From disorder to political action:

Conversations that invite collective considerations to individual experiences

of women who express concerns about eating and their bodies

by Kristina J. Lainson

Kristinas counselling work to date has been at a small community service in Aotearoa
New Zealand. She can be contacted by email: [email protected]

Abstract
This article describes an interweaving of narrative practices which has proved helpful for
a number of women experiencing concerns about eating and its effects on their bodies.
Through the stories of two young women, this paper illustrates how, by inviting collective
ideas to individual experiences, and by recognising and naming their own commitments and
agentive responses to societal expectations, the women became able to move away from
ideas of stuckness towards a sense of themselves as influential both in their own lives and
possibly in the lives of others similarly concerned.

Key words: women, eating disorders, anti-anorexia, anorexia, bulimia, collective,

political, narrative therapy

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 I work in a small community counselling service mostly with
women, many of whom are in their teens or twenties, and are
students at school or university. Describing themselves as
high achievers in academic and other realms, many hold a
variety of privileges fitting in to Western ideas of appearance,
family resources, and access to opportunities, which might
reasonably invite predictions of leading fairly robust and
successful lives according to dominant Western criteria.
Yet they all speak of experiencing pervasive and disruptive
anxiety, stress, and sadness; concerns about eating and their
bodies that have them engaging in practices that become
named anorexia and bulimia; and sometimes self-harm and/
or thoughts of hopelessness and suicide, usually relating to
some sense of personal inadequacy or possibility of imminent
failure2. In this article, I describe my conversations with two of
these women, Ruby and Natalia. The conversation style, an
interweaving of narrative practices, seems to show promise in
finding ways forward.

I would love you to write about Introducing Ruby

our conversations; word needs Ruby was 17 years old. She attended a local high school
to get out about this. and came to see me at the request of her mother, who had a
number of concerns about her daughters increasing sadness
Rosalind1 and withdrawal from her usual activities, and hoped that
counselling would help. Ruby, on the other hand, held out
no such hopes, but agreed to meet with me in an attempt
to alleviate some of her mothers concern. Ruby herself did
not see the point, and was very clear about this from our first
meeting. I enquired what she wanted us to do about that. I am
not in the habit of coercing people into counselling; so I tried
to ensure that Ruby did not feel pressured. We discussed
whether there was any point to our conversations. We agreed
that at least for one or two sessions, we would chat about life
and her mothers concerns.

In our initial conversations, by following Michael Whites

Statement of Position Maps (White, 2007), Ruby was able
to externalise and name severe depression and bad
body image3 as being problematic for her, describing their
increasing influence on her life. Severe depression, Ruby
determined, was due to a chemical imbalance in her brain,
having already been prescribed medication, but given that
she did not believe in taking medications, she held out no
hopes for any improvement whatsoever. She also told me that
she regarded bad body image as a permanent companion,
an inevitable part of not matching up to high personal
standards. But it did present a problem because it often
spoiled or excluded her from activities and social events she
might otherwise have enjoyed, persuaded her to skip meals
and was now trying to prevent her from attending school.
Severe depression often hung around at those times, too,
and supported bad body image in curtailing her activities.

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 circulated theories can be both politically progressive
Our dilemma and psychologically healing while at the same time being
I had enquired of Ruby whether she had any ideas about how blatantly sexist and humiliating, because they often rest
bad body image had insinuated itself into her life, inviting the on ideas of womens lack of autonomy and vulnerability to
possibility that there were pressures for her to look a certain beauty ideals (p. 44). The young women I work with do not
way. As part of being transparent in my practice, I do tell the lack discernment. They often have aspirations to become
people I work with if I have some ideas about how problems doctors, journalists, or academics. They are well aware that
may be constituted, but also that I do not hold a monopoly on their career ambitions require them to enter male-dominated
ideas, and although Ruby agreed these external pressures environments, and their refusal to be limited by societys
existed, she was quite sure they did not apply in her case. prescriptions for their femininity is a dearly held value. It is
She was a photographer herself and knew a great deal about important to tread very carefully, because any hint of me
Photoshop, critical media literacy, and the persuasive tricks of suggesting their difficulties are due to being taken in by
advertisers and marketers that have girls and women feeling fashion and appearance-based advertising, or that they have
inadequate about themselves and their bodies. She was allowed traditional discourses of womanhood to infiltrate their
adamant that she was not taken in by this. Nor did she hold thinking, is not only to add insult to injury, but would support
any beliefs that she had to limit herself to prescribed ways of ideas that young women are gullible, easily distracted, and
looking or being as a young woman. She had evidence of this have nothing better on their minds than to starve themselves
because she found many of her female friends conversations in a frivolous attempt to be decorative.
annoying and boring. She was very clear, however, that as a
photographer and an artist she knew what beauty was. She
said she had high standards which she had entirely set for
herself and bad body image was related to not measuring
Introducing the ideas
up to this unshakeable knowing. She assured me this was As I contemplated this apparent impasse, I thought about how
intrinsic to her and discussions of alternative positions on Ruby was getting along in this situation. I wondered at how
beauty, or questioning its importance, were irrelevant because lonely and isolating her experience seemed to be. On the face
these were her firmly held personal beliefs. of it, she seemed so resigned to her fate, and I certainly did
not want to abandon her there. But our dilemma remained.
This was not an entirely unusual scenario for me to be faced How could we converse in a way that would engage her
with, and these can be difficult conversations in which to gain and not be an affront, considering her well-educated and
a foothold. The problem story is intelligently constructed, considered position on the matter?
well-evidenced, seamlessly articulated, and any escape
routes carefully sealed off. There was much in her world In his book Collective narrative practice, David Denborough
which supported her in taking in an internal-state view of her (2008) writes about Broadening the horizon (p. 177) and
situation, and she was not easily convinced of any hope or recognising that a persons commitments and experiences
possibilities for anything being considered otherwise. Often, are not merely individualistic. In Western therapeutic culture,
when a person has come to understand an internalised and we are inclined to privilege individual problems and concerns,
individualised descriptor of their difficulty, it can be a relief individual hopes and endeavours. Yet Denborough goes
to them to hear alternative viewpoints. A solo parent who beyond suggesting that we as practitioners simply consider
is experiencing feelings of failure and being overwhelmed whether a person might relate more readily to collective
might welcome a discussion about discourses of parenthood, consideration, and invites us to look beyond dualistic
or a conversation about social injustices and the rising cost approaches to individualism and collectivism and see that
of housing. It may come as a relief that the sense of failure the two concepts can, and often do, co-exist within a single
they are experiencing may be viewed in the light of collective conversation through forms of speech. Noting that all cultures
responsibility. However, in Rubys case, as with several engage with both the language of the collective, by referring
others like her, the societal aspect of their concerns has often to we, and that of the individual, by using I, frequently
been well canvassed and discussed already, and not without moving fluidly between the two, Denborough describes how
creating difficulties of its own. Ruby assured me that she it becomes possible, when we weave these two languages
knew only too well not to take any notice of media images, together by moving in and out between collective hopes
and wanting to look like models is shallow and stupid. (we) and personal experience (I), for conversations to
be held in terms of both personal and collective endeavour
Saukko (2008) argues that current discourses about eating (pp. 179181). I wondered if it might pique Rubys intellectual
disorders inform sufferers on how to view their experiences curiosity to speak for others as well as for herself. The
and can be contradictory, pointing out how popularly- following is a reconstruction of that conversation.

