, that, that this is something that I have that is in- inherent in my personality, like a sense of humor, perhaps if you're very funny. And, and you realize that actually the-- 

this works and do more of it.

Alex: The other thing learning more about [00:43:00] looksmaxing made me think about is, you know, we're talking about looksmaxing now on this podcast because it's so unusual in men, and it's this new thing that sprung up in recent years. But it made me think of what a hard time young women, uh, young women have had forever.

You know, these anxieties that, if I don't look a certain way, I'm going to be unattractive and not a viable romantic or sexual partner, which just like men, there's like a grain of truth in it, but also there's a lot about it that's false, and women just seem to be especially vulnerable to this.

We're talking about it because it's affecting men now, but women have had these anxieties and things like body dysmorphic disorder, of course, eating disorders are lurking behind here as well, for a long time. And what an affliction it is to have to, to, to labor with this and the sense that, you know, my value as a person or as a partner is down to these immutable characteristics that I either can't change at all 

or 

that I, I find it 

very

difficult to change or [00:44:00] can be changed very 

gradually.

Rosy: Yeah. I think-- I'm, I'm glad you brought it up, and I think it's an important part of the conversation, is when you read about what soft maxing is, there's nothing on there that I think a woman would look at and think, "Oh, that's surprising."

The idea that you would 

Alex: It's just morning routine 

Rosy: Yeah, 100%. I think for a lot of women that, and especially as teenage girls and you're growing up and you're learning about, again, how the world interacts with you, how men interact with you, I, I don't think that any of these things are unusual for women. And you're right, like this is something-- I- interestingly, there was a Times article, I think actually just yesterday, saying how looks maxing is moving into, you know, the female world or whatever.

But, um, I didn't read it purely because I'm really not completely sure that there's a, a newness to that. Um- 

Alex: It's been in the female 

world

forever. 

Rosy: I haven't read it, so I'm someone who can read it and tell us what it's about. But, but I-- but again, it, it is commonplace for women to talk about things like Botox, uh, boob [00:45:00] jobs. Like it's, it's n- it's not unusual.

And so, um, I-- it made me reflect a little bit on, gosh, how much have we normalized this in, as women? Um, um, that's not a blame thing. I mean, as a s- as a society, um, that we are s- we are pointing out how unusual it is for men because it's just not for us. But likewise, like you say, yeah, absolutely. What-- I mean, when you reflect on it, what a pressure to, to be under as women, um, uh, and, you know, moving through such a, such important periods of your life, adolescence and young adulthood, um, and being put, um, having your looks being put as something that you, uh, that, that is fixable and you, that you ought to fix it.

Um, and I was actually reading a, a book just recently. It was linked with the work we were doing around the manosphere stuff, and it was talking about, a lot about the commodification of, um, girls. Um, and it was actually mostly about Gen Z. And there is so much I did not know about, um, the online world that, [00:46:00] uh, as a millennial, I, I genuinely have missed it with things to do with, um, Snapchat filters and the, that drive around, um, face tuning, et cetera.

That is absolutely, from what I can understand, relatively commonplace for young women, to be, altering and filtering their appearance regularly. to the extent I did actually see there was a news article there was a police-- I don't know how true this is, but there was a police search where they struggled to find an accurate picture of this woman because all her social media pictures were so filtered that they couldn't find a picture that actually properly looked like her.

This is a terrifying extent to which we are, um, altering our appearance, um, in, in an online, a predominantly online sort of space. Um, but certainly something that has been going on a long time.

Alex: And it's this prioritization again of image over reality. Image has to supersede reality, which is [00:47:00] part of what Ian McGilchrist calls the simulacrum. We're living in this simulated form of reality where the impression that we can create for other people, the perception we can create for other people matters more than the truth.

And the more you worship the perce- the, the perception, you know, I guess in like biblical terms, like worshiping false idols kind of thing, the more you be- you find

your true self unacceptable, and then that means you have to retreat more into the online, more into the imagistic, 

and it's just a cycle that continues u- until it gets totally 

out of 

control.

Rosy: and what a terrifying prospect. And again, as you said, it is something that to a certain extent our generation and the, the certainly older generations, w- we have been slightly protected from. Not completely, and there are certainly older people who are, are still immersed in this world. But, um, it is not the, it's not the whole way we grew up.

Um, [00:48:00] and understanding that is important.

Alex: Your husband works in a school, secondary school and sixth form for boys. Is that right? Mixed 

for secondary school 

and sixth 

form. Has he observed

this in the 

school? 

