Every time I have entered therapy with a new therapist – and over the course of my lifetime I have seen several for more than a session or two –I have encountered what I call the thin gaze and with it the assumption that I should want to lose weight. The thin gaze is the objectifying gaze cast upon the fat person by someone who is not fat. Eventually, I became able to use anger to defend myself, which of course only made me come across as resistant and defensive, but at least that was better than mutely accepting their indictment. Inside, under the anger, I felt shame and pain. Why was what concerned me of so little interest or value? Why was anything I was concerned about automatically filtered through the therapist’s notions about my weight, even when weight was not the object of my concern, at least not then?
Almost every approach to working with the fat patient in psychotherapy involves the notion that her fat is the result of trauma in the past and that the answer lies in losing weight, becoming less fat or even better stop being fat at all. But what happens if we begin to think instead that her fat, rather than being a response to trauma or any of the several complexes Marion Woodman outlines, what if her fat, if being fat is itself a source of trauma, ? What if we look at the effect on the psyche of being visibly different, visibly part of an “injured group”?
It has been assumed by some writing about obesity that one of the causes is a trauma history, that becoming fat is a defense against, a reaction to trauma. Indeed this is essentially what Woodman asserts. But consider another possibility — that it is being fat, being on the receiving end of the bias, stigmatization, vilification that comes of being fat that is the trauma, a trauma which remains present every day so long as one is fat. The fat woman who has a trauma history of abuse or neglect, for example, has not only the effects of the trauma of the past as they bubble up and influence her life in the present to deal with but also the trauma of being deviant, of having a stigmatized body and she faces this trauma every day, every time she steps outside her home. Neither trauma can be erased as history cannot be rewritten and bodies resist reshaping so the task is to learn to recognize the effects of the trauma and develop means to cope and live fully.