Publication Date


Document Type

Masters Thesis


School for Social Work


Psychotherapists-Attitudes, Intersubjectivity, Obesity-Psychological aspects, Overweight persons-Counseling of, Prejudices, Psychotherapist and patient, Countertransference (Psychology), Fat, Overweight, Obese, Oppression, Discrimination, Bias, Intersubjective, Culture, Clinical attitudes, Social work practice, Visible difference, Terminology


This qualitative study was designed with flexible research methods to explore experiences of clinical social workers in sitting with and developing relationships with fat clients. Using an intersubjective theoretical lens, this research investigates clinicians' countertransference or beliefs about fatness in the relationship building process with fat clients. An analysis of the literature revealed multiple meanings for fat, complex dynamics in therapeutic relationships and potential parallels between some racial oppressions and fat oppression using the concept of visible difference. This exploratory study presents findings based on nine semi-structured interviews with clinical social workers who see fat clients. Participants were asked about their relationship to their own bodies, their countertransference experiences with their fat clients and about the relationship building process with their fat clients. Findings show that clinicians do harbor biases and judgments about fat clients. This research points to the fact that social work clinicians may benefit from more cultural competence training around their work with fat clients. Other findings include a clearer understanding of how bodies—both clinicians' and fat clients'—enter and occupy the therapeutic space; as well as a greater awareness of the role that terminology and language around size plays within relationship building between client and clinician. Through increased attention to bodies in the room, attending to language that we use around fatness and acknowledging bias and judgments leveled against fat people, the hope is that the profession can bring size oppression out of the shadows, where it has been rendered invisible, and make it visible.




v, 89 p. Thesis (M.S.W.)--Smith College School for Social Work, Northampton, Mass., 2009. Includes bibliographical references (p. 80-84)