I am bringing this topic up to see if I am not the only person who struggles with being present during session due to feeling self-conscious.

I feel as though I have a really wonderful T. There's nothing that she is doing or not doing to make me feel self-conscious. It's really all me. With an eating disorder, I am used to feeling self-conscious and uncomfortable in my body. But, I feel as though those feelings are heightened during session and it prevents me, at times, from being completely present. It also affects some of the things I say or, in some instances, don't say. Instead of being honest, I censor myself because I feel some things shouldn't be said because I look the way I do. For example, talking about my eating disorder and food/fluid restriction seems silly because I'm not emaciated. It goes on and on like that where many different scenarios and issues are concerned. And, I'm realizing how it is negatively impacting my experience.

I know some of this stems from the fact that I believe that I'm intrinsically worthless. I don't think I am attractive at all. My therapist and dietitian have both said that I dress well and always look "cute." I'm not a beautiful person; all my life I have been called cute or adorable. It's just been in the last year that I have started dressing for my body. A lot of that is due to needing to for work (that wasn't an issue previously and I could hide in baggy scrubs, but cannot do that now). I have a distinct style and I suppose it works for me, but I'm not even sure. My T is very eclectic in her style. She's not what I'd call trendy, but she is kind of hippy trendy...if that makes sense? Maybe that's called bohemian? I don't know. She is a pretty individual. It's not as though I focus on her physical presence, but I do focus on mine and worry that she is thinking negatively of me as well.

My teeth, after decades of bulimia, are not the whitest. They aren't perfectly straight. Granted, they're far from horrific and no one has mentioned anything to me about them before. My skin color is uneven - I am red and patchy sometimes. I don't wear a lot of makeup since I have such sensitive skin, but I wear some. I should wear glasses, but I often do not. My body...ugh. And, then, I always fear that I will look dirty and unkempt. My T has made mention that the one area of self care I excel in is looking clean and put together. But, what if she is lying. As a child, I was neglected. And, since then, I am always very fearful of not being or smelling clean. Geez, I am so ashamed even sharing all of this. Hello, self-consciousness!

All of this just makes therapy all the more uncomfortable and difficult for me. Regardless of who I meet with, it's the same. Am I alone in this? Or, do others have similar concerns? And, if so, how do you combat them so you can focus on the reason for therapy rather than your own self image?