Fat Accptance and Family/Marriage Therapy

Over at Shapely Prose, Dr. Sheila Addison is looking for recommended reading for a class she is teaching on size acceptance in family/marriage therapy.

This was my input, and I encourage you to head over there and add your own!

Kate Harding's "Don't You Realize That Fat Is Unhelathy" and "The Fantasy of Being Thin" are definitely two of the best introductions to size acceptance I've ever read.

"Big Big Love" is an excellent book dealing with sexual relationships and self acceptance. I think in Marriage and family counseling you would come across a LOT of entitled fat hatred on the part of partners and parents who are not fat. Or parents who are fat and fantasize that they can "save" their child from fatness by shaming them and telling them nobody will find them attractive. Seriously, any partner who feels justified in harassing or leaving someone based on weight (no matter how acceptable and encouraged fat hatred has become) has issues of their own. They might also just use weight as the best tool to push the partner away so they aren't the "bad guy".

Fat?SO! Was also very formative for me, long before there was a fatosphere. Junkfood Science articles are extremely rational and evidence based analyses of the cultural hysteria that is the obesity epidemic and the science showing that fat is not the killer it is purported to be.

The best thing to emphasize is that fat people are no different from thin people or other social groups subject to prejudice (positive or negative). You cannot tell anything about a fat person by looking at their body. NOTHING. As with other groups, make no assumptions about your client and instead listen to them. If there are deep issues with eating or body image, they will emerge. The fact that they do not usually indicates that there are none, not deep denial. If someone tells you they eat less than their thin friends, believe them. If someone tells you that his insecurities as a father have little to do with size and everything to do with the way his parents *treated* him for his size, believe him. If food and size never come up, don't force the issue. If you must address weight because it does come up,do so in an accepting manner that is HAES and size positive. Keep things about psychological and behavioral issues and stay out of medical issues. Frame weight in terms of other prejudices to clarify how hurtful and unacceptable mistreatment of fat partners/parents/children really is. If you wouldn't say it about race or religion, it's prejudice and you're behaving rudely.

This is Important

Krista has been commenting here for a little while, and this weekend I got a chance to read her blog too. She linked to her best friend's blog, and her best friend had reposted this. Please take the time to read it. You won't be sorry.


A lot has been said about how to prevent rape.

Women should learn self-defense. Women should lock themselves in their houses after dark. Women shouldn't have long hair and women shouldn't wear short skirts. Women shouldn't leave drinks unattended. Fuck, they shouldn't dare to get drunk at all.

instead of that bullshit, how about:

if a woman is drunk, don't rape her.
if a woman is walking alone at night, don't rape her.
if a women is drugged and unconscious, don't rape her.
if a woman is wearing a short skirt, don't rape her.
if a woman is jogging in a park at 5 am, don't rape her.
if a woman looks like your ex-girlfriend you're still hung up on, don't rape her.
if a woman is asleep in her bed, don't rape her.
if a woman is asleep in your bed, don't rape her.
if a woman is doing her laundry, don't rape her.
if a woman is in a coma, don't rape her.
if a woman changes her mind in the middle of or about a particular activity, don't rape her.
if a woman has repeatedly refused a certain activity, don't rape her.

if a woman is not yet a woman, but a child, don't rape her.
if your girlfriend or wife is not in the mood, don't rape her.
if your step-daughter is watching tv, don't rape her.
if you break into a house and find a woman there, don't rape her.
if your friend thinks it's okay to rape someone, tell him it's not, and that he's not your friend.

if your "friend" tells you he raped someone, report him to the police.
if your frat-brother or another guy at the party tells you there's an unconscious woman upstairs and it's your turn, don't rape her, call the police and tell the guy he's a rapist.

tell your sons, god-sons, nephews, grandsons, sons of friends, daughters - tell everyone it's not okay to rape someone.

don't tell your women friends how to be safe and avoid rape.
don't imply that she could have avoided it if she'd only done/not done x.
don't imply that it's in any way her fault.
don't let silence imply agreement when someone tells you he "got some" with the drunk girl.
don't perpetuate a culture that tells you that you have no control over or responsibility for your actions. You can, too, help yourself.


