therapist commenting on my weight

[shadowplay]

My old therapist moved to NH a few months ago, so I've been looking for somebody new. I went to a first appointment with somebody at my university to get some referrals with people in town. I had seen this same psychologist about six months ago.

 

One of the first things she mentioned when I came in is my weight. She said "How is your eating? You look thinner than I remember. You look really thin." I told her that I was actually a bit heavier than I had been. She reiterated that I looked very thin. I asked her where and she said "all over." Then she asked me how much I weigh and how tall I am. I told her that I'm currently 5'5" and 120 pounds. She looked at me skeptically and mentioned something again about me being thin. She asked me if I eat normally and I told her that I do. She still seemed skeptical.

 

Then we moved onto something else, but what she said really bothered me. My weight has often been a concern to me because of my BDD. But I tend to worry that I'm too thin, not too fat. I've been feeling more at ease with my body lately and what she said shook me up.

 

Finally, I brought up to her that I was uncomfortable with what she said because I have BDD (which I think she knows). She didn't apologize or really say much.

 

I've been feeling dismal all day since this. I just feel like it was kind of insensitive and inappropriate for her to comment so negatively on the way I look, especially when I told her that I'm at a healthy weight.

 

I started to feel like I must look anorexic or horribly sickly.

 

This has made me reluctant to see other therapists. Why is my appearance the immediate subject of discussion the second I step into this woman's office, especially when they already know I struggle with body image problems? If I were overweight would she mention that I looked like I had gained all this weight and I looked heavy all over?

[threebyfate]

Your therapist is being highly inappropriate, especially considering that she knows about your BDD. Your BMI is 20, which is within the normal range. Don't go back to her. She's terrible.

[Meaplus3]

I would not give up on her just yet. I'm thinking it may be possible that she was trying to get a complete assessment of you in order to know the best way to help. I've been asked questions like, "How are you eating"? "How are you sleeping"? Those questions were asked to gain some insight on me. So, stick it out for a bit. And if you feel she is way off base and focusing on the wrong thing's, then move on. Good luck to you.

 

Mea:)

Edited February 1, 2010 by Meaplus3

[Devil Inside]

Hmmmm. It is a little odd to come at someone so hard with a question like that right into the session. You two do have a history though...so maybe she thought you had the kind of therapeutic relationship with you where she could be a straight shooter.

 

What I would do is bring this whole thing up next session. Be as candid and honest about it as you have in this post. If this therapist is worth her rate she will be able to use this issue between the two of you in a clinical way that you should really benefit from. At least that's what I would do...the most powerful tool a therapist has is the relationship in the room...at least the way I practice.

 

I would give her a few more session after this conversation, because it is going to be a little tough...trust me...but real good therapy can be tough.

 

Good luck.

[Datura]

You made it clear you were uncomfortable with her assessment, mentioned your body issues, and she doesn't even acknowledge your discomfort.

 

Go to someone else who has an ounce of sensitivity. You did the right thing in expressing your discomfort.

[Devil Inside]

Something else came up for me. Shadow...you suffer with BDD..so of course you are going to be very sensitive to any comments concerning your body image. One of your therapeutic goals should be to get to a point where you have the internal validation to not be so effected by others comments about your body image. So maybe this can be an opportunity to work towards that goal.

 

Of course, if you just don't feel that you can trust this therapist...then maybe it's a lost cause.

[whichwayisup]

You are paying her, so let her know how her comments made you feel. She's YOUR therapist! Hopefully next time she'll be more considerate and maybe not be so blunt about it.

 

OR, it could have been a 'test' to see how you react/handle her words? Just a thought..

[D-Lish]

Do you think your therapist was asking about your weight precisely because she knows your history and wants to ensure you are eating properly? It's a valid concern, right?

 

My Doc knows my history with eating disorders and she keeps on top of it when I see her, despite the fact it makes me uncomfortable. A good Doc doesn't shy away from the hard questions or important issues - and they shouldn't. It's in your best interest for them to keep on top of what they know your problems are.

