#TherapistsConnect is a platform for connecting therapists.
Website: www.Therapists-Connect.com
Twitter: @Therapists_C
Instagram: @TherapistsConnect
Facebook: @TherConnect
Origins of #TherapistsConnect
#TherapistsConnect is a platform for connecting therapists.
Website: www.Therapists-Connect.com
Twitter: @Therapists_C
Instagram: @TherapistsConnect
Facebook: @TherConnect
Origins of #TherapistsConnect
This episode of Therapists Connect podcast is sponsored by webhealer. The number one website provider for private practice therapists. Serving the community for 20 years, webhealer offers a non technical and fully supported online platform, helping therapists use the internet to grow their practice. Whether you need a website, a booking system, or even a secure email address for your practice, webhealer can help. Contact webhealer today via www.webhealer.net and use the coupon Therapists Connect for 100 pounds off their do it for me service. Welcome to the Therapist Connect Podcast, a podcast for therapists by therapists.
Leila Bishop:Hi, welcome to the Therapists Connect Podcast. I'm Leila Bishop, one of the volunteers here at Therapists Connect. And this is an in conversation episode where we'll be exploring anti fatness in therapy, and what it can be like for people in larger bodies and people with eating disorders to access therapy. This can be difficult topics and if you think you might be affected by the please give this episode a miss. For this episode, I'm joined by two special guests. Mel Ciavucco, who is a trainee therapist has their own blog of the compassionate therapist, and has written about fatphobia for Therapy Today. I'm also joined by Bernie Wright who works for the National Center of Eating Disorders. She's a master practitioner and registered supervisor and now focuses on training. Now, I guess, quite interesting topic and probably one that a lot of people have come across and that's exactly why I wanted to bring it. And So I'm gonna just discuss a little bit about what anti fatness is, and then we can talk about then how this affects therapy. So anti fatness is known by other names as well, some people call it weight stigma, some people call it fat phobia. And it's I guess, similar discrimination against people who are fat or overweight or obese. Just have a kind of names you might, people come across it. [Inaudible] again why we've used anti fatness is that word fat, and we're gonna come on talk about a little bit a little bit more. And it's just to really understand, you know, and have a discussion today about, well, does it affect therapy? You know, what about clients who come into our sessions, and we do perceive them to be fat or overweight? Does that affect our work with them? And also, what about the therapist, you know, is the therapist fat? You know what the client think of us? How do we judge ourselves and how well we can support and help people. And I think it's really something that isn't talked about a lot. It's something that shied away from. So to start off our discussion today, we're going to talk about the word fat, and why we use this word. And I guess, Mel, if I come to you first, if you could kick us off, and then Bernie and I can add to discussion.
Mel Ciavucco:Yeah, absolutely. Thank you. Wow, well, how do I try and keep this down to a short answer? Because I'm like, there's such a lot that can be discussed just in this because I suppose, like, I can talk about, I can, I think people have different views on being called fat. And I think it's very much for fat people to choose how they want to be described. For me, I sometimes do that sometimes I'd go with a slightly gentler in larger bodies. I avoid the fluffy stuff, like curvy. Although I don't think it's particularly offensive. if anyone said anything about you know, I wouldn't be too bothered. I suppose it's more for me thinking about what word Shouldn't we use now. And I don't mean just in terms of really offensive stuff. But a lot of people are moving away from using the word obesity, because it's linked in with it seems quite a stigmatizing word, linked in to the BMI chart, which is outdated and problematic in lots of different ways. But then again, lots of people in the industry use it, as I'm sure Bernie will say in a moment. So in some ways, it's kind of necessary. So there's lots of different ways to describe, I suppose a short version is fat people get to describe what themselves however they want to. Thin, people have got to be a bit careful when talking about fat people, because that is a very triggering words. And it's it's got lots of complications in itself. I'll stop there because this could be huge complex subject.
Bernie Wright:I absolutely agree. I think people should, 100 percent be allowed to call themselves exactly what they feel they are comfortable with. And I do think that the stigmatization in people in larger bodies has been absolutely appauling. So far back now we've almost we go just so dreadfully totally disregarding of people, and who they are. And I mean, for me, it's you know, it's a word. It's a word that people use. But but the way we've been using it so far, it damages the whole person psyche, you know, it's meant in a really derogatory way. And it's a demoralizing way. And the government has just been so appalling in the way they've dealt with it. You know, and I know that I've had conversations, before on my training, that basically we will, we will, we will use the word we will use the word fat, and we will use all of these words that make people feel so bad. So when the government has this wonderful, brilliant new idea that once again won't fail, like, you know, people just need to move around more, we're going to pay them getting bicycles, and all this total total rubbish. After the every time that they have one of these incentives. They talk about the Oh, my, my myself and all of my supervisees, we will have a dreadful couple of weeks, because so they're not coming in thinking what a great idea, we feel motivated, they come back in, and they will be absolutely walking the walk of shame into our room. And it didn't take me very long to realize each time, you know, and I'll ask the question, you know, you've been, you've been so secure in yourself what's going on? And it's when it's the government, you know, as is it anything to do what we're now with their now decision today. So, and yeah, and I agree the word obesity, I'm hoping that we will move away from it forever and ever and ever. And yet, the problem we've had in because I worked in the center of eating disorders, and for a long, long, long time, it's changing now. But people would only absolutely Google the word, if they were looking for training, there was a training in obesity, that is changing. But for a long time, that was the only way we could get, you know, we wanted to get as many people out there trained. And the great thing is, it's worked, you know, and we're now getting so many people who are working in this field, and it's absolutely still appalling. So institutions, and I don't know about yours Mel, I'm sure your colleagues will, will actually bring up the subject because they've got you. But most people go through since three, five years of training, and I became a supervisor. And we had no, I mean, it was a long time, but but I'm still working with colleges, or talking to colleges that are still can get through the whole curriculum, without mentioning eating disorders, or people in larger bodies.
Leila Bishop:Yeah. and carry on Bernie,
Bernie Wright:which is a stigmatizing, and it's, you know, Let's not mention the word not, but not, let's not mention the fact that most, you know, the majority of people are in larger bodies, you know, it's it's more normal, it's not, it's more normal to be a bigger size than it is to be a smaller size. That's what we say. But to pretend it doesn't exist, it makes people see they're not seeing I mean, even Irvin Yalom, and his book Love's Exercutioner is messy. He was very, there was prejudice going on there. So it's a case of, you know, we need it has to change, we have to change.
