Jenna White, MA LCPC is a licensed psychotherapist specializing in eating disorders, body image, and gender and sexuality diversity. She currently works with groups, couples and individuals and in the Loop and in Lincoln Square, Chicago. Jenna offered her wisdom with me to help others who might be struggling. To learn more about Jenna, or to sign up for her psychotherapy services, contact Depth Counseling today.
Q – What do you mean by “the truth about body shame?”
Jenna: First, let’s talk about the “truth.” How do we know something is true? For example, if every day you are told in multiple ways that you are “bad” or “worthless,” would you come to believe it?
This happens on the societal level all the time. We hear messages repeated over and over again, such as often-spurious assertions about gender roles (e.g., what it means to be “a man”), relationships (e.g., heteronormativity), race (e.g., light skin > dark skin), health (e.g., thin > fat), sex (e.g., monogamy > nonmonogamy) and physical attractiveness – and so we come to believe that those messages are “true.” They aren’t questioned, and we are rarely curious about them. We think “that’s the nature of the world” and don’t understand that it is actually a social construct.
Researchers call it the illusory-truth effect. Familiarity trumps truth – dare I even call it “fake news.” Marketers and politicians are very good at understanding this. Through my research, I have come to understand that the vast majority of what we consider to be scientifically-validated “Truth” about body size, health, obesity, and weight loss is the result of confirmation bias, stigma, pseudo-science, marketing, and fear.
Most of these messages come to us through advertisements from powerful interest groups (like the multi-billion dollar fitness, diet, insurance, farm, medical, and health industries) that profit off of our misery. We are barraged with around 3,000 ads each day that send complex messages about body size, food, race, and beauty, and we encode this information both consciously (about 8%) and subconsciously (about 92%). Many people believe that if it’s not conscious it can’t hurt you, but it’s actually the opposite. When it’s unconscious, it’s the most dangerous it can ever be because you’re responding to it – it’s influencing who you are and what you do – and you don’t even know it’s happening. You haven’t had the opportunity to consent.
The truth about weight-related Body Shame is that it is based on lies fed by our culture. Not all bodies can or are meant to be thin, diets don’t work and aren’t harmless, fat stigma makes things worse for everyone, obesity is more complicated than calories in and out, and our societal obsession with weight is having dangerous consequences for everyone, most especially our children.
Q – How does “body shame?” impact people?
Jenna: As if the daily tsunami of ads wasn’t enough, people often have their own early firsthand body-related traumas. You might have grown up with a long-dieting mother, or a father who thinks you’re pretty only when you’re thin, or a body-shaming doctor, or never having gym uniforms fit, etc. These messages, too, you gather up and braid together with the messages in the advertisements. Over time, they become organizing beliefs that govern your life, like: “I’m only lovable when I’m thin.” Or “Something is wrong with me.” Or “I’m too much.” Or “my body needs to be controlled.”
This indoctrination process creates body shame – and so many people are affected. 97% of women will have at least one cruel thought about their body today, but for many these thoughts are incessant. Some of the ways body shame manifests include: loathing the way your body looks, feeling insecure about your weight, wearing baggy or concealing clothing to hide your body, frequent or uncontrollable thoughts about how others see you, fixation or obsession with your appearance, compulsive body rituals, constant “checking” of your reflection, disordered eating and exercise, and even organizing your life around the fantasy of how things will be once you are thin enough. Frequently depression, anxiety, social isolation, sexual problems, and feelings of hopelessness and worthlessness abound as well. It is little surprise to me that eating disorders have the highest mortality rate of any mental illness.
Unfortunately, on the societal level, it may continue to get worse before it gets better.
I’ll never forget when the New York Times quoted Dr. Kahan saying that obesity is the last socially acceptable form of prejudice and “persons with obesity are considered acceptable targets of stigma.” He also said weight bias “occurs even in people who are otherwise fair-minded and nonjudgmental – even in obesity specialists,” who may not realize that that stigmatizing patients leads to “unhealthier behaviors and more weight gain.” And I thought: Yes! This is a major issue, even with psychotherapists! So that’s what I am writing my dissertation on.
Another recent study shows that while implicit bias is decreasing around sexual orientation and race, it is increasing around obesity. Weight stigma impacts employment, education, press coverage, research funding, health outcomes, and even our relationships. Another study showed male jurors were more likely to find fat women guilty!
We live in a culture that is disordered around food and bodies, and yet, because of our strident American Individualism, each person struggling with weight and body image is made to believe it is their own personal failing and not a complicated collective crisis that we are all complicit in. As the numbers of children with eating disorders continue both to balloon and creep younger and younger, and adolescents who are bullied for thier weight increasingly attempt suicide, I hope the ubiquity and violence of these messages gets unmasked. To paraphrase Desmond Tutu, if we are neutral in the face of injustice, we have chosen the side of the oppressor. We are hurting our children and ourselves with this weight obsession.
Just because our society is sick, however, doesn’t mean that there is no hope. Living with body shame is not the only way. Everyone deserves to feel comfortable in their own skin, and I believe this has much more to do with changing our insides than our outsides.
Q – How does body shame come up in therapy?
Jenna: In therapy we are trying to slow down and open things up, to understand and dismantle what causes us pain, and to delve into the often-obscured meanings behind our behaviors, thoughts and feelings. Humans are deeply committed to the fantasy that we are rational beings, and that “the truth” is important to us, but we often unwittingly work very hard to avoid the truth at all costs when it is painful or complex. Therapy can be a profound process of coming to radically accept the truth of what is and grieving what isn’t.