If you agree, repost it. It's that important.

How Soon They Forget

A certain person who shall remain unnamed but whom I happened to marry about ten years ago told me he had a picture of me and turned his laptop around to reveal this.

A couple of FACTS are called for here.

1. Hours after I am peacefully dreaming, this unnamed person is typically still on the internet.

2. My charms and beauty would have remained entirely unknown to him if it hadn't been for someone being wrong on...well it wasn't exactly the internet as we know it.

Before the world wide web, back in the mists of time, when dinosaurs roamed the earth there were scarcely known rooms called student computer labs, exclusively in the actual computer science building. There were computers there, unlike in dorms or libraries or apartments. And those computers could link to electronic bulletin boards through an ill defined process that non-computer people did not worry their little heads about. It came to pass that the university upgraded and would actually sell the monitor, keyboard and 300 baud modem to students. Amongst all the men buying them was the occasional nubile woman taking an assembly back to her apartment. There she could read intelligent and not-so -intelligent discourse on all manner of subjects, and give her own pithy responses.

In the course of time a misguided user named Skullhacker wrote a post so mind-numbingly ignorant that one such woman could not help correcting him. When she hit enter and returned to the forum, she found a remarkably similar response to Skullhacker. "What an intelligent person!" she thought, "I must high five them!" So she did. It emerged that this intelligent person was male. And lo, he did not ask her what color her panties were. This passed for gentlemanly behavior on what would become today's internet. So she continued X messaging him when she was online. Intellectually stimulating and amusing conversations followed, and those conversations became more stimulating over time.

A day came when the pair decided a telephone conversation would be enjoyable and smoother that X messaging. And lo, the man asked the woman if she was really over eighteen in a frightened and disapproving tone, the which concern pleased the woman and helped her believe that she was not speaking to a predator. And she offered to send a copy of her driver's license before they spoke again, and the gentleman said no, that was okay. The woman and the man continued their long distance telephone conversations, and there was much rejoicing in the AT&T billing department.

Time passed, and hesitant planning for a meeting in person ensued. The man was visiting friends up north over New Year's, and the woman was house sitting in a big city a few hours away. The woman made many dampened braids in her waist length golden hair, the better to lure the man when her hair was let down into a mass of waves. And it worked. And they attempted to get it on, but the friend's refrigerator made loud banging noises and they were afraid it would wake other people up, and they did not want an audience, and besides they were nervous.

And they traveled to the big city to house sit together, and life got better until Trent the Bondage Kitty made his appearance. And the big city was FUCKING COLD with temperatures below zero and famous winds. So they had little to do besides snuggle and make an occasional shivering one block journey to Boston Chicken for sustenance. And Boston Chicken turned out to be SO ROMANTIC!tm They decided that they were fond of each other in the face of glaring evidence that they were both already head over heels in love, in an attempt to be prudent and cautious.

They returned to their now lonely homes. They wrote and called. They visited when they could afford it. The man moved back north to be about eight hours away instead of 22. The woman moved to the big city to be about three hours away instead of eight. That year he came home with her for Christmas and her mother bestowed upon him a dowry of clothing, watches and a higher baud modem. Soon the man proposed on one knee under the fireworks. The woman danced around and said yes.

And ten years later all the man can do is mock the woman playfully for obsessing over the internet.

Bastard. :)

I love you Sweetie! Thanks for reminding me how we met.

Facelift

I changed my template to a less stodgy appearance. I like elegance and all, but I also like fun and goofiness, so the polka dots seemed to fit. Hope you like it, I sure do!

Stomach Mutilation in Children

Riolriri at She Dances On The Sand pleads to know if she is the only person opposed to bariatric surgery in children. This is my reply.

You are not alone.

I am uncomfortable with any cosmetic surgery in children who are not severely disfigured. I think surgeons should wait until teens are at least at the age of consent. I think ethical ones do.

