Fat Women’s Experiences in Therapy: “You Can’t See Beyond…Unless I Share It with You”

Abstract

This article reports the results of a qualitative exploration of fat women’s experiences with weight-related microaggressions in psychotherapy. We conducted semi-structured interviews with 15 women about their weight-related experiences as therapy clients and asked for their advice to therapists who work with fat women. We used a general inductive approach to code the data into themes and found that common microaggressions included therapists who overly focused on weight, therapists who appeared to be less interested in clients because of their weight, and dissatisfaction with waiting room seating options. Participants advised therapists to allow their clients to initiate conversations about weight. Results suggest the need for increased awareness of: (a) how clients’ weight may impact therapists’ attitudes and choice of interventions and (b) how weight might influence fat clients’ in-session presentations.     

Kant: constitutivism as capacities-first philosophy

Over the last two decades, Kant’s name has become closely associated with the “constitutivist” program within metaethics.¹1 The association of Kant and constitutivism is due above all to the work of Korsgaard – see for example Korsgaard (1996 Korsgaard, Christine. 1996. The Sources of Normativity. Cambridge: Cambridge University Press.[Crossref] , [Google Scholar], 2008 Korsgaard, Christine. 2008. The Constitution of Agency: Essays on Practical Reason and Moral Psychology. Oxford: Oxford University Press.[Crossref] , [Google Scholar], 2009 Korsgaard, Christine. 2009. Self-Constitution: Agency, Identity, and Integrity. Oxford: Oxford University Press.[Crossref] , [Google Scholar]). A close second in significance in this regard is Velleman (2000 Velleman, David. 2000. The Possibility of Practical Reason. Oxford: Clarendon Press. [Google Scholar], 2009 Velleman, David. 2009. How We Get Along. Cambridge: Cambridge University Press.[Crossref] , [Google Scholar]). For some of the other (Kantian and anti-Kantian) variants on the constitutivist idea, see Foot (2003 Foot, Philippa. 2003. Natural Goodness. Oxford: Oxford University Press. [Google Scholar]), O'Neill (1989 O’Neill, Onora. 1989. Constructions of Reason. Cambridge: Cambridge University Press. [Google Scholar]), Thomson (2008 Thomson, J. J. 2008. Normativity. New York: Open Court. [Google Scholar]), Thompson (2008 Thompson, Michael. 2008. Life and Action: Elementary Structures of Practice and Practical Thought. Cambridge: Harvard University Press.[Crossref] , [Google Scholar]), Smith (2012 Smith, Michael. 2012. “Agents and Patients, or: What We Learn About Reasons for Action by Reflecting on Our Choices in Process-of-Thought Cases.” Proceedings of the Aristotelian Society 112 (3): 309–331. doi: 10.1111/j.1467-9264.2012.00337.x[Crossref] , [Google Scholar], 2013 Smith, Michael. 2013. “A Constitutivist Theory of Reasons: Its Promise and Parts.” LEAP: Law, Ethics, and Philosophy 1: 9–30. [Google Scholar]), James (2012 James, Aaron. 2012. “Constructing Protagorean Objectivity.” In Constructivism in Practical Philosophy, edited by J. Lenman, and Y. Shemmer, 60–80. Oxford: Oxford University Press.[Crossref] , [Google Scholar]), Walden (2012 Walden, Kenny. 2012. “Laws of Nature, Laws of Freedom, and the Social Construction of Normativity.” Oxford Studies in Metaethics 7: 37–79. doi: 10.1093/acprof:oso/9780199653492.003.0002[Crossref] , [Google Scholar]), Katsafanas (2013 Katsafanas, Paul. 2013. Agency and the Foundations of Ethics: Nietzschean Constitutivism. Oxford: Oxford University Press.[Crossref] , [Google Scholar]), Setiya (2013 Setiya, Kieran. 2013. Knowing Right from Wrong. Oxford: Oxford University Press. [Google Scholar]), and Lavin (forthcoming Lavin, Doug. forthcoming. “Pluralism about Agency”. [Google Scholar]). But is Kant best read as pursuing a constitutivist approach to meta-normative questions? And if so, in what sense?²2 I’ve discussed this question previously (with a contemporary focus) in Schafer (2015a Schafer, Karl. 2015a. “Realism and Constructivism in Kantian Metaethics 1.” Philosophy Compass 10: 690–701. doi: 10.1111/phc3.12253[Crossref], [Web of Science ®] , [Google Scholar], 2015b Schafer, Karl. 2015b. “Realism and Constructivism in Kantian Metaethics 2.” Philosophy Compass 10: 702–713. doi: 10.1111/phc3.12252[Crossref], [Web of Science ®] , [Google Scholar], 2018a Schafer, Karl. 2018a. “Constitutivism About Reasons: Autonomy and Understanding.” In The Many Moral Rationalisms, edited by K. Jones, and F. Schroeter, 70–90. Oxford: Oxford University Press. [Google Scholar]). See also the discussion of Sensen (2013 Sensen, Oliver. 2013. “Kant’s Constructisivm.” In Constructivism in Ethics, edited by Carla Bagnoli, 63–81. Cambridge: Cambridge University Press.[Crossref] , [Google Scholar]), which arrives at a somewhat similar conclusion, albeit in a different systematic context. In this essay, I argue that we can best answer these questions by considering them in the context of how Kant understands the proper methodology for philosophy in general. The result of this investigation will be that, while Kant can indeed be read as a sort of constitutivist, his constitutivism is ultimately one instance of a more general approach to philosophy, which treats as fundamental our basic, self-conscious rational capacities. Thus, to truly understand why and how Kant is a constitutivist, we need to consider this question within the context of his more fundamental commitment to “capacities-first philosophy”.