Fool’s Paradise

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Back when my classmates were playing with blocks, I was stacking cartons. The glove compartment, as far as I know, might as well have been called the smokes compartment, because that’s all we kept in ours. I can visualize the plastic sealed, blanched white bodies, stacked in rows; I can still smell the unmistakeable insult of the ash that used to cling, like velcro on the lace of my shoes. He was going through two, three packs a day, habitually pounding cigarette after cigarette as if each puff was giving him life… when in fact, it was doing the opposite.

So, I’d draw family caricatures and bold, arching, colorful print that read something along the lines of “Please Stop Smoking DAD” and variations of. I’d sneak letters into his travel bag, and on the occasion I’d get to see him, I would beg him to quit. For us. For a healthier life. For, at only six years old, I was already afraid that the next time I’d see a plastic sealed, blanched white body, it’d be his.

What I had yet to learn was that the success of behavior change is determined by adherence, which can only be cultivated intrinsically. My father continued to smoke for many, many years, and despite positive behavior changes that renovated different aspects of his life, he could never fulfill the intricate web of physical, emotional, spiritual, intellectual, environmental, and social health. Because wellness is a cumulative interaction between these six dimensions of health, behavior change that hinders the maintenance of this balance may –in consequence– be fleeting, inefficient, and even detrimental.

The film, “Fat Chance,” portrays the journey of behavior change intended for weight loss that is later redirected to self acceptance. Rick Zakowich is first introduced, thirty pounds lighter but not much happier since the start of his plan to lose weight. Feeling pressured by cultural standards of beauty and acceptance, he uses appearance-based motivation to take on behavior change involving diet and exercise. It is no surprise, considering how heavily our society weighs the significance of body image, to hear a even medical professional deviate from motivational interviewing. The physician advises, “Best way to make yourself feel better about yourself… is to lose weight so that your blood pressure improves, so that you look better.” Inherent in modern American thinking is that looking better equates to happiness.

As Rick finds support from those who are content with their obesity, he adapts to a new perspective that directly antagonizes fat shaming culture; he ends the documentary by saying, “The way you are is fine. Walk through this world in that way.” On a superficial perspective, one could argue that Rick achieves a step towards wellness by coming to self acceptance, increasing his self confidence, and joining an empowered community. However, despite it being a step in the right direction, Rick fails to recognize the danger of extremes. By orienting behavior change strictly towards emotional and social health, he completely neglects the other essential components, such as physical health. There is no doubt that self love, in the right context, is deserving of praise, but the fact that he is happier does not eliminate the risks of being overweight. By the summer of 2008, my father ended up in the ICU. If he, then, had settled on self acceptance and placed another cigarette between his lips, would you have applauded him, too?

Fat shaming and fat acceptance fall on opposite ends of the spectrum, and through understanding the crucial interplay of the six components of wellness, we unveil the importance of moderation. Had the medical professional taken a different approach, like educating the benefits of exercise, rather than implying blame or demonizing Rick’s body image, perhaps Rick would not have fallen victim to an illusory state of happiness that is likely evanescent. Increasing studies now indicate that cardiorespiratory fitness and physical activity can improve multiple aspects of wellness and reduce the comorbidities tied to obesity, with or without weight loss (Dallow). This outlook on exercise may be a better approach towards positive behavior change, than one that is based on appearance. Furthermore, it would be of a greater benefit to implement behavior change that caters to both fitness, confidence, community, and other aspects of wellness. With Dr. Lerner’s medical knowledge and morale amongst Rick’s new connections, the support group could potentially be the perfect medium for a wellness program. With less emphasis on weight loss, they could tackle multiple obstacles at once and find a more permanent solution. In contrast of what they have been told by others –they can have their cake and eat it too.

To ensure safety, longevity, and efficacy of such program, professional advisement to promote adherence is crucial. Though the responsibility of wellness falls on the shoulders of each individual, it is equally important to have health care providers take the lead on public education. Patients are more likely to adhere to behavior change if they understand risk and the gravity of their conditions, so medical professionals can play a key role here (Stonerock). Proper motivational interviewing along with professional, objective, and evidence-based opinions is essential to assist others, particularly in the transition from earlier to later stages of the Transtheoretical Model. In “Fat Chance,” Dr. Moe Lerner highlights that obesity is caused by metabolism and dieting. Not once does he mention the importance of physical health. Despite his sensible attitude, his perspective holds a very narrow, almost defensive, focus to justify obesity. By relying on rationalizations and believing his physical state is not a problem, he, along with Rick and the others in the support group, regress and sink deeper into the precontemplative stage (Dallow).

