Yawen Guan
George Washington University
Abstract:
This article explores how my experiences as a plus-size woman raised in a Chinese collectivist culture have shaped my understanding of shame, self-acceptance, and leadership in group therapy. Cultural expectations surrounding body size, discipline, and social harmony taught me to minimize both my physical and emotional presence in order to maintain acceptance and belonging. Through my study of group therapy, I came to recognize how these internalized beliefs could influence my reactions to group dynamics and my emerging identity as a group leader. Ultimately, I argue that effective group leadership requires not self-erasure, but the willingness to participate fully and authentically while remaining open, empathic, and aware of how one’s social identities shape the therapeutic process.
Keywords: group therapy, shame, self-acceptance, group leadership, collectivism, social identity
Introduction
As a plus-size woman raised in a collectivist culture where thinness symbolizes norms, discipline, and worth, I learned from a very young age of internalizing the belief that taking up too much space, both physically or emotionally, was shameful. In my doctoral program’s group therapy training, I am granted the opportunity to experience how this belief affects self-acceptance and inter-group relationships. This discussion will explore how being a plus-size woman who is navigating through a journey of self-acceptance influences how I learn about group therapy and my vision of myself as a future group leader.
Growing up in China, body size and images often operated as an unspoken social currency. The collective gaze frequently turned toward appearance. Comments about weight, and discipline were normalized forms of “care” but never judgement, and I was a lucky girl who had the blessing to be “cared” by many people in my life. At elementary school lunches, some faculties who I have never spoken to would casually come up to me suggesting that I “control my appetite” so that I can stop embarrassing myself and creating inconveniences for my classmates with my growing sizes, as if my body existed as some sort of whole-class project. Similar comments would be made by my relatives at any family gatherings, all suggesting that I should learn to consider others’ feelings by stopping getting bigger. The message embedded within these comments was a shared moral tone: I was taking up too much space, and this is something I need to be ashamed of. Within this environment, I quickly learned that to be accepted meant minimizing myself, both literally and figuratively. I began dieting and silencing myself in interpersonal relationships and social spaces just so I can take a little break from continuously receiving “kind carings” from others.
From a cultural lens, the Chinese collectivist ideal of He Xie (harmony) emphasizes maintaining group cohesion and avoiding behaviors that might draw attention or disrupt balance. As Markus and Kitayama (1991) noted, individuals in collectivist societies often define the self through interdependence, prioritizing relationships over personal desires. This interdependence, while nurturing social connections and coherence, can also reinforce self-silencing, especially for individuals whose worth is closely tied to modesty and compliance (Markus & Kitayama，1991). Over time, I came to associate visibility with risk. To speak assertively or express disagreement felt as transgressive as taking up too much physical space in a crowded room. Shame also became a familiar emotional factor that arises frequently throughout my journey. Shame, as I experienced it, was both internal and relational. Internally, it took the form of a critical voice telling me, “I am wrong,” rather than “I did something wrong.” This experience reflects Tangney and Dearing’s (2002) description of shame as an inwardly directed emotion that targets the entire self rather than a specific behavior. Relationally, my shame developed through the subtle and explicit ways in which others communicated discomfort with my body and presence across the different social groups in which I participated. Over time, I learned to minimize myself in an effort to preserve group harmony and avoid further judgment. These interconnected patterns of self-minimization and shame inevitably resurfaced as I began learning about group therapy and imagining myself as a group leader.
Learning about group therapy as a doctoral student offers me a unique opportunity to understand how social interactions themselves can serve as powerful therapeutic tools. The idea from Yalom and Leszcz ’s work (2020) introduced me to how group therapy supports individuals by creating a cohesive condition that allows members to practice interpersonal learning under the guidance of a group leader. When I first imagined myself as a group leader and leading such an interpersonal space, I saw someone constantly monitoring how much space she was taking. Measuring words, tone, and posture to ensure she did not disrupt the group’s balance. The fantasy was not about leading with confidence, but of carefully blending in. I imagined myself spending more energy managing others’ comfort than trusting the therapeutic process. This image, although discouraging at first, was an honest reflection of the internalized voice that still echoed from my cultural upbringing, the one that equated humility with safety, invisibility with belonging.
