What do domestic abuse and disordered eating have in common? How do they intersect and interplay? In this blog post, both my working worlds come together in a discussion and reflection on similarities and intersections I see between disordered eating and domestic abuse, for both victim/survivors and perpetrators.

A note on language: I use the term “victim/survivors” as different people prefer different terms. I may speak about perpetrators as male, though I’m aware other genders can be perpetrators too, but I predominantly work with men. I also am speaking in binary terms in this post, but would like to highlight how trans and non-binary people are particularly vulnerable to abuse and disordered eating.

Disordered eating

Let’s start with what disordered eating actually means… well, different people define it in different ways, but for me, I like to use it as an inclusive term for eating disorders and any distress around food or exercise, irrelevant of diagnosis. Sadly, many people find it difficult to get a diagnosis of an eating disorder, and many struggle to access any help due to cultural or societal barriers. I’ve heard the “not thin enough” rhetoric too many times now from people who have been turned away from NHS treatment.  BMI (body mass index) is often still used to gatekeep services, even though the NICE guidelines say otherwise, but NHS services are overstretched as it is.

Despite what many people think, most people with disordered eating are at higher weights (Duncan et al. 2017)
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A study by Hay et. al. (2017) showed that anorexia nervosa was only 8% of all eating disorder cases, which may come as a surprise to many. The most prevalent is "other specified feeding or eating disorder" (OSFED), because unsurprisingly, eating disorders do not fit the tick boxes easily, and most people are not thin. The stereotype of the thin white teenage girl with anorexia is overused, however, access to treatment requires a level of privilege, so treatment and research is often based on this limited demographic.

I created this image, which I use in my workshops, to show how I view disordered eating and how diagnosed eating disorders are just the tip of the iceberg.
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Eating disorder treatment can largely be focussed on anorexia nervosa because it does have the highest mortality rate, and people are often very unwell by the time they access NHS treatment. The idea of being “not thin enough” for treatment means that people are losing even more weight, exacerbating the eating disorder. The system is very much “firefighting” we might say, with people only getting the help they need when they are at crisis point. I liken this to domestic abuse services… there for when people are in crisis and are trying to flee an abusive relationship. For eating disorder recovery, the goal is often a “healthy” weight on the BMI chart, in domestic abuse it’s often to get out of the relationship. Neither of these solutions fully help the issues, it’s just dragging people out of the situation that they will enviably end up back in again because the deeper-rooted patterns and issues are not being addressed.
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My view of both takes a “zoomed out” approach, considering the bigger picture of societal and cultural issues we need to tackle to help prevention. Both disordered eating and domestic abuse sit within a context of patriarchal rules and gender expectations, systems of oppression around race, body ability and size, gender, sexuality etc. Poverty and food insecurity plays a huge role in relationships with food and is a contributing factor to disordered eating. Striving for weight loss is often at the root of why disordered eating develops in the first place (though not for everyone), because of our social and cultural reliance on thinking that thinner is better. There are many different influencing factors, which is why eating disorders are so complex and need to be viewed through an intersectional lens.

Domestic abuse

I work with perpetrators of abuse, which is my way of trying to go upstream. Helping people leave abusive relationships is so important of course, but we need to go to the root of the problem, which in many cases… is men (#notallmen etc etc). YES, I KNOW OTHER PEOPLE CAN BE PERPETRATORS, but my work is mainly with men because they are more likely to be perpetrators of abuse. I’ve written another blog about my work with perpetrators, which you can read here.

I am not here to blame or point fingers at men but rather help the ones that want to be helped. Not all of them want to be helped of course, but many do want help to manage their anger and change their behaviours. This is how we break the cycle, so people don’t end up in other abusive relationships, and so that kids don’t grow up to normalise abuse. Victim/survivors and children are always at the heart of perpetrator work.

What do both domestic abuse and disordered eating have in common? Control.

Disordered eating and body image problems can be a form of coping, to try and regain control when other aspects of life feel out of control, or when things from the past have created a need to feel safe. Domestic abuse is about control, a fear of feeling out of control and sometimes a deep fear of abandonment. Many victim/survivors, and perpetrators, have experienced trauma or difficulties in childhood, which can contribute to needing to feel in control to feel safe. For male perpetrators, masculinity expectations in our society (e.g. strength and dominance) and the impact of living in a patriarchal society, and power and privilege, can all contribute to an abusive relationship.

Domestic abuse takes many forms, coercive control being a more subtle, manipulative way of controlling and silencing victims. A person’s body and appearance can be a target for a perpetrator who may want to isolate their partner. They may make subtle comments about what they’re wearing or about their weight to fuel the victim’s body image concerns, which in turn can discourage them from going out. For a victim/survivor of domestic abuse, weight and appearance might be one thing that they feel they can control. They may need to be fixated on weight loss to meet a standard their partner expects, or it may be to avoid weight-shaming comments from them. They may experience this like gaslighting, it’s their own fault they’re fat (which they may feel means “unlovable”). They may be judged for what they eat by partners, or if money is tight they may be made to feel guilty about eating. They may prioritise feeding their kids, they may have to rely on food banks and feel ashamed. Kids can sometimes refuse food as it’s their only way to communicate that something is wrong when they don’t have the language that adults do. These are just some examples, there are many ways that food and appearance can intersect with domestic abuse, both as a coping mechanism for victim/survivors, and as a method of control used by perpetrators.

Exercise and steroid abuse

Although men obviously do struggle with eating disorders too, men may find themselves leaning to exercise and “bulking up”, which we could speculate as being a quest to feel more masculine perhaps or a way to feel stronger and in control when they feel emotional and vulnerable. “Muscle dysmorphia” can lead to over-exercising and the use of diet/protein products to build muscle, and there is a risk of steroid misuse.

Anabolic steroids are legal for personal use, but it is illegal to supply or sell them, though this does not stop people from buying them online or through gym contacts. This is particularly dangerous as there could be anything in them. Anabolic steroids can increase anger, anxiety, aggression and hostility (Oberlander and Henderson 2012) as well as having physical effects and the risk of becoming psychologically dependent. There is a documentary by Reggie Yates on YouTube called “Fatal Fitness: dying for a six pack” which highlights many of the issues with exercise and steroids affecting men.

The eating disorder voice

Many people in recovery from an eating disorder speak of the “anorexic voice” or “eating disorder voice” - the critical thoughts that shame them and tell them what to eat/what not to eat. This voice, many say, is like an abusive partner (or parent) in their heads. That part can’t just be switched off, they can’t escape it, because it’s deep-rooted… it’s similar to how a victim can’t easily leave a perpetrator.
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The cycle of abuse is decidedly similar to a binge and restrict cycle:

​Shame plays a big part in this. With perpetrators we talk about the “pit of shame” and how hard it can be to get out. They can feel ashamed of their behaviour but sometimes unable to break the cycle, falling back again, feeling out of control when they get angry. For victims, trying to leave isn't just about building resilience and strength, it’s literally about safety, as the risks can skyrocket when they separate. The risk of stalking harassment and even homicide increases after separation. In the same way that victims stay in relationships to try and keep themselves safe, people hold on to disordered eating for that same safety.
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There is a great story/metaphor by Dr Anita Johnston about clinging to a log in a fast-flowing river. Even when you reach calmer water, and there are people on the river bank who can help you get out, the log saved your life so it’s hard to let go (the video is at the end of this blog if you’d like to watch it in full). This is meant to demonstrate the power of disordered eating, but can equally demonstrate the difficulty of leaving an abusive relationship.

Both domestic abuse and disordered eating are about power and control ultimately. Both are linked to trauma, and cannot be separated from systemic issues and inequalities. However, it’s important to work in a case-by-case, client-centred way, honouring their unique experience and intersecting aspects of identity.

If you’re struggling with any of the issues discussed in this blog, I offer counselling sessions online – find out more here.

If you’re looking for more information and training on disordered eating, I’m offering a workshop through Online Events on 27th September. I also plan to run training elaborating on this blog, on domestic abuse and disordered eating, so if you want to be updated on this please sign up to my mailing list.

