Our vision is distorted

From the early years of my practice, I’ve been questioning the idea of Body Dysmorphia, my feeling that it is a term used to further pathologize folx with eating disorders (which bypasses the dominant culture’s responsibility in creating insidious patterning around food restriction and control). I am not denying that people’s experiences of their bodies can be confusing and hard to understand, and include in that the conceptual understanding of its literal finite limits. 

I believe this confusion and difficulty conceptualizing both the size and felt experience within our bodies stems from many things, but for the former most certainly the natural outcome of being told, for sometimes decades, that your body is the wrong size, and being instructed to pursue a differently sized or shaped body. It is also a byproduct of a body that has changed drastically throughout a short period of time, which can happen for many reasons, at any time. It is hard to hold on to, much less understand objectively, an ever-changing body. However, in our ill culture, holding on to the idea of a perfect objectified body creates (and literally offers) safety and access, which is a collective illness which is ours to heal. 

And all of our bodies are. Ever changing. Constantly. Changing.

For a very few among us, our size can be controlled with relative ease. For many of us, dieting, restriction, and control have been the means we have tried to achieve a controlled body, and so when it inevitably changes, we feel confused, befuddled, and chaotic. Our experience does not match what we were told. Our attempt to hold onto, be static, not change, failed and shame clouds the experience. Sometimes, our body’s size doesn’t change at all but our lived experience does, or are feelings do, and if we have less access to adequate support or are feeling uncomfortable, our body has always been a scapegoat so we continue to hustle and get in line on the body project.

Walking away from this requires shame tolerance, boundary skills, communication skills, good support, a steady income and flow of food, safety….. which is a short start to a long list of unique things needed to de-identify with the idea that our body is a project. 

I would love it if healthcare professionals stopped identifying the body as the problem, and started identifying things outside of the person as the problem that have made safety and wellbeing inaccessible. The forces that have created the conditions where a person turns to body control in order to be perfectly objectified as a means of seeking safety. As healthcare providers we can offer a widened lens, we can offer a different conceptualization then has been offered before- we can say your body and you are not a problem to be fixed, rather that you are in pain and what can I do to support in removing barriers to healing. Sometimes, that’s nothing other than to sit and listen. To hold space. 

But what we’ve done is we’ve created flow charts and diagnoses and patterns of recommendations and gold standards and ideas about healing that have maybe worked for some. I am speaking of course to my expertise in my field of eating disorder recovery, but I’m sure this pattern can and does hold true in many healing settings, it certainly has in many if not most of my exposures with the healthcare and wellness realms in the US. Instead of getting curious, we have answers. Instead of asking what do you need, we decide what’s needed. Instead of saying this sucks, we say there’s a solution! 

When there is only one way, when we narrow in on the problem + solution equation, the lens becomes very narrow and the person, and their whole humanity, becomes irrelevant. Which diminishes expansiveness and possibility. It also removes safety and creates pressure. 

I understand, as a healthcare provider, and human, how scary it is to say: I don’t know, but we’ll see. I’m not sure how your recovery will go, I’m not sure if your pain will go away, I’m not sure if any outcome is assured. But, I’m willing to sit with you in this and get curious about what is possible.