ASIAN AMERICAN IN A WHITE-DOMINANT TREATMENT CENTER
Written by Rachel Wang
“Avoid conversations about politics,” we seemingly chanted together. Week after week, all patients would meet with higher up staff members to review treatment center guidelines and discuss the state of the Millieu (the name for our community of patients). Within this meeting, we would repeatedly read the Millieu Guidelines, which included the ‘no-talking-about-politics’ rule. While we briefly blipped over this guideline in about two seconds, this guideline was nevertheless harmful.
As an Asian American woman, my experiences have been and will continue to be political. Within a white-dominated society and white-dominated treatment environment, I cannot merely ‘not discuss’ my identity. My identity, after all, persistently shapes and mediates my experiences. It takes great privilege to simply ‘stay out of politics’ for the sake of community-building within the treatment environment.
White supremacy, I believe, is at the core of my development of anorexia.
White supremacy and my ED alike call on me to not take up too much space, to restrict myself and my voice to be ‘palatable’ to and ‘desirable’ by the white male gaze. White male fetishization of Asian women further provokes a need for safety via bodily restriction.
A body more like that of a prepubescent individual, after all, is less of a draw for unwanted attention by a dominant man.
Given the inherent intersection of race with my experience with anorexia, I needed treatment that took into account and honored this intersectionality. When I walked into my treatment environment, though, I was struck by the pervasive whiteness all around me. All of the therapists: white. All of the program therapists but one: white. All of the behavior health counselors: white except one or two. All of the patients: white except one. The one was me.
I cried in my room several nights thinking about how isolated I felt. I missed my family. I missed my group of Asian girlfriends. I missed Asian food. I missed not having to explain what bibimbap was to a white patient when we were filling out our menus for the week. I missed saying grace before meals with my family. I missed my favorite bulgogi and banchan side dishes. I missed hearing slurps around the table as my grandparents tucked into their noodle soup. I missed all the last bits of connection I had with food that were almost impossible to access in a white-dominated clinical setting.
Although certainly understanding and professional, my white dietitian was unable to fully take into account my lived experiences with food in her approach with me. Food for me was always representative of my connection with my Chinese and Korean heritage. While the ability to speak Mandarin and Korean was sadly not passed down generationally, we held on tightly to food as a means to stay connected within our predominantly white upbringings.
I know very intimately how my Asian grandparents would insistently say ‘don’t get fat’ to me, while also saying ‘eat more!’ and ‘why aren’t you eating that??’ The resultant tension, confusion, and trapped-feeling became all-consuming.
There was no way to separate my culture, my ethnic identity, from my strained experiences and relationships with food.
Ultimately, while I’m grateful for my treatment experience for putting me with the right foot forward to continue my recovery, I feel as if my team was not fully able to take an approach that encompassed my whole, nuanced racial and cultural experiences. And because of that, I was not given the tools and skills that were fully comprehensive to address the intersections of my experiences.
While there were several white queer people who could partake in the weekly LGBT group, which was a wonderful avenue for connection and solidarity, there was not a group similar to that for BIPOC individuals. There’d only be me and maybe one other person in that group, after all. Instead of a BIPOC group, we partook in activities like a ‘ball toss’ where we would look at another person and say ‘I see you.’ I left the room when program therapists proposed this activity.
In a ‘don’t talk about politics’ colorblind environment, I did not believe staff or other patients fully saw, let alone embraced, me as an Asian woman. My Asian-ness was unspoken, like an elephant in the room lurking in the back.
Treatment centers can ultimately affect great harm when they choose to merely ‘omit’ certain spaces within which individuals can explore and name their identity in full. My experience is not isolated. There must be more resources centering ED treatment by and for AAPI and BIPOC individuals.
According to Sineriz in the Center for Discovery’s blog, Asian Americans experiencing an eating disorder typically had the lowest rate of service utilization of any ethnic group.
On a systemic level, Asian Americans are not accessing much-needed care. It is on providers to become culturally competent and actively anti-racist in their treatment approach.
This means approaching therapy with curiosity, while not placing the burden on the BIPOC individual to explain their experiences and relive their past racial traumas. It is on individuals like us to support grassroots organizations promoting Asian American mental health.
Without this, treatment centers like mine will continue to perpetuate a notion of who is deserving of care, who is ‘sick enough’ to warrant treatment, and who we think of when we talk about eating disorders. The eating disorder trope is more than that of a white teenage girl with an emaciated body. Let’s create spaces to honor those who fall outside of that narrative to explore their identities and to share their stories.
Image credit: illustrator pimchawee.
Rachel Wang (she/her) is a college student in recovery from her eating disorder. She hopes to dedicate her career to promoting racial equity and exploring the intersection between law and mental health. She fundamentally believes in the importance of approaching therapy from a systemic lens that takes into account systems of oppression like fatphobia and white supremacy that harm marginalized individuals.