 

I look in the mirror, and I always see a 160lb woman- whether I am 100lbs or actually 160lbs. It's my Doc that addresses these sort of things, because everyone else is afraid to.

 

Geez, a friend of mine that hadn't seen me in a while told me I looked "healthy"...and I took healthy to mean fat- so I started dropping weight.

It's my doc that puts a stop to this type of warped self awareness- often by addressing it head on. People like you and I need that.

 

It's very important to discern between reality and distortion.

[torranceshipman]

120 pounds and 5'5 sounds healthy to me...I think the therapist was wrong to say what she did and also very insensitive.

 

Many therapists are, in my view, not that good. There seems to be a huge gulf between standards throughout the industry.

[LucreziaBorgia]

Do you think she was just trying to elicit a reaction and see which direction to take the therapy based partly on that reaction?

[Lovelybird]

Do you think she was just trying to elicit a reaction and see which direction to take the therapy based partly on that reaction?

I don't know if therapist use this method, but sounds reasonable

[Storyrider]

Unfortunately, therapists are human and sometimes say stupid things. It is disappointing when their foibles are so transparent, but you have to take the good you can get out of the session and ignore the rest.

[Tayla]

A therepist isnt PAID to fib or tread litely. The direct and assertive approach is healthy to establish a ground that needs reviewed.

 

One key issue that was mentioned and I can affirm is, if the trust isn't there , then keep looking til you find that PAID therepist that says exactly what you want.

 

I agree with Devil on advisal. Its an opportunity to cut thru an issue that may heal that concern .

[Trimmer]

A therepist isnt PAID to fib or tread litely. The direct and assertive approach is healthy to establish a ground that needs reviewed.

No, but they are paid (and duty bound) to act in a client's best interest. To put a patient in an anxious state as a test or probe, as some have suggested may have its place (I don't know, I'm not a therapist and don't know the ways thereof) but to fail to follow through and allow that patient to leave with the anxiety unresolved seems unprofessional.

 

Two possibilities: If, as some have suggested, the therapist was probing the OP to see what the reaction would be, then he/she should have been aware of the possibility of a negative reaction, and been sensitive to at least acknowledging it and possibly using that as a springboard for further exploration.

 

Or, if the therapist failed, right from the start, to consider that a patient with a history including BDD might be negatively aroused by repeated probing around weight, isn't that pretty clueless and insensitive? I'm not even saying that asking the question was necessarily insensitive (I agree, they're not paid to paint rainbows and flowers) but that not following up on this assertive line of questioning to gauge the client's reaction is clueless...

 

Is there another scenario that I'm missing here? Lob a grenade and run away, either because you didn't know the grenade might blow up, or because you don't feel responsible for the results left behind...

[Storyrider]

In my opinion, based on the very limited information provided, the therapist suspected Shadow has an eating disorder and erred on the side of being confrontational as opposed to subtle because for whatever reason (apparently wrongly) she believed Shadow's health was in danger.

[Trimmer]

In my opinion, based on the very limited information provided, the therapist suspected Shadow has an eating disorder and erred on the side of being confrontational as opposed to subtle because for whatever reason (apparently wrongly) she believed Shadow's health was in danger.

Fair enough, and perhaps I went off there before hearing more of the story. It sounded to me like the confrontation happened, but was then not resolved or explored. Only the OP can comment on that; I would welcome hearing it and would revise my comments if I made the wrong assumption.

 

I'm not saying therapy should be a cakewalk, and I do believe that a direct, perhaps even confrontational, approach may be warranted and used well. But I do think that a therapist has a duty to wield such tools responsibly - the purpose of the confrontation is to open the floor for exploration, with the intention to move the process toward understanding, and perhaps eventual resolution. Just creating a confrontation, bringing it to a point of tension, and then saying "OK, well, let's move on to something else then..." doesn't really do the job.

 

Maybe I assumed too much from the fact that Shadow was left anxious about the line of questioning, and unsure of the motives of the therapist. Shadow, did you guys discuss it further beyond the therapist's initial, probing queries?