Leila Bishop:Absolutely. And I think you both brought up some really interesting and good points, and I want to pick out a couple. And the first thing you both, you know, mentioned and agreed on is fat people get to choose what words they use. And I want to talk a little bit about that. And because I think a lot people say why would you call yourself fat? That's a terrible word. That's so derogatory and, you know, and you know, often someone will say Oh, I'm fat, and you're not fat, you're beautiful. And what's happening a lot in this, you know, in the fat community, larger bodies, you know, people with, we're actually reclaiming the word fat. To me, this is just a word to describe myself, it is a fact. You know, my body is large, I have fat, it's the same way I describe myself as short or brown hair, or blue eyes, you know, my skin tone, it just is something and but I think it's really important to recognize that, yes, people get to, you know, that there's still so many complex connotations with it, but it is a choice on you know, whether you get to use it, and I guess it isn't something that's forced on you, because you must be accepting of this word.
Bernie Wright:Absolutely.
Mel Ciavucco:And just to add a kind of personal note on that, but I think it's taken practise for me because it is such a hurtful word. And I have used against me in such a hurtful way, when I was a child, but like, trying to reclaim it, it takes time as well. So sometimes, it's it's something that I might use sometimes and not others, depending on how I feel because it's, it takes time to kind of reclaim these things, isn't it? And I think in the future, if enough people start doing that it might be reclaimed in the same way that queer have maybe been reclaimed as well. But there can be a pressure I think, in in if you're trying to be a sort of body positive fat acceptance person, that I sort of needed to get pushed into doing that. And sometimes actually, maybe I just don't want to do that because it's still a bit.
Leila Bishop:Yeah. Yeah. And thank you for sharing that Mel. And I think that links really nice as well to Bernie and what you were saying before about, we know how all these government programs that are against you know, about all we need to lose this fat. And again, we've got one stage trying to reclaim the word, it's just a neutral term, but then publicly, it's got all these connotations on it, and how do we balance the two? And that was why I've used this word anti fatness for this podcast, because fatness you know, there is an appetite. There is a there is an we're fat, obviously, there is that desire to, you know, be reclaiming. But as you said, Bernie, we've got these government campaigns and all these other kinds of what was the other really famous one, cancer research one of you know, of everything that's kind of in the public, stigmatizing it. And it's a really difficult balancing act, as you say, coupled with personal experiences when it's being used against you as a harmful thing. It's, it's difficult to navigate,
Bernie Wright:it's impossible to navigate. And it's from my point of view, working specialists in this field. You know, fear is not a motivator. So everyone terrifying people into losing weight, and use you're going to die COVID. And as you get thin, I mean, what are people going to do, you know, starve for three to six months, lose a couple of stone and put four stone back on three months later. I mean, just another crazy idea. And it just made me so mad.
Mel Ciavucco:It's keeping people in a cycle, isn't it? It's the weight stigma is the harmful thing that is keeping people in there. And language I was just gonna say like the, when we talk when we talk about words like fat, I think actually what my main concern is the way that the media and the government talk about the war on obesity, and this like really violent language towards fat people. It's just. You know, it's absolutely heartbreaking. It's so fear inducing as well. And it's so it creates so much division. But yeah, like war and obesity and fight the fat everything is fighting a war, isn't it? Yeah.
Bernie Wright:Well, you're so right. In fact, when Deanne Jade the National Center of Eating Disorders does her introduction on that part of our cause. She will read out this thing and she said, what how many really aggressive words are in that? And it's, and I think that the saddest thing, I find that even when I've been training for many years at the National Center now, and we, we people who come in larger bodies, you can see they've been so stigmasised, and separated, that even coming into the training. And they say they're separated almost like they're, they feel that they're that they're not okay to be there. And I just think that having been in a larger body doesn't make you any more unworthable, or unworthy or unlovable than anybody else. And that is what society's really got to get their act around and get their head together to actually move, it's got to change.
Mel Ciavucco:It makes people scared to go into trainings like that, to go into exercise spaces to go nearly anywhere it makes, it makes people afraid, and especially because medical professionals have often been the ones with this anti fatness and this weight stigma as well, that that can also be seen, you know, met that might be anticipated, because the weights to anticipated with the weight stigma is almost as bad as actually having it but the amount that people might anticipate that other professionals might treat them in the same way, certainly where I work as an assessor for an eating disorder service. Now, the amount of people in larger bodies that come that just say, well, I basically I'm scared that I'm going to die, if I don't lose weight, like I'm terrified that keep being told that they're going to die. And then these these narratives or medical professionals are backed up by their family who quite rightly are very scared. And just they're like, you know, their kids are scared they're gonna die. It and it's it's heart wrenching seeing this amount of fear, but actually, that keeps people in those same cycles. And this is why it's so heartbreaking because that is what is maintaining the disordered eating, maintaining these these habits.
Bernie Wright:That's such great points Mel, and I could not agree with you more. And yet we actually had 100 People online training last week at the National Center. You know who to see we treat you very, very, very different way of working with people in larger bodies. You know, the big you know, we we don't ever sign up for Weight Loss, you know, we talk about if they come to us, we literally enter into, you know, we I say to my clients, you know, I'm not going to work with your weight loss, you will have come to me, and you know, because you want to fix quick fix. And however, what I will help you with is what you what you want your relationship with food and everything else will follow. Yeah, and you know, and people get into habits and eating, because they have been stigmatized, and because they have been bullied and scared and fears. And you know, when every time I notice when we put this fear, people will, you know, people are far more likely to bing. And to overeat or to under eat, or whatever it is, people scared. And yet we have so few people were doctors, medics, I had one recently on my training, and nearly fell off my seat, and said thank you so much for coming. Again, that's gonna get educated.
Leila Bishop:Absolutely, because I think what people think, and what we're told is that, you know, these narratives of you know, what the eating disorder is. And as you said, Now, you know, you have people in larger bodies who are scared by their life, because they're being told that overweight, but also large bodied people, large bodies can experience eating disorders and very serious ones. And they're just brushed under the carpet because well, you don't look anorexic. Because it has a look.
