Greetings! It is with great pleasure that I write this blog post on a topic that is near and dear to my heart: People of Color, eating disorders, and counseling/psychotherapy. Identifying a starting point, to no surprise, is challenging because individual lives are so complex. Human experience unfolds in a vast array of cultural milieus that determine our strengths, needs, and vulnerabilities. And, well, before I attempt to push the needle, however small, on the matter, an introduction is in order. I am Dr. Marvice Marcus, and I work as a licensed psychologist in North Carolina. Originally from Las Vegas, NV, I am employed full-time at a private institution of higher learning. Working with and learning from students is awesome! Colleges and universities contemporize me in a way that is rich and dynamic, only adding to a sense of nostalgia and fondness that immediately comes to mind when I think about my coming of age in school.

It is a privilege, no doubt, to serve as psychologist in our rapidly changing society. The distribution of wealth, food insecurity, sociopolitical strife, and interpersonal violence impacts us in ways that are seen and unseen, material and immaterial. All of us need help, and dare I say each other. As such, perhaps a rallying point is one of compassion. A kind of compassion that is not blind to the social conditions that contribute to eating disorders, for example. Rather, a kind of compassion that allows for curiosity and criticality as we seek to better understand people, especially those constructed as “different” or “other.” Too often, we are left to combat the callous disregard for people and accountability. So much work must be done, so much healing and restoration. Toward these ends, I hold People of Color in mind because of the ubiquitous factors—social and systemic—that constitute poor mental health outcomes. As both a public servant and Black man, I find the topic sobering.

The enterprise of counseling/psychotherapy equips mental health professionals with a vehicle to forge connection. Sometimes this is easy and welcomed. However, there are times when even glib connection requires patience and a semblance of sincerity. Rest assured the innumerable intersections of identity require disciplined attention and care. So much makes up the therapeutic alliance, including a skilled expression of empathy. How does one, moreover, truly reach an individual whose relationship with themselves has been compromised in a way that begets overeating, restricting, deliberate vomiting, or unhealthy use of laxatives? Dysphoria, extreme perfectionism and control, and internal restlessness are just a few quintessential symptoms that typically manifest in eating disorders treatment. Without question, the way in which these symptoms come to existence is unique and socially determined. The pluralities of presentations are intriguing and ultimately entail ongoing learning of technical material. Simply, an ethical therapist understands, develops, and commits to an andragogical practice that integrates matters of identity and culture into their work. The notion of “I” is cultural along with the meaning of my body and how “I” relate to myself. A logical nexus between eating disorders and mental health services, then, is race given its powerful existence as a determinant of human experience.

As a Co-Chair of the African American Eating Disorders Professionals subcommittee,
I task myself with being a responsible steward of high-quality, racially sensitive care. A component of humane stewardship requires me to acknowledge my humanity in relation to those I sit across from on a daily basis. Careful analysis of person-in-environment subject matter is relevant to eating disorders work and thus race, among other identity variables, often lay dormant in the wake of seemingly intractable conditions. Delving into the depths of how a Latinx man, for example, makes sense of his desire to increase muscularity is one of human potential, if said examination covers the contours of identity. Ostensibly benign and complicated factors should be on the table. During our time together, it is plausible that both the Latinx man and I will become energized by the endeavor. Sadness and anger will likely loom ahead, as well as a cascade of other feelings. I present this example for many reasons. First, I want to underscore the significance of curiosity and highlight its effectiveness in bridging connection if used in a timely manner. Expressing curiosity to grasp the intricacies of identity will conceivably elicit defense, particularly in cross-racial dyads. Might this be a seductive element of eating disorders? Maladaptive behaviors frequently distract us from connecting with each other. Second, my contention is that identity facets are replete with history and cultural nuance, both of which are capable of moving us beyond constraining behavioral analyses. Inordinate focus on symptom reduction is limiting and results in decontextualized and “racially-numb” intervention.

I see the subcommittee as a space wherein a diverse segment of therapists and allied professionals come together to discuss their lived experience, clinical expertise, and ideas for positive social change. The subcommittee, to me, presents an avenue for instruction and experiential learning—one that promotes deeper honesty and reflexivity as it pertains to personal biases, cultural blindspots, and insensitivities. I imagine us holding each other accountable. This entails us highlighting each other’s strengths and areas of growth, as rigorous accountability ensures a proper dialectic between exercising the “art” and “science” of psychotherapy. Dissemination of knowledges (purposely plural) is likewise imperative, because People of Color and other subgroups considered “diverse” are not monolithic in disadvantage, worldview, cultural practices, and resiliencies. I am excited at the prospect of returning to ground zero, so to speak, in earnestly discussing the relational aspects of the therapeutic dyad. Inherent in said conversations is an ongoing acknowledgment that identity is in constant flux, even when someone becomes alienated from themselves due to an eating disorder. As such, remaining interested in a person and what makes them socially unique decreases the inherent chasm that sometimes persists in an affair that is both private and public: Identity formation.

Bio:  Marvice Marcus, PhD has the great fortune of serving as a Staff Psychologist and member of the administrative team at Duke University. He earned his Ph.D. in Counseling Psychology from Washington State University, and completed a predoctoral internship at Duke University CAPS. He primarily worked in university mental health, spanning three regions of the United States and views clinical work as both a place of refuge for clients and an avenue for activism. Dr. Marcus enjoys working with students who present with concerns related to adjustment, mood and anxiety disorders, social and familial conflict, and identity development (e.g., racial, sexual and gender expression). His approach to therapy is integrative, mostly composed of interpersonal/relational interventions, emotional-focused strategies, and behavioral elements. He is especially interested in developing ways to effectively use cultural studies to contextualize human suffering, as well as to elucidate the underpinnings of thought processes and behavior.

Other professional interests include men and masculinities, race and gender politics, and issues of diversity, inclusion and mattering in institutions of higher education. Contact: 919.660.1000/Email: marvice.marcus@duke.edu

*The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders and not intended as endorsement by iaedp Foundation, Inc. or its Board of Directors.*

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