Fatphobia, Capitalism, Etc. Part 2: Self-Care

This post is about cooperation, competition, self-care, and fat.

When Lisa B and I decided to work on a series of posts about fat shaming, capitalism, professional ethics and community acupuncture, I was excited because it seemed like we’d be filling a hole in our discussions about trauma informed care — like, how did we not talk about this already? Shouldn’t this have been a POCAfest breakout or something? And also, fat as a topic is just fascinating — it intersects with all kinds of other topics if you think about it long enough. Try this quote by the amazing Virgie Tovar: “There is a pre-existing discourse around health that has a history mired in racism, sexism, and ableism. There is incredible cultural impetus to be “healthy” and “health” is framed in the United States as a personal/individual responsibility rather than a federal one.” Or this one: '”Fat” is just the current catchall word for all the things that we as a culture are afraid of: women’s rights, people refusing to acquiesce to cultural pressures of conformity, fear of mortality.”

Anyway, this week it occurred to me that it’s useful to look at the topic of fat shaming through the lens of cooperation, especially cooperation as opposed to competition. There are a few blog posts I’d like to point you towards:

A Call to Action: Your Fat Friend Is Going It Alone ,which is a painful and eloquent essay about fat shaming, and

Jes Baker’s discussion of “body currency”, which she says means: we are promised value, success, and happiness if we achieve our “perfect body.” When someone says: “I'm valuable, successful and happy!” and doesn't have, doesn't want to work towards, or doesn't care about this standard… we often feel like they are cheating the system; that they're cutting in line.

Competition is embedded in capitalism as a social system. Body currency reminds me of the history of lawns. You all have heard about this, right? Lawns were historically a means of showing the world that you didn’t need to grow your own food. You could take that potentially fertile swath of ground in your front yard and, as a status symbol, NOT plant vegetables. You could (conspicuously) grow only grass, and to really show that you had your act together, you could invest time and resources to make that square of grass perfect. Lawns are a class marker. They indicate who’s winning at capitalism, who’s in control of nature, who has choices. Body currency is similar; it implies that you have control over your body: you can shape it, perfect it, invest the time and the resources to make it a symbol. Body currency is a way of showing that you can win in our social system.

But unfortunately, if you’re going to have winners in a competition, you also have to have losers. Apparently, in our society that means stigmatizing, marginalizing, harassing and limiting fat people. Because if the game doesn’t have consequences, it doesn’t mean anything, right?

So I was thinking all this and then I read Caroline’s kick-ass blog post about her acupuncture school experience. And it occurred to me that the description of a culture of judgement around people’s lifestyles (choices and otherwise) isn’t limited to acupuncture school; it pretty much defines almost all of alternative medicine in North America. What we alternative medicine types are selling, for the most part, is a vision of health that can be achieved by making better, “cleaner”, more natural choices. We’ve developed all kinds of narratives about how powerful self-care can be.

In my 20+ years as an acupuncturist (which mostly but not entirely overlapped with being a punk) I feel like I learned a lot about self-care, including that there’s a difference between self-care as love and self-care as achievement. There’s self-care that reminds me of my humanness, and then there’s self care that emphasizes my power as an individual to control nature in the form of my body; one is tender and uniting and the other is hard and separating. One is like lying down on the ground in a sunny meadow and the other is like edging the lawn so the neighbors don’t hate you. As many comrades have noted, one of the sweetest things about being a punk is being present for all kinds of people doing the best they can, showing up day in and day out to try to take care of themselves. Triumph over nature is rarely, if ever, part of that scene.

Here’s the thing, though — when it comes to bodies, not everybody has the same materials to work with. Not everybody has the desire, or the potential, to edge their lawn.

Not everybody has a body that will respond to the self-care equivalents of shaping and trimming — or even mulching and watering. We’ve made the point that it’s inappropriate to give lifestyle advice/self-care advice because you never know what people’s circumstances are, and it’s ridiculous to tell somebody to eat more vegetables when they’re about to be evicted. But I’d like to make a slightly different point: lifestyle advice/self-care advice is problematic because even if somebody implemented all of it to the letter, it’s not necessarily going to make an impact on their symptoms. If you are somebody for whom eating better and drinking enough water and getting more sleep and managing your stress makes a big impact on your symptoms, that’s wonderful, but you are LUCKY. You're lucky that you don't have a progressive genetic disorder that affects all the systems of your body; that you don't have a psychiatric illness that is only controllable through medication; that you don't have a hypoxic brain injury; that you don't have ALS. Etc, etc, etc.