When it comes down to it, though, other cosmetic surgeries are not as dangerous as bariatric surgery. They do not have a 2% perioperative mortality rate (within 30 days of surgery) 4.6% mortality within a year. They do not cause beri beri, with permanent neurological damage. They do not cause peripheral neuropathy. They do not limit the amount of fluid one can drink when exercising or feverish, promoting dehydration. They don't cause chronic vomiting and malabsorbtion of what does stay down.

These surgeries are extremely dangerous for even adults, but adults have a right to mutilate themselves if they want.

Parents should not have free reign to mutilate their children for the sake of appearance. Hell, I oppose circumcision on this ground. And circumcision doesn't cause devastating malnutrition which can stunt growth and result in lifelong neurological damage.

For details on the actual mortality risks of obesity as opposed to bariatric surgery, see this brilliant post from Sandy on Junkfood Science on the actual risks of dying from obesity.

Neat and Trim - an Improved Background & Goals

My professor friend Chad gave me a great critique, and this is the result - much better!


“So you're the one with the human bites!” exclaimed the hospital orderly as he wheeled me to physical therapy. My social work career had just been severed as surely as the nerves in my partially detached finger. Like my finger, it healed and regained function with time.

I had chanced into social work on a paraprofessional level eight years before. A job sorting clothes for Goodwill Industries led to promotion when I excelled at supervising my disabled coworkers. Now a job coach, I trained, supervised and worked alongside people with developmental, physical and psychiatric disabilities in a community based vocational rehabilitation program. Vocational rehabilitation provided a good grounding in social work skills. I learned assessment techniques, wrote individual service plans, developed time management skills, supervised people in groups while focusing on their individual needs and goals, and adapted to a wide range of community settings.

Meanwhile, I faced my own challenges. My blue collar parents had never personally known anyone with a college degree and certainly never considered sending a girl to a university. My high school counselors were no more enthusiastic about helping blue collar girls go to college. However, the flood of university recruitment letters after my college board exams had their effect. I blossomed in the dorms, took upper division classes for fun, and flirted with theater before settling on psychology. Then the money ran out. I was determined to continue my education but I would not be eligible for financial aid based on my own income for five years. So like many others, I worked and watched my friends from high school have fun on campus and finish college.

At last my turn came, and I returned to my studies with focus and maturity. My first psychology advisor at the University of Iowa told me to quit school if I needed to work for a living because I couldn't do both well. I firmly believed I could prove him wrong. Serious illness in 1994 affected two grades, but I retook the classes and did well. During my senior year I took loans out, worked fewer hours, made the dean's list both semesters. Ten years after I had begun, I picked up my diploma at the post office and cried for joy in my freezing car.

Armed with my shiny new Bachelor of Science degree and Goodwill's 1996 Employee of the Year award, I became ambitious. In Chicago I found a job life coaching a man who had severe autism. Two weeks into the job I was preventing “Mr. B” from banging his head on the wall when he attacked, biting me all over and nearly taking off my right index finger. Six police finally restrained him, but not before one of them was also bitten. Following surgery and extensive physical therapy I prepared to enter the workforce again.

Injured and humbled, I needed a break from social work. I worked in construction, supervised scorers of standardized tests and chauffeured for a remarkable disability advocate. I got married, birthed twins and moved my family to Grand Rapids. After eighteen months as a stay at home mom, I longed for the comparative peace and low stress of social work. I had emotionally healed from the attack and decided I would give my career another try. Touchstone Innovare hired me in 2002 and I have worked there since.

My five years at Touchstone have widened my skills and perspective. We treat people with serious psychiatric illness and co-occurring substance abuse. The majority of my clients at Touchstone live in crushing poverty. Most are jobless, many are homeless and few have steady incomes or medical insurance. Ingenuity is needed to help fill needs for medication and housing when those resources are absent or pending. My intellect has been challenged as I apply current research in psychology to treatment. Successfully developing treatment plans with individuals requires creativity and the ability to integrate knowledge of psychiatric diseases with unique personal and environmental factors. Teamwork and constructive criticism are valued at Touchstone, and I have learned to consult with peers and supervisors regularly, improving my clinical judgment. Outreach to unengaged clients has honed my investigative and rapport-building skills.