Bernie Wright:Absolutely Mel knows that a huge amount about this. And it sounds like you do too. But only 50% of people in it with an eating with in a larger body will have an eating disorder. You know, if you don't deal with eating disorder first, which is extremely, extremely painful, and not you know, and so many people don't like with atypical anorexia, I've worked with lots of people in larger body. And it's a case of how awful for them to feel that what if I just go to Weight Watchers or Slimming World, and they're going to do this for me. I mean, it's in order to get we called health foods to gain health, we just don't talk about losing weight. Because that's what the stigma is always been about to lose weight gain weight.
Mel Ciavucco:I think a good example of that recently was Tess Holliday, the plus size model in the, in the media where people just reacted so strongly to her saying that she had anorexia. It's just like people can't, I think to the outside world, maybe people who don't know very much about eating disorders, they just see people have restrictive eating disorders, and that's what everybody has, and they're all thin, but it's only actually about it's like, what 6% or 7% or something, people who are underweight with an eating disorder, and anorexia is the least prevalent one. So really, if we looked at the landscape of eating disorders, what people don't see is that it would be people in larger bodies, and not just with binge eating disorder. A typical anorexia is just I've had a whole conversation with with someone recently for for the in conversation series I've been working on for the charity. We were talking about atypical anorexia and Zoe Barefoot Rebel, her name. She's just absolutely brilliant. On Twitter, and she says, it's basically atypical anorexia is just an anorexia with added weight stigma. Yeah. Yeah, and all of this stems from categorizations, from the BMI as well, which, in itself, the Women and Equalities report not long ago said we shouldn't be using it should be moving completely away from that, which is going to be an incredibly difficult thing to do, because so we rely on BMI so much, but that's what's causing a lot of this stigma. We tell people that they're not thin enough to have an eating disorder, we tell people that they are too too fat to have an eating disorder. And it's all because of these BMI like categories as well. It's it's hurting, it's hurting everyone. This weight stigma it's hurting everybody.
Bernie Wright:It really Oh, it absolutely is. And it breaks my heart and as you know, I campaign about it all the time. Because it's absolutely outrageous that we are still using, you know, your BMI is not low enough, so we can't work with you, go and get iller go away and get really ill and then come back and we'll see what the hell we can do with you. But until then, and of course you're telling people who are either in larger bodies and anorexic that you're telling them and that the one thing they think they're good at is starving but you're telling there's other people who are more worthy of them because they're getting the treatment because they're nearly half dead. It's just it's it's for me it's crazy because you then you rather than just get get well these these people very young who are starving themselves or whatever they're doing before they're going to binge eating or bulimia or whatever they they morph into if they get them early on, and we just get intervention is in when they're sort of 15, 16, 17, which is why people at national, like us National Center are so successful, because we get them in early. And they haven't got time to go to the NHS and fight 4, 5, 10 years and become revolving door patients. It's just a false economy.
Leila Bishop:And as you say, Bernie, in both of you it is heartbreaking to see these people suffer. And I think actually leads nicely on to one of the other area I wanted to discuss with this is when we talk about, you know, people in larger bodies, and we know, but what about health always comes up? And you know, like Mel's wonderful article On Therapy Today, response to it, well, well, I'm going to only think about the health risks associated with being overweight. When we could, you know, we could actually, we probably well discussed that there's still lots of physical health risks of, you know, eating disorders. But where is mental health? When we talk about what about health, in, you know, kind of the cycles, as you say, that you get, people get stuck in when trying to lose weight for dear life because they're told that's the right thing to do? Yeah,
Bernie Wright:it just decreases the ability, it increases the shame, the depression, you know, all of these things. That as because we haven't been that they haven't been supported or given any psychoeducation of what you know, then there is there is an argument that yes, there are a lot of people who are, will make themselves very ill, because they are living on food that is not helpful in and I always say, 80/20 - 80% you know, you eat, okay, 20% you eat the hell what you want, without that rigidity, or that craziness of you know, weighing or any of that. Which is, which is why I think we teach it's so much better with the National Center, because it's more inclusive, its behavior changes if people want to, and if people want to, to actually gain health, then that is something also and that that is also something we do need to be mindful of too, because I'm also getting a lot of people who are feeling stigmatized for wanting to gain health, because they're upsetting, but they call their my health at over size people. So So what I'm really keen for us to do is to is to walk in that really down the middle. So I think we're always we've always failed in the past, because we've gone from, you know, sort of rigidity, of this is the way we've got to do we've got to do without orthorexia and all that crap that goes around to clean eating, and it's something about or then we can then bounce into the what will make us eventually if we do keep eating, you know, nothing but hamburgers doughnuts say yes, of course, we've also got there are health risks is that's all you eat, it's refined sugars and carbs. Because it's proved, obviously, the inflammation will be can be problematic as you go on. And yet, it's something about just living a life that we're down the middle. And if people want to gain health and see somebody like me, then they should feel they can do that without being afraid of people who are in larger bodies and very health positive, which I think is absolutely amazing. And we need to beautiful concept, but they also need to know that there, they can also do that. And we get an awful lot of results for people who do want to do that just because they might want to getting into 50s or 60s and they want to want to play with their children. And they might be getting some health benefits that that you know what we can at some stage, yeah, we have to say that there is health risks for being overweight, long term, absolutely. But the stigmatization and people need to choose and do exactly what's right for them, whether in a larger body or in a thinner body. And, you know, recently I've been having an awful lot of private messages from people who are feeling sort of stigmatized almost for having a thinner body and then having a larger body. And I'm just all I just want to keep saying is we are all in psychological pain. Despite that, that I do think that there is there is too much given we need to get the same type of research into people who are in larger bodies, and they've got binge eating disorder and, and atypical anorexia, because that is where that's where the most people need the support and are more likely to you know, anorexia is extremely difficult to treat. And we were doing the best we can, but we also knew it but but we can there's so much we can do. I feel I do on all my colleagues do with people like when people are stuck in a binge eating cycle where they're spending every penny they've got, you know, on food, or if they're purging and vomiting, and they're desperate, you know, they're running to the supermarket just to get spend all their salary on binge foods that's when I think we need to start really putting our effort or energy into.
Leila Bishop:And I really liked what you said there Bernie about, I guess gaining health. Because I think that's also why I wanted to touch on because health means many different things to say, you know, I don't think anyone here is going to sit here and be like, Oh, you only eat hamburgers and doughnuts, you will be healthy. And if people want to do that, that's like you want to live you also free to do that is a been a nutrition is multifaceted, you know, it's different things. But also, you know, only I will only ever eat more vegetables. Also not healthy diet. So it's when you talk about gain health, I think it's these other things as well, and what you said about psychological pain, Wow! Ease that psychological pain, through, you know, lessening their eating disorder, that's also gaining help?
