Radical Psychology
Volume Eight, Issue 1

Relational consequences of dietitians' feeding bodily difference

Jacqui R. Gingras and Jennifer L. Brady [*]

Relational-cultural theory (RCT) proposes that relationships are central to healing and growth (Miller and Stiver, 1997). Relational cultural theorists describe the three characteristics of growth-fostering relationships as mutual engagement (defined by mutual involvement and commitment to relationship), authenticity (the process of feeling free and genuine in relationship), and empowerment or zest (the feeling of personal strength and the inspiration to take action in relationship) (Nakash, Williams, and Jordan, 2004). Mutuality, authenticity, and empowerment present in a therapeutic context role model what is possible in relationships outside of therapy.

Within growth-fostering relationships, authentic interactions can lead to experiences of connection and disconnection. All relationships will experience disconnections periodically, but it is the manner in which these disconnections are negotiated that influences the relational outcome. That relationships are central to movement in therapy is not a particularly radical view. What we do contend is that the relationships dietitians have with their own bodies and the bodies of those who seek their services are constituted and constrained by a control discourse, which marginalizes bodily difference. Control discourse constitutes individuals’ eating patterns as a series of reasoned, discrete, and quantifiable choices (i. e. weigh, measure, limit, and avoid) in direct contrast to views that eating is determined by emotion, hunger, appetite, and sociality.

Instruments of nutrition science (body weight, body mass index, and hip-to-waist circumference ratio as three common examples) are used to define the marginalized Other’s body as too fat or too thin and justify its need for nutrition management in the name of individual and public health. Concomitantly, dietitians’ worth as professionals is signified by their cognitive and embodied mastery of these instruments.  For the dietitian, to be Other signifies her moral and professional failings to relinquish her innate hungers in favour of control discourse. This discourse inherently delimits possibilities for authenticity and connection in dietitians’ relationships with theirs and Others’ bodies. It is an ethical imperative to make visible this route to bodily difference that has dramatic potential to exacerbate feelings of body shame and hatred.

We evoke a wisdom discourse that subverts the isolation and disconnection inherent in control discourse. In this paper, we share the findings of research into the suitability of relational-cultural theory to call forth a wisdom discourse in nutrition counselling. It is our intention to demonstrate the relational possibilities that may exist for our profession and our professional practice. We explore the tensions that dietitians may experience as students and practitioners when their professional beings are constituted by control discourse. Using recent data collected during an exploration of relational-cultural approaches to nutrition counselling, we illustrate how control and wisdom discourses serve to position the concerns of those seeking dietetic services.

Dietetics’ Professional Bodies

In North America today, the dietetics profession is dominated by a discourse of bodily self control that denies the importance of the socio-economic context in shaping dietitians’ clinical work and experiences of their own bodies as well as the eating habits and choices of individuals they serve. Dietitians’ formal initiation to this control discourse begins during their studentship in undergraduate nutrition education. Austin (1999a; 1999b) describes this discourse as that which enables the diet food industry its promotional shrewdness since dietitians willingly use the control imperative to promote the food industry’s low-fat and diet food products. According to Travers (1995), the control discourse perpetuates nutritional inequities by placing responsibility for food choices solely on individuals. This frequently reinforces economic, racial, educational, cultural, and body size divides between those in the profession and clients who seek support with food and weight concerns. What their training does not prepare dietitians for, however, is the inherent emotional and political nature of their food work. Dietitians’ bodies as well as the possibilities for the ways in which dietitians may relate to others are confined by the scripts of nutrition science that grant them their status as professionals.

DeVault (1999) contends that, through professionalization dietitians become enamored and armored with the “promises of professionalism;” the view that with newfound knowledge and authority, dietitians can make a difference in the nutritional lives of others. “Inadequate [health care professional] preparation could lead to disrupted expectations or even ongoing cognitive dissonance regarding practice situations” (Sprang, Clark, and Whitt-Woosley, 2007, p. 274-275). These disturbances can have detrimental effects on dietitians, but tend to be felt most acutely as burnout, a phenomenon currently under exploration by the authors.

