A common hurdle my clients face when working through body image issues is a disconnect between their intellect and their emotions. Often, clients seek us out for our stance on Health at Every Size (HAES) treatment and anti-diet approaches to therapy, which means they typically have some familiarity with the Fat Liberation movement and have likely struggled with disordered eating. Clients ask me all the time, “if I know so much about the systemic problems surrounding body image and anti-fat bias, why do I still feel bad about my body?” The problem does not lie in what folks intellectually know, but how they somatically and emotionally feel in their bodies.
Knowledge and information gathering are definitely parts of the process of restructuring your relationship with your body, but this is where the activist movement falls a bit short and therapy comes into play. We have to look at your life experiences, family narratives, trauma history, and emotions related to your body size. This goes for folks of all sizes. We have to actually address the emotions in similar ways to emotions about other issues we deal with in therapy. Here are some strategies to help bring together your intellect and what you know with your experience and emotions.
1.Try to bring it up in therapy.
As therapists, we can only remind you that you mentioned wanting to talk about body image or fat-phobia, but we cannot know what or when something is bothering you unless you tell us. It may be imposing or offensive if we asked you specific questions about your body image or experiences with fatphobia unless we have a precedence for talking about these things. It is actually very helpful for the purposes of therapy to have specific instances to talk about. So, if talking about body image is scary or hard to bring up, start there. Ask us to help you talk about it so we can help you process the feelings you have around discussing your relationship with your body. That goes for people who are new to anti-diet concepts and understanding fatphobia as a cultural construct as well as for the people who have read every book on the topic. We will meet you wherever you are in the process. Sometimes the most well-read client might feel like they are not entitled to be uncomfortable with their body size because it may reveal internalized anti-fat biases, or they may not want to face the idea that it still causes them emotional pain even though they know so much.
2. Remember to stay curious.
Whether you have been involved in the Fat Liberation scene for years or are just starting to learn about HAES principles, it's time to get curious. There are a lot of fat activists from diverse backgrounds working against the rampant fat-phobia and dangers of the diet industry in our culture, which means there is a lot of good information out there right now. I encourage my clients and their support people to become familiar with this material if they have not already. Read books, listen to podcasts, and utilize social media to your advantage.
If you do better with more social support than individual research, reach out to your local feminist bookstore and ask them to start a fat-friendly reading group. If fiction is more your style, there are fiction writers out there writing books with fat leads. No matter what you’re reading, try to stay curious about the information you’re taking in. How does it make you feel when you read it? What do you notice about your own experience with your body as you process the information? Who comes to mind as someone you might want to share this – both HAES media itself and your own feelings– with? Who comes to mind as someone you might not feel safe sharing this with? Asking yourself these questions as you’re taking in information can make it less intellectual and theoretical, and can give you more agency to better understand your own needs and ideas within this work.
3. Try Cognitive Behavioral Therapy (CBT) principles for healing your relationship with your body.
Typically, I am not a CBT therapist, but I do believe that it can be helpful to have a clear plan of action to help with the murky, elusive feelings around body image. Therapist Bri Campos has proposed a CBT step by step process for working through distressing body image experiences, which I will briefly summarize and slightly reconceptualize in the following five-step exercise:
1) Identify a trigger or stimulus. For example, you see yourself in a photograph and it brings up feelings because it does not align with the image you had of yourself during that experience.
2) Identify the feelings. Maybe you feel shame, disgust, anxiety, or embarrassment.
3) Assess how distressing the feelings are. On a scale of 1-10 (10 being the highest and most distressing), how distressing are the emotions evoked by the image of yourself in the photo? Anything that is above a 4 is too high, so the next step is to
4) Decide how to address the stimulus to help soothe yourself. You could file the photo away in a place you will not have to see it without warning. You could ask whoever posted it on social media to take it down or untag you. You could delete the photo entirely. If your distress is below a 4 on the scale of 1-10, it is a good instance to
5) Work on your distress tolerance, specifically around issues of body image. Look at the image that brings up discomfort and observe the feelings that you experience. Soothe yourself as the negative feelings arise. You could remind yourself how much fun you were having in the picture. You could keep in mind that photos are, in part, for saving memories. You can deemphasize focusing on distressing body parts and focus on your smile or the feelings of connection you had with others sharing the experience. Remind yourself that bodies are for connection not for display or comparison. Limit the amount of time you spend looking at the photo that causes you to experience distress to no longer than a few minutes. Then put the photo away and do something to take care of yourself.