Bernie Wright:Absolutely. You know, because if you use if we support our mental health, surely everything else will follow. You know, we know, it's very, very important to put the physiology in place, if you're, if you work with eating disorders, we have to deal with diet chaos and with, with nutrition feeding the brain first. But we have it has to be like body, mind and soul. We can't just sit there at the government and put nothing in apart from telling, putting the finger of bullying on everybody and say, you know, you know, you're a drain on the system and all these awful disgusting things that are said. And that has to change. It really does. I feel so passionate and I get very angry about it. Me too
Leila Bishop:because I was really keen to to raise this awareness of all these, you know, why anti fatness? And you know, why? Any any stigma I mean, any stigma towards anyone, obviously, is bad. But we want to talk about towards larger bodies and the impact it has. Mel, you said really lovely before. It benefits everybody. I don't know if I've used exact words, but everybody gains and that then gains in health, we all gain if we can be a bit more relaxed or just less aggressive language. If that doesn't exist, then everybody benefits.
Mel Ciavucco:Yeah, everybody benefits and it's everybody's job to do it. It's not just for fat people to fight against fat phobia, because everybody has grown up in a world of weight stigma and fat phobia. So we see this in the in normal size bodies, I'm doing air quotes, but like you can't see that, on the podcast, I realize. Like it's what makes kind of thinner people or people in average sized bodies also want to lose weight. It's, it's what generates the world, the world of weight stigma that we live in. And we all have these biases that we need to unpick. And I think it's about helping people understand where those views have come from understand coping mechanisms that they've maybe created in food, but especially and something will probably come on to is that especially needs to be done in counselors, not just ones who are working in eating disorders, but in anyone who's going to be a counselor. Because as we've seen, even the most perfect air quote, again perfect therapist in Yalom can still be very fat phobic. And just going on to that it's a health thing that we were just talking about as well. Just going back to that. In terms of gaining health, I think health is about mental health, it's about sleep, it's about stress, it's about so many more things. And we've all grown up in this world that tells us that thin is healthy. But and that's what we really need to be on picking because these narratives are just not they're just not necessarily true. And it's stopping us from being able to help people because it's just spreading fear instead. And you know, as Bernie says before, like fear is not a motivator, this weight stigma is not going to help anybody. So it's sad to see every single government initiative just play into making this worse, and drive more hatreds and drive more weight stigma towards people you know, and it's just, and health and doctors and nurses and healthcare professionals not recognize eating disorders and people in larger bodies and actually just recommend weight loss, which was the problem that they got with the reason they got it in the first place. And it perpetuates the problem. So it's it does it spans it spans the whole world. And I don't think we're seeing this yet because there's a lot of other inequalities that we're still not talking about and dealing with enough. And don't think we haven't even sorted out those other inequalities, then it's still going to be well, so we get to fatphobia. But I think that this ties in when we talk about racism and gender and everything, we can be having those conversations all together, because they do tie in together.
Bernie Wright:Yeah, I absolutely agree. I was only sort of writing something about your The day and I couldn't agree more. And we just, it's something about people are people, and they all are unique and individual and amazing, regardless of their size. And I think that, and you're quite right about, you know, health, it's not necessary. And in fact, it's often people who are thinner, may have the weight problem with the health problems going forward, you know, because they're not gonna have, and there's lots of brilliant brilliant books, put by cyclic put second up (inaudible), says people should really read. And she's got some great points more about that.
Mel Ciavucco:I think just as a personal note, as well, that when I was when I was younger, and I was teased through every kind of exercise I did, and made to feel like I didn't fit in and bullied at school and things, it really didn't make me want to go and exercise. It's, it's because of this, it actually puts people off exercise. And then there's the awful hypocrisy of, you know, the myths about fat people of just needing to get up off your couch and go and exercise. But actually, the gyms and fitness classes aren't safe spaces for people in larger bodies, because there's the fear of what what if I get filmed in the gym? Like, what if I go to a yoga class, and I'm the biggest person there and I can't do it. It really, really damaged my relationship with exercise. So I had to rebuild that back up again. Because I'm just a person who wants to be able to exercise for joy. And we just have all these hypocrisys is on us, like people want to be able to go and eat. It's because of the standards. And the stereotypes put on us that many times as our fat people were actually internalizing as well, i't the, internalized fat phobia that runs runs so deep as well?
Bernie Wright:Who does? It's like so, so deep, it's, it's almost buried within within ourselves? And you know, and I'm not, you know, I still see it. Now people have the gyms, and they say, Oh, my goodness, you know, wasn't she brave coming in? Can you fancy her using that? I mean, you think no what, you know?
Leila Bishop:And also, people want fat people to do that your'e being told that fat people just need to move more. You are doing something. And and then you've been ridiculed for it. So
Mel Ciavucco:yeah, and then they don't feel active wearing your size. Yeah, they're like, they have limited the size of sorry, the actor wears just for thin people, but actually fat people go and move. It's that I think this What about three of health is not actually really about health. I mean, for some people, they're trying in a well meaning way. But for a lot of people just on the internet, they don't care about other people's health to people, oh, comment on the internet do not care about your health. They're just following a narrative and they want somebody to blame because the NHS doesn't have enough money. So fat people become scapegoats and go, well, it must be their fault. Because they're costing in the NHS too much the rate we're going I think that eating disorders will end up costing, that's it. I don't think there is an epidemic, like there isn't an obesity epidemic, in my view, there is on the way to being or probably an eating disorder or disordered eating epidemic going on. And that's why it needs help and understanding and training and not stigma.
