28 November 2014

Rethinking psychosis, rethinking fat hatred

This week The British Psychological Society published a report called Understanding Psychosis and Schizophrenia. It's free to download and there is a useful article by Dr Jay Watts, Making Space for the Meaning in Madness, which gives it some context and is a much shorter read.

Both pieces cover a lot of ground but for me the takeaway message was that variety in human experience is normal and that medical cures, used without listening to people at the sharp end of things, can be experienced as abusive and counterproductive.

This ethic can be applied to a lot of things. Autism features prominently in my life, for example, and I find the liberation and acceptance narratives that have arisen out of autistic rights activism really compelling. Although there remains a resarch community invested in proposing physiological causes of being gay, as a queer I can see what happens when people largely relinquish medicalisation, and where other forms of framing concerning identity and experience are enabled. People flourish.

It's not hard to make the connection here to fat. This week weight loss surgery was mandated by statutory bodies in the UK for many more people at lower weights. The authorities think that it will be cost-effective in the long term regarding how Type 2 Diabetes is managed. These surgeries are risky, have mixed results and exist within a context of devastating fatphobic rhetoric. I see the effects of this with clients in my therapy room every week and it is neither cost effective nor supports people's well-being in the long term. As far as I can see the institutions making these proposals offer no critical reflection on the value of these interventions and discourse. The proposers may have a financial or professional stake in offering them. User voices are absent. Surgery is now being considered the only possible route that can be taken to look after fat people's health, which itself is becoming synonymous with Diabetes.

If people with experience of psychosis who have been profoundly oppressed by trauma and medicalisation can organise for social change and influence a community of sympathetic and radical health practitioners on a large scale, why not fat people? Medical institutions, and the world in general, is much farther away from understanding fat people as a viable social group that is being harmed by what is presumed to be the cure. This applies to us too, fat people are barely organised and we suffer intensely from a shame that often prevents us from taking action, as well as marginal social positioning at our intersections. Because of a decades long war on obesity it is difficult for all of us to frame fatness as part of the diversity of human embodiment.

I hope that this will change in time and that fat activists will be able to make use of, contribute towards and expand upon, for example, the ideas of the mental health survivors' and autistic rights movements among many others. Some of us are mental health system survivors, some are autistic, some of us are already involved in activism. But at the moment fat activism is a scavenged affair, using and remodelling the vital work of other liberationists, and always very tentatively. Many fat people feel that we have no right to exist, even though we have been part of the fabric of humanity since the dawn of time. Fat activism is the perpetual newbie as a social movement and I suspect it will be a long time until we are able to offer theory and blueprints for change to share with others.

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