my T doesn't really comment on my appearance except to say "nice scarf" or something innocuous like that. but if you're in therapy and you have a lot of bruises it's understandable that he might worry that you're self harming or being abused. sometimes people don't know how to say those things unless they are confronted with them. i would think it might actually be negligent of a T not to comment if there is a possibility the patient is being harmed.