How My White Eating Disorder Therapist Keeps Forgetting I Am Black

I have a backup therapist for when my therapist is out of town — eventually she will take over my care since my therapist is about to retire.

I recently decided that I was no longer going to diet. I knew this therapist started her career as an eating disorder therapist. I decided to approach her about my decision to stop dieting and see if she was in support of me stopping dieting.

I am what the medical community would consider “morbidly obese.” I feel like no one looks at me and says, “she is not that big.” I am tall and very large.

Every doctor I have ever seen, no matter the reason, has something to say about my (perceived) dangerously high weight. Even after I have lost a significant amount of weight, they are still not satisfied and recommend that I lose more.

I tried everything that I (and others) could think of to lose weight. I was literally starving myself. It is correct to say that I hate my body and feel the world does too. I am under so much pressure to fit into a construct that is impossible for me. I will never be a thin white woman.

So, I turned to this white, cisgender, thin therapist and asked for her help to overcome diet culture and try to live a fulfilling life dieting-free.

The first thing I did was remind her that I had asked her in the past to never bring up her philosophy around dieting since I was already a part of a dieting program and was not willing to change. She said she recalled that conversation.

So, I said, “I want to take that back and ask you what your philosophy around dieting is.”

She immediately said, “I do not believe in dieting. There is nothing good about it and dieting is destructive on many levels.”

She Heard Me

It was the most fruitful conversations I had ever had about my weight and body image. I almost cried. She was on my side and I was free to heal. I reached out and she reached back, and the healing had permission to begin.

When we were done, she gave me a slew of resources and books to explore before our next meeting.

I went home and immediately went to work. After I started reading the books and looking up the resources, I immediately realized that none of these resources were written for me. They were all about white middle-class women. There was not a single resource that addressed my specific areas of concern. As a Black woman in a white world, my issues about diet culture, body image and weight are significantly different and needed to be considered when treating someone with disordered eating.

The Confrontation

I was once again caught in a position to educate my therapist. Once again, I feel exhausted having to ask for what I need from someone who should be cognizant of these issues and be proactive in leading me to culturally appropriate materials and resources.

I wrote her the following email:

Dear Therapist,

Thank you so much for yesterday; our talk was very helpful. The best discussion I have had about my body ever. I look forward to more conversations.

I am reading the book you recommended; it is good. If you can think of any of this kind of book being written by, for or about women of color, please direct me. The perspective of a white woman writer is different than a Black writer and the social pressures are unique in each community.

I did look on social media for body positive women to follow and explore. What I found is that most are white and heterosexual. I will continue to search for some body positivity influencers that are Black and lesbian, but I am worried I will have a hard time finding any. If you have any ideas on how to search for what I am looking for, that would be great. I am not so familiar with Twitter and Instagram, even though I have accounts.

The Black woman does not absolutely have to be a lesbian, but some of the sites I saw were pushing a message of being beautiful/sexy for men and not for themselves.

Thank you for any help you can give me on this.

Sincerely,

Maya

I was nervous about sending the email; I did not know if she could deliver on what I needed and was concerned she would feel threatened or offended. I did not hear from her the rest of that week. So, I was not sure what to think.

Upon my next appointment with her, she said, “I got your email and I sent it out to fellow colleagues, and I have several resources for you.” I was so relieved she heard me and responded appropriately. Turns out even some of those resources were not relevant.

It is frustrating to not have all you need when you need it.

I am still not sure how I will move forward with her. She clearly has limited experience with working with Black people with eating disorder issues. I am not sure how much a culturally specific treatment will be necessary. I may once again have to educate myself and my therapist.

By not giving me culturally competent treatment, she compromises my well-being. It is exhausting, having to confront practitioners about their white-centric approach to treatment.

For once, I just want a practitioner to admit their limitations and work to overcome them before I have to take the risk and bring it up. In the past, I have had people cry when I have challenged them on their implicit bias in their treatment of me. Once again centering themselves.

I will confront her because my insurance is limited, and she specializes in dissociative identity disorder (DID), which is the specialized care I need. I am going to ask her to do her own homework so that she can be the best possible therapist she can be. I need her. I know she means well. I just hope she is as open to working on all of this and changing her practice to be more culturally competent as I am.

I have learned through this experience that you have to advocate for yourself because no one else is going to always provide exactly what you need.

For some anti-diet, body positivity, Black-centric resources I have discovered, see my last article.