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Kristina: As you will know, its a long time since I was
at school and I am thinking that school life and Kristina: So how do young women cope, growing up
conversations might have changed considerably with that around them? [I ask this with genuine
during that time. I am trying to remember what curiosity.] I mean, when I was younger it would
conversations my friends and I had, but I dont have been bad enough but nothing like now.
recall discussing appearance to the extent you Whats it like, say, for the young women at your
have mentioned your friends discussing it. Do you school, growing up with all of that around?
think I would notice a difference in conversations [This is valuable knowledge she may hold.]
if I was to return to school now?
Ruby: Thats why everyone is taken in by it. Thats why
Ruby: Hell, yeah! Everyone talks about it all the time. everyone thinks theyre fat because they havent
Oh my thighs are soo fat even though they got a thigh gap or whatever. Its all around us all
arent. Its boring. [flops back in her seat somewhat the time, and it doesnt help when everyone talks
dramatically] about it. [She seems exasperated by the business
of everyone talking about it.]
Kristina: Those conversations are happening all the time?
I was not surprised by Rubys astute awareness, and am not
Ruby: All the time. alone in noticing that so many of the women who are living
with that which is called anorexia (Lock, Epston & Maisel,
Kristina: That sounds intense. 2004) and similar difficulties, are less overtly concerned with
issues of fashion and popularity than they are with social and
Ruby: It is. [sighing] global issues (Duker & Slade, 1988). These are often young
women who care greatly about matters of social justice,
Kristina: Why do you think that intensity surrounding such human and animal rights, and the environment. A familiar
matters happens? statement is, I want to recover/get over this/get better so
I can make a difference in the world. In their book Changing
Ruby: Social media, celebrity stuff, advertising our minds, Kitzinger & Perkins (1993) argue that modernist
everyone gets taken in. approaches to mental wellbeing simultaneously support
the sentiment behind this statement while actively blocking
Kristina: I guess it cant be easy. I mean, were pretty its realisation: Psychology suggests that only after healing
bombarded these days arent we, with advertising yourself can you begin to heal the world (p. 189). This notion
and so on? has seeped into daily conversation, and I have lost track of
the number of times I have seen on Facebook an emotive
Ruby: Yup, completely bombarded. image overlaid with some version of :You cant love/respect
anyone else until you have learned to love/respect yourself,
Kristina: Where do you think the bombardment happens invariably attracting a lot of likes. However, Kitzinger &
most? What have you noticed? Perkins (1993) go on to say:

Ruby: Oh, its everywhere. Thats why you have to We disagree. People do not have to be perfectly
ignore it, its so dumb. [rolling her eyes] functioning, self-actualized human beings in order to
create social change The vast majority of those
Kristina: I read about a study a while ago which said we admire for their political work go on struggling for
that even two to three minutes of appearance- change not because they have achieved self-fulfilment
based advertising has a negative impact on (nor in order to attain it), but because of their ethical
how we feel about ourselves.4 [I am introducing and political commitments, and often in spite of their
these ideas as a tentative prospect for her own fears, self-doubts, personal angsts, and self-
consideration.] I wonder if thats true. How much hatreds. (p. 189)
of that advertising do you think we get exposed
to each day or week? So it surely follows that where non-eating and body regulation
are acts of conforming to oppressive and patriarchal societal
Ruby: More than two to three minutes. More like two to demands (Gremillion, 2003; Maisel, Epston & Borden, 2004;
three hours. [Ruby has a slight tone of disgust in Malson & Burns, 2009), then there is the possibility for taking
her voice.] political action on a minute-to-minute basis (Hutton, 2008) by

