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Wellness culture and its unfair burden

July 30, 2020 | Social Justice

I used to believe that everything could be resolved in one’s life by changing oneself. If only we could have the right thoughts and feelings, things would be great.

Looking back, I understand where that belief came from. So much of our Western, colonialist culture holds myths of individualism, meritocracy, and self-reliance. To an extent, I think that seeing things that way allows for a sense of control. Early on, we learn that there isn’t much we can do to change the world (or so we believe), but we think we do have the power to change ourselves.

This is a mistake, of course. An error of omission. We can change a lot in ourselves but not everything. We can change some in the world but not everything.

Now let’s look at wellness culture. I first heard of this concept in the fantastic podcast, Food Psych. In it, Christy Harrison explained how the idea of dieting has lost its glamour but hasn’t disappeared, it simply has been repackaged into the idea of wellness. Now, we’re told that the goal is to Be Well: healthy, happy, fulfilled. To get there, we’re given a long list of tasks we need to do to achieve wellness. Implicit in that, there’s the message that, if something is going wrong, it’s because we’re failing and not doing enough.

I think this is unfair, as it ignores half the equation. We’re not independent; we’re interdependent. We are a blend of nature and nurture. We are the result of mixing what we were born with and the environment in which we develop. In that sense, we can’t forget that social determinants of health are a thing; that social injustice is a thing. These impact our wellness and health: whether we have access to clean air and water, to affordable nutritious food, and appropriate medical care. Recently, Malone Mukwende, a black student in London, wrote a book for diagnostic criteria in non-white skin tones. Did you know that such crucial information was lacking?

This is where the health of historically excluded groups come in. Statements that suggest that we can achieve anything if we just work hard enough erase the very real pressures that exist in society. For example, it ignores the impact of seeking care from people who don’t know what a rash looks like in a darker skin tone. How can we tell someone that, if they’re ill, it’s because they didn’t take better care of themselves? Sadly, our health care systems are not built for inclusivity.

Furthermore, ideas like these make it look like historically excluded groups can and should simply rise above injustice and systemic inequity. Like not having a well-paying job is because they didn’t study hard enough, and not because their family has carried transgenerational trauma and no one was there to support appropriate learning conditions, or because prejudiced people in positions of power tend to favor some in the labor force. Living in this environment has real and material consequences for people, and it shouldn’t be swept under the rug.

Another problem of putting all responsibility in the individual is that it doesn’t do enough to challenge our approach to healing. As health professionals, we work within models of treatment that exist within a specific understanding of the world. If our worldview ignores the issues of culture, privilege, and inequity, then it can be easy to blame the individual for their problems. Additionally, we may lose focus and believe that our treatment models should be applicable to everyone. Suddenly, if someone doesn’t respond well to treatment, it’s because they weren’t doing enough. What would happen if, instead, we challenged our approach to healing? What would happen if we saw our work as flexible and responsive to the particular needs of the people we work with?

Yes, I think we need to take more responsibility in how we provide care. Educating ourselves and providing culturally appropriate, socially-oriented services is crucial for true health care. At the same time, it’s important to work with our clients to make changes where possible. I believe it’s part of our job as providers to help navigate the line between promoting healthy behaviours when possible, and over-burdening our clients with responsibility that is not theirs. There are multiple voices telling them that it’s their fault that they’re not at their best. Let’s not add ours to the mix.

I grew up speaking Spanish. English is my second language. When I communicate in English, I make mistakes. I've chosen to let my writing reflect the kind of mistakes I make when speaking, so that you have an idea of what it might feel like to talk to me. I trust the message is still clear but, if it's not, please don't hesitate to ask me for clarification.

The information provided on my blog is a mix of my personal thoughts, professional approach, and articles related to mental health. The purpose of sharing all of this is to communicate the models at the core of my practice, as well as to provide education. I hope this will help to minimize some of the power imbalances related to my profession. The articles on this blog should not be considered as professional advice for any one person or group of people. If you have any questions about the appropriateness of this content for you, please contact a qualified mental health professional.

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