5-The Story of Being Fat: Understanding Obesity in a Victim of Child Sexual Abuse through Merleau-Ponty

5-The Story of Being Fat: Understanding Obesity in a Victim of Child Sexual Abuse through Merleau-Ponty

5-The Story of Being Fat: Understanding Obesity in a Victim of Child Sexual Abuse through Merleau-Ponty

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Sugandh Dixit

 

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Train yourself for a perfect body: your highway to health.

Your dream body can be achieved.

We live in a culture where the bliss of a perfect body and health is supported by advertisements and programs with a money back guarantee. These vows become particularly alluring to us mortals who live in the constant fear of an epidemic called obesity.

The current cultural fear of the “epidemic of obesity” has caught the attention of the entire nation as the social, economic, and personal consequences of being overweight or obese. The National Health and Nutritional Examination Survey 2009-2010 reported an obesity prevalence of 35.5% among adult men and 35.8 % among women in USA (Flegal, et al., 2012). The recent epidemiological report by The Center for Disease Control and Prevention found an 18% increase in obesity among adolescents aged 12-19 in 2013, compared to just a 5% increase in 1980 (Arell & Utley, 2014). The authorities repeatedly advise that the rise in obesity is related to the rise in hypertension, joint problems, and diabetes. The clear conclusion and related implications for obese individuals is that they need to make marked changes in their lifestyles, inculcating self-discipline and control in order to shed the extra pounds. With the announcement by W.H.O. that obesity is a chronic disease requiring professional help, campaigns have usually highlighted obese persons’ individual responsibility and the future implications for their families, in this way constructing obesity as an even greater moral and individual dilemma.

While most studies have focused on psychosocial conditions, such as SES (Goldblatt et al., 1973), and depression as they relate to eating disorders (Ganley, 1989), child sexual abuse has largely been ignored in the literature, even though the epidemiological research has suggested a prevalence rate of 11.1% to 32.0% obesity among women and 14.2 % among men who were sexually abused as children (Gustafson and Sarwar, 2005). Despite a significant relationship between obesity and childhood sexual abuse, most studies have been statistical rather than experiential. The absence of qualitative or experiential inquiry into the lived worlds of obesity and childhood sexual abuse is itself an indicator of how the body is narrated in our culture, where bodies find meaning only in reference to numbers of BMI, weight, and body size. In this very effort our bodies are inscribed and controlled by statistical analysis, biological terminologies, and moral notions. The present paper is an attempt to engage in a meaningful language of obesity beyond the medicalized corpse body towards the lived body. The term “lived body” derives from the German Leib (Leder, 1992). In German, the term Leib  is employed when one is referring to living bodies, while the term Körper is used to designate inanimate or dead bodies: the body of a rock, for example, or of a human corpse. The Cartesian paradigm can be said to eradicate the essential difference between Leib and the Körper. Foucault (1975) describes, in the eighteen century, classification of diseases shifted from a basis in the symptoms experienced by the living patient to a basis in the organic lesions found in the corpse. With the technologies such as the stethoscope, the blood test, the X-ray allowed the dissection of the lived body, analyzing it into its component parts. The living patient is often treated in a cadaverous or machine like fashion. We see this in traditional physical examination. The patient is placed in a passive corpse like passivity. The entire ritual and context serves to reduce something almost dead. Personal identity is stripped away as the patient is removed from his or her environment. The notion of the lived body hops that the body of living being is an intending entity: directed toward, an experienced world. The paper will first explore psychodynamic understandings of obesity, which were one of. the first attempts to contextualize and meaningfully understand obesity beyond the medical institution. The limitations of the psychodynamic perspectives’ mainly reductive terminology will then be enriched with Merleau-Ponty’s concept of the lived body. With the help of a case study the paper will illustrates a female patient’s attempt to meaningfully voice the narrative of her child sexual abuse through her obese body. Experience is lived and in that form is accessible for exploration. This is a plausible extension of Merleau-Ponty’s (1945/1965) gestural theory of language that defines language as rooted in corporeality, in the signifying powers of the body. He does not divide language and body; rather, he posits a continuity of expressive gestures, which starts with bodily gestures and ends with spoken or written words. Such a standpoint liberates our understanding of obesity and the impact of sexual abuse from a medical model that trivializes our experiences, both past and present, and which fails to recognize the adaptive meaning of human actions.

