Jung At Heart

I asked in my last post what obesity is a symptom of, because frankly it is not as clear as might be thought. The desire to pinpoint the cause is all but irresistible. As I have struggled with my weight in my adult life, I wanted desperately to find a reason for it, some explanation that I could rest on. At times I told myself it is all about biology and genetics, an inevitable outcome of being my father’s daughter, as the Fullers are a family replete with fat women who lived long lives. And there is comfort in that explanation because if the reason for my fat is biological, then it is not my fault anymore than my eye color or height is my fault; it is just the way I was made.

Other times I would fall to the other side of the coin and believe the cause lay in my psyche. I read Hilda Bruch, Irving Yalom, and Marion Woodman and all those others who led me to believe that if I could just work my way through my issues, then everything would change and I would be normal, I would become thin and stay that way. 

Then I read Fat is a Feminist Issue and it all became muddled again, this time in feminist politics and the tyranny of the patriarchy. I began to consider again that maybe this fat body is  my normal, maybe this is the body I am meant to have and that trying to beat it into submission, trying to make it smaller is to be in a state of war with myself. 

There is a very thin line in the space between “either” and “or”, a razor thin edge where both/and exists. In this narrow space, which is so very hard to hold on to, causation is not a settled matter. It is not a matter of either biological etiology or emotional but the place where biology meets emotion. And where there is no magical solution. In this place, I know I am fat because I came with a body which has instructions for being fat, for being really efficient about storing energy. And in this place, fat also has meaning in my life, exists meaningfully -- that is the Jungian voice in me that knows that there is a meaningful basis alongside the physical. 

It is a very difficult space to hold. It is so very easy to fall into a very concrete and linear thinking and resist looking at meaning because the evidence on the side of biology is so strong for me. And yet, I cannot entirely escape the role fat plays in my life and the meaning it has for me and how it relates to my mother complex and so much else in my psyche. If I am, if we are to hold mind and body together, we cannot privilege body at the expense of mind,  cannot hold to a purely biological cause and reject any emotional one. Surely the shame that is there right under the surface is as much a part of fat as the genes which disposed me to be fat.

When I turn to the literature, I find the Jungian world, and the depth psychological world in general, is oddly silent about fat. Other than the early writings of Marion Woodman, there is nothing to be found in the Jungian literature about it, about what fat symbolizes. There are books and articles about anorexia but not about fat, not about obesity. Much is made of the need to connect with the body, of the body as storehouse of memory. Quadrant’s description says it is a journal of “essays grounded in personal and professional experience, which focus on issues of matter and body, psyche and spirit.” Yet there are no articles that I can find about fat, save for one a year ago, “The Epidemic of Obesity in Contemporary American Culture: A Jungian Reflection” which focuses on compulsive eating. Again an equation of fat with gluttony. There is nothing about fat in the fifty-plus year archives of the Journal of Analytical Psychology. In what used to be the San Francisco Library Journal, there are two interviews with Marion Woodman, in which some of her thoughts about fat are offered, and reviews of her two books which dealt with fat and anorexia. And that is it. No one, other than Marion Woodman to answer my question: what is fat a symptom of?

The current attitude in American culture, in the public health community, is that obesity is the biggest threat to life and health today. There are more dire warnings and predictions about fat than about terrorism. Ideas about what causes obesity abound -- everything from processed food, to sugared soft drinks, to laziness, to fear of sexuality -- yet little to nothing about what it means to be fat, to deal with being fat, or about the psychic toll taken by being in a constant state of war with one's body. This is where my interest lies.

At last I am beginning to feel like myself again. This bug is a fierce thing but I seem to have finally defeated it. Thank you to those of you who missed me and sent your good wishes -- it's really nice to know that the relationship we develop in this medium are real connections.

I am working on a couple of posts relating to Huge.  I watched the second episode and I continue to like it. I want talk a bit about the issues I see and some of my thoughts about fat and the battle with the body.

In the meantime, a reader emailed me about how to know when therapy was finished. For now, I offer this, which I originally posted in Nov. 2009:

Every therapy comes to an end eventually. Under ideal conditions, therapist and patient arrive together at the decision to end and they take the time necessary to fully and respectfully end the relationship. It s a ritual of goodbyes -- taking the time to look back at what has happened, what has changed. It's time to look at what has been accomplished and what has not. It is an exit interview and a farewell all in one and ideally takes up a number of sessions. When this happens there are good feelings all the way around, along side the inevitable sadness at saying goodbye. 

Not all terminations are ideal. Someone asked me recently what it is like when a patient leaves abruptly. Well, it's hard. Sometimes a patient will call and leave a voicemail saying  they won't be back. Or send an email or a note. Or not show up and then not respond to calls. Sometimes this is part of a pattern in the therapy and the patient eventually returns. But more often, they do not and we end up not knowing why. And that is hard because it is in the nature of therapists to wonder and want to know what happened.

It's my job to challenge any changes in our work that patients bring up. It is my job to ask when someone announces they want to leave therapy to ask why now and to raise what I see as possible issues. It is not about wanting to control the patient or protect my income. It is my job. I ask at the beginning of therapy why they are seeking therapy now and we look at that. I ask at the end why they want to leave now and we look at that.  

I think it is hard to remember that the therapist is a person and that therapy is a relationship. It is a RELATIONSHIP. Patients and I spend an hour or so together every week and they live in my thoughts and occupy space in me beyond that hour. It's a relationship. So when a patient says to me, "I want to stop now", I ask why now and I ask that we look at this because it is part of our relationship, because I am a part of this relationship. And if that patient won't talk about it, won't look at why and leaves, maybe in a huff and full of mutterings about me, then she leaves. But she will still occupy space in my thoughts as I try to understand what happened and what might have led to this. And when she wants to return, as often happens, my door is open and we begin again and I do so without carrying resentment.  

It all comes with the territory.  

There are all kinds of reasons for ending -- money, time, dissatisfaction, discomfort with the process, dislike just to name a few. But it is the abrupt ones, with no chance to really say good by or talk through  what has happened and ending that are hard on therapists, and ultimately on patients as well. Ending well is important.  It lets us go forward without lingering feelings and resentments.

Ending is hard. It is hard no matter where in our lives we do it. And we tend to end in therapy in the same style we end other relationships. There are good endings and bad endings and healing endings and wounding endings. And they are all hard. And we can, all of us, learn to do them with more grace when we are willing to look at how we do it and what endings mean to us and have meant in our lives.