“Conversations in Color”
My name is Norman Kim and I am truly honored to be co-chairing the People of Color Subcommittee of the African American Eating Disorders Professionals Committee with Dr. Marcus.
I am a proud first-generation immigrant, having emigrated from South Korea with my family when I was 5 years old. Both despite and because of repeated experiences of being reminded that I was (and still am…) often the “other,” I am also equally a proud American, committed to the highest ideals of my country, a country that does not exist as it does without the many immigrants who have come here to add to her collective fabric.
Other than my passion for music, my abiding interest in issues affecting marginalized and disenfranchised people has been among the most enduring constants of my life. I come to this interest honestly. Even though the following was not anything about which I was conscious when I was growing up in Chicago, I have no doubt that growing up in a place that has the dual distinction of being among the most diverse cities in the US as well as the most segregated city in the US imprinted on me an acute awareness of the essential fact that one’s “identity” exists as a plural rather than as a singular. I grew up understanding full well the survival benefit of developing and carrying multiple identities. This is something that anyone who has experienced discrimination or marginalization or any of the -isms or -phobias knows intimately and painfully.
Because of these experiences, I have been involved in advocating for and trying to raise awareness of issues affecting minority communities since I was an undergraduate. It greatly affected my decision to go to UCLA for my PhD because of the long history of research on minority mental health in that department. Since then I have been involved in the eating disorders community for almost 20 years. In this time I have seen tremendous progress in many aspects of caring for people who struggle with the immense and debilitating pain of having an eating disorder. But it has only been in the last few years that we have had more public conversations about the fact that eating disorders affect ALL people regardless of race, ethnicity, gender, gender identity, sexual orientation, body size, income, country or origin, or any other characteristic one can think of. And it’s only been in the last few years that we have started to have the corollary conversation, namely if this is true, then what does that mean about the impact of the lack of diversity among professionals who are meant to treat all those who suffer from this illness.
These questions illustrate a constant source of conflict for many minorities in the United States, namely the tension between feeling invisible on the one hand and not wanting to be TOO visible on the other. We want to be seen for ourselves rather than as a representative of our group, but we are nevertheless of communities and cultures. Now imagine the impact of this tension on someone from a marginalized community entering treatment for an eating disorder, whether it’s their first time or their 10th time. This person is probably scared, likely struggling with intense shame, and already feeling like they are broken and don’t belong because these are the true core features of eating disorders. If this person is also from a minority or marginalized group, imagine how much all of this is magnified if you also have to worry about whether any of your treatment providers can understand this fundamental experience of being “the other.”
It is for these and so many more reasons that I am proud to be co-chairing this committee.
According to data examining the racial and ethnic make-up of the mental health workforce, nearly 90% of mental health professionals are White, in contrast to the 30% of the overall United States population made up of people from various ethnic minority groups. This discrepancy is even more concerning in light of the fact that the communities which have the greatest shortages of mental health professionals also tend to be communities with a high proportion of racial and ethnic minorities. But beyond just having mental health staff that are more representative in their diversity, the real concern is about competency in all staff’s ability to deal with issues related to marginalization, discrimination, and other issues related to minority status and stress.
We face this issue to an even greater degree in the eating disorder treatment world. It has been well established that eating disorders do not discriminate. Women and men from ethnic minority groups and those in LGBTQ+ communities suffer from eating disorders at similar or higher rates than in the general population. On top of the serious impact that eating disorders have on all those affected, people from ethnic minority groups and from the LGBTQ+ community must often grapple with long histories of additional stigma and marginalization, resulting in multiple doses of shame and understandable reasons for experiencing self-hatred. Experiences of microaggressions, discrimination and marginalization, and the other stressors associated with minority status puts people from these communities at particularly high risk for the development of disordered eating behaviors and their attendant consequences.
Despite this high risk, there is a vast disparity in the actual utilization of mental health services among those from marginalized and minority groups. People from these groups are under-identified by professionals and tend to receive treatment for eating disorders at significantly lower rates.
These disparities reflect a profound need for clinicians from marginalized communities and culturally competent assessment and treatment services for members of marginalized communities who are struggling with eating disorders. Especially if you come from a culture or family where seeking help for mental health issues is stigmatized, seeking professional help is often prefaced with the all-too important question: “Will the person who is supposed to help me actually ‘get’ me?” When treatment providers do not reflect the overall diversity of their clients, this lack of diversity can be a significant barrier to engagement in treatment beyond just “matching” based on ethnicity, gender identity, or sexual orientation, for example. It’s the idea that professionals who have a diversity of life experiences, especially when they revolve around issues of marginalization and discrimination, might be better able to cross that experiential gap without the client having to “educate” or “explain” their culture.
Beyond the need for a greater influx of mental health clinicians from minority and marginalized communities, there is an overall pressing need for greater levels of cultural competency for ALL mental health professionals. Given the diversity of those struggling with eating disorders, cultural competency among care providers is crucial in providing effective treatment. This competency is particularly important in the context of illnesses as complex and multifaceted as eating disorders.
I am beyond proud and continually humbled to be a part of this community of passionate, dedicated, and caring people who are involved in raising awareness, advocacy efforts, and making sure we are providing the best possible treatment for all those people who struggle with eating disorders. By being willing to engage in the intentional action of asking ourselves these difficult and uncomfortable questions, we demonstrate that we understand the singular importance of being “gotten.”
The antidote is always in the poison.
Bio: Norman H. Kim, PhD completed his B.A. at Yale and his Ph.D. in Psychology at UCLA. His research and clinical interests include the neurobiology and social development of people with autism, the developmental course of bipolar disorder, and the treatment of anxiety disorders. In conjunction Norman has developed an expertise in treating and teaching about psychiatrically complex populations, multi-modal treatment, and diagnostic assessment with a particular focus on Eating Disorders, Trauma, and Bipolar Disorder. He is a regular national speaker, educator, and passionate advocate for eating disorder awareness and legislation with a particular focus on marginalized communities. He is on the Board of Directors of the Eating Disorders Coalition and is the co-chair of the Transcultural SIG for the Academy of Eating Disorders. Norman is the co-founder and National Director of the Reasons Eating Disorder Center.
Contact: (917)-565-1381/ Email: firstname.lastname@example.org
*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.*