Obesity: A Story from Psychoanalysis

For a long time, psychoanalysts have been interested in the dynamic threads that bind food and body. The earliest work was shaped by the classical thought that focused on ways in which instinctual drives shape individual bodies (Alexander, 1934; Bychowski, 1950; Hamburger, 1952; Rascovsky et al., 1950). The pioneers Freud and Ferenczi spoke about autoplastic materialization, a term they used to describe how the body is utilized and molded to realize unconscious wishes. Ferenczi considered this autoplastic state to be close in proximity to the bodily ego of the infantile stage, where libidinal excitation is discharged bodily and not by mental processes (Bychowski, 1950). Furthermore, the food acquires the special meaning in the unconscious provoking love, desire, and gratification (Glucksman, 1989). The association of food, love, and desire became closely related to the feminine. In eighteenth and nineteenth century, health practitioners understood obesity as a condition due to over-indulgence and excessive desire (Cooper, 2008). Historically, the notion of excessive has been associated with the feminine. This line of thought is also visible in Bychowski (1950) works that elaborated obesity as the feminine desire to incorporate and retain both paternal and maternal figures. He argued that the desire to introject and identify with a masculine object through physical growth interferes with acceptance of feminine identity. Levy (1934) emphasized that individuals with eating disorders are emotionally hungry (for love and care) in the mother-child relationship. The maternal needs of the child are projected onto the food that provides self-soothing and comfort in the absence of a “real” mother. Thus, in early feeding experiences, the mother and child are an undifferentiated dyad (Winnicott, 1965). The satisfactory and consistent feeding environment in an infant’s world nurtures a capacity to differentiate oneself from the mother, and gives birth to a stable and cohesive self. The earlier works continued to emphasize the relation between maternal care, food, and symbolic ingestion of the breast in reference to separation anxiety, anger, and frustration.

The classic work on obesity was undertaken by Bruch (1957), who emphasized that hunger and satiety were not innate, but an organism learning the recognition and satiation of nutritional needs. In the first years of life, the biological and emotional needs are intertwined, and the early interpersonal process can create confusion around recognizing hunger needs. As a result, biological needs can remain perplexing or undifferentiated from the emotional field. If a mother’s responses to her infant’s needs are inappropriate, neglecting, inhibiting, overindulging, or preoccupied with her own needs, it might be strenuous for an infant to foster recognition of hunger and satiation. Thus, a mother’s capacity to respond to her infant’s needs and to differentiate her needs from her infant’s fosters soothing maternal functions in the infant. Goodsitt (1983) utilized this notion of a soothing function to explain that an obese individual, when anxious or depressed, replaces the mother with food and uses food that serves this soothing function, albeit temporarily.

Psychoanalytic traditions focused on obesity until 1979, dedicating books and journals to the issue. In fact, empirical studies were undertaken to understand psychodynamic factors that impact weight gain. The pioneers were Gluksman, Rand, and Stunkard (1978), who collected data about eighty-four obese individuals from seventy-two analysts, and found five specific factors that had a causal effect on eating patterns: (1.) Affect (depression, guilt, humiliation, frustration, boredom, anxiety), (2.) Self image (ego strength, boundaries, loss of impulse control, self contempt), (3.) Deprivation (gratification, object losses, disappointments, separations, feelings of being unloved or unwanted), (4.) Aggression (competition, fear of criticism or aggression, the need to control), and (5.) Sexuality (feeling of sexual attractiveness, sexual undesirability, and sexual dysfunctions). Plutchik (1976) supported those findings with new findings that 79% of obese patients, compared to 9% of non-obese patients, reported weight gains when they were stressed. Silverman (1976) developed a technique of subliminal presentation of unconscious material to test various aspects of psychoanalytic theory, especially an ungratified symbiotic merger fantasy. Silverman treated 30 obese women in a behavior modification program for overeating and exposed them to one of two subliminal messages. In the symbiotic condition, subjects received the message, “Mommy and I are one,” and in the control condition a neutral message, “People are walking,” was presented. There was no between group difference in weight loss after 8 weeks, but the symbiotic group maintained the weight loss significantly longer than did the control group. These results suggest that shifts in emotional state may alter overeating patterns. However, it is not clear precisely how subjects assimilated these subliminal stimuli, and it is difficult to specify why the symbiotic message had an effect only on maintenance of weight loss.