Dietitians’ professional role typically has been that of a weight manager, working to reduce differences among people’s body weights. The dietitian relies on “clients’” compliance with dietary advice to recast bodies that fit within a narrow range of possibilities. Given the extraordinary will of the body to resist such manipulations, weight change is not a given. Yet, dietitians may continue to expect compliance and promote the virtues of restraint, determination, and denial in the ongoing efforts to promote “healthy weights. ”  Thus, a disconnect is borne between dietitian and others. Out of “good dietetic practice” emerges a major empathic rupture.

In a promotional flyer created by the Dairy Farmers of Canada and Dietitians of Canada appearing in the Canadian Journal of Dietetic Practice and Research in the summer of 2005, “good dietetic practice” is demonstrated by an image of a dietitian balancing on one end of a teeter-totter while opposite an array of appropriately healthful foods holds her suspended in perfect and harmonious balance. The image is noteworthy as a vivid illustration of this control discourse and for what it suggests about dietitian identity. The accompanying text reads “Registered dietitians are an essential part of a balanced eating plan . . . just like the four food groups” and in small print, “You can trust Registered Dietitians to give you good advice on nutrition. Their university training has given them the technical knowledge needed to master this most complex science. ” Of note, permission for the image to appear in this article was denied.

What is most compelling about this image in the particular context of this paper, is the “coercive appeal to the authoritative status of (a biased) science…[which] seeds insecurity by casting suspicion on the value of existing forms of women’s nutritional know-how” (Aphramor and Gingras, 2009). Additionally, the dietitian’s identity is constituted as distant and removed from food. The dietitian’s own weight is a measure of her credibility. The image implies everything in moderation and eat a variety of foods, but don’t tip the balance. The image normalizes an already rampant distrust of hunger, appetite, and desire. These contradictory yet, ubiquitous nutrition messages (everything in moderation, eat a variety of foods, and maintain balance) are evidence of the ways in which the dietetic profession manifests a paradoxical reliance on bodily distrust.

This manifestation, a long-standing tradition within the profession, stands in radical relief to what we support as a move into relational connection. We believe that a renegotiation of what counts as dietetic knowledge is required. We contend that standing at a scientized arms-length from food escalates food and body dread and this can’t help but have very real and gendered penalties for those who engage in the work needed to eat (Aphramor and Gingras, 2009).

Coming to Know and Be Known as Dietitian

As students are formally educated “into established paradigms, gain competencies associated with the field, and become practitioners of a craft with its own canons and traditions” (DeVault, 1999, p. 168), they grapple with their own identities and how those identities are reconciled or not with becoming a professional (Clouder, 2003; Wilson, 2001). Students experience a self-alienation and a transformation in their relationships with their bodies, with food, and with family/friends as they become versed in the control discourse of science of nutrition and professional dietetics (Atkins and Gingras, 2009).  With the marked emphasis on a science that sanctions a narrow range of healthy foods and weights coupled with the demands of a highly competitive program and career, trust of self and Others begins to slowly erode until finally, distrust becomes the norm. As the dominant nutrition discourse does not allow space for critical appraisal, students carry their wounds silently and invisibly, still intending to fulfill the promises of professionalism. Becoming a professional promises authority and legitimacy, but only if the professional body fits into the weight ideal quantified by the instruments of nutrition science and reified in the poster described above.

As authors of this paper, we know intimately the wounds associated with coming to know and be known as dietitian. We know that in order to be seen, we must conform, we must hold our bodies in abeyance, and remain a little bit hungry. In the name of learning to be dietitians, we have had our bodies callipered, our intakes codified, and our tongues tied. We have made deliberate choices about what to eat in whose company as some foods were deemed unacceptable and humiliating to consume with our colleagues and professors. We have obediently re-enacted scripts written in the language of control discourse to excuse any perceived inappropriateness in satisfying our hunger. We have sought to achieve extraordinary academic and personal standards in order to be granted coveted internship positions at the end of our undergraduate education; positions that will enable us to secure our “registered” status, authenticate our expertise, and validate our efforts. What this competition holds for us are the wounds of exclusion, wounds that take a long time (if ever) to heal. In all, we learn disconnection, negative social esteem, and inauthentic interactions. We experience relational paradoxes such that the connection we desire is made unavailable if we risk being authentic. As we contemplate entering practice, we learn what it means not to care.