Resources

• FearLess -support for domestic abuse, sexual violence and stalking (and perpetrator programmes)
•  Freephone National Domestic Abuse Helpline, run by Refuge: 0808 2000 247 
• Men's Advice Line on 0808 8010 327 (Monday to Friday 10am to 8pm), or visit the webchat at Men's Advice Line (Wednesday 10am to 11.30am and 2.30pm to 4pm)
• ManKind on 0182 3334 244 (Monday to Friday, 10am to 4pm)
• LGBT+ - Galop on 0800 999 5428 
• Karma Nirvana on 0800 5999 247 (Monday to Friday 9am to 5pm) for forced marriage and honour crimes. You can also call 020 7008 0151 to speak to the GOV.UK Forced Marriage Unit

 
BEAT Helpline: 0808 801 0677 https://www.beateatingdisorders.org.uk/

First Steps ED: https://firststepsed.co.uk/services-and-support/ (counselling, befriending, groups, workshops and more)

Anita Johnston log video:

As a child in the early 1990s, I had free school dinners. As I clutched my special token, waiting for my slab of pizza and green custard for dessert, I knew for the first time that I was different. People thought I was poor, but – even worse – they thought I was fat.

I was told to ignore the people who bullied me (the old ‘sticks and stones will break my bones’ motto) but my worst fears were confirmed by the school nurse. I was not normal. The BMI (Body Mass Index) chart showed that I was too fat and I had to lose weight to get to the ‘normal’ category as soon as possible. The BMI chart, I was later surprised to find out, was designed in the 1830s by a mathematician and it wasn’t intended as a measure of health for individuals. It was also largely based on white, male, European body shapes, and made no provision for sex or cultural difference.1 It’s shaming and dangerous, according a recent report from the Government’s Women and Equalities Committee.2

The school nurse suggested I start exercising and try to eat healthily. She’d made a common assumption, based on the myth that fat people don’t eat well or exercise. I was doing dance classes twice a week, plus step aerobics and Mr Motivator (the coolest way to exercise in the 1990s).

Unfortunately, these assumptions about fat people didn’t stay in the 1990s. Today the same simplistic assumptions are made and many hold the view that fat people should simply eat less and take more exercise. This even includes our Government, whose ‘war on ob*sity’ campaigns are not only ineffective but potentially dangerous.
 
Fat equals stupid?

Ob*sity is a complex issue, influenced by many factors, including genetics, environment, culture and trauma, with poverty being a prominent predictor. I’ve noticed a wave of seemingly compassionate people making this connection and blaming cheap, processed food. This suggests that, if healthy food were cheaper, ob*sity would just disappear. The first problem with this approach is that it’s too simplistic – fruit and vegetables are already cheap from many greengrocers and it doesn’t make people want to munch on a carrot instead of a chocolate bar. Second, it’s based on the patronising belief that working-class people simply need educating, implying that we’re so stupid that we don’t know how to feed ourselves correctly.

As a child, I spent every weekend cooking with my Italian grandmother, mainly because I had no friends (because of being fat) but also because I loved food and cooking. Everything we ate was fresh from my grandfather’s garden – homemade, unprocessed, hearty goodness. Ironically, I was eating less healthily when I ate diet bars and shakes, which I thought I needed in an attempt to compensate for the large Italian meals. It took many years to recognise these as restrictive and compensatory behaviours, and to realise the amount of anxiety I felt around food. I was always either ravenously hungry to the point of feeling faint, or stuffed full to the brim with stomach cramps. I was in a binge and restrict cycle without even knowing it, starting from about six years old.

I thought all of this was completely normal. I also knew that being fat was the very worst thing I could be and that I’d need to do anything and everything to avoid it. I tried to override my hunger signals and told myself that I would be so ‘good’ and ‘strong’ if I hardly ate. Isn’t it strange that we don’t trust our bodies to tell us when we’re hungry? Yet we’d never ignore the signals that tell us we’re cold or that we need to go to the toilet. As babies, we cry, we get fed, then we stop crying when we’re full. Then, as we grow, we’re told to finish everything on our plate even if we’re full, and we’re introduced to ‘good’ and ‘bad’ foods. We’re taught to override our natural instincts. And then there are the beauty standards – women in the media, films and TV who are not too thin but not too curvy, sexy but still innocent, beautiful but unthreatening, confident but submissive.
 
Fixing the problem

The problem isn’t for fat people to fix – it’s much bigger than that. It’s about inequalities, austerity, discrimination, trauma and a hugely underfunded mental health system. It’s the family cycles of behaviour and trauma that can create difficult relationships with food. It’s the difficult home life and family experiences (such as domestic violence, addiction and abuse) that are more likely to affect the poorest children. It’s also a society that tells fat children that their bodies are wrong and that it’s their fault, or blames their parents, and encourages anything to get rid of the weight, however dangerous – diets, pills, barbaric bariatric surgery.

It’s about a society that would rather blame fat people than look at what is really going on. The food industry spends millions encouraging us to eat more processed food than ever, while the diet and fitness industry tells us to lose weight. This push/pull keeps many people stuck in cycles of guilt and shame, while their weight fluctuates, with the anxieties and health implications that may come with that.

Despite Government campaigns, ob*sity rates are not decreasing. The solutions so far have been short term, encouraging increased fear and anxiety around food and increasing stigma towards fat people. Shaming people into losing weight simply doesn’t work. In fact, it’s more likely to exacerbate difficult relationships with food as they search for further comfort, coping mechanisms and control. The recent report from the House of Commons Women and Equalities Committee concluded that the Government’s ob*sity strategy has failed to ‘promote healthy behaviours’ and could be ‘contributing to body image pressures’.2
It identified that the use of BMI as a measure of healthy weight has become a kind of proxy or justification for weight shaming, and called for the Government to immediately scrap its plans for calorie labels on food in restaurants, cafés, and takeaways, and to urgently commission an independent review of its Ob*sity Strategy and ensure its policies are evidence-based.
 
Fatphobia

In Love’s Executioner, Irvin Yalom is explicitly honest about his disgust at his fat client, Betty. I was both shocked and impressed by his honesty but ultimately was disappointed that the success of the client was measured by her weight loss. He recognises his weight bias but does nothing to challenge or change his own views – Betty loses weight and he puts his arms around her, seemingly delighted that his hands can reach. Even in Susie Orbach’s Fat is a Feminist Issue, fat is something that is pathologised – women especially are seen as psychologically unhealthy if they’re fat.

There are strong links between trauma and disordered eating, but working on the trauma does not guarantee a client will lose weight. When I started to explore my relationship with food and unpack my trauma, I became happier and healthier, but not thinner. I worked on finding acceptance for myself as a happy, healthy, fat person, which is still seen as a radical act in our society. My body image problems were just the surface level of my deep-rooted low self-worth.

My body image issues were part of a lifelong self-esteem deficit that affected my mental health, my relationships and my career choices. Growing up, I capped my ambitions to protect myself from more hurt, convinced that a short, fat girl from the Midlands couldn’t make anything of herself. That’s now incredibly sad to write. I just want to reach out and hug that young me who thought she was worthless.
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Weight stigma and fatphobia are prevalent in our culture and it’s arguably more harmful to health than actually being fat. If counsellors are compliant with the pursuit of happiness presented as thinness, we’re only reinforcing the myth that clients would feel better if they just lost a bit of weight. We need to delve into the unconscious biases we all hold towards fat people, question where they come from and then actively work to challenge them. Fat counsellors aren’t immune to this – in fact, internalised fatphobia might mean these biases are even stronger. If counsellors collude with the view that weight loss is always a virtuous pursuit, they’re complicit with a cycle of harm that keeps clients from finding their true self-worth beyond how they look.
 