Bernie Wright:Absolutely. And in our in our training, which is a on with people in larger bodies. I mean, it's under no illusion by the time people leave after the training that you know if there's if they still go out and work in that that way, which is so stigmatizing and will keep people just draw it you know, it's traumatizing. You know, it is absolutely traumatizing over time to be to go through all of this in I mean, I don't know if you saw that with your Liz Jones The the anorexic journalist. I don't know if you saw that recently. I found it absolutely staggering. She look at it is in but she actually decided to spend one day and she in a sort of a surgical sort of fat suits. And she Oh, yeah. She was just horrible. You know, the day she just couldn't believe how she became invisible. Or get very visible by people's reactions and stigma and just the way people are. You know, and it is a lot of account comes from parents. A lot of, a lot of parents are very against people in larger bodies, so it's hardly surprising that their children, see always says that they children who are overweight at school and the ones that really, really struggle, you know, very, very early on. And if anything is fine, but not to be in a larger body. It's
Mel Ciavucco:yeah, I literaly actually thought that fat was the worst thing that you could ever be That's That's what I always remember, from a really early age that that's just the thing that I desperately got to try not to be, it's really hard to try and move through the world. Even if you had a parent that was by quite supportive when the government and your people at school peers, teachers, like everyone, nearly everyone that you meet is going to reinforce this message. Like it is just so many people it's so hard to fight back against. So it really does. It really does feel feel like a fight. Like now in the circles that I'm in and the stuff on social media sometimes that, you know, I see a lot of people with the same views as me. So I've got myself in a little bit of a bubble. But I do have to remind myself, if I see adverts, or I see another government obesity strategy that I'm very quickly crashing back down to earth and go and go, Yeah, I remember now, I remember. It's really hard to live, it sounds dramatic, but it's hard to live in a world where people really hate you. And I mean, there's a lot of groups and groups of people who are very much discriminated against. I'm not taking anything away from any group. But we you know, we do have to be honest and say there is a hatred and a fear of fatness and a fear of fatness drives, all sorts of different problems in our society.
Bernie Wright:Absolutely. And I think I mean, I've heard it Yeah, I think I'm sure you said no, that there was when you were growing up, there was something about being in a larger body and you weren't good at school, not right at school, and then your parents or was it was it that you're, I've heard that so many times that, you know, then the parents are start on you because the government starting on them, and it's and it's you know, I'm really not okay, because not only my kids, people call me names at school. Now, they're now that now that they've bring my parents in to say that I've got to be put on the diet or whatever, and it's just, it just isn't an audit, it's not going to do any difference what to it, and apart from internalized shame that people carry through for the rest of their lives, you know, and I, I work with people in their 50s and 60s, and it's just, just, it's still, even now I've been doing that job for years and years and years. It's still when I do that, you know, when I do a piece of work, which is a lifeline, which Mels seen a couple of times, and it's you know, they look back and think, and you just know, you can see where it started. And it certainly wasn't. And of course, genetically, some people aren't ready a lot of people have genes that have been, you can't fight against so much. But but we just assume that we know, a lot. So many people have got a thin privilege. I mean, I've certainly had eating issues in my time, you know, most people who end up in the National Center have, but but my was probably more of an overeating issue and a sort of binging issue. And yet, at the end of the day, I still had a thin privilege. You know, I believe that passionately. And you know, and a lot of you know, because even though you know, what I was eating, I should have been a lot bigger. But it's and others are like that. And it's we that's what people don't actually take into account.
Mel Ciavucco:I think, sorry.
Leila Bishop:Yeah, I'm still going to move us on kind of, but basically saying, but you say what you want to say
Mel Ciavucco:I was just gonna say on that, I think that there's, you know, I've been told some pretty awful experiences from some people who have assumptions made about them, because they're thin, like, assuming that they have anorexia or something just because they're thin or comments, like just go eat a burger, that kind of thing. You know, and it's, and it's awful, but it is quite different to systemic fatphobia. Because, like, that's not to take away any of that pain, because that's a that's a really hurtful, awful thing to happen to them. That's a traumatic thing. And it's bullying, it's, you know, it's awful. But when people when when people in very large bodies can't even move through the world because it doesn't accommodate them. It that's a wider systemic issue where you can't you know, where you where maybe you have trouble booking onto a flight because the seats aren't big enough, or you can't sit in a waiting room chair. Like it's just these things that everybody else will overlook it in the same kind of way as disability like when the world doesn't access you. That's a trauma as well in itself, because you're othered. You're told you don't need, like literally you don't fit here, you don't fit in.
Bernie Wright:Oh, absolutely, you know, the amount of people that said to me that they bought the bike or their clothes from a charity shop or, and their dream was to just to actually find a shop that could actually cloth them know our job as a society is to find shops that do have both clothes, you know that in beautiful fashions and then everything else that people don't have to go to charity shops and you cause you know, in, in shops that we know are sort of people in larger bodies because it should it needs to be the norm as opposed to, you know, the people shouldn't feel bad going into shops, and they should be able to go in lots of shops that can accommodate their clothes too, rather than actually having to buy online. Or
Leila Bishop:it's,
Bernie Wright:it's so difficult. Yeah,
Leila Bishop:absolutely. And I think I want to thank you both for sharing some personal experiences there. And I guess, especially you Mel, really highlighting how just the difficulty and damaging how it is just to exist in a larger body. And I guess what I think, brings us neatly on to is, because we've not touched on this yet, is how we deal with this in the therapy room on, but I guess even actually, educating counselors, that this is actually probably quite a common experience. And, you know, someone in larger body that actually just existing is difficult. And I think what I wanted to highlight is that in my training, um eating, eating disorders, weren't really discussed from from memory, but especially, you know, I mean, we know also diversity anyway, and by aren't covered as well as they could be in absolutely should be. But the enemy's in weight stigma was brought up was because I did a topic on it,
Mel Ciavucco:you know, well,
Leila Bishop:we don't have diversity, you know, we're asked to bring something to diversity, and I bought a weight stigma. And I know, it wasn't else but because nobody else did that topic. And I just gonna think So how on earth? Is it that are we can we support these clients who come into us with shame, internalized fat phobia, you know, these, you know, these skewed conditions of worth of what the world has told us, when we're not even educated about to in the first place?
Bernie Wright:I think it needs to start in the colleges, I think I think, because if we just bang it on straight into every training institution, whether it's, you know, doctors, nurses, teachers, you know, psychotherapists, counselors, all of us, every single one of us, we need to be educated ourselves, and then the rest will follow. But until we get educated until, you know, we still we went back to the beginning liner, you know, 100 people turned up online last week to work with the National Center, and we didn't have one doctor will help you amongst the whole lot. Every time Deanne says any doctors here? We might have odd psychiatrist, and of course, the odds, the psychiatrist, really got to learn how to how to work with people who rather than just give them a label of some kind of demoralizing, dehumanizing label to find out what's really going on.
