Treating Diverse Clients With Eating Disorders
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For Black women , the bias against natural hair results in higher levels of anxiety about their appearance . Additionally , many Black women feel socially pressured to straighten their hair for work , which is twice the rate for white women . Another example is food — there is ancestral and historical connection with food . Not only does food nourish Black women ’ s bodies , but also their connection to their culture .
Interpersonal factors that could increase a diverse client ’ s susceptibility to an eating disorder include microaggressions and the archetypes depicting behavior or attributes that BIPOC individuals internalize as ones they should possess . When providing counseling services to BIPOC individuals , it ’ s important that LCMHCs be open to their experiences . Microaggressions are a common occurrence for many people of color ; we must ensure that they don ’ t experience microaggressions in their work with us . Microstatements such as , “ I don ’ t see color ,” “ You are so articulate ,” and “ Is that your real hair ?” contribute to the stress that people of color experience , even when the individuals who make such comments may not intend to offend .
Microaggressions communicate negative , derogatory , or hostile messages , targeting marginalized individuals . We all grew up with the nursery rhyme , “ Sticks and stones may break my bones , but words will never hurt me .” Many Black people used this phrase as a means of protection or armor , and as a way to avoid adopting the negativity that was projected onto people of color . Still , we all know that names and words can be , and are , hurtful .
Psychological factors that affect Black women may include experiencing a greater number of acute life events as stressors than white women , such as divorce or job loss . The trauma of racism can be a significant source of stress that contributes to mental health concerns . To be a person of color in this country can feel as if you don ’ t matter .
The stress of being a Black woman has damaging effects and places them at higher risk for some health crises — stroke , heart disease , high blood pressure , diabetes . These biological factors are not primarily about the types of food consumed , but the stress of racism , poverty , and discrimination on the body ’ s hormone and cortisol levels . Due to factors such as systemic oppression , there is a higher likelihood that Black women experience toxic stress and are more vulnerable to impacts of race-related stress than other women of color . These factors are just a sample of the experiences that BIPOC individuals encounter , often daily .
CONSIDER THE ROLE OF STRESS
“ Trauma and toxic stress ... are not , of course , problems limited to girls and women . But they often stem from experiences that occur disproportionately in the lives of girls and women — and of girls and women of color in particular ,” according to a 2017 report by the Center for American Progress (
www . ampr . gs / 2VYR1G0 ). “ Women in the United States are more likely than men to live in poverty . They are far more likely to experience sexual abuse and assault . Moreover , girls and women of color must also deal with racism in all its overt and covert forms . The psychological toll of this lived reality is consequential yet all too often overlooked or misunderstood .”
The pressures that a woman of color feels to succeed are unlike those that other women in our society experience . Her successes are not only a personal victory , but a victory for the community and the future legacy . This pressure also sends a message that women of color must be strong and capable of handling all challenges , and must not display weakness or vulnerability .
The feeling of needing to be “ Superwoman ” can result in extreme amounts of stress that are hidden and highly internalized . Keeping this hidden can lead Black women vulnerable to the development of an eating disorder .
EFFECTIVELY TREAT DIVERSE CLIENTS WITH EATING DISORDERS
Resources
• “ Treating Black Women with Eating Disorders : A Clinician ’ s Guide ,” edited by Charlynn Small and Mazella Fuller
• “ The Renfrew Unified Treatment for Eating Disorders and Comorbidity : An Adaptation of the Unified Protocol , Therapist Guide ,” by Heather Thompson-Brenner , Melanie Smith , Gayle E . Brooks , Rebecca Berman , Angela Kaloudis , Hallie Espel-Huynh , Dee Ross Franklin , and James Boswell
Cultural congruence is a process that transpires between LCMHCs and our clients as they develop an appropriate fit in their provider-client relationship . Here are several steps LCMHCs can take to demonstrate their acceptance of diversity , as well as their cultural awareness , sensitivity , and competence .
• Do not discount disordered eating behaviors . When assessing
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22 The Advocate Magazine Spring 2021 American Mental Health Counselors Association ( AMHCA )
www . amhca . org