Separating Healing from Healthism

A lot of language around health focuses on should’s.

What habits we should have, what foods we should eat, how much media we should consume, how we should engage with our bodies, when we should be active and productive, how active and productive we should be, and on and on and on. 

But why? And, maybe more importantly, what if in centering our health and all of those “shoulds” we were actually getting in the way of really caring for ourselves?

What is healthism?

Healthism, essentially, is the cultural idea that being healthy is the most important thing; that healthy is equivalent to good, hardworking, educated, and valuable, while unhealthy means bad, lazy, stupid, and expendable.

Healthism was an idea introduced to popularity by an economist, Robert Crawford, in the 1980s, in an essay published under the title “Healthism and the Medicalization of Everyday Life.” The essay was written in response to a cultural rise in self care movements in the seventies, but is still relevant in this new wave of individualist and commercialized self care. An excerpt from it reads: 

“…healthism situates the problem of health and disease at the level of the individual. Solutions are formulated at that level as well. To the extent that healthism shapes popular beliefs, we will continue to have a non-political, and therefore, ultimately ineffective conception and strategy of health promotion. Further, by elevating health to a super value, a metaphor for all that is good in life, healthism reinforces the privatization of the struggle for generalized well-being.”

Basically, healthism asks: if you’re sick or unwell, what did you do wrong? And the follow up: if you can’t make good or healthy choices, why should you get care?

What healthism overlooks:

There is a lot left ignored in this understanding of health. In fact, very little of your “health” is determined by personal habits. Your health is influenced by your genetics, your socioeconomic status, the environment you live in, your access to medical care and nutrient dense food, experiences of racism, sexism, homophobia or transphobia, medical discrimination, bias or neglect, and more. All of these things are outside an individual's control! 

We put so much importance on individual habits and choices because those are what we can control in our day to day life, but that also makes it easy for us to be blamed for our own poor health, or sold something that says will make us better, but really only exists to make someone else a profit. 

The healthism we see on an individual level (rather than a structural level, like being denied insurance for a pre-existing condition) also often focuses more on the aesthetics of health, than on health itself. One major example of this would be the health risks fat people face just by actually going to the doctor. The anti-fat bias within “health” centered spaces is so damaging, that when actually going to attend to their health, fat patients risk having their health harmed by abusive medical professionals, who often only tell them to lose weight without actually tending to their medical needs–and without acknowledging both that rapidly losing weight is dangerous to your health or that being underweight is actually more dangerous to health than being overweight. 

The other obvious thing that is overlooked by healthism is mental health. Healthism believes your health is your responsibility, but your genetics and your brain chemistry are not within your control! While yes, moving your body and nourishing yourself are good for your mental health but mental health cannot be exercised or dieted away! That prompts the question, if you are physically “healthy” but are treating depression, are you still “healthy”? Can anyone really be fully “healthy” when we step back and think about it holistically? And if we can’t, why do we place so much importance on striving for perfect health above all else?

What shifting away from healthism can do for your healing: 

This isn’t to say your health is insignificant–when you are sick or injured or unwell in any way you deserve care and medicine and support. The rejection of healthism isn’t a rejection of taking care of yourself, but shifting the motivations behind it. 

Instead of caring for yourself because you want to be healthy so you can deserve love and care and support, can you care for yourself because you are alive and deserve it? Can you shift your habits of caring for yourself so they come from a place of love and joy, rather than guilt and shame?

Removing morality from health means when your health declines, you know your worth does not. 

When you are unwell, you have value and deserve everything you have when you’re well. Rejecting the healthism mentality means recognizing this–even if the reason you are unwell is the result of a choice you made. This means caring about and for yourself isn’t dependent on how healthy your habits are. Instead it’s coming from a place in your mind that is asking, “okay, how can I both nourish myself and feel good in this body and life?”

Want a weird, real life example of this? Look at kinksters. In kink and alternative sex communities there is an acronym RACK, which stands for risk aware consensual kink. This means that all participants understand that there is no 100% safe way to practice kink as there is always some sort of risk, even if it’s very small. But they have made themselves aware of those risks, and decided that the benefits of what they would get out of the experience outweighs those risks, so they still enthusiastically consent. 

We can think of our choices with health in the same way–you don’t always have to choose what is healthiest if another option offers something else to you; it’s about being aware and making choices based on your own needs and desires. 

Rejecting healthism also helps to ground you back in your healing. Healthism is a tool of capitalism! You don’t need to be constantly buying things to make yourself “better”; you need to tune back into yourself to listen to what your needs are, and respond to what you’re exploring internally, not what’s being sold to you externally. Take the CEO of Whole Foods saying:

“We are all responsible for our own lives and our own health. We should take that responsibility very seriously and use our freedom to make wise lifestyle choices that will protect our health.” 

We know of course, that that’s not true! Like we discussed above, there are many factors to health, very few of which are influenced by personal choice and habits. But we can also see that he’s clearly selling something to us here. He’s saying: if you want to be healthy and live a good, long life, shop at Whole Foods! But that’s not the only way to achieve health–and for people who can’t afford to shop there, that economic strain would actually impede their health. 

Rejecting healthism takes guilt away from seeking joy, and gives you back the power to determine your purpose. Instead of feeling shame over “indulging” in things you “shouldn’t” or not putting all of your effort into achieving peak physical health, you can spend your time and energy in ways that rejuvenate you. 

How therapy challenges healthism 

Healthism says: whatever health or wellness problems you have in your life, they’re your fault. If you had made better choices, you would be better off. 

Therapy says: there are so many things that make you who you are and that impact how you are. Let’s explore them and see what motivated your choices, what needs you were meeting, and give compassion to you for taking care of yourself as best as you could. It says being unwell doesn’t always come from one thing, and it’s not your job alone to be healthy or well–relationships and support systems are a huge part of taking care of yourself, and you deserve access to them. 

Shifting away from a mindset based in healthism can be hard, but we’re here to support you. Get in touch with our office today to get started with one of our expert clinicians.