I have established and maintained therapeutic rapport with hundreds of people with psychiatric disabilities, but I lack the necessary education to fulfill my career goals. A master's degree in social work from Grand Valley State University would give me the knowledge and credentials to practice social work at an advanced level. I could work intensively with women experiencing mental illness during pregnancy and postpartum. Poor women face challenges in getting adequate and humane psychiatric treatment and I would like to help solve that problem.

Grand Valley State University stands out as the best choice for me. It compares favorably to other programs in important ways. I would not need to move my family to another part of the country, find another job, and build a new network of supports to attend. Grand Valley has been highly recommended to me by coworkers who are alumni. The emphasis on social justice and diversity appeals to me because I share it. GVSU offers part time study completed during the day, which would allow me to spend more time with my family than a night program would.

The most compelling reason to choose GVSU is the chance to study with faculty members whose areas of expertise would be very helpful to me. Joan Borst could teach me much about addressing barriers to health care. Dianne Green-Smith's focus on family therapy, pregnancy and infant adoption dovetails with my interest in reproductive health. I find David Lehker's study of male parenting important because he could expand my knowledge of men's reproductive lives. Shelley Shuurman's work in parenting issues and advocacy could be valuable to me since I want to develop advocacy methods myself. No other MSW program I have considered can compare with Grand Valley State University in terms of professors who could foster my professional development.

I once thought that being bitten by a client would ruin my social work career. Time and a sincere dedication to helping others brought me the strength and courage to return to the work I love. Earning an MSW at Grand Valley State University would seal that choice and prepare me for advanced practice. I hope you will invite me into your department.

Background & Goals Grad Essay

“So you're the one with the human bites!” exclaimed the hospital orderly as he wheeled me to physical therapy. My social work career had just been severed as surely as the nerves in my partially detached finger. Like my finger, it healed and regained function with time.

I had chanced into social work on a paraprofessional level eight years before. A job sorting clothes for Goodwill Industries led to promotion when I excelled at supervising my disabled coworkers. Now a job coach, I trained, supervised and worked alongside people with developmental, physical and psychiatric disabilities in a community based vocational rehabilitation program. In the 1980's sheltered workshops flourished and placing workers with disabilities at regular businesses radically challenged the status quo. I was proud to be one of the first job coaches in Iowa promoting diversity in the workplace and visibility of a stigmatized group. Vocational rehabilitation provided a good grounding in social work skills. I learned assessment techniques, wrote individual service plans, developed time management skills, supervised people in groups while focusing on their individual needs and goals, and adapted to a wide range of community settings. Early on I emphasized basic social skills such as saying “please” or “excuse me” and zipping one's own coat, since many of my employees had led isolated lives in institutions or at home before coming to Goodwill. Employed in teams at stores, hotels, factories and museums my workers approached jobs usually regarded as menial with dignity and enthusiasm.

Meanwhile, I faced my own challenges. My blue collar parents had never personally known anyone with a college degree and certainly never considered sending a girl to a university. My high school counselors were no more enthusiastic about helping blue collar girls go to college. However, the flood of university recruitment letters after my college board exams had their effect. My parents could only afford loans for three semesters, and I will always be grateful to them for financing those despite their doubts about the utility of college. I blossomed in the dorms, took upper division classes for fun, and flirted with theater before settling on psychology. Then the money ran out. I was determined to continue my education but I would not be eligible for financial aid based on my own income until age twenty four. So like many others, I worked and watched my friends from high school have fun on campus and finish college.