Methods - Relational Inquiry in Nutrition Counselling

To date, there has been no inquiry regarding relational-cultural approaches to nutrition counselling. During eight months (January to April 2007 and September to December 2007), I (JG) engaged in nutrition counselling with students seeking support regarding their eating and weight concerns. This service was provided to students referred from Student Counselling and Health Services at a mid-sized urban university. Students were also invited to participate in the research and 50% of students (8/16) elected to have their sessions audio-taped for the purposes of evaluating the effectiveness of a relational-cultural approach to nutrition counselling. Of those who participated, a purposive sample of three women was included for analysis given the range of issues raised in these women’s sessions and the backgrounds of the participants. The following elaborates on the findings of this study and the implications for how dietitians engage with others on matters related to food, eating, and body weight concerns.

The three female participants were all current students at the university. Their average age was 21 years. They self-identified as white women from upper-middle class family backgrounds. One had been previously admitted to an eating disorders clinic and was currently seeking “maintenance” support for her eating. The other two had never before sought support from a dietitian and were doing so at this time to address their concerns about “non-healthy attempts to lose weight.” Two also had established relationships with a counsellor at the university and one had no other sources of allied health care support. All participants were provided with pseudonyms.

Participants provided consent to have their sessions audio-taped, transcribed, and analyzed using a constant comparative method. NVIVO 7. 0 (QSR International) was used to organize the transcriptions for analysis. This study was approved by the university’s ethics review board.

Results - The Relational Possibilities for Dietetics

The three emergent themes of trust, relationship with food, and control were the primary findings of our inquiry. The themes were inter-related and reciprocally shape each student’s experience as well as the relational encounter with JG.

Trust

Resonating throughout women’s narratives is their increasing sense of disconnection from friends, partners, parents, and other family members. Moments of trauma imposed by dietitians and other health care staff punctuate their stories as they remember having their social-worth measured up by the size and shape of their bodies. Their narratives recount an underlying lesson; distrust in their bodies means not measuring up, it means being Othered, and it means having to “take the consequences” incumbent upon having a body that is different.

Melanie shares an account of the relational disconnection from her mother and dietitians who were concerned about her weight:

I was a very overweight child and I got up to a very high weight of about 200 pounds to the point where I did have to go see dietitians. That started I guess, like, the diet mentality. Reflecting back now I'm a believer that eating disorders stem from dieting and that’s just the way that I see it. … so they would suggest and kind of put into my mind you know, “No eating after 8 o'clock, eat on a smaller plate to restrict your meal size, have smaller more frequent meals throughout the day. ” Then ‘cause my mom felt like she was overweight, the dietitian encouraged that we do this together, make it a mother-daughter thing and that would help the process of us doing, of me, losing the weight. . . there was encouragement of the food guide but, it was more of those kind of, the wives tales sort of things. . . It got to the point where there was no junk food in our house and if I was hungry,…I would go stand in front of the fridge and if I was you know, indecisive about something that I'd want, she would say to me, “Well, if you don't know what you want then obviously you're not hungry” and tell me things like that. And to this day she’ll still say things like that. Very very heart-breaking.

Rachel reveals the social import of losing weight and sacrificing her body’s needs in the following exchange:

JG: How has that experience with Ben [Rachel’s boyfriend] over the last week, how has that translated into your eating and your body consciousness?

Rachel: Um, I notice it more I think, like what we talked about last week, putting the words like you know?  Associating them with when you’re starting to eat and stuff. Definitely like rejection is like huge and I’ve been eating. I just get this urge to just eat all the time and then it’s countered by, “No, I gotta lose weight to look good” cause like, prove him wrong you know?  But definitely yeah, I’ve been, I’ve been thrown off and I’ve been eating really bad.

