Foucault, and stuff (this is a piece I wrote for a newsletter on social justice informed practice)

When clients come into my office for psychotherapy, they are usually focused inward, potentially seeking a diagnosis, and often asking “what’s wrong with me?” Yes, the majority of my clients are working through gender dysphoria or pursuing recovery from an eating disorder, and while these are indeed conditions I can diagnose, much of the work I do with folks is about exploring the ways in which structural oppression related to their sexual orientation, gender expression or race is causing distress, both directly and in its internalized forms. In other words, we shift from asking “what’s wrong with me?” to “why do I think something’s wrong with me?”

From a social justice perspective, one of the most insidious ways oppression in the form of patriarchy, misogyny, class bias and racism (among others) does its work is through internalization. When people internalize these structures of power and disempowerment, the self hatred and self doubt that ensue wreak all kinds of havoc in terms of beliefs that impact behavior and emotional experience, which then often leads to the development of some form of psychopathology. I vividly recall a professor at the Smith College School for Social Work stating: “The greater the oppression, the greater the depression” and I have seen this to be true over and over again in the lives of the people who walk through my office doors.

There was a time (and in some cases, that time is now) when people in my chosen profession, social work, were largely tools of oppressive structures. In the words of Michel Foucault: “The judges of normality are present everywhere. We are in the society of the teacher-judge, the doctor-judge, the educator-judge, the social worker-judge.” For example, as the majority of my clients are transgender or gender non-conforming people, many require authorization from me for their insurance companies that they are “trans enough” to receive gender affirming hormone therapies or surgeries. Many of these folks also experience profound depression and/or anxiety: how would you feel if your fate, your ability to live a life as yourself, was in the hands of an ostensible expert, deemed more expert than you about your own self-hood by virtue of their social position and capital?

My work, as a social justice oriented feminist relational psychotherapist, is kaleidoscopic. I work to support my clients in identifying the ways in which they’ve internalized oppressive structures. We work together to identify the ways they’re policing themselves and warping their sense of self through these lenses, and then we work to dismantle the problematic internalized beliefs that are setting them up for emotional distress and behavioral dysregulation. In other words, I sincerely look forward to a day when I become obsolete.


My way or the highway.

I am a serious fan of perspectives. I had a high school history teacher who was fond of saying that “truth is increasing complexity”, and in both my personal and professional lives, I have found this to be, well, true.

When a client presents me with a truth, about themselves, about an experience, we work to increase complexity. Are you sure that’s true? Has it always been true? What else might be true? What do others in your life believe to be true? Often, in this way, we are able to triangulate, and to move in the direction of deeper knowing, of more true, but also to open space for subjectivity, and breathe some light or humor or next questions into that space.

It is in the spirit of that kind of inquiry that I offer the following blog post by Holly Glenn Whitaker:

This is not a prescription. This is not an indictment of AA. It is also not an endorsement of Holly’s sobriety coaching program. It is, however, a perspective. There’s this Buddhist expression, “If you meet the Buddha on the road, kill him!” It speaks to the dangers of making something or someone your god, which is easy to do when you feel as though you have been saved, but the reification of any one concept or any one guru or organization can be fraught with peril.

I work with a lot of clients who struggle with substance abuse because when the world offers you its misogyny, its transphobia, its racisim and its fat phobia (amongst others) to internalize, numbness and escape often sound like the loveliest of sirens. I have folks who come to my office who have found a sober life working an AA program, and it’s glorious. I also work with clients who have found that the language of powerlessness and surrender was inaccessible to them in the context of a history of sexual trauma or internalized hatred and disempowerment, and who echo Holly’s statement that in fact, making the choice to let go of alcohol because you can’t use it and be well is profoundly powerful, and profoundly empowering.

You can’t get sober by yourself, but you’re also the only one who can get you sober. The rooms of AA are one available community within which to do that work, but they are not the only one: could this be a truth?

Here’s What Happens When A Man Spends Two Weeks Eating Nothing But Food Made For Women

“Why is this strategy (or, as my wife calls it, “the bullshit I’m subjected to”) so dumb? Because at best, even when these food products are fortified, the nutrients are seldom present in “enough quantity to actually do anything,” an expert said recently. And at worst, they minimize half the population by constantly calling them fat and turning them into a species that requires its own type of food.”

via Here’s What Happens When A Man Spends Two Weeks Eating Nothing But Food Made For Women.

We’re clean eating our way to new eating disorders –

“Because overdoing it is the American way, we’ve now managed to warp even healthy habits into a new form of eating disorders. Welcome to the era of orthorexia.