Edited February 3, 2010 by Trimmer

[shadowplay]

Fair enough, and perhaps I went off there before hearing more of the story. It sounded to me like the confrontation happened, but was then not resolved or explored. Only the OP can comment on that; I would welcome hearing it and would revise my comments if I made the wrong assumption.

 

I'm not saying therapy should be a cakewalk, and I do believe that a direct, perhaps even confrontational, approach may be warranted and used well. But I do think that a therapist has a duty to wield such tools responsibly - the purpose of the confrontation is to open the floor for exploration, with the intention to move the process toward understanding, and perhaps eventual resolution. Just creating a confrontation, bringing it to a point of tension, and then saying "OK, well, let's move on to something else then..." doesn't really do the job.

 

Maybe I assumed too much from the fact that Shadow was left anxious about the line of questioning, and unsure of the motives of the therapist. Shadow, did you guys discuss it further beyond the therapist's initial, probing queries?

 

Here's what happened when I brought it up again. I told her that her comments made me uncomfortable because of my BDD. She said something along the lines of "that makes sense." And how it was a good thing I mentioned something because I might have left the office feeling down as a result. But then she just kind of left it there. I told her that her comments made me uncomfortable and she didn't really say anything to resolve it. This almost left me feeling worse.

 

I can't quite put it into words but there was something insensitive about her tone when she first mentioned my weight and then her response when I re-broached the issue. In addition, I didn't get a feeling of empathy or anything from her response. I almost got the vibe she was annoyed by my reaction as if I were attacking her style.

 

Confrontational therapy has its place, but only if done right. The patient shouldn't leave the office feeling worse unless there's some point in him/her doing so. I don't feel that I learned anything from the experience.

 

I guess it upset me so much because I hadn't seen somebody in awhile, and I was hoping to sort of come to the office as a safe space. If she had just been some regular woman her comments wouldn't have offended me as much.

 

I still feel pretty bad about what she said, but I'm trying to push it out of my mind.

[Taramere]

Here's what happened when I brought it up again. I told her that her comments made me uncomfortable because of my BDD. She said something along the lines of "that makes sense." And how it was a good thing I mentioned something because I might have left the office feeling down as a result. But then she just kind of left it there. I told her that her comments made me uncomfortable and she didn't really say anything to resolve it. This almost left me feeling worse.

 

This is a tricky one. I don't know whether or not what she did is a valid approach in counselling. What I do think is that one of the number one things any person seeking to help another should do is empower them. Part of that might involve giving the person the message that they must take responsibility for their own feelings.

 

To try to explain: I've mediated disputes before. One of the things a party on either side will often do involves trying to press the mediator into taking responsibility for the conflict and its resolution. That's not the mediator's job. The moment a mediator accepts that kind of responsibility the chances of the dispute resolving successfully drop. Why? Because if the mediator allows a party to transfer that sense of anxiety and responsibility onto them, the party then feels free of the responsibility. The upshot being they'll put less effort into compromising and attempting to resolve the problem.

 

Your counsellor isn't responsible for the way you feel about yourself, or the way you see yourself. I don't mean that harshly, I just mean it as a statement of fact. From her perspective, there will always be people out there who will comment on your weight and provide you with triggers for feeling bad.

 

A way to get something positive out of this might be to raise it again next time you see her. Maybe something along the lines of "Last time, I left feeling bad about the fact that you commented on my weight. It was useful for me to reflect on that, because comments about my weight are obviously a trigger for me...and I'd like to learn some methods of coping with triggers like that when I'm faced with them in everyday life. To reduce their impact they have on me."

 

With that approach, you'd be providing a clear focus for the counselling session. One that involves an issue that is very troublesome to you, and that might well result in some work between you and your counsellor that will be of genuine benefit to you.

 

That said, if you're really not clicking with her and don't feel you're going to get a proper hearing from her, then it may be that it's a problem to take along to a new counsellor you can gel better with.

Edited February 3, 2010 by Taramere

[shadowplay]

This is a tricky one. I don't know whether or not what she did is a valid approach in counselling. What I do think is that one of the number one things any person seeking to help another should do is empower them. Part of that might involve giving the person the message that they must take responsibility for their own feelings.