Relationships with Food

The anguish of being Othered triggers the women’s attempts to reshape and control their bodies. A relational paradox ensues for these women whereby maintaining access to their relationships means disconnecting from their bodies’ knowledge and denying insistent hungers. The lesson is quickly learned; controlling bodies and rejecting desire for physical nourishment affords access to relationships. This lesson resounds in Melanie’s retelling of her response to being Othered:

I guess I was around 170 pounds and I became very very sick, I got the stomach flu for a week and when I started losing all this weight all, all I got was positive comments that I looked really good, and “If only you could just keep going, look how good you look, look how much better you look than what you did before” and all these positive comments just kept feeding and feeding into me…and then I became really really sick one week. . . 5 pounds went in that one week because I was sick because I didn’t eat and because I was throwing up all week. As soon as that happened I was like “Whoa, that worked”. . . in February, I went from 170, 160 to the end of June I was down to 125 and it went right off of me, and the thing that upset me the most was my mum knew what was going on but she didn’t say anything. . . I know what I was doing was so wrong but everyone was like “Oh! Mel, you look so awesome. ”

Julianne speaks of her growing self-doubt and disengagement from food as her body changes with her new role as a full-time university student living away from home for the first time:

I’m usually hungry all morning so I was thinking about where I was on the [hunger meter] scale, and I usually wake up hungry and have breakfast and then a couple hours later I am hungry again and then um, so I was kind of rating that on the hunger meter and then, I found it harder to judge after I had eaten than before I had eaten cause after I had eaten it was kinda more of a grey area about how full I was. . . like in the afternoon and night when I am less hungry it’s harder for me to figure out when to eat [scoffs] cause I am not like ravished like I am in the morning so… and I still usually eat by the time but I am really trying not to though so…I am trying to eat when I am hungry.

Rachel shares similar feelings of self-doubt and denial of her innate cues to nourish her body:
 
I wanna lose weight obviously and so I feel like I am kinda at a stand still where I haven’t been able to lose weight; not that any attempts have been like, really serious but I was using bad methods like I’ve tried laxatives and like, and like bulimia and stuff. So like obviously that, like I mentally know what that, I was doing to my body but, I don’t know. You, like always just you know like I always thought that I was smarter than that but it just felt almost like, like, hopeless, like, I don’t, you know?

Having learned that their bodies and appetites are unreliable and untrustworthy, Rachel’s connection and ability to respond to her natural hunger cues is diminished:

I don't trust myself, like totally which is like a huge part of it I think. . . cause I can't be trusted to do like do the right thing when it comes to like food you know like eat right, or you know exercise. . . I couldn’t trust myself to go and work out or eat just the right things so it was like I could eat the bad things that somehow I want to eat.

This lack of trust to nourish their own bodies extends to other aspects of the women’s lives including their relationships.

Rachel: And so in my email [to Ben] I even said “I don’t want to be that person who is demanding you change or be something else. I don't, I don't think anybody should change for somebody else so,… if I don’t inspire you to be that way then we shouldn’t be together. ” So I guess, I just never asked for things for me. I guess I was just like “If that is who you are and you can’t be the way that I am then that’s fine then well just go our separate ways. ”

JG: Do you fee like you need to ask more directly?

Rachel: I feel like if I demand things, from especially men that they'll just leave or get tired of it.

JG: So that’s a relational image, that’s a very clear relational image, a very important one, a very significant one and the reason why I stop and point it out is it can, it can say a lot about trust and about assertion. Asserting your needs, even if you're just doing it to yourself saying this is what I need right now. I need to go out for Chinese food with my best friend and I need to just eat and talk.

Melanie likewise reveals her sense of lost connection with her body and nourishing relationship with food:

JG: What kind of relationship do you want to have with yourself with food?

Melanie: A good one.

JG: So what would a good relationship look like?

Melanie: I don’t know cause. … I don't even feel like I know what normal is.