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not going along with, or resisting the demands of, anorexia/ disagree with these pressures? [Again, I ask this
bad body image/bulimia, and so on. Kitzinger and Perkinss with genuine curiosity. Knowledges of this nature
challenge to how modernist ways of thinking both pathologise would be worth their weight in gold as part of
individual experience and stymie action that might otherwise co-research.]
be restorative to the individual had me wondering whether,
if taking political action can precede recovery, then we might Ruby: Probably not. [hesitating momentarily] Well, maybe
think of this differently. Rather than viewing the hope to make they disagree with it, but they dont do much
a difference as an impetus for the personal work of recovery, about it.
we could make available the possibility that actions taken
toward resisting anorexia/bad body image/bulimia may, in Kristina: Do you ever disagree with it?
fact, be at least part of the making a difference, which
would render the concept of recovery in this instance Ruby: Oh, I think its wrong. Really wrong. [speaking
redundant. From this perspective, it is as if modernist ways emphatically]
of thinking had blocked Rubys exit route by insisting that
a perfect recovery is a pre-requisite to political action, yet Kristina: Do you ever do anything about it? Like resist it or
political action of this nature (that is, resisting anorexia/bad protest against it or anything?
body image/bulimia, and so on) would be the very stuff of
what is often named recovery. Importantly, this is not about Ruby: Oh, Im not into protests. [looking at me as if I must
taking action in order to achieve self-fulfilment; it is simply be mad for suggesting such a thing]
that nominated political actions and thus-named recovery
might, in another frame of non-dualistic reference, turn out Kristina: Im sorry, I didnt explain myself very well. I wasnt
to be one in the same. thinking about marching with a Love Your Body
banner or anything. Although I know those things
Narrative approaches suggest such actions would not need have been done with very good effect. I was just
to be grand. Calling on the ideas of Kaethe Weingarten wondering about much smaller things. Whether not
(1998) that Trumpets neednt blare. The stuff of daily life, joining in the conversations was a sort of protest?
the small and the ordinary, can be fertile ground for the most You know, not going along with it. Im thinking the
sophisticated concept, then perhaps we [are] searching advertisers might love it if you got hooked in as
for the smallest shred of evidence that protest [has] been well, but you seem to be refusing to do that.
present. We [are] searching for an exception to the dominant
plot that featured her as compliant and silent (p. 4, 7). Ruby: Yeah, I refuse to join in those conversations.
If modernist thinking tells us the struggle is a personal [Rubys tone is decisive and unequivocal.]
and internal one, and feminism tells us it is a political one
(Hanisch, 1969) then perhaps just the very act of wrestling Kristina: Refusing was my word really wasnt it. Does it fit
with these ideas is enough to be considered an embryonic for you, or is there a better way to describe what
political statement or inauguration of action. you are doing?

Of course, great care must be taken not to proselytise or Ruby: Refusing works.
to burden someone with unwelcome political tasks: There
would, indeed, be ethical concern about counsellors who set Kristina: So this refusing is it a kind of protest? Do you
out to politicise the counselling session in a way that was consider the refusing that you and I have spoken
focussed on general social change without addressing the of is a kind of protest?
particular local experience of the client (Winslade, 2005,
p. 352). However, I had a sense from our conversations that Ruby: [considering my question carefully and taking her
Ruby might be interested in these ideas, and that we could time before answering] Maybe. [She says this
address them in ways that focussed on her particular local slowly and slightly drawn out, but I sense an air
experience. Perhaps a carefully-constructed invitation to think of curiosity.]
of it this way might be a useful move away from pathologising
notions and individualised interpretations. This is what I Kristina: So what about your friends? Or young women in
attempt to do in the following abstract from our conversation. general? What if we thought about young women
across the whole of New Zealand, or even in
Kristina: So, do young women at school ever take a stand other countries, do you think any of them might
on this? Do they do anything to stand against or be refusing too, and not joining in? [I am moving

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 out very slowly here, step-by-step, focussing on a thinner, but I dont see why I should. People say to
gradually expanding panorama. My intention is to me, I thought you had bad body image, why are
link Ruby to others in similar situations, so once you wearing tight clothes? I thought you would just
she has sight of the link between herself and her wear baggy clothes. But I like tight pants, I feel
friends, I expand the vista to include all young good in them.
women in New Zealand, before moving beyond
to other countries in order to expose this as being Kristina: Were getting a bit of a list here. Would it be alright
very clearly other than merely individualistic, while do you think to make a list documenting some of
not losing sight of how she personally is an integral the protests you are making? Would that be a good
part of this bigger picture.] idea?

Ruby: [She contemplates this for a moment.] Probably, Ruby: Yup. [She seems eager.]
a few I guess. [nodding slightly]
Kristina: Okay, so do you want to write the list? [handing her
Kristina: I wonder if your refusing would influence them, a marker-pen and and art pad]
if they knew about it.
Ruby: Sure.
Ruby: Maybe. [Rubys tone has lifted. Her saying of the
word maybe is inflected and she seems less Kristina: I remember your refusing to join in conversations...
cautious.]
Ruby: Eating what I want not wearing black wearing
Kristina: Are there other ways young women could protest? tight pants. [She writes each of these in large
[I stick with the word protest for a little while, to letters as she speaks.]
ensure a clear sense of the idea we are engaging
with before we develop a more varied vocabulary Kristina: Maybe one day, if you chose to share it, this list
later on.] Other than marching with banners, could inspire others to follow your lead ?
unless that is their thing, of course but smaller
things, like refusing to join in conversations. [We continued to list a number of actions that Ruby
What could they do if they wanted to disappoint sometimes took as a protest against these pressures. Ruby
the advertisers? later said that she would be happy for the list to be shared
with others who were similarly interested.5]
Ruby: They could eat whatever they wanted and wear
what they wanted, without wondering what it made Kristina: Are you happy with the word protest? Or is
them look like. [Ruby is becoming very engaged there something else you would consider better?
and enthusiastic. She is sitting up in her seat and [It now seems possible to expand this idea beyond
becoming more animated. She seems pleased what could be being limited by continued use of
with her idea.] protest and ensure that we are using terminology
that is meaningful to Ruby.] Some people think
Kristina: Wow, thats a thought, isnt it? Eating what you of appearance pressures as a gender issue, you
want and wearing what you want as a protest? know, like feminism6. They call it a political issue,
Gosh, what do you think about eating and wearing some people think of it as cultural thing or a social
what you want being a protest? pressure. Would you agree?

Ruby: We should be able to do that anyway. Ruby: Whats it got to do with Politics? [looking a little
startled, but curious]
Kristina: Well, I have to say I agree with you. Do you ever
protest or rebel in that way? Or perhaps other Kristina: That would be politics with a small p. Not like
ways? whether you vote National or Labour, but politics
like civil rights and social justice7 do you know
Ruby: Sometimes. I get so fed up of not eating that I what I mean by that?
just eat what I want. [pausing momentarily while
she thinks] And I dont wear black all the time. Ruby: So this is a political protest? [This does seem to be
Everyone says you should wear black to look piquing her intellectual curiosity.]