There was a dearth in psychoanalytic literature on obesity after 1979. In contrast, weight gain has remained a topic of discussion in the medical field, as well as throughout various forms of media, including newspapers and books. Discussions have delivered sermons on the willpower, motivation, and moral responsibility that are demanded in weight loss. Thus, even when we have paid attention to the body, we have either resorted to the medical model or to a discourse of the mind, i.e., that individuals’ thoughts control their bodies and that this can be changed and manipulated. Much of the research has focused on the physiological aspects of obesity, which equates obesity with metabolic rate and enzyme reduction (Turek, et al. 2005); or. alternatively, it has employed a behavioral model that understands obesity as a form of maladaptive coping, or it has utilized a psychoanalytic perspective that reduces it to oral or Oedipal phases. Most models continue to pathologize obesity as a maladaptive response and negate the meanings that are lived through an obese body.

In contrast, psychoanalytic perspectives have indeed engaged in these meaning-making aspects of obesity, capturing the dimensions of self-soothing, feelings of control, expression of emotions, and communication of needs. However, oral and Oedipal phases have engaged in reductionistic theory making, the very fallacy that led to the fall of the mechanistic models of behaviorism. Thus, as much as I appreciate psychoanalytic thinking’s engagement with meaning and its interest in the teleology of symptoms, it tends to ignore the centrality of the lived body that Merleau-Ponty beautifully captures in his work.

Merleau-Ponty’s (1945/1962) insight about the centrality of embodiment for subjectivity makes him a valuable companion in understanding what it means to be a spatially situated and embodied subject . Challenging the Cartesian way of separating mind and body, Merleau-Ponty’s phenomenological reflection reveals instead interrelatedness: we are not subjects or minds separated from the world or from others, but we are always “being-in-the-world” and “subject[s] committed to the world” (Merleau-Ponty, 1945/1962) , I consider that his concept of embodied subjectivity, where bodies are already enmeshed in a world of meaning,. As Grosz states, “I am not able to stand back from the body and its experience to reflect on them; this withdrawal is unable to grasp my body-as-it-is-lived-by-me” (1994, p. 86). I have access to my body only by living in it, and it is through the body that I receive information and bestow meaning. Merleau-Ponty emphasizes that consciousness is not a process that happens in a person’s brain. Rather, consciousness is embodied, so that the body and self, as well as body and the world, are intertwined.

Therefore, my interest lies in understanding obesity as a meaningful gestural communication of the world of victims of child sexual abuse. I will seek to understand this effort to communicate with the help of a case study. Despite an extensive literature on child sexual abuse and obesity, no effort has been made to understand the meaningful gestural communication of victims of child sexual abuse. I present a single case study, the value of my work takes solace in what Robert Stolorow (2004) calls psychodynamic phenomenology, i.e.,the study of phenomena as they transpire in the specific inter-subjective dialogue of the psychoanalytic situation. I do not claim that these dynamics are universal, yet they are meaningful as they shift our perspective from viewing obesity as a maladaptive response to to a meaningful one.

Story of Samantha

Samantha, a bright young woman, 34 years-old, with a heavy build and bright smile, waived an enthusiastic “hello” as I encountered her for the first time in the waiting room of our university psychology clinic. She apologized for being five minutes late, as I stood in reverie that, despite her height and heavy build, I was really meeting a young girl. Samantha entered psychotherapy with concerns that, in interpersonal relationships, she invests time, emotions, and care, yet feels that her partners never return the same. During her freshman year of college, she had sought therapy to adjust to the stress of school, but she had never trusted anyone to speak about her childhood, what she termed a “dysfunction” at home. Samantha remembers a childhood full of fear and nervousness. The constant parental fighting over her father’s alcohol addiction and extramarital affairs not only led to parental separation but also financial struggles. Samantha’s mother worked hard to meet the family’s financial needs and solicited her brother’s help to take care of her young children. Taking advantage of the situation of Samantha being an unattended child, Samantha’s uncle began sexually abusing her when she was eight years old. The abuse continued until she was twelve. For three years, Samantha lived in fear and panic and was unable to report the crime to adults, as her uncle threatened to kill her and her family. She finally gathered the courage to report the incidents of abuse to her mother, who resorted to legal action against her brother. Although legal action was a strong choice, it led to strains in the family. Samantha’s grandmother blamed the child for being too provocative and pressured Samantha’s mother to ask Samantha to report that the intimacy was consensual. The intimidation by adults led Samantha to lie to the legal agencies. She still carries the baggage, horror, and shame of lying about one of the most traumatic truths of her life.

