The Fat Lady

Well, yes, it's true that he said that he wanted to learn something and that is positive. But. He had a choice in the way he wrote that text. He deliberately chose nouns, adjectives and verbs to describe this woman and the way she moved, in a way theat would belittle her. The fact that he chose those words, which he knew would trigger a particular effect in the segment of society that despise overweight people, is frankly despicable. He chose his vocabulary for a particular effect, not just to make himself look good ("look at me, I chose to treat this repulsive person!") but also to nod and wink to the sizeist people, deliberately positioning himself among them and not among the people who have overcome their prejudices. (If he had overcome it, he wouldn't write like that.)

Well, who NEEDS to read this, to have their perspective changed, and therefore who better to cater to? I realize I am alone in my opinion, i'm okay with that.

I find yalom smug, condescending, judgmental and self congratulatory -the fat
Lady was just an example of it.
Women get to take up space in the world.

Which is an excellent point because Yalom didn't title the piece, FAT CLIENTS. His hurtful and abusive comments clearly highlighted his prejudice toward overweight women and how they infringed upon his narcissistic need for all women to fulfill his fantasy of how women should look. I used to really like Yalom until I read this essay a few years ago. Now I can't pick up one of his books without remembering how he wrote about that client.

I have never read anything by this guy. I'll make sure I don't. I have body image issues to. I'm 5 ft tall and no small fry. I feel uneducated and unworthy every where I go. Some people say why did you choose to be like this and why don't you choose to be different.

I didn't choose this. I doubt anyone did. No one says "When I grow up I want to be fat". Things happen and I got this way, you can't just un get this way. I'm pretty sure people look at me an say ugg. Lazy, sorry, worthless, and stupid.

A male friend of mine said I Love larger girls. They are kind hearted, they are very understanding, they are accepting. They are not stuck on themselves, they want to be understood not pretending to be what there not. They are good people who have been hurt in a lot of ways just because they don't fit the mold. People were giving him a hard time about dating big girls. Not after he was done setting everyone stright. I've never felt so honored to have him for a friend as I did at that moment. That may be the only time my self image was positive.

Sometimes I feel like we big girls have a gift. We are able to look life in the face every day knowing we are going to be judges, laughed at, thought less of, and the days struggle has already been planned for us, yet we get up and face the world every day smile and continue to make good things happen and defy the odds. If you were skinny where would that power come from. You would never know you had that power exist inside of you. You can chose to think of the negative or let others see the positive in you. Confidence shines reguardless of our size.

You know it doesn't matter what others think. The Lord loves you and that is all that really matters.

For what it's worth, I was really bothered by Yalom's story, so I discussed it with a counselor friend of mine who I thought could give some insight into why Yalom would feel the way he does. Here was her response:

The "mommy issues" thing just seems like an excuse to me. If he was so repulsed by the woman, all he had to do was refer her elsewhere. I find it disgusting that the only reason he took her on as a client was to help himself. He should have looked to a supervisor or other mental health professional to help him figure out his prejudices instead of trying to do it through this woman who probably wasn't even aware of the situation in the first place.

Also to add to this, it seems like he only started to like the woman/learn something from her after she began to lose weight. He specifically says that when she started losing weight he could see the shape of her breasts again or something like that (like great, I can see her breasts so she must be making progess). In that way he connects her weight loss to her being more likeable, which is again perpetuating a stereotype. It was only after she began to lose weight that he began to see her as a person, and he specifically connects her weight loss to her progression in therapy, as though the only way you can make progress or become more likeable is by fixing who you are on the outside, not vice versa. Seems like he is just reinforcing his old beliefs.
And another thing, she seems to have lost a great deal of weight in a very short period of time. (I think he said she was with him for less than a year) and lost what? like 80 pounds. That seems pretty unhealthy to me; healthy weight loss takes time. Also, he says she went on a liquid fast or something ridiculous. Liquid fasts are not healthy and Yalom is an idiot (or at the very least, extremely irresponsible) for implicitly promoting such an extreme, unhealthy way to lose weight and commending it.
It is just very sad that Yalom seems to think that is an OK way to lose weight.