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Kristina: Some would say so do you think so?
Keeping it small and close
Ruby: I like that. [Her back straightens a little and her There is nothing new in small and close conversations.
shoulders moves back slightly, as if perhaps she is A fundamental part of narrative practice, experience-near
experiencing some pride or a return of dignity as a questioning maintains relevance and connection to personal
consequence of this idea.] experience. Generalisations and abstractions can create
theoretical conversations that bear little relevance to personal
Over the next couple of weeks, Ruby engaged in what experience and therefore are less likely to resonate or
Michael White may have called investigative field work, impact on daily life. My sense was that talking about close,
researching her own political protests, or political action as immediate, and intimate contexts such as school friends,
she later came to name it. We devised a plan in which she as well as discerning small actions and micro-practices
documented these actions by taking pictures with her phone8. embedded in Rubys everyday experience, such as refusing
Ruby thought there were already enough selfies in the world, certain conversations, would more likely draw her in and be
so these pictures were artistic representations of the stands meaningful to her in ways that create change. Winslade,
she was taking in her life that spoke of her actions and her Crocket and Monk (1997) speak of how experience-near
commitments. Stored on her phone, these pictures acted as exchanges help a person redefine experience in ways that
a living document of her daily acts of resistance, the political alter its trajectories (p. 69). My question Gosh, what do
actions as she referred to them, that she was taking in her you think about eating and wearing what you want being
life. These included photographs of her imperfect dinner a protest? which spoke to the minutiae of Rubys daily life
surrounded by a smart table setting as a direct contrast being under political scrutiny elicited both her strong position
to those frequently posted on Facebook and Instagram, (We should be able to do that anyway) and a detailing of
outfits she put together and laid out on her bed that she said actions (I get so fed up of not eating that I just eat what
would annoy the fashion police and an open book lying on I want, and I dont wear black all the time), which, in turn,
her unmade bed suggesting a preferred way to spend her led to an ongoing interest in her own resistances an interest
free time to constant exercise. She said these photographs which may have slipped by us had we merely engaged with
and this way of thinking helped her feel less like there was broader theorising.
something wrong with her. The last time we met, Ruby spoke
of how bad body image was no longer always getting the
last word, and of how she was a lot more hopeful about
possibilities for getting on with her life. Moving between we and I
By moving between collective and individual experiences
through the use of the language of we and I, it became
The four elements more possible for Ruby to envision the connections between
her own personal experience and that of others who shared
I had not altogether expected this turn of events at the similar contexts, and she became able to speak not just for
beginning of our conversations, and so reflected a good herself, but for others too. Her concerns therefore became
deal on how it had come about. It seemed to distil down to visible as both individual and collective endeavours. It seems
four elements, all existing practices within the narrative field, important that we moved in and out, between we and I,
working together. These were, between the collective or societal and the individual or
personal, reinforcing those connections by keeping the links
keeping it small and close between the realms tight (Do you think any of them might
be refusing too, and not joining in? and I wonder if your
moving between we and I refusing would influence them, if they knew about it?), thus
making the connections increasingly visible. The we was
naming political action chosen carefully and needed to be a we that Ruby identified
with. Had I simply introduced the concept of women in general
recognising agency. as being the we, she may not have seen the relevance to
herself, nor might she have felt able to speak for the diversity
I wish to discuss each of these briefly in turn as, on reflecting of people under the umbrella of women. We spoke of her
on our conversations, they were crucial to our work together. classmates and other school environments, big enough to be
I think they also have much to offer in my other work. a collective interest, but no so big that sight of herself within
it became lost, gently widening the vista before drawing her
eyes back in to her own actions.

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In some ways this back-and-forth movement and creation of more discernible as personal agency. It is also significant to
an experience is resonant of Johnella Birds (2000) work on point out that our task is a naming of existing actions, not
relational languaging, in which ideas are acknowledged as an inviting of new action, at least not in the first instance.
both external to the person and yet of the person, connected We were speaking of how Ruby was already acting against
to them but not them, by using language that moves between the pressures, even if that action was simply a wrestling
the particular and the general, that allows perspective of that with ideas or wanting something different (Heath, 2012). By
relationship. Perhaps we are doing something similar here. identifying that she was against these pressures and acting
When the conversation focussed on we, Rubys vision was accordingly, while simultaneously bringing into focus how
turned outward to others who experience life similarly (So do pervasive the complicity of social institutions is (White, 2011,
young women at school ever take a stand on this? Do they do p. 89), and revealing the extent of these discourses and their
anything to stand against or disagree with these pressures?), influence, we were able to bring both her circumstances and
exposing how these powerful influences permeate the culture her resistance into focus in a way which strengthened, not
and context in which she resides. And by moving back to diminished, her. To focus only on what she hadnt noticed
the I (Do you ever disagree with it?, and, I wonder if your or identified as influential in her life may have depleted her
refusing would influence them, if they knew about it?), she sense of herself, but because we brought this into focus in
experienced how their lives were linked to hers, how these the context of her own resistance, we better maintained and
broader influences infiltrated her daily circumstances too. upheld her position as an agent in her own life, and perhaps
influential in the lives of others.