As Heather Hansman notes this week in Fast Company, orthorexia differs from other forms of disorders in that the obsessive focus is not on how much or how little one consumes, but the perceived virtue of the food itself. As she reports, “Nutritionists and psychologists say that they’re seeing it more often, especially in the face of restrictive food trends, like gluten-free, and growing information about where food comes from, and how it’s grown and processed.” Though the term has been in use since Dr. Steven Bratman coined it in 1997, the uptick in cases is leading to a new push to formally include it in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders – aka the DSM 5.

Along with “gluten-free,” “juice fast” and other phrases, you may have been hearing “orthorexia” a lot more lately. Last summer, popular health and food blogger Jordan Younger made headlines – and faced intense criticism – when she announced that she was “transitioning away from veganism” as she realized that she had “started fearing a LOT of things when it came to food,” and had been struggling with orthorexia.”

via We’re clean eating our way to new eating disorders –

Does this Baby Make Me Look Fat?

Don’t worry – the pregnancy related posts will run their natural course some time soon because I’m due in mid-March, but until then, it’s pretty hard not to reflect on something that’s so powerfully shaping my experience of myself, as well as the way other people experience me. According to this excellent article (Body Image | Brown University Health Education“Body image is a widespread preoccupation. In one study of college students, 74.4% of the normal-weight women stated that they thought about their weight or appearance “all the time” or “frequently.” What gets really wacky with pregnancy is that suddenly many of the people I interact with on a daily basis are now also thinking about my weight and appearance all the time or frequently, and they appear to feel quite comfortable commenting on these factors.

I spend a fair amount of time reassuring clients that no one else is paying as close attention to their body and the subtle shifts in appearance that folks tend to fixate on within themselves. And this is true. Really, it is. You can even do an experiment. Look at someone you know every day for a week. I can guarantee you that their weight will fluctuate within at least a 3-5 lb range based on the time of day, the sodium content of their food choices the previous day and etc, but to you, they will appear stable. Especially for the I-weigh-myself-one-million-times-each-day crowd, the same is probably not true for your own body image. In other words, if you see numbers fluctuating on a scale, you will believe that you see your appearance shifting drastically because the beliefs you have about those numbers will skew your perspective. It is possible to look at the same thigh two days in a row and see it as reasonably proportionate one day, and massive and disturbing the next without the poor leg actually changing at all.

What’s really zany about pregnancy is that suddenly all bets are off. Everyone, from receptionists, to friends, family, mail carriers and dudes holding doors open actually is actively visually assessing me, which if it wasn’t obvious from the gazes is obvious because people say stuff. Feel free to gasp. It is the worst nightmare of the dieter, the disordered eater, the female high school student, and, some days, me. Everything I’ve been taught, everything I preach to my clients about body image and reality-checking has been turned on its head for the last 27 weeks (12 weeks and 6 days to go, in case you’re keeping track). I can now assume that when I leave my house, someone’s going to comment on my size. Many days, it’s many someones. In our culture, bearing a babybump is basically the same as wearing a flashing neon sign on your head that says “Hey, check me out! And then compare me to pregnant celebrities! To my face!”

The fascinating part of this turn of events is that the assessments of how I look, and the comments that are made, frequently pretty obviously say more about the person making the comment then they do about my actual appearance. I know this because sometimes I get a “Wow, you’re such a petite person that it makes your stomach look really huge”, and then five minutes later I get a “Wow, you’ve really only just started showing, your bump is so tiny” and then an hour after that I get a “Wow, your boobs are so huge!” (no, I am not making these things up). In other words, just like personal body image fluctuates with mood and context, so do the assessments other people are making about my body across the course of one day in which the only thing actually changing is how bad the baby-induced heartburn is. The ludicrous diversity within these comments has actually helped me get some perspective because clearly people are not seeing me. They’re seeing me, distorted through their own ideas about femininity, motherhood, my role in their lives and probably their relationships with other women.

It’s terrifying, don’t get me wrong, and I am very much looking forward to getting out of this spotlight, but I’ll be taking some lessons with me about how profoundly relative and subjective thoughts and feelings about appearance can be.

From Emma Watson’s nude threat to abusive YouTube comments

This re-blog is a bit outside the realm of my usual commentary, but I think it’s important, and highly relevant. The cultural context within which our bodies live has a huge potential to impact our relationships with ourselves, and the ways others perceive the embodied female form (or male, for that matter). The more the female body is objectified and/or disrespected in the public eye, the more likely those beliefs are to leach into women’s relationships with their own bodies, or other’s attitudes towards them.


“Stolen celebrity nudes are, by definition, not consensual. Someone who looks at them is complicit in the abuse — he is looking at something released explicitly against the will of the person depicted. That’s bad behavior. It’s also scary behavior. Because if someone doesn’t care about consent in that context, where else might he decide it doesn’t matter?”

via From Emma Watson’s nude threat to abusive YouTube comments: why women aren’t safe on the internet | The Verge.