Mel Ciavucco Counselling
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Unpacking Yalom’s “Fat Lady”: Anti-Fat Bias in Counselling Practice

5/5/2025

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Let’s talk about Irvin Yalom’s “Fat Lady” chapter from Love’s Executioner. I was given this chapter to read as “homework” during my first year of counselling training. Well… I wasn’t expecting it to pack such a punch.

The way Yalom talked about his client, Betty, was shocking; “I have always been repelled by fat women. I find them disgusting.”

His evocative words to describe her seemed purposely cruel, clearly chosen to make the reader uncomfortable. As a writer, I partly admired being able to evoke such strong reactions, and I’ll admit I read the whole thing captivated but astounded. I went back to my course the following week itching to talk about it, but there wasn’t space or time for discussion. So I bought it up in “open group” (like PD group) and shared my concerns about reading the “Fat Lady” chapter without any time for critical reflection. Most people said they were just blown away by Yalom’s honesty, and that was it.
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Back then I didn’t have the knowledge, language or confidence to challenge this further, but I certainly do now! For context, I work in private practice, predominantly with people with disordered eating and body image problems, and I work with many clients who have experienced weight stigma and anti-fat biases. I train counsellors on these topics and have read and written about this extensively. It’s safe to say this blog has been a long time in the making and I hope it’s a helpful deep dive.

Picture of Irvin Yalom sitting at a desk signing a book.  Unpacking Yalom’s “Fat Lady”: Anti-Fat Bias in Counselling Practice by Mel Ciavucco
Irvin Yalom. Image: Wikimedia Commons

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Solidarity with the Trans Community

4/21/2025

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Following the recent Supreme Court ruling that “the legal definition of a woman is based on biological sex”, I want to show my support for people trans, non-binary and gender queer people. As a counsellor with a strong ethical stance in social justice, I’m keen to make it clear that I stand with the trans community (which I’m using as an umbrella term), particularly trans women at this difficult time. Trans people are loved and supported, this week and forever. 
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Understanding Incels and Mental Health

4/11/2025

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The term "incel" has become a focal point of media attention lately, since the release of Adolescence on Netflix, and due to violent incidents in recent years such as the Plymouth shooting in the UK, and the Toronto van attack in 2018. The term "incel" stands for “involuntary celibate”; a label adopted by people, predominantly men, who feel unable to form romantic or sexual relationships despite wanting to, and often blame others for this. What started as an online support group (ironically, set up by a queer woman) in the 1990s grew into an ideology rooted in anger, resentment, and misogyny.

Two hands on a black background, one holding a red pill and the other holding a blue pill. Understanding Incels and Mental Health by Mel Ciavucco

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Unpacking Adolescence (Netflix): A Therapist’s Reflection on Masculinity, Power Dynamics and Shame

3/25/2025

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Contains Adolescence spoilers and discussion of violence/abuse.
I also have a video covering this on YouTube if you prefer to watch/listen.
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Adolescence (Netflix) has sparked a lot of important conversations about social media, masculinity, the manosphere, and more. As someone who has long been concerned about the rise of misogyny and the manosphere, I’m glad this show exists. It’s also rare to see a show that focuses on the perpetrator’s family and the abuse and stigma they experience. I’ve always been fascinated by what leads people to cause harm. I’m a counsellor in private practice and I used to work for a domestic abuse charity with perpetrators doing group and 1:1 work with predominantly men (you can read more about my experiences here). In this blog, I’m doing a deep dive into Netflix drama “Adolescence”, exploring the influence of the manosphere, power dynamics, gender roles, shame and trauma. These are just my theories/opinions and may differ from others, and also keep in mind that counsellors and psychologists are trained very differently.
Adolescence Netflix promo image of father and son. Unpacking Adolescence (Netflix): A Therapist’s Reflection on Masculinity, Power Dynamics and Shame by Mel Ciavucco
Image: https://www.netflix.com/gb/title/81756069

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Therapeutic Writing Exercises to Improve Body Image

3/14/2025

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Writing can be a powerful tool for exploring and processing emotions. As a writer and counsellor, I have experienced for myself how writing can be deeply therapeutic. We pour parts of ourselves into our words, even sometimes without realising it. Looking back, I can see that my early fiction writing was a way of processing my feelings and experiences, as well as my journalling. Writing blogs helped (and continues to help) explore themes like trauma, social inequalities, eating disorders, and body acceptance, which are central to my work.

Below are some suggested writing exercises that may help build self-compassion and improve body image. Some of these exercises are more structured than others, so do whichever ones feel right for you. The key is to write in a way that feels good or helpful, without any writing rules or pressures.


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How to Start Healing Your Relationship with Food

3/2/2025

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People struggle with eating in many different ways, so there is no one-size-fits-all approach to recovery and healing. I'd like to offer some insights into what healing your relationship with food might look like, based on my experience as an eating disorder counsellor but also from my own lived experience. This is just my perspective and some common themes I’ve noticed in practice. The most important thing is that you find the right path to explore these issues in a way that feels right for you, at your own pace.
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Weight Loss Injections and “Food Noise”

2/23/2025

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With all the buzz about weight loss injections recently, I’ve been hearing the term “food noise” a lot. As an eating disorder counsellor, I often work with people who experience some kind of food noise – incessant thoughts about food, cravings, anxieties about eating, food rules, and more. Many people discuss taking weight loss injections, such as Ozempic, Wegovy, and Mounjaro, to help reduce food noise. But is this the best approach to tackling food noise, and at what risk?