It is important to note that, while I have described these as

Na ming political action four discrete elements in a linear progression, in practice they
By naming Rubys decisions to act differently as political operate more as threads which are being continually pulled
action (So this refusing is it a kind of protest?), we were together and woven to create particular experience. I intend to
moving distinctly away from internalised notions of the illustrate this in the following conversation with Natalia.
problem. This is not action which is taken through the inward
direction of self-help or self-improvement, or managing ones
genetic predispositions or personality traits, but outwardly Natalia
towards an external context. Of course, the word political
may never arise. In a different conversation, it might be called Natalia was 15 and recently discharged from a public mental
social action, counter-cultural choice, a decision to do health service. After being treated for anorexia nervosa
things differently than is expected of me, being prepared under a medical model, and achieving her goal weight, she
to have an opinion, or some other term that is of interest to was referred to me for what were named by the referring
the particular person we are speaking with. There is scope agency as her ongoing body image issues. Our early
for developing and using a rich vocabulary around this, and conversations using Michael Whites Statement of Position
we can collect ideas from the people we work with. But by Maps (White, 2007) provided us with a rich externalised
identifying and naming the political nature of Rubys actions, description of anorexias ongoing influence and its effects
we both moved away from the psychology/pathology/ on her life and on those around her, and I had introduced
self-help paradigm that often has people stuck, to one of ideas of anti-anorexia (Maisel, Epston & Borden, 2004) and
purposive action in unjust circumstances, while also allowing the Archive of Resistance.9 Natalia became very interested
for her commitments not to be entirely individualistic, by in spotting anorexias activities, particularly its hypocrisy in
broadening the horizon of identity (Denborough, 2008, telling her it was concerned for her health and wellbeing while
p. 187). insisting that if she was not hospitalised, she had not tried
hard enough; however, she felt convinced that it was her
personality traits that would never allow her to leave anorexia
Recognising agency behind entirely. Medical and psychological discourses
have privileged ideas of personality traits (Moorey, 1991),
Recognising and naming agency might, in some measure, distorted cognitions (Treasure & Schmidt, 2013), and genetic
be seen as the outcome of the first three elements. It is predisposition (Kaye, Wierenga & Bischoff-Grethe, 2013) in
through naming of action as political that we are able to relation to eating disorders. Hospital staff had also spoken to
see it for what it is, agentive and meaningful, not passive Natalia of societal influences as barely consequential, or as if
or submissive. Agentive practices which stand outside it was somehow Natalias responsibility to manage or ignore
conformity to social norms often make their first appearance despite her predispositions, making this a very internal,
framed as failure (failure to fit in, failure to measure up) but, personal, and isolating experience for her. The following is an
when viewed through the lens of political action, become abridged reconstruction of one of our conversations.

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Kristina: You said that anorexia has a louder voice nearer Kristina: It sounds like theres an importance to having
exams, or when assignments are due. Do you have something which defines you and makes you
any thoughts or ideas about why that might be? special.

Natalia: Its because I set myself really high standards. Natalia: Yes, its important, otherwise you are just
At the hospital, they said its because Im a replaceable, you could just not be there one day
perfectionist and that I need to learn not to worry if and someone would replace you and nobody would
I just get merit. But I cant not worry. [She throws notice. [This reply trips off her tongue with such
her hands up as if to express the ridiculousness ease and certainty that suggests she has thought
of a perfectionist being told to not worry. They about these ideas before.]
certainly have her in a bind with these opposing
ideas.] Im never happy unless I get excellence. Kristina: You mentioned earlier that people have used the
word perfectionist. But this sounds like it might be
Kristina: Is there something important about getting a bit different.
excellence?
Natalia: Well, its just the way I am. [She seems resigned to
Natalia: Partly, its because I know you have to get really her fate.]
high grades to get into medical school, and I want
to be a doctor, so I have to get high marks. Kristina: Only, Im just wondering I hope you dont
mind but Im trying to make sense of this. It
Kristina: Yes, the entry requirements are tough, arent they. sounds like the word perfectionist would describe
Do you think that puts a lot of pressure on young something that you are, something fixed about
people? [Here I am inviting the language of we.] your personality.

Natalia: Only if they want to do something like medicine. Natalia: About grades, yes.
There are lots of choices, but Ive chosen medicine.
[Natalia says this decisively but with an air of Kristina: Do other people feel this pressure to get good
resignation.] grades and have something special about them
too? [Inviting the language of we, introducing the
Kristina: You said that was partly the reason. Are there idea that she may not be alone in this.]
some other parts to this?
Natalia: It might be grades, or it might be something else.
Natalia: Well, you have to be good at something. Everyone If you have a special talent then youre lucky,
else is good at something. I mean really good, you wouldnt need grades so much to define you.
not just average or quite good. They all have a [This seems like quite a thought-through philosophy
thing that kind of defines them. [She relays this she holds.]
philosophy with a conviction that suggests it is
something she has given a good deal of thought, Kristina: This idea of the importance of having something
and on which she has taken a considered position.] special how do people know about it? [using the
language of we] What do you see around you
Kristina: Do you mind me asking who you mean by [following quickly with the language of I] that is
everyone? [keeping it small and close] letting people know having something special that
defines them is important?
Natalia: All my friends at school. [She is speaking
animatedly, but with a furrowed brow, suggesting Natalia: [She thinks for a moment or two.] School lets you
this concerns her greatly and causes her some know.
distress.] They all have something, either art or
dance, or the way they dress, or whatever. Its a Kristina: Your school, or all schools? [I am wanting to create
thing they have that makes them the best at that a link between her immediate environment and the
special. I havent got anything, so I have to have wider context.]
excellent grades so I have something too.
Natalia: Probably all schools [pondering for a moment,
then emphatically] but definitely my school.