For those who struggle with what I am calling Body Shame and/or Body Image Instability (Dysmorphia), challenging body “pseudoTruths” often activates the sympathetic nervous system (or Fight, Flight, Freeze response). This shuts down the prefrontal cortex (executive functioning/thinking part of the brain), and puts the amygdala (primitive, emotional, survival part of the brain) in charge. In this state, nuanced thinking isn’t even possible. Things are black and white. Work with a trusted therapist helps calm this paralyzing physiological response and get the mind back “online.”
Part of how I help clients move beyond this panic is to cultivate willingness. You must be willing, and a bit brave, to do the archeological digging into unconscious beliefs. This requires amenability to the process of unpacking where these “truths” came from, what memories inform your understanding, and how those beliefs have guided your choices.
Often there is a kind of core terror of fatness that has to be gingerly unpacked. This is true of people with all body types. For example, an Esquire Magazine survey found that 54% of women said they’d rather be hit by a truck than be fat. They’d rather be dead – fatness is that bad. This makes tolerating yourself – fat and all – a kind of revolutionary act.
Most of us don’t want to be revolutionaries, we just want to be human and go about our lives.
Fighting the tide of fatphobia and socially-sanctioned fat discrimination is exhausting. And yet I’ve increasingly come to believe that it’s the only way out.
Q – Depth Counseling strives to go “beneath” the symptoms to understand the person in greater depth. How does this approach differ from other approaches?
Jenna: As a psychodynamic therapist, I know that you aren’t a “diagnosis,” but a whole complex person. My goal in therapy is to understand you, understand how you move through the world, and also the ways you are (unconsciously) stuck and causing yourself more pain. Working in this way – slowly over time – cultivates a greater sense of freedom and agency. Choices begin to appear where before there were none. Carl Jung said, “Until you make the unconscious conscious, it will rule your life and you will call it fate.” In this depth work, freedom is born.
Body shame is not a one-size-fits-all problem, but a unique and subjective one that is further complicated by the societal stigma and misinformation. For example, what types of meanings might be discovered as you do the therapeutic work? Maybe you never learned how to care for yourself because you were busy caring for others. Maybe you decided your own feelings were bad and numbing them with food worked. Maybe weight loss gave you a sense of being indestructible. Maybe the only time you felt loved was when you’d lost weight. Maybe starving yourself provides a sense of control when life is going off the rails. Maybe extra weight made you feel safer after a sexual assault. Maybe the fantasy of what life would be like once you were thin was its own kind of addiction. Maybe dieting distracted you from an unhappy marriage.
Other approaches will focus on “fixing,” but this only addresses the surface issues. Depth Counseling seeks to go beneath the surface to identify the root cause, and heal deeper wounds, thereby producing lasting change.
Q – What might you say to someone who is interested in starting therapy for body shame, but feels uncertain or afraid about asking for help?
Jenna: Buddha said “You yourself, as much as anyone else in the universe, deserve your love and affection.” Too many of us have been taught to devalue who we are, to hate how we look, and to feel uncomfortable in our own skin. Too many people struggle in silence and continue to feel “wrong”, “broken,” or that they will only be worthy of love once they are “fixed.” I know there is another way of being in the world, but it does require time spent coming to know your own mind in the context of a transformational relationship.
Too many people think “Things aren’t bad enough for therapy” or “I should be able to do it on my own”. Yet growth in isolation is labyrinthine: we get lost. It is extremely difficult to have an alternative vantage of ourselves and our circumstances because we are too close to it. We are also much shriller with ourselves. Too many people think that they need to be hard on themselves to be successful, but from my experience and the research bears out, we actually get much further with self-compassion. We often need the nutrients of a caring and compassionate outside perspective, and it helps a lot when it is someone who has no skin in the game (i.e. a therapist isn’t attached to you being any particular way, as a family member or friend would be).
Q – How can I help fight weight-based discrimination and fatphobia?
Jenna: I would recommend approaching it as you might approach any type of discrimination. In addition to doing your own therapeutic work to better understand your own biases, I recommend educating yourself! You can find some wonderful resources below. You can also step in when you see discrimination or bullying happening, join interest groups to lobby for policy changes, seek out diverse news sources, follow body-positive activists, and have hard conversations with the people in your life.
- Everything you know about obesity is wrong
- Fat Bias Starts Early and Takes a Serious Toll
- Study: Bias Drops Dramatically For Sexual Orientation And Race — But Not Weight
- Susie Orbach “Bodies”, “Fat is a feminist issue”
- “What’s Wrong With Fat?”
- Harriet Brown “Body of Truth: How Science, History, and Culture Drive Our Obsession With Weight – and What We Can Do About it”
- Linda Bacon’s “Health at Every Size: The Surprising Truth About Your Weight” and “Body Respect: What Conventional Health Books Get Wrong, Leave Out, and Just Plain Fail to Understand about Weight.”
- Jean Kilbourne’s research
- Erich Fromm’s “Sane Society.”- If you are interested in the impact of capitalism on our psychology
- For clinicians: “Hungers and Compulsions” and “Body-States: Interpersonal and Relational Perspectives on the Treatment of Eating Disorders”
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