Control

Literally and figuratively, “fitting-in” requires doing the “right thing” as Rachel describes it. This means representing an inauthentic body made-over in the image of patriarchal ideals of women’s body size and shape. Appropriate body size is spoken of in terms of being thin and being perceived as healthy. To this end, connection and trust in these women’s bodies is replaced with external directives of what, when, with whom, and how much is appropriate to eat. It is throughout this process of externalizing their relationship with food and hunger that these women’s stories most notably echo the control discourse of nutritional science.

Julianne’s telling of her effort to offer support to a friend also experiencing body disconnection echoes the connection made by the tools of nutritional science between small (but not too small) body size and healthfulness:

I am probably in better shape than she is, but like, she is thinner than I am and so when she like, talks down about herself it does makes me feel bad but I am like, “No we are both healthy. ” So I tell her “No, she looks great” and stuff.

The connection Julianne makes between being healthy and being thin is further reflected in how she describes the relationship with food that she wants to have; she feels that she eats healthfully but still feels necessary to restrict herself:

Right, like I want to be healthy still, like, I am a healthy person, I think I eat healthy food and stuff but I just want it to come, like I don’t want to be obsessed with it and I don’t, I don’t wanna. . . like I find it hard to eat healthy without restricting myself. . . .

Held up by dietetics as the canon of healthy eating, Canada's Food Guide routinizes control discourse as it functions as a tool for regulation of body size and weight. It marks out categories of restraint and of sanctioned quantities and types of food; a schema that fundamentally denies hunger and desire in order to manage bodies. This language reverberates through Melanie’s self-talk after an encounter with a colleague who refuses Melanie’s offer to share some potato chips because she is on a diet.

I thought “Well, that's OK, you know, they're baked, but THEY’RE CHIPS,” which was that old side of me “But their baked, so it's gonna be OK. But they’re chips and that’s bad. But they're baked so it’s OK…”

Rachel similarly described the relationship with food she would like to have through control discourse which repudiates the emotional experience of food and eating:

I think, I just need like a coping, like a different way to look at food. . . cause I just, right now I just don’t think of it in, I want to think of it as like a fuel you know, like something I have to do to keep my body functioning, I just don’t know how to get my head there cause right now it’s like, you know emotional or like, just, it’s just not good . . .

These narratives illuminate the absence of wisdom discourse and the effects of such on these women’s relationships with food and trust in self/Other.

Relational Approaches to Acknowledging Bodily Differences

Rigid standards of “normal” that are informed by control discourse may prevent an authentic connection between dietitians and those seeking dietitians’ services. The scripts of dietetic practice, internalized through their becoming registered professionals, set out boundaries which define who the Other can reveal herself to be in this relationship. Both become actors, their bodies subjugated, performing and reinforcing the use of control discourse that place them as trusted expert and passive patient in a power-over relationship. Connection in this context is constituted by and thus, limited to the professional dietetic lexicon that denies an embodied understanding of food and eating and therein, does not acknowledge the emotional experience of this exchange. The following experience shared by Julianne demonstrates the power of these scripts to delimit the possibilities for professionals and those seeking their services to be in relation:

When I first came to university I guess ‘cause I stopped dancing and stuff ‘cause that’s like 10 hours of exercise a week, I gained like 30 pounds, or like 20 pounds, and I didn’t really know what to do about it and I was like, I have to change this and I became really depressed and it seemed like nothing worked to get me back where I was . . . in first-year and second-year I just became really obsessed, and I’d think about food all the time and so, that was basically, I was like you know obsessed and I was just trying to get rid of the obsession thing cause I know I am actually like really healthy and in first-year I um, I went to one of the nutritional, she was a nutrition student and she was like um “you eat perfectly, you’re fine” and I was like “Oh!”

The dietitian identity is validated and yet fragmented by control discourse; dietitians’ mastery of their nutrition knowledge is made visible by the degree to which their bodies conform to this script. Dietitians’ bodies are an outward manifestation of the legitimacy of their professionalism. Thus, claims to authority made by nutrition science and the extinguishing of difference are mutually-reinforcing. Questioning the authority of science to reshape dissenting bodies is to invalidate oneself as a professional and risk becoming Other; to risk being different.