Rosy: So I asked him because, um, for the purposes of doing this, and he said he did ask around. He said the general sense was that most of the kids did not really have much of an awareness of what it was. But there was a, a sort of some younger staff members who, who had heard of it and knew a bit about mainly about bone smashing.

But it didn't, it didn't come up as a, "Oh, yes, this is something we're all very, very aware of." Um, which I think is both reassuring and interesting in and of itself because we do see this happen. 

Alex: so, so, so He asked the staff rather 

than the students?

Rosy: He asked the 

students?

as well, and they're both boys and girls. Um, so he, he, he asked, he asked a, a, a [00:49:00] group, but the one that's-- the one that identified they'd heard about it was a, was a young staff member.

Alex: One thing I wondered is what is now the responsibility of people like cosmetic surgeons, plastic surgeons when dealing with this? Is this-- I wonder if this phenomenon is causing an increase in referrals for things like elective plastic surgery, and what responsibility they have, and to what extent is this regulated in the UK and other countries?

To what extent do patients need to undergo a psychological assessment, for example, if they're asking for a aspect of their facial appearance to be changed in the absence of an objective deformity? Is 

this something 

that's being

thought 

about? I don't know 

the 

answer to

Rosy: Is this something that if this responsibility if this focus moves like the medical association, um, have responsibility if they would also say let's regulate and then compare and contrast what they've said to patients later through a psychological assessment route. If they're [00:50:00] also, uh, expecting their patient experience to change now since the Trump effect has ended, or is this something that's been going on for a long time and they're just- I don't know either.

I think our intuition would say that probably that demand, um, has increased, and I think we see that just by the predominance, predominance of sort of, um, aesthetics practices just on the high street. And so I suppose at the softer end of the spectrum, the idea of Botox and fillers becoming something that just so commonplace that you can go and get it at your dentist or at your beautician.

I do think there is a bit-- There-- I, in fact, I, I'm pretty sure there's a move much more towards regulation, and I believe that there are recommendations around screening. But again, until there's proper regulation in place, I don't think you're going to be able to enforce the screening. And it-- I suppose also it's what you do with that information, because if, if you, if you really feel that somebody's in a lot of distress because of this, um, perceived flaw, but you're not qualified to understand the background around body dysmorphic disorder, it-- are you thinking in your mind, "Well, I can fix that and I'll take your distress away"?

That would be, uh, I'm probably being a bit kind here, but the-there is a possibility that that might be the way that people perceive it. I have to say, though, that I have very [00:51:00] little understanding of why somebody w-would be practicing something like the leg lengthening that we saw in that documentary.

Um, that for me feels so uncomfortable. Yeah. 

Um, and I can understand that there would be grounds in which, I guess, from a pediatric perspective, um, if something has, has happened at birth or there are-- I can understand, um, when, when there is a real need, um, I guess anatomically. But, but, but that feels so uncomfortable as a doctor.

Alex: And it's telling that the individual went to another countries.

Um, was it 

Romania? 

Was that the country they went

Rosy: I can't remember, but again, we see that a lot with these practices. I mean, BBL, uh, is the Brazilian butt lift practice that is, y- I think the most dangerous, um, uh, cosmetic procedure you can have. And, uh, 

Alex: did not know that. And what, what makes it 

dangerous?

Rosy: I think because it's just so, um, in-invasive, um, and it's moving f- it's moving fat from, you know, from a, a [00:52:00] compartment where it should be, arguably, to where it shouldn't be, and, um, the body can't, can't tolerate it.

But, but also because so unregulated. So awful cases of people having, um, other substances such as, I have read, cement, um, injected into them. And again, this is about regulation and where these practices are happening, because understandably they're very expensive procedures and so therefore people are finding ways overseas by which to be able to afford them, and then therefore the regulations are changed or, or non-existent.

Um, which I don't know what the answer is to that. Um, but certainly it does feel like us being mindful and understanding about the process by which someone seeks that sort of a procedure is, is at least a start.

Alex: We've, we've been doing a fair amount of, I 

guess, millennial doom-mongering and pearl-clutching. What if someone was concerned about their [00:53:00] son or their daughter or their brother or their sister who they felt, wow, they're getting really preoccupied with their looks in a way that's a little bit unhealthy.

W- how do you think-- what kind of advice can we give that person in terms of how to approach 

the, the, their loved 

one? 

Rosy: I think it's, I think understanding that there is an opportunity to ask the question about what is, what are you spending your time doing online and, and why, and how is that making you feel You know, does it make you feel better or worse when you're spending all of this time online? What sort of conversations are you having?