Yalom ....I swear is the pen name of my old, cold distant T.

I wonder what even made him want to become a mental health professional in the first place? This one takes the cake for irresponsible/unethical/just plain BAD therapist, in my opinion.

I wonder if Yalom is all that different from any other therapist. Except maybe other therapists have different repulsion factors. Like they don't like black people or uneducated people or people with specific disorders. Or gay people.

My therapist strikes me as a weight-bigot, even though she herself was once overweight. Maybe it's BECAUSE she has first-hand experience that she has no problem bashing fatness. She doesn't censor herself around me because it's not an issue I struggle with. She uses my low-weightness as a reason I should like myself (as in, "You're smart, you're pretty, you're thin...) Early on in our relationship, I felt like I couldn't gain a pound or she wouldn't like me anymore. I'm 20 lbs lighter now than I was before therapy (which she pointed out to me). I hope this is just a coincidence.

But I'm also black. I've always wondered about how that might be affecting our relationship. I don't think she's a racist, but she has told me that her family was vehemently racist. She grew up in the segregated south, with black nannies and so forth. Racism has a way of seeping in by osmosis. She has said some things in passing that make me go WTF!, but I just attribute them to carelessness rather than maliciousness.

I can drive myself crazy wondering what she thinks about me, but I guess all that matters is how she treats me. (Easier to say than believe!)

Your fears are not unfounded, since there are indeed haters all around. But everyone deserves to be evaluated as an individual too.

Exactly- her behaviour showed signs of ED and all he had to say to that was great as long as she's loosing weight.
Also I really hated at the end of the story how she told him she knew all along he was repulsed by her and that it was OK because she was too. That's what I call a successful therapy ending...

I so hope she helps you in some different and more important areas that you didn't mentioned (and I can't think of).
Cause, man, she sure sounds like a terrible T to me.

I'm an advocate of cutting Yalon some slack here. It takes guts to be that honest. It also takes guts to face one's prejudices head on the way he did.

I think it hits at the heart of the question "can a provider turn a patient away because they don't like them?" Is that ethical?

Can a physician refuse to treat a drug dealer that has been critically injured? A person that self-injures? Attempts suicide? It's an ethical question with two sides for sure.

The bottom line is I think Yalom thought he could, despite his bias, help this woman - and I think he did - at least by his account.

She changed him too.

The collisions we have with our therapists are not elastic. We aren't pool balls ramming into each other on a table. We transfer energy to and from each other.

He left her therapy a better person for sure. I can get past his original bias and celebrate what he became. All in all, the next overweight woman he treated - well, he was better at it. I think that's good.

As far as sexualizing the female, I think that happens a lot of the time with men. I think they are hard-wired that way - it is neither good nor bad, just different from women. I think fighting that ingrained, evolutionary sexualization is futile.

It doesn't mean that all men see women as sexual objects only. It's a part of the package however.

Not ideal for sure, but okay.

This is where I disagree - but I've already explained why, so I won't go into that again. Just to say, again, that he chose which words he used. And he is surely aware of the implications inherent in choosing one word rather than a different one.

Agreed. That's a whole lot of nasty adjectives to use on one (unsuspecting) person

She's not terrible. She may be terrible for someone else. I don't think she's the epitome of awesomeness. But her approach works for me. I actually like that she's so human, possessing the same flaws that other humans exhibit. It makes her feel more real to me.

Wow. I actually defended Yalom in this forum once (unrelated thread), but this really saddens me. I have always struggled with my weight, and my T has seen me at both my heaviest and thinnest. Right now I'm on the high end of my normal weight range, and he has said a couple of things lately about being physically active and what am I doing these days for exercise? So I'm self-conscious and defensive about it, and it has, along with many other little things in recent months, really changed the way I feel around him. Not in a good way.