The project to conform differently shaped bodies surely changes the relationship between the client and her body as well as the relationship between the client and the practitioner. Control discourse locks the relationship into old structures where the client is unable to move the practitioner. Instead, the client and the practitioner can easily perform their respective roles of professional demonstrating power-over client in the all-important body project to keep women’s (and increasingly men’s) weight and eating under control.

These familiar scripts influence the women’s relationships with JG, the dietitian, the trusted food and nutrition “expert.” The internalized role expectations and body control discourses explored above are reenacted through their conversation with JG. There appears to be significant vulnerability in how the women are in their relationship with JG, but also in how JG attempts to resist the control discourse while at the same time attempting to remain mutually empathic.

JG: What would happen if you were working from a meal plan right now?

Melanie: I think that would help. . .

JG: OK, do you want to try it? Do you have an idea from previous meal plans about what numbers have worked?

Melanie: I've never been on a meal plan before.

JG: OK, can you think of any way a meal plan might sabotage you this time?

Melanie: Yes and no, cause it may get me back to that diet sort of thinking.

JG: Yeah, yeah, it’s tricky isn’t it?

Melanie: That's why I'm just, I just don't know but in the same sort of way I need that; guidelines. I need some one to be like, “No, like you need to eat this much. ”

In inviting Melanie to consider a meal plan, JG is able to engage critically with the disembodiment that a meal plan perpetuates. Although providing meal plans has been a mainstay in the dietetics training that JG received, her experience has taught her otherwise in terms of their usefulness. This is another example of the wisdom discourse that can be made more prominent as a disruptive force in the dietitian’s efforts at reinforcing bodily difference.

Towards a Political Ideal for Dietetics

In this paper, we have made visible the ways in which control discourse constitutes dietetic practice and the implications of that discourse to engender disconnection within the dietetic practitioner and between the practitioner and those seeking the dietitian’s professional services. We claim that the root of this relationally-disconnecting practice resides in dietetic educational regimes that overemphasize technical knowledge and objective skill development (Dall'Alba, 2009). Yet, the process of “becoming” a professional tends not to be held up for critique by educators. Throughout their training students come to understand that becoming a dietitian involves disregarding bodies, emotions, and being.  In other words, students learn to negate a wisdom discourse leaving the dietetic practitioner with very little language for what s/he then experiences in practice. We offer that this has a devastating impact on dietitians and those they work with in public health, clinical, and administrative settings.

We proposed a redressing of the relational aspects of learning, teaching, and practicing dietetics. As relational-cultural theorists have illuminated elsewhere (Walker and Rosen, 2004), the culture-bound “story” of professional education is intractable from scientific objectivity. Given that trust, relationships with food, and control are subjective elements of being, the training that dietitians receive needs to engage and reflect relationality in order to prepare dietitians for the human dimensions of their practice. Dietetic educators and preceptors can not ignore the sociopolitical realities that have dietitians disappearing their bodies and the bodies of Others.

In an effort to foreground issues of embodiment, trust, and relationality, we are aware of the double bind that results. In resisting and denouncing the effect of individualism and self-reliance, we reiterate a power dichotomy typical of traditional approaches to nutrition therapy whereby the dietitian is responsible to remedy the situation. This is simply a reenactment of binary approaches to establishing trust and caring whereby rational, privileged, and autonomous individuals are responsible for heightening their trustworthiness. To negate this double bind is to consider “mutual reliance and social flesh” as new vocabularies for reducing social inequities (Beasley and Bacchi, 2007). Beasley and Bacchi (2007) challenge the assumption that caring learned in the context of an interpersonal relationship will effect wide scale transformation of all other interpersonal and social relationships since Others are not dependent on more privileged groups, but are embodied and fleshy citizens situated within complex sociopolitical contexts. That is, by bringing together the fleshy body with sociopolitics, a new vision for embodied inter/subjectivity emerges (privileging relationships as ways of knowing). Communities are groups of people with mutual needs for trust and caring that are connected to each other within the realm of social hierarchies while together possessing mutual reliance and social flesh.