I appreciate that many people feel they need weight loss drugs desperately, and they have every right to take them. The problem is that many people don’t qualify for weight loss injections through the NHS and seek them elsewhere. This can lead to numerous problems and risks, which I discussed in a previous blog post.

I stand against harmful diet culture and the idealisation of thinness in our society but I do not judge people who choose to take weight loss drugs or pursue other weight loss interventions, given the cultural pressures we face. As a counsellor, my main mission is to help people improve their relationships with food and their bodies and to build self-acceptance.
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When Food Feels Like an Addiction

2/8/2025

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As an eating disorder therapist, I hear a lot of people say they feel like they can’t stop eating. They say they’re out of control, that food has a hold on them, and they just can’t resist certain things (normally the food deemed "bad"). For many, it can feel like inner conflict, like an angel and a devil on their shoulders shouting at them.

Food can certainly feel like an addiction for many people, with powerful thoughts and feelings commanding them to eat. It can feel like a yearning need, with real distress at the thought of not getting what they want. This is not simply just about willpower or weakness, this is a distressing battle of the mind. It can have such a huge impact on daily life and mental health. This distress can be indicative of disordered eating or an eating disorder, for which people deserve tailored help/therapy.

There can be similarities in how addictions and eating disorders develop and are maintained, but there are important differences when it comes to treatment/ therapy.

Silhouette of a woman eating from a spoon sat at a table.

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New Year, New You? How to beat the January diet culture boom

1/1/2025

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It’s that time of year again - the endless barrage of adverts: diet products, gym memberships, expensive supplements, weight loss drugs and injectables and more. And let’s not forget the “psychological approaches” to weight loss - the ones that say “we’re-definitely-not-a-diet” when they most definitely are! The New Year comes loaded with expectations: to be better, fitter, healthier, more successful… and, of course, to BUY MORE STUFF. Businesses selling diet culture don’t care about your health, they care about making money.

So here’s your friendly reminder: you don’t have to listen to any rules, “shoulds” or “musts” about your body in the New Year. Sometimes, the stress of trying to “improve” does more harm than good. Perhaps the aim can just be to show ourselves a little more kindness and compassion this year.


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Atypical Anorexia and Weight Stigma

12/7/2024

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Did you know that many people with eating disorders are not underweight?

It's common for many people to think of thin young girls with anorexia when talking about eating disorders but realistically it's a lot broader, with disordered eating affecting people of all different shapes and sizes.

One study reported that only 6% of adolescents with an eating disorder are classified as underweight.

This is hugely important for the way we view, and help, people with eating disorders. It’s the reason why I’m so passionate about the connection between weight stigma and disordered eating, and about my therapeutic work with people experiencing eating distress and body image issues.

So I wanted to talk about “Atypical Anorexia” in this blog as this is an aspect of disordered eating impacting people who are not underweight, and this is heavily influenced by weight stigma.


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What is binge eating and how to break the binge cycle

9/22/2024

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Binge eating disorder (BED) is one of the most prevalent eating disorders, with many people caught in a difficult cycle of negative thoughts and difficult emotions. It can often be a secretive or shameful thing to talk about, so that’s why it’s important we do talk about it! Whether someone has a diagnosis or not, binge eating can have a huge impact on a person’s life. So let’s dive into what binge eating is, the binge cycle, and most importantly, what can help stop binge eating.

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What’s the deal with weight loss injections?

6/30/2024

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Skinny jabs. Weight loss injections. The new miracle drugs to “tackle the ob*sity crisis” once and for all. Drugs like Ozempic and Wegovy are being hailed as wonder drugs. Oprah raves about weight loss drugs and says “obesity is a disease” so it’s not about willpower. This apparently can help get rid of weight stigma…by reinforcing weight loss and thin ideals? This doesn’t make much sense to me.

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Reflections on working with perpetrators of domestic abuse

5/6/2024

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A couple of years ago I wrote an initial reflection on working with perpetrators of domestic abuse when I was relatively new to the work. Since then, sadly the service has closed as the funding ended. This is not uncommon in this field; victim services are barely funded enough so perpetrator services can be a hard sell. So, given this sad ending, I wanted to reflect on this amazing work and what I’ve learned about working with perpetrators of domestic abuse, and about what we need to do as a society to help men. Due to the nature of this work, no names or identifying information about the organisation or individual involved will be used.

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A Big Picture Approach to Body Image

4/8/2024

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Body image problems affect lots of different people. We live in an appearance-centred society, but it’s not just about vanity or being shallow. Body image issues aren’t something “silly” experienced by teenage girls, nor are they something we can just “get over”. Body image is partly about how we see ourselves and perceive our bodies, but this is influenced by wider issues such as societal views, diet culture, inequalities, power dynamics and discrimination.

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ARFID: What is “normal” eating anyway?

2/29/2024

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​What is ARFID?

ARFID - Avoidant/Restrictive Food Intake Disorder – is a lesser-known eating disorder, categorized in the 5th edition of the DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders). ARFID is described as an “eating or feeding disturbance” which may include sensory sensitivity, fear of aversive consequences of eating, or lack of interest in eating. This can manifest in various ways, such as avoiding certain food textures, colours, or smells, experiencing a lack of appetite, or having a limited range of acceptable or safe foods.

In this blog, I share my own experiences of difficulties with illness and eating, as well as exploring aspects of ARFID, the overlap with neurodiversity, and the pressures and expectations that come with "normal" eating.

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  • Home
  • About Me
  • Counselling
    • How does online counselling work?
  • Workshops
    • Bespoke Training
  • Body Image
    • Body Image Counselling
    • Helpful Resources
  • Eating disorders
    • Counselling for disordered eating
    • Consultation for Professionals
  • Blog
  • Contact