My T suggested I read the book, Loves Executioner, more then once and low and behold , I came across the fat lady last night. Same book. I have T today and I'm gonna ask him what he thinks, I cant truly gauge my reaction as I had read this thread before I actually realized I was reading THIS BOOK. However...so far I applaud his honesty, he knew how people would react and he could have left this entire chapter out or sugar coated it. Truth is that there are people out there who have prejudices against others and he admitted this ugly truth about himself. I do think he is a narcissist who sees himself as super T, but in this case I think he was trying to show he is also human.

He is not the only person who has a prejudice (repulsed, etc) against fat people. Some people move so close to the wall when you walk by... to give you extra room... the hallway if 5 feet wide... its so exaggerated and unneccesary... I don't take up 4 ft.

Hell I got a prejudice against my own fat. I always find other peoples willingness to talk about their weakness as a good thing. Putting it in a book an earning money from it I find repulsive. But maybe that's my prejudice. I think a deep breath is needed when reading the fat lady. And try and seperate ones shock and ones curiosity. Personally his tale didn't make me feel less than. This is his feelings, he doesn't know me, how I feel about me(I'm not obese, but over weigh) isn't dependent on some therapists words in a book, unless it suits me too.

First and foremost - mswinter - I am deeply saddened that this essay has caused you so much pain.

Second, I am saddened to hear some of the responses to this post/essay...i have similar body issues that the rest of you have reflected and actually identify myself with the image that he portrays of Betty even though I am not the same size.

But I would ask who has read the whole essay? Not just the parts that were quoted or the partial essay online? I have the book so I've now read the entire essay.

In the end Betty admits that she too hates fat people and didnt want to go to overeaters anonymous or any other dates with obese people etc because she didnt want to be around other fat people. She was not oblivious to his disdain for fat people and confronts him with it at the end of the essay. Part of the reason that she stays with him was not because he was a "great psychiatrist" because she clearly doesnt feel he is great, but because he was interested in what she might say if she wasnt trying to entertain him all the time. He started to be interested in her once they had the agreement that he could interrupt her when she was being silly, entertaining, etc. The real work started then and prepared her for taking a more active role in her own health.

This psychiatrist worked through his and her issues. I am not defending his methods. And he stated that he had limited to no experience with obese clients.

Further, she was enrolled in an medical weight loss program at the same time that she was seeing Yalom. He had no involvement with the weight loss except as it came up or across in the therapy.

While I acknowledge that this is a difficult topic for many of us, different approaches help different people with this issue. Having just spent 10 weeks in an eating disorders program - I learned first that I have an eating disorder and I am not the eating disorder and second that it is never about the food -- the food is just a symptom and that comes out very strongly in this essay.

I like the comment from the therapist that they all have biases. I am sure other people out there have been shunned for reasons other than weight. I'm a diagnosed depressive, GAD, borderline with an ED - most therapists dont want to touch me with a 10 foot pole and have been thru 7 therapists and unfortunately may have to find number 8.

I know that there are nice looking people who are ugly because they are so dark inside and I know there are people who are not "10s" but are so incredibly beautiful because they are so beautiful inside.

I hope we all find our inner beauty.

I did read the whole thing along with another book of his. I still think he is an ***. I am glad if his approach helped some people.

got my hand up here. I have the book too, and read the whole thing, and right there was where I lost my respect for Yalom. I agree with the posters above, opinions very well stated.

I have been keeping out of this thread, but have decided to come out; I am decidedly not a fan. in fact, the only Yalom you will find at the Therapy Client Accessory Store is the dartboard

I've never noticed that, but I'll keep an eye out for it in future.

I read a Yalom book several years back, and found him to be cocky. I had never read this essay until it was posted here. I want the dart board SAWE. Send it asap.