How might the notion of mutual reliance and social flesh respond to the “ethos of atomistic individualism” (Beasley and Bacchi, 2007, p. 286) that is evidenced in dietetic education and practice? What can relational-cultural theory and critical feminist appraisals of the body (Gingras, 2005a) add to addressing the issues of mistrust inherent in the narratives of women struggling with food and body relationships as well as the dietitians that reinforce this mistrust? These are ethical questions for the dietetic profession; a profession that often extorts individual self-responsibility for “healthy eating” to resolve nutrition and health inequities. This approach lacks an acknowledgement of how knowledge about food and eating emerges from bodies, not simply from nutrition education brochures, food guides, or credentialed dietetic professionals.

Can dietetics consider a feminist imperative towards embodiment, not as a demeaning method to naturalize biological differences, but as a way to see bodies as expressing a vital wisdom discourse? Wisdom discourse could emerge by dietitians coming to terms with their own hungers, desires, emotions, pains, and pleasures. When dietetics can re-introduce the relational and embodied aspects of food and bodily practice and at the same time hold that fleshiness as related to social hierarchies, structures, and patterns, there exists a possibility for a new ethics of dietetic practice. This is offered as an ideal for dietetics; a “political ideal [which] is aimed at ‘a justice that is not yet here’” (Diprose as quoted in Beasley and Bacchi, 2007, p. 289).

We boldly imagine dietetic students and dietetic educators cooking and eating together as well as respecting the vulnerability in doing so. Given that cooking and eating together engages the fleshy aspects of the body, these acts hold the possibility to be highly relational. Within the sociality of these embodiments, “connection offers safety from contempt and humiliation, however it does not promise comfort,” since within growth-fostering relationships, connection and safety allow important differences to emerge of which conflict is a likely and hopefully constitutive outcome (Walker and Rosen, 2004, p. 9). All of this would require relational aptitude in contexts where being relational is not the dominant mode of being and where disconnection has become the strategy de rigueur.

Previous inquiry has illuminated the “longing for recognition” (Gingras, 2009) that exists among dietetic practitioners, which is always conferred from elsewhere (Butler, 2004). In making relationality more visible in professional discourse, we emphasize bodily trust and trust in social flesh. By holding eating and bodily functions as non-relational, we actively undermine trust. In writing across student-educator hierarchies, we, as authors, engage beyond dualism (Dunlop, 1999) and into a relational reality. This reality is spiked with relational tensions, possibilities for disconnection, and vulnerabilities, but despite those challenges we remain committed to enacting a mutual reliance on social flesh. We have experienced mutual reliance as a means for surviving the academy and we have remained relationally steadfast in this view through the tears, the searing disappointment, the broken promises, and the mundane violence. Thus, our writing exists as a political intervention, a collaboration of bodies, women’s bodies, intellects, curiosities, hungers, and differences. This collaboration acknowledges our bodily differences, accepts our lived contradictions, embraces fleshy wisdom and reconstitutes what is possible for dietetics.

Acknowledgements

We are grateful to the women who shared of their lives as an act of trust for the purposes of mutual understanding, healing, and growth.


 References


Aphramor, L., and Gingras, J. R. (2009). That remains to be seen: Disappeared feminist discourses on fat in dietetic theory and practice. In E. D. Rothblum and S. Solovay (Eds.), The fat studies reader. New York: New York University Press.

Atkins, J., and Gingras, J. R. (2009). Coming and going: Exploring first and final year nutrition students’ experience of their education. Canadian Journal of Dietetic Practice and Research.

Austin, S. B. (1999a). Commodity knowledge in consumer culture. In J. Sobal and D. Maurer (Eds.), Weighty issues: Fatness and thinness as social problems. (pp. 159-181). New York: Walter de Gruyter.