References

1. Gordon A. The bizarre and racist history of the BMI. Medium 2019: 15 October. http://bit.ly/2ZhiroN
2. Women and Equalities Committee. Changing the perfect picture: an inquiry into body image. Sixth report of session 2019–21. London: House of Commons; 2021. https://publications.parliament.uk/pa/cm5801/cmselect/cmwomeq/274/274.pdf

It’s that time of year again when the adverts start popping up: Slimming World, Noom “we’re-definitely-not-a-diet” diet scammers, and various other teas, pills, workouts, gyms and all the other money-grabbing companies trying to shame you. There are a lot of expectations and pressure to make changes, be better, fitter, healthier, more successful… BUY MORE STUFF!
So here’s your friendly reminder…you don’t have to do any of that. If you choose to, that’s up to you, but you don’t have to. Sometimes the kindest thing to do for yourself is to not do anything at all. Maybe you don’t need to change yourself, and the effort of trying to do so is stressful in itself.

Many people see Christmas time as a “free pass” to eat what they want – and good for you! BUT…what happens in January then? This time of year can bring about feelings of guilt and shame, and negative thoughts about yourself and your body. For some people, this can lead to disordered eating. Whether you have an eating disorder, or you struggle with food a bit, or it’s more about not liking your body – all of these concerns are valid. Instead of punishing yourself, you deserve help and support. People can be in a vulnerable place to be lured into the diet-scammers territory when they’re not feeling good about themselves. Trust me – they don’t care about your health, they are just about making money.

If you like to make New Years Resolutions, how about trying to make them without weight loss in mind? Maybe your resolution could be to be kind to yourself and work on self-acceptance. Maybe you don’t need to make resolutions at all! I remember at school going back after Christmas and being asked to share our New Years Resolutions. I never felt like I fit in so of course I jumped on the bandwagon, and what’s the thing I knew I was expected to say? To lose weight. It was the only acceptable answer as a fat girl. There’s an expectation for fat people to constantly strive to be thin. We’re expected to dedicate our lives to worrying about our bodies, trying different diets til we find “the one” that works (spoiler alert – none of them work!) Eventually, I decided I wasn’t going to stand for that anymore. I could have spent my whole life trying to change my body, but instead I chose to work on accepting it. I’ll be honest and say I don’t think I “love” my body, but it’s a life-long work in progress. I just know I’m glad I made the choice to put my wellbeing first instead of paying money-making diet scammers with empty promises.

I did a talk about my experiences at the Boys at the Crossroads conference on 12th October in Bristol, for more information, click here.

I’m a group facilitator on a Domestic Violence Perpetrator Programme, which, if I ever got invited to fancy dinner parties, would probably go down like a lead balloon, as the saying goes.

But really, people are usually intrigued, some are just less afraid than others to ask questions! This blog contains my honest reflections and experiences of being a group facilitator working with men who have used abusive behaviours. My workplace and the overarching research are mentioned, but these views are my own and are not of my employers, the researchers or the programme creators. Confidentiality is of the utmost importance here too, so I won’t be using any names or identifying factors for individuals, but will sometimes refer to “group members” generically as a collective when talking about patterns and themes.

The language is binary due to the nature of the programme I work on as it’s for cis-gendered heterosexual men only, but I just want to flag up the vulnerability of trans and non-binary people being abused by partners and family members, also male survivors of abuse. None of these things are talked about enough.
 
What is a perpetrator program?
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Programs and interventions vary in different areas, so my experience is only based on the Reprovide study of a domestic abuse programme. It’s a 26-week intervention for men who have used abusive behaviours toward their partners or ex-partners, offered through domestic abuse charity, Splitz Support Service.

The weekly group sessions are 2.5hrs (with a short break) and involve a check-in at the start, followed by a led session based on themes and content from the programme manual. The sessions focus on different aspects of abuse, ranging from what abuse is (which is very important due to the misconception that only physical abuse is “real” abuse), sexual respect, anger management, attachment theory, CBT (cognitive behaviour therapy), emotional regulation, and more. It’s not something the men can do as a quick tick-box exercise to appease social services, it’s a long intervention and it’s challenging. It takes commitment, bravery, responsibility and accountability, and it involves dealing with a lot of difficult emotions.

​There are very few perpetrator programmes in the UK (though areas differ) as proving that they work and getting funding is difficult (hence the reason for the research study). There’s no doubt that prioritising helping victims/survivors is crucial when it comes to funding domestic violence services, but this can lead to a lack of help for perpetrators who want to change their behaviour, which in turn helps keep their partners (and children) safe. Perpetrator work is crucial for long-term change in helping victims/survivors and their children, to avoid them going into other relationships with the same patterns of behaviour. The safety of partners, ex-partners, children and future partners is at the heart of the programme.
 
Why just men?

A question I’m asked a lot (and I initially wondered this too) is “what about women?” Well, studies show that men are far more likely to be perpetrators than women. I know that statement will make some people feel uncomfortable and may prompt the response “but women can be abusive too”. This is true, but this response steers the focus away from the central issue. It’s similar to saying “all lives matter” - it de-centres the current problem, making it harder to focus on areas for change. Other perpetrator interventions in other areas may accommodate women, but the particular model this programme is based on (the Duluth model) involves content specifically to unpack masculinity and issues of power and control in a patriarchal society. It’s sometimes called a “pro-feminist” model for that reason, though I personally would argue that working on the basis that patriarchy and inequalities exist isn’t inherently “feminist” but is rather just highlighting an issue that affects us all. Naming the patriarchal imbalances doesn’t have to be an attack on men (as is often assumed about feminism) as it can help men too; after all, the patriarchy is damaging for everyone and places various harmful expectations on men.

In a wider social context, it can be difficult to talk about male violence (especially on social media) without there being a lot of anger and defensiveness. We do still live in a society based on historical patriarchal values and that can make it difficult to have conversations about male violence as it can be met with de-railing and gaslighting tactics (albeit sometimes not conscious). Powerful people often fear losing their power and want to stay in control, so equality is risky for them. It’s the same with individuals who use abusive behaviour, it’s about power and control and the fear of not having it.
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We need to centre what’s important to be able to make a positive change in the world, and that means we need to put aside our discomfort with talking about male violence and abuse. This isn’t about pointing the finger or blaming men, but rather looking at how we can help. Patriarchal values can be harmful, with narratives about being a “real man” and expectations of being “the provider”. The messages about being strong and not showing emotion are prominent in the group, and we do work around “the man box” and masculinity expectations to unpack these. Many of the men on the programme have never been in spaces where they talk about emotions, and certainly never with other men. Many would say they’re not emotional people while forgetting that anger is an emotion too. We sometimes draw icebergs to demonstrate this, with anger at the top and all of the other emotions under the surface; anger being the emotion often seen as more “acceptable” for men to show.

As a facilitator it’s been amazing to see how powerful group work with these men can be. They share experiences, model new behaviours, and both challenge and support each other. The group allows a safe and boundaried space to start to process these difficult emotions without the judgement or stigma they may otherwise face for having the label of “an abuser”.

What got me into this work
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About ten years ago (at the time of writing) I got a job as a receptionist at a counselling organisation, and like many newbies was given tasks such as stuffing envelopes. We had a domestic abuse signposting pack, which contained flyers for a perpetrator programme, and it instantly struck me as such a crucially important thing. I would never have dreamed that ten years on I’d be working on one myself! I was just a self-conscious receptionist, I hated groups and I never thought I’d be able to become a group facilitator, or a counsellor too…but proving myself wrong has been pretty awesome I’ll admit!

When I was learning more about feminism and inequalities, I became quite fascinated by men’s rights activists, incels, pick-up artists and “men going their own way” (MGTOW), in the dark depths of the internet known as the “manosphere”. It was part horrifying, part ridiculous, and mostly infuriating. I was channelling my anger and processing some of my stuff no doubt, but I was also curious about where these kinds of views and such blatant misogyny stemmed from. Since then, I’ve trained as a counsellor (at the time of writing in my final year) and have benefited hugely from being able to look at both systemic and individual factors and issues which lead to abuse, both in my own time, my work and through studies.