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Kristina: How does your school let you know that being Kristina: [speaking gently] I can see that. So, if other
special is important? [keeping it small and students in the assembly were feeling the same,
close, wanting to build initially on her very local and also not wanting to admit it in case they were
experience asking after the micro-practices that the only one what could they do? Do they just
support these ideas] put up with it? Could they do anything? [using the
language of we and the same language of not
Natalia: Well, there are the certificates they hand out for wanting to admit it to expose possible links and
achievement or effort, you know, at assemblies. But similarities between her experience and that
its only for the best ones. The highest achievers, of others]
the most effort. So its like if you dont get the best
marks, or you havent tried harder than everyone Natalia: Tell the school, but then they would be admitting it,
else, you may as well not even be there. Youre and it wouldnt change anything. [She shrugs.]
nothing. [She waves her hand in a dismissive
Kristina: So if telling the school felt too difficult and it
gesture.]
wouldnt change anything anyway, could they do
something small? Do they have to just go along
Kristina: Wow! Thats a thought isnt it. Best or nothing.
with it? [continuing to use the language of we]
And the ways that school celebrates success
encourages that idea? Do you think they realise
Natalia: When they are clapping for the person getting the
this?
certificate, they could decide to clap for everyone
else who tried too.
Natalia: They mean well and I am happy for the people
who get the certificates. [Natalias tone is soft and
Kristina: So the clapping would be for everyone who tried
generous.]
not just for the one who did the best in the
teachers judgement?
Kristina: Im sure you are, and I guess schools have the best
intentions. But perhaps you know some things that
Natalia: I think it would be a nicer thing to do, and I would
they dont. Things about what its like to be in that
feel better about it.
environment. [Here I am using the language of I,
bringing forth her individual experience, her insider-
Kristina: So you would do it? [Natalia has already moved
knowledge of the consequences of this system.]
from the language of we to I and so I follow her
lead by questioning her about this.]
Natalia: It makes you feel invisible, irrelevant.
Natalia: I sort of do it anyway. [She looks at me as if
Kristina: Do you think other people feel like that too? You wanting to check out my reaction.] I think, Im
know, the students sitting around you in assembly. happy for you getting that certificate, but others
Do you think some of them might have that feeling have tried too.
of being invisible or irrelevant too? [Inviting the
language of we, using the same language of Kristina: So you are already doing it? [highlighting her
invisible and irrelevant to link their experience agency] You know, some people would call that
with hers.] taking a stand against something they dont
agree with. Would you call it something like that?
Natalia: Maybe. [nodding gently with her eyebrows a little [introducing the element of naming it as political
raised as if this is not an unwelcome possibility] action]

Kristina: But you dont ever talk about it? Natalia: Im not doing what Im expected to do. [her naming
of this action]
Natalia: [mulling over this question for some seconds] No,
because then you would have to admit it and they Kristina: Not doing what youre expected to do. [I repeat her
might not feel the same. [She meets my eyes and words so the not doing is identified as agentive,
holds my gaze for a moment before dropping her not merely an omission. This particular philosophy
head and staring at down her hands, which rest in that she is both immersed in and yet breaking from
her lap.] is often invisible, making escape difficult.] What are
you doing?

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Natalia: Im being more caring to everyone. [Natalia states interacted with others, in ways she could be proud of. She
this with certitude.] observed that she had always invited otherwise-excluded
people into conversations rather than sticking with a clique;
Kristina: Do you do other things youre not expected to she asked people where they had been if they were absent
do sometimes, perhaps other ways of being from school so they knew their presence or absence was
more caring? [inviting recognition of agency and noticed, with the intention of creating a sense of group
engaging with the language of I] belonging; and she initiated conversation when everyone
else was on their phones in a determined effort to keep the
Natalia: I dont talk about grades when we get tests back. group more connected. Natalia said that realising she was
not doing what was expected of her supported her in not
Kristina: Why is that? [It sounds like there is something doing what anorexia and perfectionism expected of her too.
important in not talking about grades.] She still worked hard for good grades, but more to become a
doctor and help people than to be special a profound move
Natalia: It could be hurtful if someone else is feeling bad, or towards her escape from ideas of elitism.
I could be upset if everyone else did better.
Natalia decided to invite her mother to an impromptu outsider-
Kristina: So this is a concern for others and a caring for witness ceremony (White, 2007), telling of these ways of
yourself? being, and acknowledging how she had learned many of
these skills, practices, and commitments from watching her
Natalia: It makes it nicer. [Natalias resolute manner and mothers expressions of connection and caring with her
definitive tone suggest she is taking a position friends, that seemed to have their roots in a shared cultural
on this.] background. I also took the liberty of preparing a Care-
tificate which acknowledged All young people and students,
Kristina: So here you are immersed in this school including Natalia, who share a common delight in recognising
environment which celebrates being special everyones efforts, and are linked by the diverse threads of
and you are quietly getting on with celebrating an appreciation of caring and connection11. Natalia agreed
everyone and doing what youre not expected to that Care-tificates were a much more inclusive way of
do? [keeping it small and close, maintaining the appreciating effort.
language of I, claiming her agency and naming
it as political action]

Natalia: Yes. [smiling]

The effects
I observed what seemed to be four distinct effects in the
Kristina: Do you think it influences others in any way; might conversations with Ruby and Natalia:
they do the same?10 [moving outwardly to the
language of we, linking her action and agency with Traction: where earlier there had been a sense of stuckness
others experiences] in our conversations, both Ruby and Natalia became engaged
with ideas and there began to be movement or change.
Natalia: When I act in more caring ways, I think it gives
people more confidence to do the same. I think it Reclaiming of dignity: a lessening in the idea that there
makes it nicer for everyone. was something intrinsically wrong with them, and more that
they saw themselves as being located in difficult or unjust
Natalia subsequently became increasingly interested in circumstances.
catching herself doing things that were not expected of
her. She said a particularly transformative example of this External critique: a recognition of, and critical engagement
was reconnecting with the Latin American culture of her with, their social circumstances, and a growing awareness
mother, a community she found less competitive, friendlier, of self alongside others responding to unjust circumstances,
and that had placed greater emphasis on connections than rather than accepting internalised notions of a faulty self.
comparisons which, in turn, supported her in enjoying eating
and being happier in her own body, because those matters Interest in and enjoyment of the conversation: an active
were also thought of differently. Natalia began to realise these awareness of an existing participation in their own
commitments to connection and caring had long influenced resistances, as well as growing interest in taking further
her doing of things that were not expected of her by how she action in their lives and those of others.

