The student is encouraged to select from the group someone with whom he will be comfortable, and to pair up with him for counseling experience. While one member of the pair becomes a client and talks out some problem, often a minor one, the other member of the pair is counselor. They may at another time reverse the situation, or a student may choose to be a client with one fellow student, a counselor with another. Recording equipment is available so that these interviews can be recorded, listened to, and discussed. BMI measures physical appearance, not health, yet the term obesity is used to pathologize bodies. When the American Medical Association declared obesity a disease, it overrode a recommendation by its own expert panel, which had found that correlations between obesity and morbidity and mortality rates established no causality. The panel expressed concern that medicalizing obesity would lead to further stigmatization and unnecessary treatments. Using the word obesity is dehumanizing, yet it's so normalized that few people notice. Most fat people can't even name how it bothers them because the health narrative it's couched in makes it acceptable. It can be easy to forget that the word obesity is a reminder that the world pathologizes fat bodies and polices all of us. Shaming also comes in the form of other health messaging, like signs proclaiming Your health is up to you! What's wrong with that? It assumes a level of privilege and control most of us lack. Few individuals control major factors that influence our health, like genetics, neighborhood, socioeconomic status, access to health care, education, or social supports. I'm missing out on watching my son grow up. He's my whole life! James acknowledged that social media is another arena in which he compares himself to other men like himself. Being on social media is so self-destructive for me. I always end up feeling worse after logging on. The truth is, so many of my friends post pictures of their families, their girlfriends, and their cool trips.

Since my breakup, finances have been tight, and I haven't traveled much. I spend less time with my son because of shared custody. I feel awful about myself when I see all the other dads with their kids, wives, or girlfriends. I'm tired of always feeling that everyone has it so much better than me and that something is missing from my life. Even when this counseling remains at a superficial level it is a most useful experience because it gives the student the opportunity to learn, in the discussion after the interview, how he is experienced when he is endeavoring to be a therapist. Sometimes both members of the pair are willing to have a third person present as observer, and in this instance the counselor is able to learn how his functioning seems to a neutral party. Since all the comments and reactions can be understood even more deeply by listening to the recording, the relationship is indeed viewed under a complex type of social microscope. As might be expected, such mutual counseling frequently goes beyond a superficial level. One member or the other may feel enough confidence in the relationship to use it for personal therapy, sometimes at a deep level. Here the student who is functioning as counselor can carry on with comfort, since it has been understood in advance that either the client or the counselor may withdraw from the situation if he finds that he is uncomfortable. Thus if the student-counselor finds that the student-client is going beyond what he feels competent to handle, he may transfer his client to one of the staff counselors. Often, however, he carries through, thus obtaining his first complete experience of therapeutic responsibility. The supervision of the counseling in these student pairs constitutes an important part of the practicum experience. What is involved in the supervision depends upon the needs and desires of the individual. Nor can we prevent our exposure to health-threatening trauma such as abuse, racism, or stigma. GETTING HELP There are numerous tools you can utilize to help combat the effects of shame, but few are as effective as saying it out loud. In some situations, it may be safer to reveal your shame to a paid professional than a friend. In addition to the chance to understand yourself better through therapy, the simple act of revealing hard truths about yourself to someone and then see them stick with you can help you tolerate and accept yourself. Support groups, especially if committed to confidentiality, can also be valuable.

The internet may provide anonymous support, as can a hotline. If you are stuck in the I am bad mindset, there are resources out there to help alleviate your discomfort. Of course, there are many potential practical barriers to accessing resources like these, including cost, lack of insurance, limited time, the difficulty of missing work, inconvenient locations, limited clinic hours, transportation challenges, and child care difficulties, to name a few. Go easy on yourself if you have trouble accessing help. I literally feel like I'm broken inside. Not only do sites like Facearticle and Instagram provide us with an endless supply of social-comparison opportunities, but we can also access them anytime and anywhere, making our natural drive to compare ourselves to others hard to keep at bay. Social comparisons that take place online are unique in the sense that they almost exclusively evoke upward comparison--those comparisons with others who are seemingly doing better than us. Rarely does someone post about what went wrong on their vacation or about the family fight that broke out right before that perfect holiday family picture. The idyllic representations of others can naturally give us the feeling that something is wrong with our own lives, triggering emotions such as fear of missing out (FOMO), shame, and self-doubt. Over time, in our sessions together, it became clear that James's compulsive upward social comparisons were feeding his vulnerability to envy others. Envy, a By-Product of Upward Comparisons Envy is a normal human emotion. We feel envious when we want what another person has, like fame, fortune, or power. Envy is different from jealousy; In some instances the student-counselor may feel concerned about various aspects of what he is doing, and the relationship with the instructor is essentially a therapeutic one, in which he talks out his concerns and reorients his attitudes toward the task. At a later time, or with another student who feels more secure, the instructor may raise questions to bring crucial issues to light, or may tell how other counselors have handled certain situations, in order to broaden the scope of the student's thinking. In some instances the student may want to have specific criticisms, and if so, the instructor analyzes the interview critically, from his own point of view. The general aim of the supervision is to respect the degree of confidence and skill which exists at this point in the student, to help him clarify his own attitudes, to help him see other ways of thinking and doing, provided that all these helps still leave him free to do as he feels is right. Multiple Therapy. Within the past year, to further enrich the practicum experience, we have been experimenting with multiple therapy as it has been developed by Whitaker and Warkentin (220.

