In my last session I found out that my T is straight, to my surprise. I had assumed (and hoped) that he was gay because I have huge body image issues. As a fellow member helped me realized, I wanted my T to be gay so that my worth to him would not be compromised by my unattractiveness.

The rational part of my brain knows that they way I look should not matter to my T, regardless of his sexual orientation. The rational part of my brain tells me that my T is there to help me through difficult times and to help me as I embark on a journey of self-discovery, which includes exploring why I use food to medicate painful feelings... in fact, why I eat my feelings.

The emotional part of my brain does not believe any of the above. The emotional part of my brian believes that my T is like most people and therefore he would much rather spend 45 minutes with an attractive woman in his office; he would rather not have to spend time with someone who is overweight and he probably does not like to look at me.

In the midst of this internal struggle, I happened to come across an essay written by a noted,and largely praised, psychiatrist psychoterapist, Irving Yalom. He wrote about his experience with an overweight patient and how he accepted her for treatment so that he could work through the biggest challenge of his career... overcoming his countertransference repulsion for "fat women."

Most of the essay is available online via google books, only a couple of pages are missing. I should warn you that if you have body image issues and if you struggle to believe that you are worthy to your therapist, this essay will likely make you cry, make you sad and feel unworthy.

http://books.google.com/books?id=y_w...0yalom&f=false

If you don't care to read the essay, here are a couple of excerpts to give you an idea:

"I have always been repelled by fat women. I find them disgusting: their absurd sidewise waddle, their absence of body contour – breasts, laps, buttocks, shoulders, jawlines, cheekbones, everything, everything I like to see in a woman, obscured in an avalanche of flesh. And I hate their clothes – the shapeless, baggy dresses or, worse, the stiff elephantine blue jeans with the barrel thighs. How dare they impose that body on the rest of us?"

"Early in my career, I worked in a maximum security prison where the least heinous offense committed by any of my patients was a simple, single murder. Yet I had little difficulty accepting those patients, attempting to understand them, and finding ways to be supportive. But when I see a fat lady eat, I move down a couple of rungs on the ladder of human understanding. I want to tear the food away. To push her face into the ice cream. "Stop stuffing yourself! Haven’t you had enough, for Chrissakes?" I’d like to wire her jaws shut! Poor Betty – thank God, thank God – knew none of this as she innocently continued her course toward my chair, slowly lowered her body, arranged her folds and, with her feet not quite reaching the floor, looked up at me expectantly."

Yalom goes on to write that he also found her boring and he pretty much continues to insult her throughout the essay, describing how he had to push away his repulsion to pay attention to what she had to say. This in particular disturbed me:

"Once I accept someone for treatment, I commit myself to stand by that person…most of all, to relate to the patient in an intimate, authentic manner. But could I relate to Betty? To be frank, she revolted me. It was an effort for me to locate her face, so layered and swathed in flesh as she was. Her silly commentary was equally offputting. By the end of our first hour I felt irritated and board. Could I be intimate with her? I could scarcely think of a single person with whom I less wished to be intimate. But this was my problem, not Betty’s. It was time, after twenty-five years of practice, for me to change. Betty represented the ultimate countertransference challenge – and for that very reason, I offered then and there to be her therapist."

Ever since reading Yalom's horrendous essay, the emotional part of my brain has taken over. I wonder if my therapist feels the same repulsion towards me and he is using me as his "ultimate countertransference challenge." It makes me never want to go back into my T's office. I don't want to be the fat lady in his office...