The Otherness of Fat: An Intersectional Enactment of Epic Proportions

Abstract

Intersectionality teaches us that inequality and discrimination are determined by a complex interplay between socially-constructed identities. The resulting states of otherness can introduce intersectional shame into the clinical encounter. When a fat analyst and fat patient share marginalized difference, their mutual shame can multiply across their relationship, producing an intersectional enactment. Exponentially high degrees of shame create a compounded need to disavow associated “not-me” self-states, resulting in a failure of reflective awareness with potentially significant consequences. Thus, it can take a radical, destabilizing intersectional enactment to penetrate this mutual dissociation. In such instances, the dramatic intensity of an intersectional enactment may represent the key to understanding it.

Keywords:

• enactment
• fatness
• intersectionality
• otherness
• shame

Acknowledgments

I would like to thank Matt Aibel, LCSW, Brian Chisamore, MD, FRCPC, Adriano Bugliani, PhD, Irwin Z. Hoffman, PhD, Hazel Ipp, PhD, Lynne Layton, PhD, and Brenda Rowlandson, Grad Dip Psychotherapy, for their time, comments, and encouragement in writing this article.

Notes

¹ I am using the term “father” in more than one way–as either one who is a biological/assigned male at birth father, or a father fantasy hero (Benjamin, 1991) or someone of any gender identity who serves in the role of the parent who is not the primary caregiver and has an outside agenda.

² Benjamin’s (2004) definition of thirdness refers to the intersubjective mental space that results from surrender and serves to restore mutual recognition between “like subject[s].”

³ Roux-en-y refers to the type of weight loss surgery that Emily had that involved bypassing part of her intestine in a way that affected both the amount and degree of absorption of food. It usually results in losing significant amounts of weight very fast, although it is more commonly associated with severe complications.

Additional information

Notes on contributors

Hilary Offman

Hilary Offman, MD, FRCPC, is a psychiatrist and psychoanalyst with a private practice in Toronto, Canada. She is a lecturer and supervisor in the Department of Psychiatry at the University of Toronto, and a faculty member and supervising analyst at the Toronto Institute for Contemporary Psychoanalysis (TICP). As well, she is former co-chair of the Candidates Committee for the International Association of Relational Psychotherapy and Psychoanalysis (IARPP) and is a current member of the IARRP Board of Directors. She is the author of the publications “The Princess and the Penis” and “The Queering of a Cisgender Psychoanalyst” used to teach about working psychoanalytically with patients who identify as non-binary.