Personal experiences in my own life have led me to have increased curiosity about perpetrators of abuse and sex offenders, and understanding these client groups has been helpful for my own healing too. I still had doubts about if I was being naïve, especially as most other counsellors (and trainee counsellors) I met did not want to work with these client groups. I wondered if I was kidding myself; wouldn’t I be terrified sitting in a room full of abusive men? Often I get the sense that certain client groups are seen as “too manipulative”, “untreatable” or “resistant” (interestingly, eating disorders are thrown into these categories too, which is my other line of work), but this has only sparked my interest and passion further. I wonder how much these labels were more about the practitioners and their views, judgements and societal stigma.  
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Born evil?
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Words like “perpetrator” and “sex offender” hold a lot of stigma and seem to spark instant fear, leading to them being quickly deemed as “monsters”. There’s a sense that they will never change, or can’t change, or even that they were “born that way”. This is absolutely not the case, even serial killers and “psychopaths” were not “born evil”, despite what the media would portray. It’s instead a complex mix of genetic and environmental factors which can create disruptions in early brain development. People are not “born evil”, this is a myth perpetuated by society, potentially as a way to focus on the ”baddies” and ignore systemic societal issues and trauma which influence this behaviour. It takes curiosity and compassion to look beyond the labels and stigma, and holding strong boundaries, and being self-aware and reflective, so supervision (group and one-to-one) is very important in this work.
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Perpetrators and offenders have often been hurt and traumatised themselves. This is not an excuse for their behaviours but it’s important we look at the potential causes and influences. Experiences are different for every individual, but themes can include violence or controlling behaviour in their home when they were growing up, substance abuse, poverty, trauma, mental health issues, and systemic inequalities and discrimination such as racism. The first few years of life is a vulnerable time and we know from various literature that not having your needs met and not having enough love in the early stages of life is detrimental for brain development. (I suggest reading Sue Gerhardt’s book “Why Love Matters” if you’re interested to learn more). This in conjunction with attachment theory (Bowlby), means that a child may grow up with an insecure attachment based on not forming secure relationships with caregivers when they were babies, which becomes a template for their relationships and their whole lives. Part of the benefit of group work is to form and grow relational bonds through relationships with the facilitators and the other group members.

My expectations when starting as a group facilitator

When you picture a perpetrator group, what do you see? Many new guys starting the programme have told us they expected Stella-swigging blokes in vests with tattoos on their necks. The men tell us they’re often surprised and relieved to find that it’s “normal guys” just like them. But sometimes, they may hope to find men “worse” than them, so they can position themselves as “not as bad as that guy”. This can happen with men who have not used physical abuse. They think they are not as bad as other guys because they’ve not been physical, but part of what we do on the programme is to go over all the other types of abuse and the impact – that emotional forms of abuse stick with women for years, if not their whole lives. There is no hierarchy of abuse in the group, they’re all there because their behaviour is impacting people negatively and they want to change that.

I’ll be honest, I was absolutely terrified when I sat in on my first group. I knew that there would be men from all different backgrounds; a range of ages, working class and middle class, in different professions and from varying cultural background. But…how would I feel sitting with all these men that I knew had abused women? What if I freaked out? Cried? Got scared? I soon realised that many of these men were anxious and scared too, especially when starting the group. It can be terrifying for them, as they share the same fears around what to expect, but also there’s the worry of what we’re potentially going to put them through! Some of our role plays are hard-hitting, and we run empathy exercises (for instance asking them to sit in the role of their children and answer questions about the dad) which can bring up a lot for them, but it’s within a safe, contained and boundaried space.

These men are dealing with a lot of shame, past trauma, attachment wounds, anxiety and many other factors, so safety and being “held” is vital. For me, being able to offer this “holding” and containment has been a real honour. I get to sit in a world that only a few see, and that feels like a real privilege and a gift. These men sit with really tough emotions and work really hard on their behaviour and self-development, and I find myself admiring and respecting them. This can create internal conflict in itself, forming relational bonds and feeling somewhat proud of the guys and the work they do, in the context of a society that says they’re “bad”. Many people have done bad things, but it doesn’t make them “bad” people. Underneath this behaviour there is often pain, shame and low self-esteem. The paradox for the men can be feeling as if they don’t deserve to improve their self-esteem, but this is needed in order to move out of the “pit of shame” as we call it (sometimes known fondly in our group as the “pit of sh*t”).
 
My reflections one year on

I started working for Splitz about a year ago (at the time of writing), which means I’ve done a full run of the programme (it’s continuous, so men join at different stages). The original members of the group who I started with have completed the programme, so there have been some heartfelt endings and it’s been lovely to hear the reflections from the men in their final group. I’m not involved in the research side of it, but if you ask me if perpetrator programmes work, then ABSOLUTELY. I have seen, felt and experienced it. Not everyone will be ready to change, but many are, and this can have an impact on their whole family.

It’s so important that we see beyond labels, judgements and stigma to see the human being behind the behaviour. I like to believe that nobody is “untreatable” or “too resistant” or not worthy of help. Working on a perpetrator program helps take a bigger picture approach to domestic violence and abuse, by moving beyond the reactionary system currently in place, which often just involves helping victims stay safe in a dangerous situation. This just means the perpetrator continues their behaviour, and even if the victim can leave, they both risk getting into other abusive relationships in the future, so this approach isn’t helping to break cycles in the long-term. Helping perpetrators reflect on and change their behaviour is a vital longer-term approach to help break cycles of abuse, ultimately helping the next generations to come.
 
Click here for domestic violence and abuse support organisations

Information and referrals to the Reprovide programme
 

Talking Tales, our friendly storytelling night in Bristol run by Stokes Croft Writers, made its return on 23rd September 2022 at The Wild Goose Café in Easton. The Wild Goose is a drop-in centre offering meals, hope and support to anyone experiencing insecurities such as hunger or homelessness, and it’s part of the charity InHope. Thank you to those who donated on the night (if you’d like to donate you can find ways to contribute on their website). This was the first face-to-face Talking Tales event since before the pandemic, so it was exciting to see familiar faces from the storytelling scene, plus new faces, and also participants from some writing workshops I’d facilitated upstairs at The Wild Goose, in conjunction with Arkbound, a charity book publisher founded in Bristol.

​Creative writing workshops 

I was delighted when I stumbled across an advert for a creative writing group facilitator, it fit my experiences and passions perfectly; creative writing and leading groups. In my other work, I run body image and disordered eating workshops and I'm a co-facilitator on a Domestic Violence Perpetrator Programme (blog coming soon about this!) As a writer myself, I’ve done lots of different writing workshops and courses, in the UK and in New Zealand (where I lived for a few years) and I’ve subsequently written in various formats – novels, novella, short stories, flash fiction, screenplays, blogs etc. Now as a student, I’ve been learning how to write academically too - quite a shift from creative writing! At the time of writing this, I’m going in to my final year of a degree in counselling and therapeutic practice. 

​It was an honour to facilitate the writing workshops at The Wild Goose in conjunction with Arkbound (you can read more about the workshops in Arkbound's blog post here). It was important for me to be involved with workshop providers that prioritise and uplift voices not usually heard, which is exactly what Arkbound do, giving a platform to people from disadvantaged and diverse backgrounds. So many writing courses, workshops, groups and storytelling nights are filled with white, middle-class people - no offence if you’re in this demographic but this really limits the stories being told and the narratives spread. The influence that stories have (books, TV, films etc) is a crucial part of the systemic inequalities and discrimination people face in our society. Storytellers (and those who platform them) have power, and therefore a social responsibility. Chimamanda Ngozi Adichie talks about the “danger of a single story” in her Ted Talk. Who gets to tell their story? Who’s voice is heard? Who’s narrative is deemed “normal”?
 
I’ve personally felt uncomfortable being working class in many middle-class workshops and training (especially in the counselling world, which I wrote about here) so if it felt like that for me – a white person with various other privileges – it will likely be a hundred times harder for anyone of minoritized groups or disadvantaged backgrounds. For those familiar with my story “Zombies on a Boat”, this story was effectively a backlash against a snobby writing teacher who spoke down to me and criticised me for not writing "like Hemmingway". Creativity certainly isn’t cultivated and inspired by being told there is a “correct” way to write, so I find it more important to facilitate groups that cultivate safety and respect. People often write for their mental health and share personal things; it can be therapeutic, processing difficulties in life. Whether you write true stories or not, there’s always an element of you in them, and so this needs to be celebrated, not squashed with too much emphasis on the writing “rules”, perfect grammar or going at it too hard with the red pen.
 
