The Weight of Life
The ADDRESSING framework domain I chose to discuss is physical/mental health disability. I have an extensive history of physical and mental health issues which place me in a unique position to consider how my individual trajectory might impact my career. Although not commonly referred to as a “disability”, childhood obesity is a debilitating health problem with numerous developmental and interpersonal implications. My ongoing struggle with the rippling effects of excess weight since early development have been ever-present in my experience of selfhood. This disruption in a cohesive self-concept will undeniably affect my practice as a therapist both consciously and unconsciously.
Growing up obese affects everything from your bone development to your complexes and self-esteem. In The Owl Was a Baker’s Daughter, Marion Woodman discusses the debilitating lifelong physical and psychological impacts of childhood obesity as distinct from the experience of obesity acquired later in life (Woodman, 1980). I was in the 99th percentile of weight from 0-19 years old. When I lost 80 pounds in my sophomore year of college, I went through an identity transformation akin to a rebirth. That is, the entire male population finally recognized me as a human; I was suddenly respected in professional settings; I could fit into normal clothing; I could feel some semblance of pride and worth. As a female, learned early on that my value was inextricably tied up in how I looked, as evidenced by how people treated me. Such social rejection in my case was compounded by parental disapproval and attempts to ameliorate the problem, something largely out of my own control. Needless to say, the negative impacts of my childhood/adolescent obesity persisted long after the initial weight was shed.
On a physiological level, fat cells never go away, and so the possibility of regaining weight as a former fat person is high and often the scale fluctuates uncontrollably. Even still, the scoliosis and aching hip/shoulder issues of my past remain no matter how much lose. The battle feels so much more intense on a psychological level, though, as years of disordered eating, lack of assimilation with normal teenage rites of passage, self-loathing, body objectification/neglect and compulsive rituals to feel better are still haunting me to this day. Indeed, I gained back every pound of old weight when I was pregnant this past year and have not yet lost most of it. The shame of my adolescent past creeps up even now.
In the Cultural Complexities textbook, Hays describes “bias” as “a tendency to think, act, or feel in a particular way” (2016, p. 23). When I consider how my life has unfolded in the context of my future therapeutic career, I imagine a complex dance of self-awareness will be required. In some ways, I am equipped with an invaluable toolkit of personal experience regarding eating disorders, rejection, shame, guilt, body dysmorphia, social exclusion, and identity problems. This will be incredibly salient when relating to clients of all ages with parallel issues in this scope. However, I also need to be careful not to project my own experience onto others, as I see myself doing this in my current life already.
Even though my weight issues have been difficult, even detrimental to my development, I must be careful not to assume everyone with extra weight is plagued by it in the same way. Indeed, many people are happy with how they look and feel in their large bodies, and I must not project my own self-rejection and desire to change onto them. I also must be aware that all eating disorders manifest in varying physical symptoms and internal representations, and not assume my own eating disorders and body complexes are universal. I especially need to not assume that simply because someone possesses our culture’s “perfect” figure that they have suffered less than those who do not; all humans have struggles, and my brand of suffering is not more real because I personally faced such adversity.
Overall, as a cis white woman, my privilege is quite important to remember. I must commit to learning as much as I can about how my personal upbringing and implicit biases will contribute to and hinder my ability to relate to a vast range of people. The ADDRESSING framework is a useful tool to work through each of the paramount domains of identity to consider the most mindful and adaptive approach to other people. My own life is but one small point on an endless spectrum of human variations, strengths, and weaknesses. Being culturally competent for years to come will mean not accepting my first thoughts at face value and staying open to new information from each client I meet along the way.
References
Hays, P. (2016). Addressing cultural complexities in practice: Assessment, diagnosis, and therapy. (3rd ed.). American Psychological Association.
Woodman, M. (1980). The Owl Was a Baker’s Daughter: Obesity, Anorexia Nervosa, and the Repressed Feminine–A Psychological Study. Inner City Books.