Austin, S. B. (1999b). Fat, loathing, and public health: The complicity of science in a culture of disordered eating. Culture, Medicine, and Psychiatry, 23, 245-268.

Beasley, C., and Bacchi, C. (2007). Envisaging a new politics for an ethical future: Beyond trust, care and generosity - towards an ethic of ‘social flesh’. Feminist Theory, 8(3), 279-298.

Butler, J. (2004). Undoing gender. New York: Routledge.

Clouder, L. (2003). Becoming professional: Exploring the complexities of professional socialization in health and social care. Learning in Health and Social Care, 2(4), 213-222.

Dall’Alba, G. (2009). Learning professional ways of being: Ambiguities of becoming. Educational Philosophy and Theory, 41(1), 34-45.

DeVault, M. (1999). Whose science of food and health: Narratives of profession and activism from public-health nutrition. In A. E. Clarke and V. L. Olesen (Eds.), Revisioning women, health, and healing: Feminist, cultural, and technoscience perspectives. (pp. 166-183). New York; London: Routledge.

Dunlop, R. (1999). Beyond dualism: Toward a dialogic negotiation of difference. Canadian Journal of Education, 24(1), 57-69.

Gingras, J. (2005a). The defeat of imagination: Repressive codes governing our media. Feminist Media Studies, 5(2), 255-257.

Gingras, J. (2005b). Evoking trust in the nutrition counselling context: Why should we be trusted? Journal of Agricultural and Environmental Ethics, 18, 57-74.
 
Gingras, J. (2009). Longing for recognition: The joys, complexities, and contradictions of practicing dietetics. York, England: Raw Nerve Books.

Hodges, B. (2006). Medical education and the maintenance of incompetence. Medical Teacher, 28(8), 690-696.

Jarratt, J., and Mahaffie, J. B. (2007). The profession of dietetics at a critical juncture: A report on the 2006 environmental scan for the American Dietetic Association. Journal of the American Dietetic Association, 107(7), S39-S57.

Jordan, J. (2002). New developments of the relational-cultural theory. In M. Ballou and L. S. Brown (Eds.), Rethinking mental health and disorders: Feminist perspectives (pp. 48-70). New York: Guilford Publications.

Miller, J. B., and Stiver, I. P. (1997). The healing connection: How women form relationships in therapy and in life. Boston: Beacon Press.

Nakash, O., Williams, L. M., and Jordan, J. V. (2004). Relational-cultural theory, body image, and physical health. Stone Center Works in Progress #416. Wellesley, MA: Wellesley College.

Sprang, G., Clark, J., and Whitt-Woosley, A. (2007). Compassion fatigue, compassion satisfaction, and burnout: Factors impacting a professional's quality of life. Journal of Loss and Trauma, 12, 259-280.

Travers, K. D. (1995). “Do you teach them how to budget?”: Professional discourse in the construction of nutritional inequities. In D. Maurer and J. Sobal (Eds.), Eating agendas: food and nutrition as social problems (pp. 213-240). New York: Aldine de Gruyter.

Walker, M., and Rosen, W. B. (Eds.). (2004). How connections heal: Stories from relational-cultural therapy. New York: The Guilford Press.

Wilson, A. L. (2001). Professionalization: A politics of identity. New Directions for Adult and Continuing Education, 91, 73-83.

Biographical notes:

Jacqui Gingras’ research involves theoretical and experiential explorations of critical dietetics epistemology. She has a particular interest in how dietetic students’ and professionals' subjectivities are constituted by power and discourse to inform advocacy, policy, and pedagogy. Her research engages autoethnographic, narrative, and arts-informed methods as a means for situated and particular understandings of dietetic theory, education, and practice. Her work appears in the Food, Culture and Society, Feminist Media Studies, and Journal of Agricultural and Environmental Ethics.

Jennifer Brady has completed studies in Women’s Studies, Nutrition and Food, Nutrition Communication and is currently a dietetic intern at the Hospital for Sick Children. Her research interests include feminist, critical, and post-modern analyses of modern discourses of nutrition and healthy eating, body, weight and weight loss, eating, and food.