If you follow these CBT steps, over time, when body image distress arises, little by little your distress levels will fall because you have proven to yourself that you can handle the feelings that come up. You have also proven to yourself that when your bad feelings related to body image are too much for you to cope with, you have agency to alter your environment to reduce feeling too vulnerable or unsafe. If your distress is always towards the higher end, like 6-10, it's possible you need more specific trauma therapy with a professional, like myself, to help you address the traumatic experiences you have survived regarding your body size.
4. Change your narrative by changing how you talk about food and bodies.
Language has power and, in part, creates our reality. When we use it self-deprecatingly, we are reinforcing harmful anti-fat rhetoric. With your language, you can signal to yourself and others that all bodies are good and we all deserve to nourish ourselves with food. Try to be as direct as possible about your feelings and avoid the ways we are socialized to talk about our bodies. It's likely you are mentioning something negative about body size or food because you are feeling bad and need support.
For example, it may be harmful to yourself and others if you tell your friend, “I looked so fat in the birthday party photos, I am going to have to start eating more salad.” The message here is that fat is bad and needs to be fixed with restriction. This is actually a disordered eating thought. It makes sense that you are asking for support because you are feeling vulnerable. However, you might find it more helpful to share your feelings by saying something more like, “Seeing myself in the birthday party photos brought up a lot of bad feelings about my body and it's making me want to diet even though I know that won’t help.” That gives you a chance to say what is really bothering you and it gives your friend a chance to help regulate your feelings of low self worth in that moment. Choose a trusted friend to confide in, one who understands fatphobia and your journey with body acceptance, and will not encourage you to diet or respond dismissively. In this way you can change the narrative of what is acceptable when talking about bodies one interaction at a time.
5. Be willing to experience negative feelings as grief.
Campos coined the term, “body grief,” which can be a useful reframe to process negative feelings attributed to our own body size. Part of what makes the negative feelings related to body size feel so bad is that individuals feel blamed and responsible for being oppressed. You feel grief for the life you may never have, for the perfect life you envisioned for yourself if you ever became thin, and for the idealized version of your life from when you may have been in a smaller body. It is natural to feel afraid and upset when privileges, basic necessities, health care, dignity, respect, and even love are being limited to you based on something that you cannot control like your body size.
If you find yourself feeling grief because of your body size or a change in body size, this is not because your body size is wrong, it's because our culture has convinced you that you are less than and has limited your access. Processing through this by allowing your self-blame, fear, and shame to be experienced as grief helps you to externalize and identify the basis of the problem, which is a fat-phobic culture. Grieving these losses can feel more satisfying and more mentally healthy than hating your body and blaming yourself. In truth, you are being subjected to systemic injustices for something that is not your fault and you cannot control or hide. As we know from other forms of grief, the pain never goes away, but it does get less sharp and less frequent if we are able to process through our emotions and if we can get support.
6. Hope.
On an individual level, our negative emotions and beliefs about body size can feel isolating, shameful, and can be life-threatening when they manifest as eating disorders. These thoughts thrive in darkness and separation. Know that you are not alone and that the healing happens in relationships. There are safe spaces and safe people with whom to share these feelings. There are ideas and strategies that can help you feel better.
On a systemic level, it can feel hopeless if we become overwhelmed by the impact of fat-phobia as we are on the verge of yet another harmful diet treatment method being promoted by celebrities and sanctioned by our medical system. You do not have to be an activist to promote the anti-diet, Fat Liberation movement. Your individual healing is enough. Your healing is a part of a whole social movement out there making change happen for future generations and we are on the verge of that change.
