Written by Carrie Pollard, MSW RSW
A client has been referred to you that struggles with rigid rules around eating and exercise to the point that it has caused significant weight loss and interferes with this client’s day-to-day life. What do you picture in your mind? What assumptions did you make about this client’s age? Sex? Gender expression and identity? Race? Religion? Body size? Did you imagine this person to be able-bodied? Eating disorders do not discriminate, yet marginalized populations are not only higher at risk, but they also have differential access to care, are underrepresented in research and are often misdiagnosed in clinical and medical settings.[i]
When we have biases about the folx we work with, we can cause significant harm and distrust. Engaging in our own inner work to examine and challenge our implicit biases and beliefs, and acknowledging our privileges is critical to providing informed, compassionate care.
Before moving forward with my ‘Top 5’ list, please recognize that this is a simple list about serious and important work and is, by no means, comprehensive enough. It has also been written from my lens as a cisgendered, heterosexual, white, able-bodied, registered social worker that has a parent that is an eating disorder warrior in ongoing recovery. The suggestions I make on how to work from a mindfulness-based, anti-oppressive practice in eating disorder care are reflections of this and will continue to change as I grow as a person. I hope they provide some guidance on how to do your own work.
1. Be vulnerable. Dig deep and explore how your identity (and all the intersections that inform it) and experiences have shaped your beliefs about yourself, others, and the world. Acknowledge your privileges and how it informs hurtful beliefs, biases, and actions. This includes blindness to our differences and silence in response to injustices and discrimination of others. [ii]
2. Be mindful. Take time to pause and reflect on the language you use and how it guides questions and assessment. Learn about ways to neutralize your clinical language and be more inclusive. [iii] Acknowledge microaggressions and other harmful assumptions that present themselves in session. Mindfully slowing down this process will increase awareness and reduce defensiveness. Mindfulness also helps us recover if we’ve made an error or caused harm, so that we can compassionately be accountable, apologize, and if possible, repair.
3. Be curious. Take courses, read books, participate in group discussions and debates, and listen and learn from the experiences of others[iv] so that your knowledge and understanding of the diverse and complex relationships folx have with food and their bodies expands.
4. Be compassionate. We’re all imperfect and shaped by the biases of the world we exist in. In the journey to providing mindfulness-based, anti-oppressive care to our clients, we’re going to fail and feel uncomfortable… repeatedly. When this happens, we need to ‘pause for compassion’[v] (rather than shame or defensiveness) as this will better foster accountability and nurture change.
5. Be brave. Have courage to address your own harmful beliefs and behaviours, as well the willingness to challenge others in their practice. Moreover, work to create a safe space for your clients and/or patients to correct and question you.
Let’s try this again…
Pause for a moment. Notice the sensation of your feet on the ground and focus on your breath. With a clearer mind, read this again:
“A client has been referred to you that struggles with rigid rules around eating and exercise to the point that it has caused significant weight loss and interferes with this client’s day-to-day life.”
Now what did you picture in your mind? I’m hoping that these practices, which help me, allow you to make less judgements and assumptions of who struggles with disordered eating and body shame.
References
[i] Doan, N. (2021). Socially Driven Inequities and Disordered Eating Experiences. Retrieved from WWEDC October 20, 2022, from http://www.eatingdisorderscoalition.ca/blog/2021/11/5/socially-driven-inequities-and-disordered-eating-experiences
NEDA. Eating Disorders and Identity. Retrieved October 20, 2022, from https://www.nationaleatingdisorders.org/identity-eating-disorders.
NEDIC. Affirming Care for Every Body. Retrieved October 24, 2022, from: https://nedic.ca/2slgbtq/
NEDIC. Eating Disorders and BIPOC Communities. Retrieved October 24, 2022, from https://nedic.ca/bipoc-initiative/
[ii] Saad, L.F., (2020). Me and white supremacy. Sourcebooks.
[iii] Millyard, A., Gilbert, C., & Liss, K. (2021). Neutralizing clinical language: Working with gender and sexual diversity. Retrieved October 20, 2022 from, https://cyndigilbert.ca/wp-content/uploads/2020/05/Neutralizing-Clinical-Language.pdf
[iv] NEDA. The Marginalized Voices Project. Retrieved October 20, 2022, from https://www.nationaleatingdisorders.org/marginalized-voices
[v] Magee, R. (2021). The inner work of racial justice: Healing ourselves and transforming our communities through mindfulness. Tarcherperigee.