At last my turn came, and I returned to my studies with focus and maturity. My first psychology advisor at the University of Iowa told me to quit school if I needed to work for a living because I couldn't do both well. I had gained confidence as a social worker and firmly believed I could prove him wrong. I did encounter stumbling blocks as I worked up to 60 hours weekly and studied full time for six semesters. At the end of spring semester 1994 I fell ill and did not recover in time to finish two incompletes, resulting in F grades. I later retook the classes and did well. I believe that the lesson I learned about respecting my limits and overcoming mistakes taught me more about life success than passing would have. In addition, I only earned C's in classes that I would have sought tutoring in given time and money, which lowered my overall GPA to 3.11. In my psychology major I earned a 3.76 GPA. During my senior year I took loans out, worked fewer hours, made the dean's list both semesters and earned a 4.08 GPA in my final classes. Ten years after I had begun, I picked up my diploma at the post office and cried for joy in my freezing car.

Armed with my shiny new Bachelor of Science degree and Goodwill's 1996 Employee of the Year award, I became ambitious. I went to the big city and found a job working with a man who had severe autism living in a specialized group home. I said goodbye to good friends and Goodwill, and moved to Chicago. Two weeks into the job I was preventing “Mr. B” from banging his head on the wall when he attacked, biting me all over and nearly taking off my right index finger. Six police finally restrained him, but not before one of them was also bitten. Following surgery and extensive physical therapy I prepared to enter the workforce again.

Injured and humbled, I needed a break from social work. Several years passed. I worked in construction, supervised scorers of standardized tests and chauffeured for a remarkable disability advocate, keeping a foot in the door for social work by volunteering with her group of disabled teen girls, the Empowered Fe-Fes. I got married, birthed twins and moved my family to Grand Rapids. After eighteen months as a stay at home mom to infant twins, I longed for the comparative peace and low stress of social work. I had emotionally healed from the attack. I missed professional work and decided I would give my true career another try. Touchstone Innovare hired me in 2002 and I have worked there since.

My five years at Touchstone have widened my skills and perspective. Although the main focus is treating people with serious psychiatric illness, co-occurring substance abuse is common. The majority of my clients at Touchstone live in crushing poverty. Most are jobless, many are homeless and under half have steady incomes or medical insurance. Ingenuity is needed to help fill needs for medication and housing when those resources are absent or pending. My intellect has been challenged as I apply current research in psychology to treatment of individuals in an evidence based manner. Successfully developing treatment plans with individuals requires creativity and the ability to integrate knowledge of psychiatric diseases with unique personal and environmental factors. Electronic record keeping and resulting high standards have improved my documentation skills, allowing me to form thorough and accurate client files. Teamwork and constructive criticism are valued at Touchstone, and I have learned to consult with peers and supervisors regularly to my clients' benefit. I gained an awareness of my strengths and weaknesses which has promoted objectivity and successful treatment approaches. Outreach to unengaged clients has honed my investigative and rapport-building skills.

I have established and maintained therapeutic rapport with hundreds of people with psychiatric disabilities, but I lack the necessary education to fulfill my career goals. A master's degree in social work from Grand Valley State University would give me the knowledge and credentials to practice social work at an advanced level. This would afford an opportunity to work with women experiencing mental illness during pregnancy and postpartum. (See social justice essay.) Poor women face challenges in getting adequate and humane psychiatric treatment and I would like to help solve this problem. Completing graduate work at GVSU could enable me to pursue that goal through several possible avenues. It would allow me to address the problem individually by giving therapy to women in that situation. I could network with fellow students in the macro program and develop a community agency specializing in mental health services for women in their reproductive lives. Or I could pursue further academic work, earn a Ph.D. and research reproductive mental health needs on a state or national level.

Grand Valley State University stands out as the best choice for me. It compares favorably to other programs I have looked at in important ways. GVSU operates in and contributes extensively to my community through faculty activities and the education of new generations of social workers. I would not need to move my family to another part of the country, find another job, and build a new network of supports to attend,a major consideration. Grand Valley has been highly recommended to me by coworkers who are alumni. Your high quality social work program with an unapologetic emphasis on social justice and diversity appeals to me because I want to right inequality and prejudice to the best of my ability. GVSU offers part time study completed during the day, which would allow me to spend more time with my family than a night program would. Your program allows specialized micro study, allowing me to focus on the area where my personal skills fit best but maintain contact with peers with administrative talents.