Leila Bishop:Absolutely, and I think that education there is it needs to happen at so many levels. And I guess I want to kind of share my own experience. And that, you know, when I was receiving personal counseling, and I was talking about my weight, and actually, I was getting to a place where I was, I'm happy, you know, I'm largest I've ever been, and that's okay. And my counsellor pulled out, oh, you know, what's really good, My Fitness Pal, let's calculate your calories in the session, Oh my goodness, oh dear and unbenown. And for some reason, I stayed with that counselor a bit longer. But I obviously never discussed that topic again. And that's just so shocking to me, and what is shocking, shocking, then I just didn't know to react. And now I'm a lot more well versed in this area, and everything. But I think that's again, I don't think that's a unique experience, to me.
Mel Ciavucco:No, yeah, no, I've worked with lots of counselors over time. I mean, not to say in a sort of professional environment, because I've worked in like counseling charities and admin roles and things. And yeah, there's been ones on sort of various different diets. Some of them involve, like, fasting starvation days, when they've got seven clients back to back and I'm just back then I didn't know what I know now, because it's quite a long time ago, but I was still thinking, is that really right to like, not be eating for a whole day. And also, if you have these views about dieting and want to change your body, this person was actually thin anyway, how is that going to? What might you unintentionally collude with us as a therapist, even if they are not talking specifically about weight? But I kind of now just think, How can we expect counselors and psychotherapists to challenge this or recognize as a problem when the BACP, one of the main membership bodies has a diet advert in the back of it for what seems like years, how, how long do you think it was out Bernie?
Bernie Wright:at least one year and two months and 21 days. Just Just for the record, I'm still waiting to come back and see us. You know about all of this. It's working with eating disorders, but so I've got I'm pretty busy now. So probably can't fit them in now. But
Mel Ciavucco:yeah, do you want me to just explain a little bit?
Bernie Wright:Because I assume everyone knows because it went on for so long. Please lead the way.
Mel Ciavucco:And yeah, I looked at it. Got some back issues at work of Therapist Today, actually. And I kept looking back through them and this advert, Cambridge diet advert for Ambassador. So Cambridge diet is sort of like the milkshakes and soups, those kind of things. Yeah, yeah, meal replacement stuff. So. And in the classified bit at the back of Therapy Today, there was an advert sort of more geared towards counselors to say, hey, why don't you be an ambassador, because they'll go really well with being a counselor. So because I'm a trainee, I only recently like, well, last year started getting Therapy Today. And I hadn't really seen it before that. And I just thought this isn't like this is completely unethical. Then I realized that Bernie had been working on this for quite a long time already trying to pin down and have a conversation about it, which has been incredibly difficult. So I said, What can I do to help and Bernie said, we could write a letter because we've all been trying to do that. So I wrote a letter to and send it to the BACP, which I seem to just get a copy and paste reply that they've sent to everyone. I've
Bernie Wright:People got the same one. I think we did. Yeah.
Mel Ciavucco:And then I also wrote into Therapy Today and did not expect a response. And then the editor of Therapy Today, sent me an email and said, we want to publish your letter. And that was like, in the same edition, as the actual advert like you can't make this up, can you really. So they published my letter saying how unethical and rubbish it was that they've got a diet advert in there, along with the diet adverts. But then a month or two later, it disappeared. Yeah, I don't know why I don't think I've said nothing about it they said anything to you. Bernie
Bernie Wright:no it's about the time I was sacked from Twitter for a while, never found out why, but it was Friday when I came back on Twitter. But we actually had to, we actually sit there nationals of eating disorders. We actually had three of us, Deanna, Jade, and another, another psychotherapist. Winter had two meetings with them, and they were each each meeting was an hour time. And they absolutely, even after all that and all the letters, they still refused, removing it, saying that it's up to the therapists to self regulate themselves. Which selling it selling it authorizing a diet that actually I've had people go psychotic on. So it's like, really? So there you go.
Mel Ciavucco:yeah, and that that's terrible, they need to be at, you know, I really feel like the BACP is one of the biggest membership bodies really needs to be leading the way on this. And for me, if they I don't think it was them, it was probably just the person themselves, who pulled the advert for whatever reason for bad press, or maybe it wasn't working. It's a good thing. It's gone anyway, but I would have really liked it to come from the BACP instead. And for them to put something out saying we realize why this isn't okay. To me. That's not happen. So their views are still the same. So effectively, they're saying, Yeah, it's fine. Counselors could end up being on diets, they might even have eating disorders themselves, they might have stigmatizing views around fat people. And and the other thing is, when I was first reading, like on my first Foundation Certificate course, we were given the Yalom Loves the executioner fat lazy chapter to read. It was just that chapter. So I hadn't read the rest of the book. So it was quite shocking, didn't know the style of the book, but just went straight in with that, and was like, What is this? And I got back and everyone's just, everyone's always praising Yalom anyway, but everyone was having a conversation, it you know, it was just sort of how brave he was and how amazing he was for being honest. And I kind of went, I really don't feel okay about this, like it. I don't think this is okay. I wasn't sure about myself then. And this was to my entire cohort as well. And I was like, you know, I don't think this is okay. It's come from a real position of privilege. He doesn't challenge his own views at the end, he hugs his client who's lost weight, and he can fit his arms around her and the message that he's giving is not one of him, challenging his own biases at all. And then people praise him for being very honest, which only shows their own fatphobia as well. So I think we could be taken that story now and using it in the way that I took it in and explain this on my cohort and we had a conversation around it. And because Yalom is a really good writer, I feel like we can be using that story in a different way now, and starting a conversation around fatphobia. And to kind of, you know, it's okay, if we have these views about fat people, we don't need to beat ourselves up about it, because we've all grown up in this world. But what we need to do is recognize it. And then we can work with that. And I would love to see those conversations. As a trainee counselor, I would, I don't see any of this, we don't talk about food. We don't talk about eating disorders. We barely talk about race, we barely talk about gender. And, you know, within the the kind of, I don't want there to just be a diversity session. I want it to be throughout our training. And I want that diversity of race to be linked with fatphobia. Because fatphobia has racial origins to it. And this is a conversation that can link together and the richness, and especially in an experiential style would be so brilliant on our counseling courses, it really was
Bernie Wright:absolutely amazing. I mean, I've always been astonished. I think there was something about a huge debate that went on for a ridiculous amount of time, I think I put it I think was on one of my tweets. I think I bet 200 site ridiculous talking conversations guy just said, you know, I can't believe that we're actually all talking about, you know, whether we should we have to cut our clients cup of tea, talk to a supervisor about that. So, honestly, we've got 1000s and 1000s of things to worry about with with people in larger bodies and how they've been treated. And as you say, all the adversity that goes on, and we don't even talk you know, and things of people who've got, you know, who we've got, we've got a learning pool neurodiverse so they're autistic, or their ADHD, you know, that may affect their eating behavior. But that's never talked about either.