And if you can’t remember that you’re lucky, you probably need to get out more. If you believe self-care makes a difference for everybody's symptoms, you are for sure missing out on knowing some amazing people.

One of the things that I do that doesn’t help manage my stress, but I keep doing it anyway, is that I read acupuncture social media. Sometimes I even look at groups like Acupuncturists on Facebook. I guess you could argue I need to know some of this stuff for my job, but it’s really more like watching reality TV.  It’s a sometimes horrifying peek into the mental bubble we acupuncturists were socialized in. Anyway, recently I was reading some thread — I can’t remember, it might have been a bunch of acupuncturists complaining about fertility patients refusing to make their own bone broth or something — and I said out loud, “Jesus wept — you people need to get out more.”

And I realized that sums it all up: basically, the acupuncture profession needs to get out more.

Alternative medicine has established a niche in capitalism and part of that is all these narratives about the power of self-care. We’re selling the promise of controlling nature — but we’re virtuous because our methods of controlling nature are all natural, right? We sell mulching and watering as opposed to herbicides and sod transplants. And again, that’s all fine, I just think we need to be honest that we’re selling something, and also that what we’re selling is not something that everybody is in a position to buy.

Alternative medicine developed these narratives about the power of self-care in part because alternative medicine generally caters to a very limited, very privileged, self-selecting pool of people — people for whom eating better and drinking more water and getting more sleep are likely to make a difference in their symptoms. If you’re a punk in a busy CA clinic, you’ll still be working with a self-selecting pool of people, but it’s a lot bigger, and if you’re busy enough, you will be seeing people for whom all the self-care in the world doesn’t make a difference in their symptoms.  I think a lot of us feel strongly that, like everybody else, these people deserve access to acupuncture to use on their own terms, to find out if it will improve their overall quality of life — because sometimes it does. Sometimes it really, really does. Some of WCA’s most devoted regulars are in this category.

We need to decouple acupuncture from competitive self-care in capitalism. We need to restore it to a context of cooperation, to emphasize it as a way of cherishing our common humanness.  We need the sunny meadow, which has room for everybody, more than we need a bunch of individually perfect lawns.

And fat shaming is a great place to start thinking about how to decouple acupuncture from competition. Because fat shaming implies that everybody has control over their bodies; fat shaming buys into and reinforces the competition of body currency. And we're not competitors here, we're cooperators — right?

To prevent this post from going on forever, I’m going to close it by linking to yet another fantastic blog post about fat-shaming, this one by Dave Hingsburger. I love this post. (His blog is one of the ways I try to get myself out into a wider world.) Competition's so lonely and body currency doesn't buy happiness. There are things that are worth so much more — let's invest in them.


Author: lisafer

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  1. I had such a great moment yesterday, as I saw a new client begin to collapse in as she told me of her lack of exercise, her poor eating habits, how much she drinks, as though protecting herself from the lecture she thought was inevitable. And I felt relief, knowing it was just fine, to say, well, let’s see if we can’t help you with your pain. We can come back to these other things at some point, if you want to focus on them. And she bloomed and relaxed. Thanks POCA.

    Also, I read this yesterday, and it made me super grateful for POCA too. https://www.washingtonpost.com/news/wonk/wp/2016/04/19/why-becoming-an-adult-means-something-very-different-when-youre-poor/

  2. Thank you so much for this article. I have to admit that I’m guilty of this too. I’m by no means “perfect” in any sense of the word, yet I find myself making assumptions or judgements about my patients. It is definitely something I am working on. I need to meet everyone where they’re at (including myself)!

  3. Thanks for this great blog… (and for introducing me to Dave HIngsburger.) It is taking time and courage to unpack all the distorted messages I received in my youth, to realize how deeply they affected and me, and to acknowledge how I’ve sometimes perpetuated them. I appreciate you Lisas for continuing to shine a light on this.

  4. Thank you for the above post! I wanted to share this article: https://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html?action=click&contentCollection=Theater&module=Trending&version=Full&region=Marginalia&pgtype=article

    It talks about following contestants from the reality tv show “The Biggest Loser” (wow, how I’ve always detested that show name) and how the majority of them saw the weight come back after the show. The article notes that scientists are finding correlations to weight loss slowing metabolism, the role of leptin in satiety and appetite, and stepping back from the obesity epidemic to look at science and say that 30% of the population of the United States is not experiencing a lack of will power. I think it will help turn the tide against fat shaming.

  5. I laughed out loud about the Acs on FB comments.
    And the lawn analogy is spot on.
    I was so trained for so long to “edge the lawn” instead of laying down in the meadow. It has been a journey of many years to stay put in that meadow. Thank you for this funny and beautiful validation.