 

To try to explain: I've mediated disputes before. One of the things a party on either side will often do involves trying to press the mediator into taking responsibility for the conflict and its resolution. That's not the mediator's job. The moment a mediator accepts that kind of responsibility the chances of the dispute resolving successfully drop. Why? Because if the mediator allows a party to transfer that sense of anxiety and responsibility onto them, the party then feels free of the responsibility. The upshot being they'll put less effort into compromising and attempting to resolve the problem.

 

Your counsellor isn't responsible for the way you feel about yourself, or the way you see yourself. I don't mean that harshly, I just mean it as a statement of fact. From her perspective, there will always be people out there who will comment on your weight and provide you with triggers for feeling bad.

 

A way to get something positive out of this might be to raise it again next time you see her. Maybe something along the lines of "Last time, I left feeling bad about the fact that you commented on my weight. It was useful for me to reflect on that, because comments about my weight are obviously a trigger for me...and I'd like to learn some methods of coping with triggers like that when I'm faced with them in everyday life. To reduce their impact they have on me."

 

With that approach, you'd be providing a clear focus for the counselling session. One that involves an issue that is very troublesome to you, and that might well result in some work between you and your counsellor that will be of genuine benefit to you.

 

That said, if you're really not clicking with her and don't feel you're going to get a proper hearing from her, then it may be that it's a problem to take along to a new counsellor you can gel better with.

 

I'll write a longer response later, but I just wanted to comment that nobody has ever made such an extreme comment about my weight or been so insistent about it. That's why it was so weird.

 

And I just want to reemphasize that my weight is normal. Unless my eyes and the scale are both lying, I look far from anything approaching anorexia.

 

I am insecure that I'm too thin, but that's mostly because I pick on every aspect of myself that deviates from average. Still what I see is a figure that's within normal range. Maybe I'm totally delusional.

Edited February 3, 2010 by shadowplay

[Taramere]

I'll write a longer response later, but I just wanted to comment that nobody has ever made such an extreme comment about my weight or been so insistent about it. That's why it was so weird.

 

And I just want to reemphasize that my weight is normal. Unless my eyes and the scale are both lying, I look very, very far from anything approaching anorexia.

 

Yes, that part of it is weird. 5 ft 5 and 120 pounds is slender, but it's not malnourished.

 

Edit to add - when I say "there will always be people who comment on your weight" I mean a generalised "you". I think any woman who's slim - or even just not overweight - will tend to attract a lot of commentary about her slimness. It just seems to be one of those personal things the world and its dog feel entitled to comment on. Which is unfortunate when the person being commented on is suffering from BDD...in which case any commentary on their appearance could be a trigger.

 

I often have mixed feelings about therapists. There's one I know very well who is incredibly bright and insightful....but she can get quite "faddish" about issues. Let's say, for instance, that she's been reading a book on eating disorders. Suddenly that's an issue that's on her mind and she'll start talking about who she believes (in our circle of acquaintances) might have an eating disorder. Or if it's Autism she's been reading up on...lo and behold, she'll identify a few people whose behaviour seems mildly autistic.

 

Being a highly trained and qualified professional doesn't seem to render her immune from that kind of thing. I wonder how many other therapists are guilty of the same thing....ie suddenly taking a professional interest in a particular issue, and inappropriately bringing it into patients' sessions.

 

That's just wild speculation of course. There could be any number of reasons your therapist would say that. Is she overweight? People who are do sometimes tend to incorrectly categorise those of a perfectly healthy weight as being too thin.

Edited February 3, 2010 by Taramere

[Devil Inside]

Look Shadow...if you do not feel that you can trust this woman then maybe it is time to look for a new therapist. Like I said...the first step any therapist takes should be to establish a relationship with the client...I don't see her doing that here.

[SadandConfusedWA]

Is she overweight? People who are do sometimes tend to incorrectly categorise those of a perfectly healthy weight as being too thin.

 

This is actually the first thing that came to my mind when reading your post Shadow.