Mel Ciavucco:Think it's seen as an other specialism as an eating disorders where people want to go and train and then they might do a one or a couple of hours, CPD, and then they tick the eating disorder box, or people just tick the eating disorder box anyway, because they think they can, they can work with it. You know, I see that in listings, like the counseling directory, there are people who I think just tick every thing, if you're going to work out with eating disorders, especially you do need to go and do proper, really good, robust training, like the ones that Bernie do, does. But I also think for people not working with eating disorders, we've got to take away this otherness, and have generally relationships with foods and weight stigma and fat phobia talks about together because as a counselor, you you it would be impossible to never encounter anyone with like a food who's never had any body image issues, issues with foods, or you're just gonna never have like a fat client, you know, it has to be done. It has to be a core competency as also talking about race and exploring whiteness, because there's so many white people in in counseling and privilege and class. And all these things to do with class like class and obesity. Have a lot of links as well, there's so much brilliant stuff that could be explored. So if I'm on my course now they try and have another conversation about if we should have a glass of water or we should pass some tissues I honestly I'm just gonna go mad.
Bernie Wright:My favorite one Mel was only on it was one that said I've just seen a spider in my counseling room, what should I do? I mean, really, but um, for all you, listen, please do not congratulate your clients on weight loss.
Leila Bishop:Really good point, Bernie. They are not
Bernie Wright:better off because they've lost a stone since work with you shouldn't be discussing weight loss it is something that they they come to you for. I mean, I But equally, I think it's as therapists we need to be asking our clients, you know, what is your relationship with weight, food and shape? And if they say, Oh, I'm eating terribly, I don't stop binge eating. Do you want some support on that? And then if they say, Absolutely not, then you move on to what they want. But you can't ignore it. I have a client that came to me and is absolutely true. She'd been working with someone for five years. She had so much weight stigma about and she's been she's been so stigmatized, but she was desperate to talk about it. And it was she said it was her last session someone said to her I noticed we didn't talk about your weight. And it was like what you know, and that might have heard that. I've heard that in varying degrees in so different ways. But equally when people come to people like me, they're just so grateful that it's that you know that it's out there, not a prob it's not an issue. You know, you can talk you can talk about what you want to talk about here. And you can get and we will work you know because was support, we will support I will support you. And I'm so sorry this happened to you because it was wrong. You know, it was wrong. And that's the reality of. So I'm hoping we change. I mean, you know, I really do hope that people start understanding again educated getting, you know that people are worthy of love and care and everything and a beautiful, adventurous life, in whatever damn body they've got. Whether it's a small body or a large, whatever, you know, we are all unique and wonderful. And that's what I started definitely about the counseling world, you know, that we taught, we teach, we sort of give, we give a voice to the core conditions. And yet we walk you know, and yet, we don't actually know what they are half the time, because the core conditions are allowing people to bring their shame into the room, in whatever they want to bring it in, not to be afraid to hide, not for them to be afraid and, and not to be able to come out and say this, this is what I feel. And it's no surprise to me that people might have seen three or four therapists and they will tell in the first session, people, finally someone someone gets them. And that's what we we owe, we owe, counselling world, owe, the medical world owe, that type of knowledge to avoid stigmatization and, or to eradicate this awful stigmatization going forward?
Leila Bishop:Absolutely,
Mel Ciavucco:I speak to, I've had this feeling that they've never, they don't have anybody else in their life, or they've never had anyone who isn't trying to encourage them to lose weight, I sometimes feel like I'm the only person they've spoken to that isn't colluding with this whole, you got to lose weight, or you're gonna die thing.
Leila Bishop:And my private work focuses on body acceptance, you know, and again, like, when I say to people, you know, they come to my weight loss journey, and I say, I'm not here to support you, and you're not support you, I'm not here to help you lose weight. I want you to accept yourself as you are right now, as you will be in the future. And that may be as you were in the past, as well, it's, you know, and I kind of want to join two things you've both said, and put them together, where Bernie was just saying, then, you know, all people, are people, and all people are worthy. And where you said, former, and that means everybody benefits. You again, if we're treating everybody with respect, and that they're worthy, regardless of what they look like, what we perceive their health to be, again, that just benefits everybody.
Bernie Wright:Absolutely, and we, you know, when I'm working with people and training people, you know, we're not, we're not, we're not, I'm not gonna go away and say, you know, here's a diet sheet, and this now that I will go and say things like, go and change one, if they really do want to come to us. And it's, you know, again, if people want to want to gain health and become healthful, and it's affecting their health, and then that's where they come. But you know, we will be looking at things like change three things, you know, say three things you always say no to. Notice three things you'd always say yes to, and they cannot be anything to do with food, weight and shape. Because they got to know that you can, you can change and change, but it's not. So we're not going to clap, you if you lose a pounds, we're not going to if you stick to it, you know, it's just, it's just so wrong on every level.
Mel Ciavucco:Yeah, maybe it's really important for therapists to model that to their clients that it doesn't matter to them, if they've, if they've lost weight, or gained weight, because then that can, you know, hopefully start to support them in seeing past making a change in their body to look beyond to what's really going on, which might be something to do with self worth, or trauma, you know, whatever is kind of underneath that, that makes them want to want to change their body. But yeah, going back to the kind of equality that in treating everybody equally and everyone deserves you know, anybody of any size, I suppose the difficult thing about equality is that that's the ideal world that we want to live in. But it doesn't happen unless people do the work to get there. Because it's the same, you know, with race or gender or disability or anything else. It's like, we can't just say we want to treat everybody equally, we need to be doing the work to be able to help those people and helping the ones who are the most stigmatized to be able to get there. And it's going to take a lot of work in our society because we're basically it feels very rebellious. Anything we say about size, acceptance is pretty much going against what our government says. So I think for many people, it would be very difficult to get on board with and so this is a longer journey, but counselors are crucial in that and healthcare professionals as well as bonuses. This comes down to education, and training. Ideally, education in schools like for kids I would absolutely love. Maybe I've just created a bit body image resource maybe if I can, you know that talking about me witing some lesson plans for that and get some body image stuff in schools, bring that in with the with diversity as well bring it and bring in these conversations so that people can have them from a from a younger age.