In a society that strongly antagonizes fat and with a disproportionately increasing prevalence of obesity, there is a strong need for leadership towards fitness in all populations, especially obese individuals. The fact that Dr. Lerner’s personal stake in the issue does not take a backseat to his obligation to the public, and that another medical provider advises Rick “just do it” as a plan for losing weight reveal how the medical care system has ample room for improvement. Physical therapists, and all medical providers, can and should “provide key elements of effective behavioral change interventions” so that the general public can adhere to wholesome decisions about wellness (Rhodes). Even the most effective interventions whittle down to scraps, in the absence of patient adherence.

It is easy to believe a person is well when one aspect of wellness has been satisfied. One might say being fat and happy is better than being skinny and unhappy; one might argue the opposite. During an interview, supermodel Kate Moss was quoted saying, “Nothing tastes as good as skinny feels.” When we fall victim to such paradigms that cater to one aspect of wellness, such as emotional health, we neglect all else. The temporary contentment that follows blinds us from seeing the short-lived nature of it, and the resulting imbalance may put an us in a worse position than we started from. Fooling ourselves about our well-being is like sipping on a pina colada, floating comfortably above a circle of sharks. In shallow waters, it becomes more clear that a fool’s paradise –though paradise– thrives only in the minds of fools.

 

References

Bezner JR. Promoting health and wellness: implications for physical therapist practice. Phys Ther. 2015;95:1433-1444.

Dallow CB, Anderson J. Using self-efficacy and a transtheoretical model to develop a physical activity intervention for obese women. American Journal of Health Promotion, 2003;17(6):373-381.

Fat Chance. Dir. Jeff McKay. Perf. Rick Zakowich. YouTube. NFB, 17 May 2015. Web. 19 Apr. 2017.

Rhodes RE, Fiala B. Building motivation and sustainability into the prescription and recommendations for physical activity and exercise therapy: the evidence. Physiother Theory Pract. 2009;25:424- 441.

Stonerock GL., Blumenthal JA. Role of Counseling to Promote Adherence in Healthy Lifestyle Medicine: Strategies to Improve Exercise Adherence and Enhance Physical Activity. Prog Cardiovasc Dis (2016), http://dx.doi.org/10.1016/j.pcad.2016.09.003

Why the Asian Kid With A Trophy Didn’t Actually Win

“I’m happy for you,” she smiles, swiveling in her seat to face me. It skids to a stop as her small toes drag in circumference across the hardwood floor. “I didn’t want to say anything before you made up your mind, but I was hoping you’d pick Columbia.”

Quickly nodding an eyebrow in acknowledgement, I say, “I’m just glad it’s over. Weighing professors and comparing curriculums, it was driving me crazy. I was more stressed about making the right decision than going on the interviews. Once I settled on a choice, it seemed so obvious, like I only had one option all along.”

An incoherent jumble of Korean voices drone from the computer speakers behind her. This is how our conversations usually happen – abruptly, at odd dusk hours if and when our time at home coincides, and usually in the midst of her melodramatic soap operas (the inevitable obsession of tiny, little Korean women across the globe).

“Your Dad wanted Columbia, too.”

A sigh leaves my chest. “Dad knows nothing about the programs. He doesn’t even know what I do for a living. He’s only about Columbia,” I joke, knowing every joke has a bit of truth to it, “because it’s Columbia. Because he gets to tell people it’s Ivy League. Is it really that big of a deal? Don’t you think if I were going for the name, I’d be going for the wrong reason?”

In a lowered voice, my mother mutters, “Do you want to know something, though? It is that big of a deal.

“Look at how prideful Asians are. We push our children harder than most to get the best grades, to get into the best schools. Do you know the real reason? It’s a competition. It has been engrained in our minds to measure success through our children. If your child doesn’t excel, the whole community views it as a reflection of your own capabilities.”

In a sudden flashback, I think back to all the times my grandparents favored my brother and me over our cousins, who — despite being smart, charming, and well spoken — weren’t as academically “successful.” One of my last vivid memories of my grandpa is of him crying and chasing after us in a car, repeating, “You’re all I have. You’re all I have.” He had a wife, 6 kids (as far as I know), and even more grandkids — so what did he mean by that? We didn’t necessarily bond with him any more than the other grandchildren did, yet he elevated us to a higher pedestal. It was later explained that since we had the most potential (on a scale of A through F), we stood out as his pride and joy.

“Why do you even care?” I shake my head, and a disgruntled noise slips from my lips. “You know, there are so many things I can’t stand about the our traditional outlook. There are a lot of people, but the community is so small. It feeds off of bragging rights, gossip, and judgement. At family reunions, for example, why do we greet each other with comments like, ‘You’ve gained weight?’ instead of ‘How are you?’ We take excessive pride in beauty and academics; the nation’s standard of success is twisted. You are a good mother. If I fail, it is because I let myself fail. It’s not on you.”