The workshops at The Wild Goose ran for 8 sessions, alternating between myself and another facilitator. We covered topics such as getting inspired, plotting, character building, motivation, imposter syndrome, building confidence, and publishing.
The idea to run Talking Tales came about only a few sessions in, as having a storytelling night to finish off the workshops seemed like a perfect way to celebrate the participants, whilst reviving our beloved event.

Talking Tales storytelling night 

Talking Tales #30 (yes, the 30th one!) was a roaring success with a packed full house, filling every chair in the café! I hosted the night, a sequin triple-threat in sequin trousers, a sequin top AND with a sequin notebook. The pink power jacket topped it off, giving me the fake-it-til-you-make-it confidence I needed! My homemade disco ball earrings only fell apart once, which is the real achievement of the evening.

​Our performers were astounding! We had a wonderful mix of short stories, even shorter stories and spoken word, from incredibly talented writers of Bristol and beyond.
 
Our performers:
 
First half
Jonathan Evans
Shakara
Elaine Miles
Claire Barnard
 
Second half
Fin
Phil Mac
Oliver Kennett
Shakara (link in first half list)
Tony Thatcher
Mark Rutterford
 
Please follow and support these writers! I’d like to thank Shaun Clarke from the Urban Word Collective for introducing us to Shakara and Phil, two awesome spoken word/poetry creatives. Check them out on Instagram (linked to their names above) and check out the Urban Word Collective anthologies - Lyrically Justified. If you'd like to donate to them, or find out more about supporting them or how to get involved, click here.

Thank you to all our wonderful performers! We had great fun doing Finish the Lines too, of which Oliver Kennett came first place and won a highly-coveted Talking Tales badge.

Thank you to our lovely audience for being so supportive, and thank you to Naomi Millard at The Wild Goose, and to Riyan, Val and the Arkbound team.

For more information about Talking Tales and Stokes Croft writers, head to Chris Fielden’s website. Follow Talking Tales on Facebook and @SCWriting on Twitter for updates about future Talking Tales events. See you again soon!
 

“Eating disorders can affect anyone of any shape or size.”
“Eating disorders don’t discriminate.”

You may have seen these statements online and most people would agree, right? But in reality, is this ethos really working in practice?

When plus-size model Tess Holliday spoke out about having anorexia, people on social media lost their minds. It seemed impossible for people to comprehend someone in a larger body restricting their eating. After all, our society teaches “eat less, move more” as the simple equation for weight loss, so there was an assumption that she must be lying because if she was really restricting, how could she possibly still be fat? Of course this resulted in a lot of online trolling for Tess, and in turn the underlying reinforcement of the idea that only thin people can have restrictive eating disorders.

When I say restrictive eating disorders, I’m referring to Anorexia and Bulimia. I think many people automatically picture a thin person, usually white, young and female, associated with these eating disorders. Often, fat people are associated with binge eating, but in reality thin people can binge and fat people can restrict. Many people aren’t familiar with the term OSFED - Other Specified Feeding or Eating Disorder – which is actually the most prevalent diagnostic category, because eating disorders don’t fit into tidy boxes like we expect them to. They are complex and nuanced; there’s no one reason someone develops an eating disorder (and all the many reasons are way too long to go into here!) Atypical Anorexia can come under this category, which is anorexia but at a “healthy” weight or above. The issue here is what is deemed as “healthy” is based on a flawed BMI system, created for white European men only, so it has been recognised as not an accurate predictor of health.
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There are also biases and assumptions of medical professionals, plus the limited resources on offer for eating disorder treatment, which often results in the “sickest” people getting help (i.e. thinnest). It’s a reactionary system, based on restoring someone's weight, though of course as eating disorders are to do with mental health, having a “healthy” weight does not mean the person has recovered. The short version of this is, the entire system is broken and people are not getting the help they need. (No disrespect to anyone working in the NHS, you’re just trying your best and I thank you for that.)

My focus is usually on the societal and cultural aspects of eating disorders and disordered eating. I use the term “disordered eating” as that includes people struggling with eating who don’t fit the diagnosis criteria too – of which there are a lot! I’ve worked for eating disorder charities for about 5 years now and I continue learning more every day. I’ve heard more and more stories over the years from people who are frustrated, unheard, not believed, passed off, sent to weight management services or Slimming World, and judged because they don’t fit what an eating disorder “should” look like. All of this is causing an incredible amount of harm, discouraging people from seeking help. Even writing this here, I’m concerned about creating more fear. Do we warn people of this and risk putting them off asking for help? Or is warning them needed so they can be prepared?
 
If you’re reading this and you’re considering reaching out for help with an eating problem, please still do – there are good people out there who can help you. If you don’t find one initially, see someone else. If you’re at a higher weight, a focus on anything to do with intentional weight loss will NOT be helpful so do set boundaries around this. You can refuse to be weighed too, or if they say they need to, tell them you do not want to know it. I tell healthcare providers that I do not want to know my BMI every time I visit and they are fine about that. I used to feel awkward about setting those boundaries, but with practice I now definitely don’t! Boundaries are self-care!
 
My work has led me to learn so much about people’s relationship with food, and to continue reflecting on my own. Everyone has a body, and everyone needs to eat, so it’s really important for professionals to consider their own relationship with food and their body. Sadly there is a lot of weight stigma, bias and discrimination in the medical world, in the therapy world, and…well, THE WORLD. Nobody is immune to weight stigma and fatphobia. When I talk about weight biases in the medical profession I don’t blame individuals but rather recognise that we’ve all grown up in a society that tells us thin is good and fat is bad. This is why unpacking and challenging weight stigma and fatphobia is so important. 

On an individual basis, the fear people hold about being fat is both deeply understandable and so saddening to me. There is no shame in holding these views, there is no shame in chaotic eating, or having tried every diet in the world, or having purged, and there is certainly no shame in having difficult emotions around food and your body. We live in a world where this is created and normalised.

If you’re in a larger body and you’re embarrassed or ashamed that you just can’t seem to lose weight or keep it off, please know that this is not your fault. Many people’s bodies just aren’t naturally made to be thin, and the focus on thinness often drives disordered eating. Sadly, this focus on trying to do something which supposedly makes you “healthy” is likely the very thing negatively impacting your physical and mental health. 
 
The fear driven by narratives such as “the ob*sity epidemic” is very real and can make some people terrified that being fat will kill them. It will not; fat is not the killer but rather associated illnesses, plus the stress and trauma of living in a world that terrifies people into unhealthy behaviours such as yo-yo dieting, disordered eating, eating disorders, compulsive exercise, self-harm and more. This fear is not driving change, it’s only making things much, much worse. Fat is not an evil thing to be eradicated, but weight stigma, fatphobia and discrimination is extremely harmful and needs to stop.

Many professionals will say that not all eating disorders are about body image and weight, which is true, however dieting is the biggest risk factor for an eating disorder. Dieting is often a result of wanting to lose weight to fit with the societal narrative of thinner equals healthier (not true), so it’s all rooted in weight stigma and fatphobia. Eating disorder professionals, medical professionals, therapists/counsellors, and other professionals working with anyone who may struggle with eating (which is A LOT of people) need to understand weight stigma and fatphobia for this reason. Many people are avoiding reaching out for help, being refused help, being wrongly diagnosed, and being judged for not being “thin enough” to have an eating disorder (sadly this is very common) so things need to change now.

When I see statements like “eating disorders don’t discriminate” it makes me think about how eating disorders can often be seen as a disease that suddenly grips people, as if in a bubble from the rest of the world. Eating disorders are created from, and influenced by, a world full of inequality and discrimination. We cannot separate the person from the society and culture that has shaped them. The eating disorder treatment world is largely white, middle-class and able-bodied (professionals and researchers, and well as patients) which means this is the centred experience and everyone else is potentially left out. Also, recognising that fatphobia has roots in racism (see Sabrina Springs' work) and the impact of transphobia too, in the wider context of a capitalist system… the people who need help the most are sadly so often the ones being failed.