Bernie Wright:Absolutely not agree more and stop weighing the kids in schools please
Mel Ciavucco:If enough parents all take their kids because you can take your kids calling you can opt out. So we just get all the parents please just opt out, and then I'll get them.
Bernie Wright:Exactly, and it will eventually, eventually, eventually, people will find their voices heard loud and clear again, regardless of their size that is that is the only hope we can have.
Leila Bishop:And I think Mel is really important. So this is a long journey. You know, we've kind of started as part of our discussion, saying, I guess, how can we improve things for counselors, you know, and we'll talk a lot about education, and actually, but it's a journey, we're undoing years of, you know, internalized weight bias fatphobia along with conflicting messages from the government, but I do. So that is a long journey. But what I would like to kind of start to come to the end and think about was actually can do, and isn't really talked about is, I guess, practical considerations when working with people in larger bodies. And I guess the main thing really thinking about is what is your counseling room setup? Do you have furniture that's appropriate for someone in larger body? Have you've got a beautiful chair, but it's got the most annoying armrests?
Bernie Wright:Absolutely, absolutely. It's really important that you've got furniture that people aren't going to come in and think that they've done on aeroplanes, would I be able to get out of that? Yeah. Oh, you know, can I fit in that? And it's just another stress another pressure that people have to go through. Which is is just makes it makes it a difficult time, even harder.
Mel Ciavucco:And another thing that maybe gives a message to people like you don't fit in here. Yeah, you know, this place isn't isn't for you, it isn't set up for you. Yeah, but I mean that that problem is probably in in colleges, and then the educational settings as well, because you know, that the chairs and the places that we're sitting and working from in universities and colleges potentially don't don't really cater for that either. I think it's something that would mostly just slip people's minds. In the same sense, having, you know, disabled access or even thinking about access for, for, you know, thinking about people. Yeah, lots of different access, accessibility problems, basically, that doesn't cross people's minds unless it's specifically talked about in training at the moment, and finding that you have to go somewhere else, to learn about privilege, and about thinking about different types of people. So I had to go elsewhere and do training on gender and on race, and on eating and things because it's not on my course. So it adds the extra pressure of I just don't feel like they really, you know, it's and that's just my course, I think that's all the courses, I've been a couple of different colleges, I think it's it's across, it's across the bordes through curriculums. But I mean, I think what we're really talking about here, sorry to bring it back, or you were trying to keep it practical, and I've taken it big again. But it does come back to privilege, it comes back to people not thinking about these things, not thinking about chairs, not thinking about access, not thinking about stairs, because they don't need to. And there's a massive level of privilege that comes through counseling training from the top through institutions it's completely institutionalized and systemic. So no one's gonna bring it up. Because there's all this privilege. And that's yeah, that's where that's where we're, we're missing, again, missing out.
Bernie Wright:Yes. And, and I find in counseling institutions that often is that there's a fear to speak your mind, or to say, what's really you're thinking about because they're the ones that were actually passing, you're your boss, and you're through your. And I think that that, that is another thing that I don't agree with, you know, that, that we should have a voice silenced and say where people in larger bodies have, because they're worried about getting through our modifications, we need, you know, there's something about everyone has a right to a voice. Whether it's whether it agrees with with the university and the colleges or not, as long as it says respectfully and with, you know, with with respect, I think everyone's voice should be heard.
Leila Bishop:Yeah, absolutely. And I think Mel you're so right to say, you know, I mean, still have the practical question, but it's related to the big picture, the privilege, you know, and it's, as you say, most people, myself included, I wouldn't even thought about oh, I need to make sure my chair is appropriate if I hadn't gone through this work, and which is why I made a point of mentioning it now, because you just don't think about it unless it affects you. And that's, as you said, that's what needs to change for any change in colleges, in training, and just in so many levels, because this is how deep rooted these difficulties are.
Bernie Wright:Long and enduring. Yes.
Leila Bishop:Lovely. Well, we're about to come to the end. And I want to thank you both so much for coming on. And I also wanted to invite you, if you want, I guess there's anything else that you want to add to our discussion today that we haven't brought up that you feel would be important for our listeners and our focus community to kind of know or, again, yeah, that would be of interest to them.
Bernie Wright:I think, whether, I don't have interest, but I think when we talk about looking into looking at our clients and walking in their shoes. Let's really walk the talk and walk in their shoes. And at the moment, I don't think that's what we've been taught how to do.
Mel Ciavucco:Yeah, I would just say, I suppose maybe I'm saying this to myself as much as others. But for training counselors out there, you know, speak up and fight for these things that we should be learning, because we're going through quite a revolutionary time in terms of counseling, it's a very exciting time to train to be a counselor, because COVID pushing everybody online, I think has fundamentally changed the way that we'll do things, some people working online before, but now, a lot more going to with being online that brings accessibility, and now we've got opportunities, we've got so many opportunities, with training, changing the way they're doing. I don't you know, my university has a blended approach. Now, this going forwards can only really help inclusion and diversity. And this is kind of you know, what it all comes back to as well. So I think there are positives in that. And we're moving in the right direction. But it is, you know, there's a there is an opportunity, there's an opportunity here for people who are going to be, who think about training to be counselors who want to be like the sort of people going into it, we want to question ourselves, we want to be pushed out of our comfort zone, we want to do that we wouldn't be training to be therapists otherwise, that's an opportunity, like, and there's an opportunity here to look at these biases. And that includes weight stigma.
Bernie Wright:Absolutely. I couldn't agree more. I really couldn't.
Leila Bishop:I agree. Again, thank you both so much for coming on. It's been an absolute pleasure. And I thought I knew a lot about this subject and you both kind of taught me something or just reminded me of things in a different way. And I feel our listeners will feel the same way. Again, thank you so much to Mel and Bernie.
Opening:Thank you for listening to the Therapists Connect Podcast, go to www.therapists-connect.com. For more discussions, and debates. This episode of Therapists Connect podcast is sponsored by webhealer the number one website provider for private practice therapists serving the community for 20 years a webhealer offers a non technical and fully supported online platform, helping therapists use the internet to grow their practice. Whether you need a website, a booking system, or even a secure email address for your practice, webhealer can help contact webhealer today via www.webhealer.net and use the coupon Therapists Connect for 100 pounds off then do it for me service