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Perhaps there is something about how we moved in and out the politics of experience, an invitation to include collective
between the collective and the personal, the we and the considerations in discussions about individual experience
I, that supported dignity. To be singled out as different or and perhaps the elements, in being pulled together and
putting pressure on oneself can be a shaming experience, interwoven, create something stronger and more complex.
a position of deficit, one which is freely offered by modernist Perhaps the key is in the continuous interweaving of all four
approaches to mental health and wellbeing. The young elements, their interplay creating the effects the gentle
women I have spoken with usually come well-resourced with back-and-forth between we and I, the close attention to
a host of explanations and descriptions of their personal the details of local context, the naming of action as political,
deficits and pathologies. I am rarely the first person they have and the recognising of her agentive engagement both in her
spoken to about their difficulties; often having engaged with life, and that of others. Each element acts as warp and weft,
mental health services, they will list personality traits, genetic in and out, crossing one another, supporting and reinforcing
predispositions, and biological brain disorders (Bulik, 2013; each other, gradually weaving a rich counter-story that has
F.E.A.S.T., 2014; Kaye, Bailer, Klabunde & Brown, 2010; resonance and validity one that both strengthens and
Lock, 2013) among the problems they have (or, one might dignifies, one which moves beyond the stymying nature of
argue, are). While I hear that these have been spoken of pathological descriptions of personal problems, or neoliberal
kindly in professional circles, and well-intentioned strategies definitions of personal growth and individual responsibility
have been offered to overcome or manage these inherent (Sugarman, 2015; Verhaeghe, 2014), and into the dignified
ways of being (Lock & Le Grange, 2005), they actually seem realms of collective experience, collective responsibility, and
to me to offer little by way of dignity. the potential for social movement.

Instead, by externalising and introducing ideas of the

collective, we can open space for women to take up a very
different position. Perhaps it was in the keeping it small and
Ethics/power/privilege
close that we enabled both engagement and enjoyment? When I met Ruby, she had no interest in counselling. Age,
Experience-near descriptions of womens context and education, and professional status afford me considerable
responses ensure these are tangible and therefore easier to privilege, and the young women I work with are often very
engage with. Nor does the concept of action seem distant skilled in meeting the expectations that others place on them.
or unachievable. These are local experiences against which Consequently, I hold a level of power that needs attending
small stands become eminently possible. to lest I unintentionally impose counselling conversations
on people who do not wish them, and which privilege my
Further, naming actions as political with Natalia invited an voice over theirs. So I spoke directly to this power imbalance
external critique, as opposed to an internal critique. The latter between Ruby and I to make it more visible, pointing out that
would have had her vision turning inwards, seeking changes sometimes when young people come to see me, it can seem
she should make to herself or of her ways of being in the that because I am old enough to be their parent or teacher,
world. But here her vision was directed outwards towards and because I have the title of counsellor, it means they
considering what was operating in her environment and on are obliged to answer my questions. I explained that I would
her, the institutions she engaged with, and societal practices not want to engage anyone in an unwelcome conversation,
which supported limited and limiting ideas of a successful nor would I be at all offended if she chose to spend the time
personhood, shrinking the space which she may inhabit. in some other way, offering a number of alternative options
such as an art activity, or simply hooking her phone into the
Perhaps the careful scaffolding (White, 2007) also created available free wifi until her mum came for her. Ruby decided it
this sense of traction, allowing Natalia to see herself in a would be okay for us to chat, choosing the option of getting to
different light in a wider context, with the identifying and know one another, and that is how we spent our first meeting.
naming of agency highlighting what she was already doing,
and making change seem more possible. Perhaps, too, it was During that conversation, I asked if it can seem that
the small, close questioning and the ability to engage in ways counsellors have all the answers, the right solutions or
which dignified, not depleted; but there is no doubt in my mind special knowledges about how to live, and Ruby agreed it did.
that the nature of our conversations changed dramatically However, she also said it made sense when I explained that
once these four elements were being employed. I actually believe people are best placed to know what is right
in their own lives, but that I can bring some knowledges and
This might, however, seem a rather simplistic breakdown understandings that might be helpful (Tarragona, 2012) as
of element and effect, and maybe there is something a little part of a collaborative effort. It was in part drawing attention to
more going on. This is a delicate approach to addressing her insider-knowledges and my secondhand understandings