She clears her throat, ridding a shaky voice. “When Koreans look at me, they assume I do what I do because I am stupid. When I was a nurse, I was highly regarded. Now, they see me differently. They look down on me, because the bigger wallet gets you a higher seat, and I am silent about it. But when I get to say I have a daughter who attends Columbia, it’s like I’ve made it. I get respected. I’m no longer bottom of the totem pole. They think — wow, she raised such a smart daughter. She must be somebody.”

My heart hurts a little from hearing this. I feel an undeniable shame. So, I pick up my pen and write the following words that encase my incomplete grasp of the culture that raised me:

It seems to me that pride and respect are two of the few core principles that hold the most weight in many Asian cultures. I can speak, through experience, of a Korean viewpoint: my viewpoint. There is an installment of a social hierarchy, as implied through diction and mannerisms. Formally, we rank people by age, dishing out a gradience of respect that begins with utmost respect for the highest elder. There are obvious distinctions in speech formality, and our physical etiquette extends even into casual settings.

For instance, with alcohol use being introduced and encouraged at a younger age than the Western culture, elders teach the young how to drink while the young show respect in return. The younger person must receive drinks with two hands, pour with one arm supporting the other, and consume while facing away from the elder. There are clear behavioral and lingual displays that insinuate: age demands respect. I remember being told to bow before I even knew what bowing was.

In more traditional homes, displays of affection are nearly absent. The first time, post childhood, that I hugged my family and said the words ‘I love you’ was in my second year of college. For my brother’s graduation, I could see other families hugging and laughing, but all that was going through my head was, “So… do I give the guy a handshake or what?”

For a period of time, it felt so natural to fall into formality, but so awkward to express love, yet I never acted that way around my friends. It was as if (and sometimes I still feel this way), I am wearing a mask around Korean adults. The more traditional the person is, the more guarded I stand. I’m not one to care too much what others think of me, but I have such a vivid subconscious recall of the conservative Asian perspective that I cannot let go of my tendencies. We aren’t subject to becoming the product of the environment we are raised in, but we sure are heavily influenced, as reflected in our unconscious conduct.

Less formally, judgment is passed based upon financial status, personal affairs, self presentation, physical appearance, and as my mother mentioned, the success of the offspring. There’s this superficial expectation to look a certain way (which is why plastic surgery is a staple rather than a luxury), dress a certain way, behave a certain way, etc. The shallow judgment is surely not unique to the Asian culture, but it is heightened to a point where it is cringe-worthy noticeable.

I actually fear returning to Korea, because I look fully korean but my tongue is not. If a Caucasian spoke as fluently than I, it would be impressive. But if I converse at my level (I don’t have an accent, but my vocab is limited), the more traditional folks give looks of disgust and disapproval. Back when I was serving at an Asian restaurant, I overheard people referring to me as “whitewashed” or “embarrassing.” What’s embarrassing –I wanted to say– is the fact that you’re a grown adult and you tip like you have the allowance of a 16 year old. But through conditioning, respect is given to strangers and elders even when it isn’t due, so I would bow and walk away with my tail between my legs. Even in times of impulsive fury, I am bound by cultural habits that reflect the peachy pale hues of my skin. 

I, of course, wouldn’t say this extends to every Asian home, just as the All-American white-picket fence doesn’t reach every house in America. It’s a  matter of parental choice on what is included in upbringing; like corporal punishment and summer camps, there is no conclusive evidence on what is right for a child. However, I bring attention to the principles many Asian families adhere to that promote critical judgement, tough love, and competition.  It pushes us to our potential and helps us succeed the same way it hinders us from addressing emotions and conflicts in what is supposed to be the most intimate and open setting: our own homes.

I don’t feel shame for being Korean. I feel ashamed for the way the critical outlook within our own community gives excess value to superficiality and materialism. I feel let down by the racist and sexist attitudes that have yet to recede the front lines of our culture. And most of all, I think we could do more, as new generations take heed of upbringing, to understand respect can coexist with affection. My parents love us more than anything in the world, but it took me over 20 years to realize that. And it took just as long to understand that the criticism amongst Asians isn’t derived from hatred, but rather the influence of cultural paradigms that shape our being.

The culture we are born into gives us a foundation. The culture we are raised in shapes the exterior. But the culture we determine, through combining our formed beliefs with the ones we encounter, is what gets passed to the generations beyond us. Let’s make it a good one.