How do you feel in between those conversations? Um, do you have a life outside of this online world, and what does that look like? Um, and how, how can we better balance your time? I think all of these things are just an important starting point is, I guess, the curiosity around what, what is happening for you there.

And I think maybe just bringing it into the daylight of, [00:54:00] okay, so you're having these conversations with people, and they're talking about the way that you look. How's that making you feel? Do-- does it feel like a positive thing or is it making you really worried about it? And understanding that if people are starting to ruminate and worry, you are-- they hopefully be able to talk to you.

Perhaps you have to lead the conversation, but about your sleep, your level of preoccupation when you're in a different environment, like when you're at school, are you able to focus? Um, are you finding that your mind is constantly being drawn back to checking? And do you seek-- are you, are, are you feeling better when you check, et cetera?

How much are you checking? I think feeling confident to be able to just ask those questions and, and, and then have a thought about where you might get help if, if needs be. Um, because it's all very well and good asking all of these questions and then thinking: Well, now what? You know, what, what, what do I do?

Um, and I suspect, as ever, the answer's going to be talking [00:55:00] to a healthcare professional, probably a GP as an entry point, um, and being very clear about what the concerns are. Um, and certainly, obviously a psychiatrist, we're, we're here too, although, um, it's often a d- uh, goes via a GP referral. Um, and there are on- lots of onlines.

I mean, the BDD Foundation website has a lot of information, um, online too. Um, but I think it's the starting point is really that curiosity around, um, what, what, what is happening? How are you spending your time? Who are you talking to, and how is it making you feel? Um, is, is, is, is at least a start.

Alex: Yeah, I think that, that's a great start, and I- I'm building on that. I would probably advise that person that with regards to their loved one, talking to them about the idea that dealing with the fear of rejection is perhaps one of the most powerful things you can do in your whole life.

It's like if there's two things I would

want my child to be aware of, it's like how to delay gratification into [00:56:00] the future in a healthy, sustainable way and how to deal with rejection. It's like a superpower, and that doesn't just mean romantic rejection. It just means putting yourself out there in any number of ways, making friends, romantic, starting a new business, public speaking, and dealing with the fact that some people may not like you, and that, that's totally okay.

And actually, the more you do that within reason, the stronger you become, as long as you don't overwhelm yourself and flood yourself and do too much too soon. It actually makes you a much more resilient person. And again, for a guy or a gal, one of the most useful things you can do is to get over that young, because then that gives you the whole rest of your life to be, to not be encumbered by fear.

Because so many people live their life totally encumbered by fear, and there are things they really want to do, whether it's get into a relationship or learn salsa dancing or just learn a new skill. And the only reason they're not doing it 

is because they're [00:57:00] afraid of what other people will think, which is, 

in 

my view, like a real, real tragedy. 

Rosy: Yeah. Yeah. Agreed. And I, and I, I wonder that in a, in a, parent-child relationship, that might involve a bit of uncomfortable role modeling in which you as the parent have to go and, go and do the thing you're afraid to do. Um, and again, I think understanding that a lot of that learning actually comes from young people seeing other people overcome their fear to go and do the thing.

Um, you, you're going to learn that by witnessing 

Alex: Yeah. 

Rosy: practicing it yourself.

Alex: And you don't know what you're missing out on if you spend your life online. You, you don't know the vividness of what it means to live a real life, the ups and downs, the adventure of life, the positive emotions, but also the negative emotions can... It's all part of the richness, uh, of living a real life.

And if you spend all the time, all of your time online, you just don't know what you're missing out on, actually. You think you know because people tell you what life is like. You know, influencers will tell you this is what life is [00:58:00] like, and you may believe it, but you don't know until you

actually engage 

with 

life first 

person yourself.

Rosy: And, and not just what are you 

not learning about life by not being out there and living it, but what are you not learning about yourself and who you are, and your resilience or capacity 

Alex: And what makes you 

attractive, 

Rosy: what makes you attractive,

Totally. I- you

if 

Alex: which is so much more 

than your 

Rosy: yeah, exactly. And if, if, if you're not testing any of this stuff out in the real world, and like you say, just learning from other people telling you, then you are-- you have lost the opportunity to learn all of these things that make up that rich fabric of who we are as a, as a human species and, and, and, and the world in which we live in.

You know, it's a fascinating and exciting place, but it's not always easy. But that's okay because we cope, and you've gotta get out there and find out though, right?

Alex: I think that's a, that's a good point to end on. I think we're sufficiently looks maxxed. Rosie, thanks so much for coming on. I look forward to speaking to you again as we [00:59:00] continue

to 

freak out about modern cultural happenings.

Rosy: Yeah. Sounds good, Alex. Thanks.