Nevertheless, Samantha feels that she has made a conscious decision to not let her past affect her. She works hard in her job and imagines great possibilities for herself. As our therapy work progressed, Samantha’s concerns shifted from relational problems to her weight. Samantha is a very organized, motivated, and energetic woman who kept long lists of tasks she would accomplish. She made sure that her house, job , and social life looked perfect. However, of all the things she has achieved, it was the weight loss she failed to achieve. Being on diets or regulating her weight remained an ongoing challenge. More than eating, it was exercising she hated, often calling it “an uphill task that I am not meant for.” One day, she timidly and embarrassingly reported her weight, emphasizing that it was the first time she had told another person; even her partner was unaware of her actual weight. While Samantha was clinically obese, I never experienced her as overweight. My lived experience was of a woman who is tall and well built, who probably could lose a few pounds to fit the thinness regime, but I never encountered her as fat. The lived experience of individuals’ bodies is different from “Körper”represented by tools such as scales and BMI. Welsh (2013) reminds us that taking a phenomenological attitude to embodiment, where the body is seen as a situation, helps us listen to the lived body as a source of meaning.

Beyond the cacophony of demeaning labels like “ lazy” and “lacking will power,” Samantha and I welcomed the voice of her body: the muted and unsaid voice of the body, where fat became a canvas for seemingly lost and forbidden voices, reorganizing and stabilizing Samantha’s experience. We listened, engaged, and responded to different types of voices that echoed beyond spoken words. We listened to the silenced and muted experiences that were too fearful to vibrate from the throat and found speech on and under the skin. It was as if her body was shouting out loud: “You can continue in this world, while I will remember and carry your unheard experiences. The layers of fat are stories of your unheard world.” It was in this process of welcoming the voice of her body that the different voices of her experience emerged.

“I am Damaged and Imperfect”

Samantha uttered these words, the unheard pain of her body reaching my ears that were obstructed with psychoanalytic jargon. It seemed that the words were not simply uttered from the throat, but her whole body spoke. Her teary eyes, trembling voice, and closed hands were gestures that narrated the story of her body that carried her through life.

Samantha’s life was very disciplined. Her house remained clean and organized. In her professional life, she made sure to work harder than required, often completing other co-workers’ tasks. Her friends would often comment on the perfection with which she lived. However, the only aspect of her life that was not disciplined was her weight. The perfection of her house and job ensured that her past had not affected her, that she could keep it all together: tidy and clean. Thus, it seemed that her body weight allowed her to contain the uncontrolled, messy, imperfect, and murkier nature of her past. She validated my assumption in the next session with her powerful insight: “If I lose my weight, then I will be perfect and people will forget.” Reduction of her weight would imply that there is not and never has been something wrong. The perfection of her body would mean that people would forget that something painful happened to her and her story would be finally forgotten. People would forget her pain, her story, her struggles, her silence, and her trauma. Her body was her speech, speech that was nullified. Others asked of her that she be a normal girl, pretend to be unwounded. The wounds were only visible through her weight. Samantha conformed to the demand of normality that perpetuated muteness, because neither did she know how to express herself, nor was she expected to express herself. Coy (2010) argues that survivors of abuse, especially women, utilize their bodies to communicate crises between experiences of the psychic self and the physical self. Merleau-Ponty would say that the Samantha is learning to speak again through her body and is communicating both her silence and trauma through the body.

Merleau-Ponty says: “It is the body which speaks” (1945/1962, p.197). The statement does not refer to the idea of the biological body, which has vocal cords, but an expressive and intentional body as a source of meaning. He defines language as rooted in corporeality, in the signifying powers of the body. He does not divide language and body; rather, he posits a continuity of expressive gestures, which starts with bodily gestures and ends with spoken or written words. However, in sexual, physical, or psychological abuse of children, speech about the abuse is sometimes thwarted: by force, ignoring, mocking, or re-describing victims’ trauma casually (Courtois, 1996; Davies & Frawley, 1994). In Samantha’s case, Merleau-Ponty (1945/1962) would say that the flesh of her skin carries the signification of the embodied experience and a call for the pain to be seen, addressed, and validated. Samantha’s weight is what Merleau-Ponty (1945/1962) calls “the anonymous force,” born not out of voluntary will but an expression of existential space. The bodily abuse that Samantha underwent does not merely belong to a past but follows a non-linear continued time where present discloses the past. So even when consciousness could not comprehend the trauma of her experience, the body carried her in the inaccessible affective space in order to express that which was not allowed to be expressed in words.

