💬Discussion post: Do you talk to anyone about your body stuff?
Anna Maltby and I want to know.
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Now, a discussion post — less “Mikala writing,” more “commenters commenting” — in collaboration with Anna Maltby, who writes the fabulous newsletter How to Move.
Anna emailed me about something she’s noticed in the course of her own work and suggested I write about it. I thought I’d open it up to my readers, and Anna’s, because it’s a great question that I really don’t know the answer to.
Here’s what Anna shared and asked:
When I’m speaking 1:1 with someone about exercise — usually an intake session with a new personal training client or an “office hour” session with one of my subscribers (where we troubleshoot their workouts, programming, etc.) — I often notice that people need a lot of time to talk through/explain/process their back story with their body and movement.
Nearly everyone has been on such a long and winding road of dieting, disordered eating or exercise, injuries, fertility/pregnancy/postpartum stuff, and health issues that have had a significant impact on both how they feel physically (which of course has a mental health impact) and their body image. They often fight back tears when talking through it all (as do I, listening). It feels like a mini-therapy session, except of course, I’m not a mental health professional.
In one recent conversation, someone described the particularly horrible place she was in with her body dysmorphia. Just persistent, intrusive negative thoughts about her body, clouding around her pretty much all the time. I gently asked her if she’d spoken with her therapist about it, and she said, “Not really.”
I’m always so grateful to folks for being open and vulnerable with me, and it’s hugely helpful to me to understand their experiences, but I’m so curious whether most folks actually bring up their body stuff in therapy (outside of eating disorder treatment and/or specifically working with a body image–focused therapist). I definitely don’t think I ever have. We really need support for these issues, but aside from reading work like yours, Mikala, or following (hopefully) helpful people on social media, we may not necessarily be getting it. In therapy settings (if we’re in them, which is a whole other issue!), I wonder how many of us are leaving out this huge thing that has an enormous impact on how we feel every day, physically and emotionally.
I find this fascinating because, of course, I am someone who talks (and writes) constantly about my body stuff. The first place I started doing all of this was in a therapy setting, with a therapist who helped me start understanding and dealing with my binge eating disorder. In all the years since, even if I was primarily speaking to a therapist about something else, my body stuff was up for discussion at some point or another. For better or worse, it touches so many points of my life, and talking about it makes it feel so much less harrowing when I’m going through an especially iffy time with it.
I also talk pretty openly about body stuff with trusted friends because we’ve established that sort of trust with each other over the years and many of us have been through the same thing. That’s only my experience, though; Anna’s email makes me wonder about other people’s.
Anna had this to say about her own:
I truly hadn’t even thought about this in my own life until I started wondering about it for my clients and subscribers. And I admittedly don’t think I have a particularly tough relationship with my body (I’m very, very lucky and, as far as I can tell, unusual in that regard), but we all swim all day in the waters of diet culture, and of course it gets me too, especially as I’m starting my initial tiptoe into the perimenopause/aging process.
If I’m really honest, I think some part of my brain thinks body image is less important to deal with than my other issues, like relationships with loved ones, parenting shit, my fun little social anxiety problem. Yet, the body is always there, and always changing, whatever else is happening. And: I love my therapist so much — she’s truly the BEST — but part of me thinks I would almost feel embarrassed bringing up body stuff with her? Even though I totally know body stuff is just as big a deal as anything else. I think there’s some kind of stigma hanging around it for me that I haven’t processed yet. Maybe it’s time to make an appointment.
So, let us hear it: Do you talk with a therapist or some other sort of professional about your body? If not, is there a reason why? Do you at least talk if you need to with friends, a partner, or some other supportive person? Simply put: Where do you go when you need to talk about this stuff, process it, and get it off your chest?
We’re also calling in some fantastic people on this platform who are either therapists, doctors, dieticians, or who have written about this sort of thing. We’d love to hear their thoughts, too, and direct you to their work:
Not really, now that I think about it. I'm thinner than my therapist, my friends, and my partner, and I try not to bring up my body dysmorphia and years of body image bullshit because I'm aware of how it looks and sounds, very champagne problems if you aren't in the exact body and brain space that I am. I try to be very aware of how my words will affect others, so I avoid speaking about it at all in order to avoid triggering or activating someone else's stuff. But the trade-off is that I don't really have an outlet for any of the self-hatred I deal with every day and it sometimes boils over into participating in self-harming behavior like purposely triggering my ED or BDD because I'm hurting so much and don't feel like it's okay to talk about. Nobody likes to hear the skinny girl bitch about how she thinks she's fat!
What a great question! (And thanks for the shout-out.) I have had many similar professional experiences to Anna's. A patient will come to see me ostensibly about one medical issue and the conversation SO OFTEN turns to body size and body shame.
Sometimes it's an issue that could conceivably be related to body size (like, back pain, although I will remind everyone that lots of thin people have back pain -- lots!!). But often it's something that is truly unrelated: "I'm here to talk about a toenail fungus, but oh, Dr. Gordon, did you see that I gained 5 pounds? I need to lose weight. I need to 'get healthy.'"
I'm happy to have those conversations. It's a huge part of my job. Or maybe it's that people don't have any other spaces to have those conversations!
But I've been thinking critically about how primary care -- my field -- has really come to be seen as sort of a "fatness audit" rather than a place for holistic care. And I get it -- insurance sucks and appointments are 20 minutes long -- corporate primary care doesn't always feel like a healing place.
Still, I'm continually struck how deeply people associate primary care with an assessment of body size. Most of my patients expect that I will tell them 1) that they should and 2) how to lose weight. (Except for a small subset of patients who seek me out of as a size-inclusive doctor and know from the get-go that isn't my style.)
I'll also share one personal story: As a writer and a medical educator, I often find it much easier to talk about body stuff in public than with people in my own personal life! It still feels deeply taboo, and I'm on a pretty public roadshow about this stuff. An eternal work-in-progress!