Until we as a society can get our heads around the fact that most with people eating disorders are fat, AND that those people may also be black, trans, disabled, and/or a mix of identities, we will continue not to meet people’s needs. Saying “eating disorders don’t discriminate” is all well and good but sadly the systems designed to help and treat people often DO discriminate.
 
I offer training for professionals on weight stigma and disordered eating, and I run Body Acceptance Workshops for people wanting to improve their body image. Find out more here.

I am in the final stages of training as an Integrative Counsellor and I will be taking on clients in 2023. Please contact me to find out more.

​Body image problems affect lots of different people. It’s about how we see ourselves and perceive our bodies, but this is influenced by wider issues such as societal views, diet culture and inequalities. Body image isn’t something “silly” experienced only by teenage girls, nor is it something we can just “get over”. It’s not about vanity or being shallow. I could share a bunch of statistics about how many people don’t like their bodies but I think we all know… it’s a lot.

I struggled my whole life with body image problems, mine mostly centering on weight but I’m aware that other people have body image issues that have nothing to do with weight or size. My work with individuals and in workshops however does tend to sway towards weight because it is such a big factor for so many people. Weight stigma is so prevalent in our society so it affects thin people too. Living in a larger body brings a lot of challenges but hating our bodies, being unkind to ourselves, and trying to change the way we look isn’t the solution (as much as it may really seem like it is!)
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Part of my own continued body image journey is being able to share my professional and lived experience with people, helping others understand body image on a deeper level and challenge perceptions of their bodies. I personally found that learning about wider societal expectations and inequalities, as well as past experiences and trauma, can help build an understanding as to why we struggle with body image, and this can help us be more compassionate to ourselves.

I sometimes find that "body positivity" can be too fluffy, as much as it can be helpful for a lot of people. It just seemed unrealistic for me to pose in a bikini when I couldn't even wear a swimming costume without a big baggy t-shirt over the top for many years. "Body positivity" is unfortunately capitalised on by companies who have noticed its popularity, and by influencers and thin attractive people online who want to promote themselves. This takes it away from the very people who need the moment the most, e.g. fat, black, queer, disabled people and others who have faced discrimination and oppression.

My body image approach involves taking a "big picture" view, understanding the societal and cultural issues surrounding how we see our bodies, including class, gender, disability, race, and more. Accepting our bodies can feel like a radical act in our society where capitalism needs us to be ashamed of our bodies in order to make money. So there can be such a lot to unpack when thinking about body image, which is why I offer workshops as well as one-to-one sessions. These can help you understand body image in more depth and help you move towards accepting your body.
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My next body image workshop is on Tuesday 6th September 2022 and is focused on “body acceptance” with a mix of educational content and exploration, along with guided meditations offered by meditation and reiki teacher Lesley Bailey (bios below). 

​The online workshop is for anyone struggling with body image, or those wanting to support someone else, for professionals, or for anyone wanting to learn more about body image.
It will include:

◦ Why exploring body image is important
◦ Causes of body image problems and the impact
◦ Lived experiences
◦ Weight stigma and dieting
◦ Myth-busting
◦ How we can help improve our relationship with our bodies
◦ How to support others with body image problems
◦ Practical tips and recommendations

Find out more and book here.
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About the hosts

About Mel Ciavucco:

I have been working for eating disorder charities for over 5 years and have a passion for understanding body image, eating distress and weight stigma. My own lived experience of struggling with body image, food and weight stigma plays a big part in my work as a trainer, I feel it goes hand-in-hand with my professional experience to bring enriching and inspiring workshops.  I am a counsellor in training, due to qualify in 2023, and I also work on a Domestic Violence Perpetrator Program as a group facilitator. I run workshops on body image through First Steps ED, plus I have created comprehensive body image resources for them. I currently run creative writing workshops for people affected by homelessness too.

​About Lesley Bailey:

Lesley is a trained bereavement support worker, a senior administrator and a fundraiser for a local bereavement charity, as well as a Tropic Skincare Ambassador/Leader and a Reiki Master Teacher (Holistic Health Connection).


Lesley says...
"I began learning Reiki for myself back in 1998 until becoming a teacher and now meditation, grounding and being centred are an integral part of my own life and what I share with others.  I am happy to have shared online meditation sessions throughout the pandemic but Reiki training, treatments and workshops are now available in person again. My love of natural skincare fits in beautifully with my ‘holistic head’ and led me to be an Independent Ambassador with Tropic Skincare nearly 9 years ago.  It gives me the chance to find healthy and planet protective solutions for myself, for those struggling with skincare issues or for people who just want to make more mindful choices.  I train and support my lovely team of Ambassadors to do the same.
My work with Stafford & District Bereavement & Loss Support Service since 2014 is both humbling and inspiring.  Experiencing losses myself, I understand the importance of having a safe, confidential and caring approach to the support needed at these difficult times.  The fundraising aspect of my job is both a passion and a need in order to maintain this free service for our local people."
Find Lesley on Facebook: www.facebook.com/lesley.bailey.58 with links to her Holistic Health Connection and Tropic Skincare pages.
 
To find out more about other workshops click here.

In 2020, I finished my Foundation Certificate in Counselling and Psychotherapy, then applied to go to university to continue my studies… but I’d been refused full student loans and was freaking out. I was mad about the industry (I still often am) and I wrote about my experiences here. I honestly thought I might ruin my career before I even started, I was so scared to share my thoughts. Now, two years on, thankfully I am on the degree I applied for after a nerve-racking “Compelling Personal Reasons” appeal to Student Finance. 

I used to hold counsellors up on a pedestal. The middle-aged, middle-class women I saw in my workplace were so different to me, I didn’t see how I could fit in. My Introductory course and Foundation Certificate was held in Bath where people laughed at the way I said “hug” (I’m from the Midlands but don’t have a particularly strong accent). It was as if some had never met a working-class person before. I struggled to speak up in group work, which I now think was partly about class and power but I didn’t have the words to explain that back then. Our short “diversity” session (a tick box exercise in my view) resulted in most people not saying a word for fear of getting something wrong. I realised I spent most of that year sitting in groups with very polite middle-class people wanting to be seen as the Nice Middle-Class Counsellor Who Treats Everyone Equally ™.
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The problem with “treating everyone equally” is that it ignores, minimises and denies people’s experiences (the opposite of what we should really be doing as counsellors!) If I’d tried to talk about class on my course, it would likely have been met by a very awkward quiet room again. No doubt there was also fatphobia in the mix too, something I passionately write and train people on, fat working-class people often getting the brunt of the blame for being a “burden on the NHS”. This is no disrespect to my course pals, they were lovely so I don’t want to point the finger at people but rather look at this on a systemic level. There are a lot of Nice Middle-Class Counsellors ™ doing great work in this industry, and the issue is not individual counsellors but the lack of intersectional approaches, diversity and inclusion from the top. ​

When coming to the end of my Foundation Certificate I was asked why I wasn’t continuing at the same college (seen as one of the “gold standard” colleges) to which I told them I couldn’t afford it as they offered no financial help. The response I got was either “but you can pay by installments” (erm, where do they think that money is magically coming from?) and “we have a bursary”, which is for a person of colour. I am not a person of colour. That bursary should go to a person of colour, but did it? Being in Bath their answer is often, “it’s a white area” but a number of us were travelling from Bristol so that just seemed like another excuse. I got the sense that their “one bursary place” was more about them trying to be seen as a Good College For Nice Middle-Class Counsellors Who Treat Everyone Equally ™. There are lots of these colleges, so I am by no means singling this particular place out. These training establishments offer very good training, there’s no doubt, but only for a specific demographic.

I have various privileges which meant I could train at the college in Bath, if only initially, but also I have managed to pay for all the *extras* of which there are a lot in counselling training! Insurance, membership body fees, supervision, personal therapy, transport costs… There’s a lot to take into account so even with student loans (which don’t cover much in terms of living costs) it’s A LOT, and that’s without factoring in having to work for free (for me in two different placements) to build up placement hours. This isn’t to put anyone off who wants to train to be a counsellor but this is the reality and is a large part of why the industry is so white and middle-class.
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Going to university in Newport (Wales) to do a degree in counselling was very, VERY different from the college in Bath – OBVIOUSLY. But for me, I was relieved to find myself in a place with a slightly more varied cohort, I say “slightly” because of course it’s still mostly women. I’ve always found it strange that an industry built on theories by mostly men is so dominated by women.