Merleau-Ponty would argue that this traumatic experience does not reside as a representation limited in time, but is present in all aspects of being-in-the-world (1945/1962). Samantha therefore carries the body of the silent and abused child that resides within like a phantom limb, amputated but not thrown away. It is this forgotten body that resides within Samantha like a stranger, which continues to haunt the present body, “a former present that has decided not to become past” (Merleau-Ponty, 1945/1962, p. 88). While sociologists have argued that the body is now more closely connected to the notion of success (Shilling, 2003)–something that Samantha corroborated when she explained that buying an expensive cupcake reminds her of her success–her weight reminds her that she should not forget the chaos in which she once lived. Her weight thwarted her life from disintegrating, as if to say, “ I am there holding you.” The weight continues to carry the story of a lived history where the past sediments itself in the continued present and where trauma is not a representation but a style of being-in-the-world, living in every structure. It is with the acknowledgment of the affective situated milieu that Merleau-Ponty allows us to have a dialogue with the silent un-representable spaces of our existence (1945/1962). The body echoes to Samantha: “While you have these layers of flesh, your narrative will not be forgotten by the other: the other who forgets and denies.”

“It Will not Happen Again”

Samantha’s body weight ensured her protection. She was no longer a thin, little, fragile girl whose boundaries could be trespassed. Her body size ensured she was safe, and behind the wall of fat, the little child in her is protected against the threatening world. Bick (1968) pointed out that our earliest interactions with skin create a psychic boundary that provides a bodily experience of containment and prevents the outer and inner world from inter-penetrating. When this boundary is compromised, a second skin is formed that protects others from entering in and feelings from coming out. Unlike the original psychical and physical violation, one’s own skin controls the penetration of inside and outside on one’s own terms. Violation of bodily boundaries like physical and sexual assault remove perception of corporeal ownership (Coy, 2010). These experiences induce the felt sense, by survivors, that they lack sovereignty afforded to the body and feel estranged from their bodies, what Maria Epele (2001) calls learned estrangement of bodily experience. Samantha’s body revealed contradictory feelings: powerlessness and control that was once lost to her.

Besides the play of power and powerlessness, Samantha’s body carried the desire to be hidden and the fear of being seen, as well as the unintended demand to be seen. She described this being seen as the gaze of the other who haunted her everywhere. In the supermarket: “Oh! God, look at what she is buying!” In the gym: “Oh! Is she going to work out?” On the street: “Oh! Look at her!” The voice and gaze would always be announcing and checking her actions. Samantha would often call these thoughts “stupid” and “silly,” yet they carried repeated feelings of being shamed. The feeling of shame is closely connected to the gaze of others (Merleau-Ponty 1945/1962). Retzinger (1991) points out that when overt shame is unacknowledged, the person still feels the mental pain of it but does not identify the experience as shame. Instead he or she describes it in terms of “feeling bad,” “stupid” or “insecure.” Being sexually abused during childhood is taboo and shameful, and so is the feeling of shame itself. Since shame threatens social bonds and is mentally painful, it is often repressed and denied (Scheff, 1990).

Samantha’s words echo again in my head: “I am just silly,” “Just stupid.” I wondered whether her childish laughter was narrating and mourning another story: “Wasn’t I silly to tell them,” “Wasn’t I stupid to lie,” “Wasn’t I silly to be provocative,” “Wasn’t I silly to keep quiet,” or “Wasn’t I silly to seek protection?” Samantha was told that the abuse was her fault; she was too provocative or wanted it. She was living the contradiction— in the lived firled that Merleau-Ponty (1945/1962) calls “the expressive space,” that is, the body expressing the contradiction of abuse: living a wholeness that is meaningful only to the body and that appears pathological and meaningless to others (p.140). As Samantha’s repetitions of calling her abuse “silly” touched me, I wondered if she intrinsically was questioning my capacity to see the seriousness of her pain: asking if I can hear the validity of the shame she feels when she perceives that others are looking at her, or if I will join those critical others and only belittle her experience as irrational, a mere incident of societal gaze that most obese individuals feel The possible meanings that I heard in her silliness touched on the contradictory nature of the life she lived: when adults were silly, she was labelled silly; when adults had to protect her, they scarred her; when others were guilty, she carried the shame.