Yet as I deepened my understanding of group therapy, that image began to change. The first change I observed was my perception on how shame connects with my presence in a group. In Ribeiro’s (2020) exploration of how social identities impact group therapy, she explains that clinicians’ beliefs that are shaped by their own social and cultural positions, can unconsciously influence how they perceive members, interpret dynamics, and define what constitutes “healthy” group functioning. Learning and reflecting on this concept helped me recognize that my instinct to maintain harmony and minimize my presence is not only a personal habit from previous shameful experience, but also a culturally informed belief that was formed by my social identity as a plus size woman. I realized that I hold such belief that conflict is a relational rupture rather than an opportunity to repair. The unconscious intention to interpret and assume other members as potential sources of rupture was what prevented me from envisioning myself as a successful group leader. Active awareness, according to Ribeiro (2020), requires therapists to recognize how their personal beliefs and biases shape their moment-to-moment reactions during the group process and to move beyond assumptions rooted in their own identities. Yet, beyond self-reflection, what else could help me move beyond these assumptions? I continued to ask myself this question as I read the course materials emphasizing the importance of challenging assumptions, and I eventually found the answer in self-acceptance.
Self-acceptance, a common protective factor that helps individuals increase mental health, well-being and self-worth, can be focused as a major therapeutic theme in specific groups. A transdiagnostic behavioral model called Self-Acceptance Group Therapy (SAGT) was developed by Schoenleber and Gratz (2018) specifically to address shame by enhancing self-acceptance through psychoeducation, cognitive reappraisal, and behavioral exercises aimed at reducing self-criticism and fostering interpersonal connection. Practices in SAGT including identifying the spectrum of shame and self-acceptance, and proper exposure to shame in a safe space are introduced to the groups as the session progresses. In their open-trial study, participants exhibited significant reductions in shame and increases in self-acceptance, improvements which held at follow-up (Schoenleber & Gratz, 2018). By bringing this framework into my reflection, I began to envision how self-acceptance might not just be an abstract ideal, but a lived process for me even as a developing leader.
In my own practice of interacting with the sense of shame, this meant allowing myself the same compassionate stance encouraged in SAGT. Gently noticing self-critical internal voices, challenging them with balanced self-talk, and experimenting with behavioral acts of acceptance (for example, pausing before apologizing or speaking up when hesitant). Through continuous learning, I gradually shifted from fearing that my visibility would take up too much space, to begin trusting and validating myself through acceptance.
Through the process of learning about group therapy and envisioning myself as a future group leader, I began to recognize that my journey toward self-acceptance is inseparable from my professional growth. At the beginning of this journey, I imagined effective leadership as carefully monitoring my words, tone, and presence so that I would not disrupt the group or make others uncomfortable. This image reflected the lesson I had internalized throughout my life: that safety and belonging depended on making myself smaller. I now understand that this tendency toward self-erasure could limit my effectiveness as a group leader. If I become overly focused on preserving harmony, I may avoid necessary conflict, hesitate to name difficult dynamics, or unintentionally communicate that discomfort should be suppressed rather than explored. What began as a struggle with internalized shame has therefore developed into a deeper awareness of how my personal and cultural experiences may shape my clinical decisions.
In future group sessions, I hope to implement this awareness by monitoring moments when I feel compelled to withdraw, or quickly reduce tension among members. Rather than automatically interpreting discomfort or disagreement as evidence of relational rupture, I can pause, remain present, and invite members to explore what is happening in the group. For example, when conflict arises, I might ask members what emotions the interaction has brought up, whose perspectives have received space, and whose voices may have been minimized. I can also model self-acceptance by receiving feedback without excessive defensiveness or self-criticism and treating mistakes as opportunities for reflection and repair. By creating space for members to discuss shame and practice expressing themselves without judgment, I hope to support a group culture in which vulnerability is not treated as a weakness and belonging does not depend on self-silencing. I am therefore moving from an understanding of leadership based on blending in and protecting others from discomfort toward one grounded in active awareness, authentic presence, and the capacity to remain engaged through tension. Group therapy has taught me that effective leadership does not require taking up less space; instead, it requires using that space responsibly while helping others feel safe enough to occupy their own.
References
Markus, H. R., & Kitayama, S. (1991). Culture and the self: Implications for cognition, emotion, and motivation. Psychological Review, 98(2), 224–253. https://doi.org/10.1037/0033-295X.98.2.224
Ribeiro, M. D. (2020). Social identities explored in therapy groups. In M. D. Ribeiro (Ed.), Examining social identities and diversity issues in group therapy: Knocking at the boundaries (pp. 78–92). Routledge/Taylor & Francis Group. https://doi.org/10.4324/9780429022364-6
Schoenleber, M., & Gratz, K. L. (2018). Self-acceptance group therapy: A transdiagnostic, cognitive-behavioral treatment for shame. Journal of Contemporary Psychotherapy, 48(3), 193–201. https://doi.org/10.1007/s10879-018-9389-4
Tangney, J. P., & Dearing, R. L. (2002). Shame and guilt. Guilford Press. https://doi.org/10.4135/9781412950664.n388
Yalom, I. D., & Leszcz, M. (2020). The theory and practice of group psychotherapy (6th edition). Basic Books.