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of her world that I asked, Its a long time since I was at in relation to lesbians engaging with psychological and
school do you think I would notice a difference if I was to psychotherapeutic practices available more than twenty years
return to school now?, inviting her into her position as the ago, we must still consider these significant concerns if we
more knowledgeable of the two of us about how do young are to engage in ways which do not serve to pathologise,
women cope, growing up with that around them? These were isolate, or harm our clients. Freedman & Combs (1996)
questions asked from a stance of genuine curiosity Morgan argue that the unique character of [narrative] therapeutic
(2000), to which I did not have an answer, but hoped she may. relationships has to do with the ethical practices that shape
their construction (p. 265) and, as such, the very practices
I am also aware that questions are influential, informed in of externalising problems, linking people around similar
particular ways. We need to monitor and expose our influence concerns, and identifying unique outcomes and absent but
in order to work in transparent and responsible ways. implicit commitments, refute these internalised pathologies
Kitzinger & Perkins (1993) say, We need to be careful about which can render a person stuck.
allowing psychological thinking to obscure the causes of our
problems, and the full range of different solutions to them It is these concerns about internalising and individualising
(p.10) and, given the relentless, invisible, and unregulated problems that I attempted to address in this work through
way in which modernist psychological ideas spread through my use of specific practices, including joining people in
the operations of power and privilege in institutions, through their experience of the world (Freedman & Combs, 1996, p.
media, and socially-sanctioned ways of being I do not 277). While creating ill-thought-through connections between
want to operate in similarly subversive ways. I believe my those experiencing eating concerns is documented as having
offering of alternative perspectives for consideration is not hazardous potential (Lavis, 2011; Osgood, 2013) by evoking
only ethical practice, and that to not offer these considerations hypothetical audience (Lobovitz, Maisel & Freeman, 1995,
would be unethical indeed, but to do so ethically there must p. 229), I was able to link Ruby and Natalias experiences to
be a transparency of values on my part (Lobovits, Maisel school friends and other young women. I also invited them
& Freeman, 1995, p. 235). So, I tell clients I have some to share their ideas and knowledges about problems and
thoughts and ideas about problems, as I did with Ruby when protests, partly to help me understand more of their world so
I initially invited ideas that she may experience pressures to that I might become better at assisting others (I was careful
look a certain way. I wanted to check to see if these ideas to inform them of this project), while also attending to the
fitted for her, and said so. Perhaps it was because I also indisputable fact that their knowledges and ideas could act as
explained that I by no means hold a monopoly on ideas, and a direct and invaluable contribution to the lives of others.
different practitioners, like different people, are informed by
a wide variety of philosophies and world-views, that she felt With regard to race, culture, and socioeconomic status, there
able to let me know that she held another position on the is rarely an imbalance in the room when I am working with
problem, viewing bad body image as intrinsic to her. young women in the realms of eating concerns. Engagement
with competitive educational environments, cultural
It was also important to ensure as I proceeded that I was not commitments, and expectations placed upon us have often
unwittingly engaging in subtle coercion, or recruiting Ruby been very similar. However, shared values and beliefs can
and Natalia into a position in line with my own ideas. To allow have their effects invisibilised, allowing an acceptance of the
for this possibility, it was important that our conversations status quo. Mary Heath (2012) argues, I believe it is possible
brought forward values and positions they already held. to reflect upon ones own cultural location but it is not possible
And, by speaking of existing actions, rather than inviting to speak from outside it (p. 18), and so ethical engagement
new ones and interjecting my questioning with what do for me involves self-knowledge through reflection, discussions
you think?, do you agree?, is that how it is for you, or is it with others in the field (both narratively informed and not), and
something different?, and are you already doing this? that ensuring I am well-read, both from narrative and non-narrative
I conscientiously took a de-centred position, without entirely perspectives, to gain a sense of what others working in these
relinquishing influence. I offered possibilities and listened realms are noticing, while bearing in mind that many who
carefully for Ruby and Natalia to speak of alternatives, have reached a position of professionalism have also been
focussing on holding their beliefs and values central. committed to ideas of individualism, achievement, and the
predictable practices embedded in educational institutions.
This particular work has been greatly influenced by Kitzinger
& Perkinss (1993) claim that the very idea of therapy is Freedman and Combs (1996) describe how White and
wrong and that it is in and of itself a fundamentally unethical Epston place emphasis on effects of practices so that what
enterprise (p. 104) because it privatises pain and severs therapists do is not evaluated by how well their actions follow
connections between us (p. 86). While their writing was rules but by the actual effects of those actions on peoples

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lives (Freedman & Combs, 1996, p. 269). So I asked Ruby
and Natalia what was more or less useful, in the belief
Looking back
that client-informed feedback is both beneficial and ethical In this paper, I hope to have shown that by enabling women
practice (Duncan, 2014). This is how I discovered that they to identify and speak of themselves as part of a wider social
experienced our conversations in ways that had them thinking group impacted by appearance-based and/or academic
less that there was something wrong with them, and more pressures which invite ideas of comparison or measuring
focused on their own responses to unjust circumstances up, they became able to engage in an external critique of
which impacted on others as well as them, and that this societal and institutional expectations, rather than turning to
was helpful in countering the problems that tried to disrupt an internal critique, or to ideas of needing self-improvement.
their lives. And that it was through the naming of their commitments
and actions as being something beyond just themselves that
notions of individual disorder were replaced by thoughts of
political action in support of change.

Notes
1.
With appreciation for all the women who have generously shared 8.
This practice was informed by White & Epston (1990): There
their stories and made this project possible. While not specifically are also those documents that are significantly authored by the
documented in this paper, conversations with Rosalind and others person who is their subject. In these documents, the subject plays
contributed significantly to this project. a central role in contributing to the specification of her own self.
2.
 ere I refer to the particular women I worked with in this context.
H In so doing, she becomes conscious of her participation in the
It is important to note that there are many people experiencing constitution of her own life. This can lead to a profound sense
similar difficulties who would not identify with this description. of personal responsibility, as well as a sense of possessing the
capacity to intervene in the shaping of ones life and relationships
3.
This was how Ruby named these concerns.
(p. 191).
4.
I am referring to Hamilton, Mintz, & Kashubeck-West (2007). 9.
The Archive of Resistance is a valuable and ever-growing anti-
5.

Thoughts of sharing Rubys list with others who are similarly anorexia/anti-bulimia resource comprising of personal stories,
affected by these concerns came from ideas of Enabling scholarship, essays, poetry, and conversations, contributed to
contribution (Denborough, 2008, p. 3) and the restorative widely and maintained by David Epston and others. It is freely
possibilities which come when suffering is recognised as having available at www.narrativeapproaches.com
not been for nothing (Myerhoff, 1982, as cited in Denborough, 10.
My drawing of Natalias attention to the potential for her actions
2008, p. 3).
and commitments influencing others in this way was informed
6.
This question was informed by the idea that not addressing by ideas of narrative practices contributing to social movement
issues of gender within the problem (of anorexia) would, as (Denborough, 2008, p. 178) and how, without imposing agendas,
David Epston is prone to state act to co-produce the problem. we can support an increased sense of agency that enables
(Madigan, 1996, paragraph 35). creative possibilities for both contribution and change.
7.
I chose these examples (and feminism above) because they are 11.
This was inspired by White & Epstons (1990) use of alternative
included in the New Zealand high school curriculum and I believed documents as a counter to rituals of exclusion (p. 190), such as
Ruby was likely to have some knowledge of them, but also as the school award ceremonies of which Natalia spoke.
part of introducing familiar concepts where peoples individual
experiences of daily life have been visibly impacted by political
agenda, eras, and social movements, and where individual
contributions have made considerable differences to the lives of
others and created historical change.

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