Samantha’s body also allowed her to maintain the boundary between the perfect and imperfect, the injured and the healthy, by narrowing her struggle to one particular area. That is, it is not the whole of her life that is wounded; her suffering was centered around a particular aspect. Thus, the chaotic, uncontrollable, and strongly physical and emotional pain was discharged in a contained manner. Her weight allowed the rest of her life to stand in temporary contrast to that aspect of experience that does not have wounds or pain (her career and home that Samantha felt was perfect) .Samantha also commented that her weight, while deemed unhealthy by the medical world, prevents something more threatening to emerge: “I am fearful that if this weight would reduce, then something more dangerous would happen and I am not sure if I will be able to handle it.” While the rest of her life was engaged in running, finishing work quickly, her weight made her slow down. Her body was carrying her when she was busy being functional.

Possible Voices for Healing

It seems that the structure of child abuse in Samantha had led her body, autonomously, to preserve and hold the reality of her abuse. Yet, if the body keeps on re-creating the patterns of the past, how can she expect to move towards healing? It seems the answer lies in the body itself and can be found in Merleau-Ponty’s understanding of the “intentional arc” and “reversibility.” Merleau-Ponty defines the “intentional arc” as that “which projects round about us our future, our past, our human setting, our physical situation, our ideological situation and moral situation or rather which results in our being situated in all these respects” (1945/1962, p.136). The openness of the arc generates the possibility of multiple meanings or, as Merleau-Ponty would say, indeterminate meanings. He affirms that “ambiguity is of the essence of human existence and everything we live or think has always several meanings” (1945/1962, p. 169). It not only opens up multiplicity, but indeterminacy, thus allowing the body to discover newer and unforeseen possibilities. Moreover, Merleau-Ponty’s concept of slippage and reversibility, or what he understands as the chiasmatic inter-corporeality of bodies, can illuminate the perplexing way in which the dominated and abused body not only marks “the terminal locus of power,” as Feldman puts it, but also “defines the place for the redirection and reversal of power” (as quoted in Doyle, 2006, p. 184). Doyle points out that the reversibility of the body that Merleau-Ponty brings allows the body to be made both abject and empowered. It is this reversibility that can be used for both empowerment and change. If the body is the source of control, it is also the source of empowerment, yet this empowerment should not be understood as an individualistic ideology. Merleau-Ponty’s concept of reversibility reminds us that we do live in a relational world, where I know that I as a toucher am also touched, as a seer also seen. In the case of the victims of abuse, the difference between the person’s touching and being touched is now the difference between the body as violator (re-perpetrating the abuse) and the body as the victim (re-living the pain).

According to Merleau-Ponty (1945/1962), for speech to appear, there must be a structure of reflexivity in and between the self, other, and world . The very reflexivity between self, other, and the world that is required for speech is the scope of our work. Samantha needs to speak and hear herself through her own body and find a voice that is spoken from her mouth rather than from her weight alone. Britzman (2000) comments that part of the therapeutic work requires us to make an ethical relation to the stranger, to encounter vulnerability as a relation and thus move beyond the impulse of repeating the trauma by placing helplessness and loss elsewhere. The crucial aspect of the healing process in our therapy is to gradually construct a “narrative skin” (Turp, 2003). I have to receive this narration and meaningfully reflect it back to Samantha, thereby helping her build a sense of continuity and to acknowledge her pain. I need to build responsible witnessing that is motivated by a wish to understand the symptoms with respect to the trauma. Moving beyond the preoccupation with the practical aspect of losing weight, I need to be attentive to the person who is struggling to negotiate a history of trauma and loss. I as onlooker need to question how to take a stance that witnesses without turning away or turning against.

Conclusion

Moving beyond the medicalizing and pathologizing tendencies of much contemporary discourse, Merleau-Ponty’s conception of embodiment allows us to see the habitual weight gain of Samantha’s life in a meaningful way. As Merleau-Ponty says, “Habit is neither a matter of knowledge nor an automatism, it is knowledge that resides in the hands, that yields itself up only to bodily effort, and that cannot be translated into an objective” (1945/1962, p. 139). The story carved by the layer of skin is then a lived history, an affective situated milieu that allows Samantha to have a dialogue with the silent un-representable spaces of her existence. It helps us to consider her weight as a way of expressing the muted voice in a mode that preserves or narrates her personal history. At the same time, excessive weight is the voice she has adopted to prevent something more threatening from emerging. The contained space of psychotherapy allows this threatening voice to emerge in the interdependent space, where the voice is not lost in a repetitive translation, but is spoken and heard with an other.

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