The most compelling reason to choose GVSU is the chance to study with faculty members whose areas of expertise would be very helpful to me. Joan Borst could teach me much about addressing barriers to health care. Dianne Green-Smith's focus on family therapy, pregnancy and infant adoption dovetails with my interest in reproductive health. I find David Lehker's study of male parenting important because he could expand my knowledge of men's reproductive lives. Similarly, Shelley Shuurman's work in parenting issues and advocacy could be valuable to me since I want to develop advocacy methods myself. No other MSW program I have considered can compare with Grand Valley State University in terms of professors who could foster my development in my particular area of interest.

I once thought that being bitten by a client would ruin my social work career. Time and a sincere dedication to helping others brought me the strength and courage to return to the work I love. Earning an MSW at Grand Valley State University would seal that choice and prepare me for advanced practice. I hope you will invite me into your department.

Social Justice Essay for Grad Application

An often overlooked issue of social justice is the disparity in treatment for psychosis during pregnancy between poor or underinsured women and middle class privately insured women. An impoverished, pregnant and actively psychotic woman is among society's most vulnerable citizens. Yet doctors often will not prescribe the same medications for potentially deadly psychosis that they give for inconvenient nausea in pregnancy. This leaves pregnant women committed in locked facilities for weeks or months untreated, fully psychotic and incapable of directing their own medical tereatment. Incarceration is not treatment.

Psychosis is the most severe form of mental illness, often robbing its sufferers of recognition that they are ill. 4-10% of psychotic patients commit suicide. Unmedicated pregnant psychotic women run four times the risk of psychiatric hospitalization as those who take antipsychotics. Hospitalized women have twice or more the rate of stillbirth, infant death, premature birth and low birth weight. Antipsychotics are proven safe throughout pregnancy; several are routinely used to treat nausea. Mood stabilizers are safe after the first trimester, and one is proven safe throughout. The fact that middle class women with private insurance are not routinely committed and left untreated indicates that the lack of treatment of impoverished women is a case of social injustice, not prudent medicine.

This travesty could end. Widespread advocacy and education on the safety of antipsychotics and risks of witholding them would protect doctors and benefit patients. Networking could link women with doctors who will prescribe medications during pregnancy. Volunteer medical guardians enforcing the treatment preferences of psychotic women incapable of consent could be provided. Universal health care could reduce discrimination based on insurance and give poor women access to doctors with ethical treatment standards. This would prevent a woman from being held in a locked unit rather than medically treated until she gives birth, simply because she is poor.

Time Flies. Also, Random Weather Thoughts.

So apparently it's been almost three months of silence here. I have been binging on other people's blogs and ignoring my own. Maybe I should feel guilty, but I've lived with myself for a long time and have come to accept certain character flaws. :)

We've been having a lot of snow days here, and I'm hoping to have ANY vacation time left come April. There was a sixty car pile up in my state today, and the roads are packed snow frozen over with a layer of ice. It's very dangerous driving.

I watched most of a program on the Little Ice Age from the 14th to 19th centuries, and going over what happens with just a bit of a temperature drop (4 degrees F) makes me aware of the devastation a similar temperature rise could do. Massive drought for years on end, increased storms, killing off of staple crops. In the first part of the little ice age it rained virtually every day for five years straight in England. Many thousands of people died from starvation because it killed the grain crops they depended on.

That's one reason that I'm opposed to eating local. I don't care if sometimes people choose to do it, but I am concerned that Congress is considering making it a requirement for public schools. Being able to eat tomatoes in February is one of the marvels of modern living. If I were eating local, there basically wouldn't be vegetables after October and before June. How that's healthier is beyond me.

We need to join the rest of the world in the global effort to minimize damage to the ozone layer and prepare for global warming. I was neutral for some time but I'm convinced at this point that it is happening, though I'm not entirely convinced that we are causing it. The little ice age happened without human input. This is clearly a version of Pascal's wager, though. Even if we don't believe in global warming, the prudent course is to believe in it and behave as if it does exist.