Through speaking to various trainee counsellors at different training establishments, I’ve personally started to notice a theme; there can be a tendency for the universities/colleges to prepare trainees for lower-end wages in charities or agencies, whereas the private colleges (where you need to pay for it yourself as they don’t offer financial help/loans) set people up to go into private practice. One particular college I heard about doesn’t require students to do placements in agencies, but instead students go straight into PAID private practice. These students are the ones who can afford this privilege of course, so predominately white middle-class middle-aged people, who are being trained to immediately see mostly middle-class clients. These colleges, and students, may not talk about class, race or any other “difference” because they are being primed to stay in a middle-class bubble.

These private colleges almost feel cult-like to me sometimes; they like you to see therapists and supervisors who have trained with them, then train to be supervisors with them, all “keeping it in the family” (cult), conveniently continuing to make more money out of students. These colleges don’t want working-class people, or people from marginalised groups, as they need to uphold this elitism. This is the same in many other industries of course; money comes first and they always make sure they maintain their power at the top. Of course the membership bodies mirror this too.

It also means these colleges don’t have to change their curriculum to accommodate anyone “different” (I put this in quotation marks because what is “different” in this sense is only ever decided by those power). They can do their few hours of “difference and diversity” to tick a box, whilst sticking to the same old theories mostly written by middle-aged middle-class men.
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There are very few undergraduate degrees in counselling, like mine, in the UK. Most courses are at Master’s level, which is another major form of exclusion as you can’t do these courses unless you have a degree. My course is Integrative with a splash of Pluralism – a concept popularised by influential white middle-class men who tell us we should “prize diversity” (Cooper and Dryden, 2016).

​I’m glad be on a course with a little more “diversity” and to be learning more modern approaches to integrative therapy. My course had a online counselling module long before the pandemic – ahead of the game! Online counselling allows for more inclusion, for both counsellors and clients, so it’s important in my view to not rush back to “normal”. I think “normal” was old-fashioned, exclusionary and snobby, and I’m delighted to be part of a changing counselling industry that can offer more flexibility, adaptability and inclusion. 

Attendance and able-bodiedness has always been a focus in therapy (for both clients and counsellors), some courses insisting on 100% face-to-face attendance. Chronic illnesses, disabilities, social anxiety, work and family commitments, and many other factors can make it difficult for people to attend in-person, both counsellors and clients. Our training providers and membership bodies need to reflect that by valuing online learning (and counselling) and supporting students by meeting their needs. If there’s a silver lining of this awful pandemic, it’s an opportunity to work towards the kind of accessibility we should’ve already had in the industry.

This year has taught me the importance of needing to be adaptable, creative and open-minded in the ways I offer counselling, and how this can still be done in a boundaried and ethical way. I continue to learn and remind myself of the natural neurodiversity amongst people and how everyone needs to communicate, learn and engage in different ways. I continue to keep learning and checking my biases about race, gender, sexuality, body size and appearance, neurodivergence, disability, and more, because this is so crucial for working ethically, and I always encourage other counsellors to do the same.
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I’m continually grateful for the privilege of being able to do this work with clients in my placements, in my job as a group facilitator, and running training and workshops.  I’m sure my last year is about to fly by and I’ll be writing another follow-up blog before I know it as a qualified counsellor!

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I'm running an online body acceptance workshop on 13th July - find out more here!

Content warning: domestic violence and abuse
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I work in domestic violence services and I’ve been horrified to see the public display of toxicity around the Johnny Depp and Amber Heard case. It’s EVERYWHERE. Memes, jokes, videos, GIFs, hashtags… mostly mocking Amber Heard, labelling her a “liar” and a “psychopath”. It scares me how much of an impact this has had, with such hatred on social media, showing the way our society sees domestic violence and abuse (DVA) and who we label “victims” and “perpetrators”. I’m not going to outline details of the case as there’s tons of information out there, I’m more interested in the impact on a social and cultural level. I work with perpetrators and am a trainee counsellor, so I have an interest in understanding how and why abuse happens. I take a big-picture approach when thinking about wider systems of power in which abusive relationships exist. I care more about the impact of this case on “normal” people, rather than debating the toxic details of two super-rich privileged celebrities.

“Real” abuse

It seems many people still view “real” domestic abuse as physical violence. There are many other forms of DVA, including emotional, financial, sexual etc, and lots of forms of coercion, manipulation and control. The breadth of DVA is shown in the power and control wheel later in this post (just one example, geared towards male perpetrator work). Physical violence is just one aspect of DVA, but all kinds of abuse are damaging and are traumatic. Perpetrators can use this idea of physical violence being the “worst” to position themselves as different to the “bad guys”. They reassure themselves by minimising and denying their behaviours, thinking they’re “not that bad”. They can say to themselves “but I’ve never laid a finger on her” or “I’d never hit a woman” to try to show they’re a ”good guy” and normalise their other abusive tendencies. This is to protect themselves from shame, a very difficult emotion to process, whilst allowing themselves to continue to feel the power and control of using their abusive behaviours.

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​The impact on the general public

The real victims of this are the people watching. It’s people stuck in abusive relationships who see their friends post memes on social media mocking Amber. It’s the general public who are being shown an inaccurate portrayal of abuse, and it’s men who will now be able to ignore/justify/defend their behaviour more than ever. This case will scare victims off speaking out about domestic abuse, even if they don’t name their abuser. It may keep people in toxic relationships, doubting themselves, thinking that they’re not a “real victim”. But the impact on perpetrators really concerns me too. There’s no doubt there will be a rise in defamation cases. Perpetrators often see themselves as victims, so this case will validate this for many. Any perpetrators who were starting to question their own behaviour, may now stop. They may think “maybe it was her all along” or “I knew she was lying”. Perpetrators engaging in interventions may drop out now as they have another reason to minimise and deny their behaviour. The repercussions of this very public, messy celebrity case is catastrophic for everyday people, be it victims, perpetrators and arguably most importantly – any children involved. What are we teaching the next generation?
Seeing this unfold has affirmed to me that things are never black and white. Our society’s narrative is that there must be one victim and one perpetrator, but it’s way more nuanced than that. The Depp Vs Heard case wasn’t even about that but the public wanted a good vs evil battle. Amber, whether you think she is a perpetrator or not, does not deserve to have death threats and be hated in the way she had been. Abusers are not born evil, it is learnt behaviour influenced by our own societal views. In that sense, we help create perpetrators, but we can also help them change.

It's all about the nuance

Johnny Depp and Amber Heard have both perpetrated abuse, and this has been called “mutual abuse” but this does not mean it is equal. When a man holds this much power, it will never be equal. When women are silenced and not believed, I’m reminded that we have not yet reached gender equality. My plea is that people look at the bigger picture and see the larger systems of inequality, power and privilege involved. I would like people to understand that domestic abuse is not just about bruises or having “proof” but about power and control in more subtle ways. As an example, if a man puts his wife down for years, making digs about the way she looks, discourages her from seeing her friends, controls finances, makes decisions about their relationship based on what she “should” do as the woman and how he “should” act as the man… what happens when she snaps and physically pushes him or hits him? Is she the abuser and he’s the victim? We need to look beyond the physical violence and understand coercion, control and power. It’s never as simple as whoever proves they have bruises wins.
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My personal interest in working with perpetrators has always come from wanting to be part of a deeper solution, instead of just helping victims leave abusive relationships. Obviously a person’s safety is always the most important thing initially, but when we help people get out of toxic relationships, they can be drawn into others. Helping tackle to root of the power and control issues in perpetrators is crucial long-term work, and in turn helps victims and children. My empathy and compassion extend to perpetrators as I believe there are complex lifelong issues that lead to perpetrating abuse (childhood development, attachment etc, but this post is too long already to go into that!) Perpetrators are people who have learnt certain behaviours to be able to cope. I believe we can help them and help victims.  But we can’t help anyone caught in toxic relationships if we keep these short-sighted societal views of domestic abuse. We can use this Depp vs Heard case as a learning curve, holding a mirror up to our society to show us that our views of domestic abuse must change if we are going to support victims and help the next generations.
 