Haigh and Kell (77) have described the use which has been made of it in our own Center. We regard the development of this new procedure, and its adaptation to the training function by Whitaker and his colleagues, as one of the most important social inventions of recent years in this field. Without attempting a discussion of multiple therapy, it may be said that it is the discovery that if two or even more than two therapists begin with the client, the relationship is formed to both of them, and therapy proceeds just as meaningfully as it would with one therapist, though perhaps a little differently. With some clients it may even facilitate therapy. There are so many economic and practical challenges that the act of seeking help can sometimes feel like yet another burden. BRINGING IT HOME Experiencing shame is part of being human and thus unavoidable. Please show some compassion for yourself when you experience shame. While you may not be able to make it go away, you can develop the resilience to recognize it, move through it constructively, and grow from your experiences. One of the most powerful potential antidotes to shame is speaking it. Making yourself vulnerable and showing your authentic self allows you to sit with it and lessen its power over you. When we reach out to others, we can find that we are not alone. We can be met with the empathy that helps us tolerate our shame. We can also find the love and connection we need to survive amid unfairness. Envious feelings aren't only triggered by material possessions. We can also envy people in our community and social circle and even family members who are admired, influential, and successful. We all know how bad it feels when we're envious of someone else. Sometimes our envious feelings manifest as hostility or anger. At other times our envious feelings manifest as shame and inferiority. Most people work hard to hide their envious feelings, especially from the very people they envy.

Envy has long been of interest and regarded as an important emotion in psychoanalytic theory and practice. Melanie Klein, a psychoanalyst from the early twentieth century who was influenced by the work of Sigmund Freud, wrote about envy and its potentially destructive consequences. Klein believed envy to be an innate or biological expression of destructive impulses, meaning it is present from birth, and that it has a constitutional basis. In addition to seeing envy as the product of angry feelings from what another person possesses and enjoys, Klein also believed that envious feelings are sometimes accompanied by an impulse to take away or spoil whatever it is one envies. From the point of view of our immediate interest in training, however, it means that two therapists have lived through, emotionally, the same therapeutic relationship. The discussions of the process in the client and of the feelings that each therapist has toward the functioning of the other, have a vividness and reality achievable in no other way. The specific manner in which we are using multiple therapy in the practicum training involves every student in two ways. Each student is given the opportunity to become a co-therapist with an experienced staff member in handling a client. The client is one of the other students in the group. The student who is co-therapist in this experience is given the opportunity to be a client in another multiple therapy relationship, and the client in this first trio is given the opportunity to become a co-therapist in another relationship. Thus each student may act as co-therapist in one situation with a staff member, and as client in another situation, in a relationship with a staff member and a fellow-student as co-therapists. This arrangement has an astonishing number of advantages. The student can begin to function as therapist earlier, because the staff member can carry the major burden of therapy, with the student entering in only to the degree that he feels comfortable and confident. The student can gradually feel the responsibility for the delicate handling of a real life -- a responsibility more keenly felt because this is a fellow-student, and because, as client in another relationship, he experiences the importance of that delicate handling in himself. That kind of vulnerability is hard, though--and complicated. If we share our shame in the wrong context, it can get exacerbated. That is why we need to exercise care in cultivating relationships, protecting ourselves as we go--enough of an imperative to merit an entire article on vulnerability. Keep reading. I refer to people with penises rather than men to include trans women who may have penises. This term is a great example of how social normativity feeds our language and customs, in this case legitimizing couples as the norm.