Freephone 24-Hour National Domestic Abuse Helpline: 0808 2000 247
or visit www.nationaldahelpline.org.uk (access live chat Mon-Fri 3-10pm)

TW: eating disorders, discussion of BMI and ob*sity

Weight stigma isn’t only about the bullying, abuse and discrimination faced by fat people, it’s about wider societal systems of inequality and biases/assumptions which affect the way we think about eating disorders and disordered eating. Weight stigma and fatphobia is still present in eating disorder treatment and services, and is a barrier for so many people who need help.
Not all eating disorders develop from wanting to lose weight or dieting… BUT dieting is a big risk factor for developing an eating disorder. Weight stigma affects everyone, just in different ways and to different extents. Even if a person doesn’t have an eating disorder based on trying to lose weight, their access to treatment is based on a system embedded in fatphobia and weight stigma. And for those who do develop an eating disorder from trying to lose weight or diet, weight stigma was likely a huge catalyst in that.

The BMI chart
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Eating disorder treatment is known to have very little funding and limited resources, meaning that many people end up being told they’re “not thin enough” for help (see Hope Virgo’s fantastic campaign “Dump the Scales”). The BMI (Body Mass Index) chart is relied upon far more than it’s meant to be, despite the NICE guidelines saying not to use BMI to diagnose an eating disorder or to make decisions about treatment. The DSM-5 – the big boss American diagnostic people – list the BMI categories specifically in terms of what is “too thin” so the entire system is based on conflicting messages. Ultimately, it seems that healthcare professionals are pushed into a place of using BMI to decide who gets treatment (in restrictive eating disorders, mainly anorexia) because there’s only enough space for the very sickest people to get help. What that means is they’re waiting for someone’s eating disorder to get so bad that there are risks of serious medical complications before they can get help. This is reactionary and generally just really, really unhelpful… to say the least.

The BMI scale was made in the 1830s by a mathematician and astronomer who based it on mainly European men – it was for general statistics, not a measure of individual health. So I think we can safely say that it isn’t exactly the best thing to be basing any kind of decisions/treatment on. When you add weight bias and eating disorder stereotypes (of people with anorexia being thin, white, young, female etc) this only makes the situation a whole lot worse.

Weight bias

We’ve all grown up in a world that tells us that thin equals beautiful, happy and successful, and health professions, GP’s therapists etc – as well as policymakers and people in charge – are not exempt from that. We hope that they’d address their own prejudices and biases during their training, and learn about eating disorders in the process, but this seemingly isn’t happening. I’ve heard too many stories of people who were told they couldn’t possibly have anorexia because they weren’t thin, and that somebody must binge eat because they’re fat. These kind of assumptions are due to weight biases and can be extremely harmful. In my experience as a trainee counsellor, we’ve barely talked about eating disorders on my training so far, so we certainly haven’t approached weight stigma (though I’ll be sure to find a way to bring in conversations about it of course!) GPs apparently only have a couple of hours of training on eating disorders, which is shocking. I’ve attended quite a lot of trainings/webinars/events about eating disorders and, no disrespect to any of them, but many of them were pretty basic. They just explain what the main eating disorders are, as if they’re rare diseases that are tragic flukes and completely out of our control. Yet eating disorders are deeply entwined with cultural and social ideas so we can all play a part in helping prevent them. This “othering” of eating disorders, seeing them as the opposite of ob*sity (they’re not) and disconnecting them from the normalised diet culture and fatphobic society we live in is not helping. Disordered eating is so normal in our society, many people likely can’t even tell if they have difficulties with food.

Bullying and shame

For people who have body image problems or eating issues due to trying to lose weight, many will have experienced bullying from a young age and may have encountered teachers, health professionals and other authority figures using shaming approaches to encourage weight loss. Kids can be mean, but they’re just exercising their power over people who seem different based on what they’re learning to be “normal” from their families, TV, films etc. When kids were mean to me at school I could try to shrug it off, but when adults and health professionals told me I had to lose weight, I had to do what I was told. It led to me trying to diet from a young age, trying to restrict my food, hating my body and blaming myself for being too fat. When it starts young, this stays with people for years and takes a long time to unpick. For me, it’s been many years of counselling, reading, learning and growing. It’s been 100% worth the effort though!

People can often be well-meaning with their comments about dieting or weight loss. Maybe they’re just saying what they think is expected of them, making a joke or genuinely trying to help people feel better about themselves. However, this just reinforces diet culture and the idea that “thin is good”. Attempting to change our bodies to make ourselves feel better or happier is only a surface-level, short-term solution. Instead of changing our bodies, it’s about changing the way we think about our bodies. That’s why body image and eating problems should all be part of a broader mental health conversation.

Fatphobia

Eating disorders are often entwined with a fear of fatness (otherwise known as fatphobia). Many people working in eating disorders have a weight bias against fat people too – this isn’t to blame them as it’s something that is ingrained in our society. It’s systemic, throughout the medical profession and in our general culture, saturated in the system. So it’s nobody’s fault but it is our responsibility to recognise and challenge it in ourselves. Attempting to treat eating disorders in a system of fatphobia and weight stigma is hypocritical and counterproductive. Treatment within a broken system isn’t real treatment, it’s a Band-Aid at best.

We are told we have an “ob*sity epidemic” whilst we in fact have a huge mental health crisis going on, throughout an actual pandemic (COVID). All the ways our government has tried to help the “ob*sity crisis” so far have been based on shaming and stigmatizing approaches (mainly involving blaming individuals and making people feel like crap about themselves) and it’s causing more harm than good. The focus needs to be on mental health and relationships with food. I firmly believe that eating disorders are a much bigger issue than we see on the surface.

There are so many people who face barriers to treatment due to:

• Not recognising they have an eating disorder due to normalisation of disordered eating in society
• Not being able to access treatment due to stigma, shame, cultural or religious beliefs, family pressures etc.
• Not being "thin enough” or looking a certain way
• Not being able to access treatment because healthcare professionals prescribe weight loss instead of recognising an eating disorder
• Lack of services that can support people with eating disorders with disabilities, autism, diabetes, or any other aspects which co-exist and often exacerbate the eating disorder

The list could go on. If we really knew the full scale of eating disorders, disordered eating and difficult relationships with food, we’d see the real epidemic.

What can we do
If you feel you’re struggling with any kind of body image or food-related problem, know that you can ask for help, even if you don’t think it’s serious or you don’t think it’s an eating disorder. Any kind of anxiety or distress around food or your body is important and you are deserving of help. For fat people especially – no body shape or size is more deserving of help, so go and take what you deserve!

For people who are not affected by eating or body issues, it’d be helpful if you’d spend some time considering your own relationship with your body and your views of others. This is very important if you work in medical care or are a counsellor/therapist (and especially fellow trainees – hello!) Learn about weight stigma and eating disorders, consider your own experiences growing up and the narratives you heard about thinness, fatness and eating. Think about the rules you had around food (eg at the dinner table) and the way fat people have been treated at school, in workplaces and in their everyday lives.

To everyone: consider shaking up your social media feeds – unfollow anyone who promotes dieting or thin ideals and follow diverse people instead. We need to hear more from people who are not the standard “norm” (mainly thin and white) to widen our views of the world and perceptions. As I hope I’ve demonstrated, the entire system is broken as it is based on fatphobia rooted in thin white bodies being the ideal. Anyone who doesn’t fit that (a LOT of people) is potentially be excluded, stigmatised and shamed. We must challenge the norms, the ideals and the stereotypes.

Thanks for reading. Here are some resources which might be helpful:

Anorexia & Bulimia Care
Beat
First Steps ED
Beating Eating Disorders
The National Centre for ED – excellent training for professionals
NEDA – I highly recommend the roundtable discussion videos from fat, LGBT+ and black communities

A note on the word ob*sity – many see this as stigmatizing language, hence the asterisk, as are terms like “ov*rwe*ght”, as they’re based on the BMI system which as explained is outdated, exclusionary and harmful to many people.