Self-consciousness affecting ability to be fully present during sessions...

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?

Not alone at all. It is hard but with time I think gets easier.

I censor stuff too. You are definitely not alone in that. My shame is due to other things (dependence, non-functioning, overeating) but the effect on me is the same.

I feel the same way,, usually what I'm dealing with emotionally is enought to knock it to the background.. but there are times when I feel so untogether and just blah. I have dentures on bottom teeth and not the best other, I usually don't have energy or want to put make up on and am not the most stylish person.. T is really sharp and looks very together. all the time.. sometimes he makes comments on his self care and making sure to take care of the lilttle things everyday.. I feel bad for how disgusting I feel physically so i kind of "pass by " those comments and sometimes think to myself.. ugh.. it looks like he takes good care of himself and that is good and honestly I feel safe like that.. but it still makes me feel bad about how I feel about myself. like I'm less thatn

I have this issue, just not related to eating disorders. It's such a small, intimate space with nothing else for my T to focus on, and I despise being the center of attention. I am painfully aware of every single flaw of mine during those 50 minutes, and it changes what I say and how I say it. I can be direct about anything in writing, but she has me read any writings aloud, so I just don't bring any.
The only time I felt more at ease was when I decided to lie down. My position made it more awkward to look at her than not, so her staring, facial expressions, and body language weren't my focus.

I completely relate to trying to be fastidious in my grooming due to neglect as a child. I always fear smelling badly or being unclean. Stained clothing bothers me a great deal. I'm not sure yet how to get over it. I am overweight but I try to dress trendy or at least clean and pressed. My t's have all said that my eating is disordered somehow but I don't fit an existing diagnosis. Over the years I have gotten better about just telling t's what is on my mind. They have heard it all and they tend to be really kind people who are driven to be helpful.

My current t had an abusive childhood which helps me open up to him about my own past. Taking the first step and telling t how uncomfortable you are is a good first step.

I'm completely self-conscious about my looks. I was pretty when I weighed less. I used to do modeling when I was younger. But now, I'm way over-weight. I feel like a disgusting piece of s***. I always worry about if my T notices how ugly I am. I struggle with self-care. But I make sure to always shower for T (wouldn't want to be dirty when she gives me a hug!) I also have skin problems and teeth problems, and never wear make-up. There's also the problem with the couch... It's an old leather couch. I sink back into it, so that when I get up it rocks with me (so embarrassing!) I can barely get out of it.

It was really bad one time. I admitted to my T some of the words I call myself (i.e. whale). She repeated the words back to me. I think it was supposed to feel like it was untrue. Instead, it felt like she was calling me those words. It hurt and felt so uncomfortable.

I just try my best to put the thoughts and feelings out of my head. I try to focus on the topic. Sometimes, the thoughts creep in. So I still struggle with it.

I completely understand how you feel. I think being the center of attention is torture. I stopped seeing one therapist as he'd always sit and stare at me, and then when he told me I looked very nice in the dress I was wearing, I was so uncomfortable I never went back!!!

Most of us don't see ourselves as others see us. Watch this 6 minute video by Dove Soap where they hired a forensic artist to sketch a group of women based only on their descriptions of themselves--the women were behind a curtain so he couldn't see them. Later these women came back and were assigned to chat with a random stranger for a few minutes, and then the stranger described the women to the artist who drew a second sketch based on that person's description. It's very interesting how much more accurate the stranger's description is. I've watched this numerous times, and find it's really helped me to see myself more accurately.

Dove has done some great work in its campaigns against body shame. I do like that video

I can relate so much to your post. I've been starting to just say in session when I feel awkward, embarrassed, or uncomfortable either emotionally or with my body. I usually avoid eye contact while I do this, but it helps me to get it out and start to talk about it. Some of it I wasn't ready to talk about beyond mentioning it, but I'm slowly getting there.

I saw that video too... it is super powerful!!!

For me the issue was the asymmetry. Feeling so exposed while the other person is protected does not feel right. It feels voyeuristic. I think it's important to listen to the body, to see if it is experiencing too much distress or dsyregulation from this kind of intense exposure, rather than ignoring such signals. If it feels distressing or exhausting or upsetting, then it is.

If you're therapist tells you that the one area of self care you excel in is looking clean and put together, you should believe her. She's telling you the truth. It's your own fear that is causing you to doubt her. One thing I've learned is that if someone says something positive about you to you, believe them. They are telling you the truth, they have no reason to lie.

For me, it got easier as I got older, as many things do. (don't know if we become wiser or just don't care anymore, maybe both)

For years there were certain words I wouldn't say - body, woman and vulnerable to name a few. In therapy I gradually began saying "the 'w' word" - actually calling it that out loud. The t knew what I meant but didn't push it, and it gradually became easier. I still don't like some words, but can at least use them.



Sometimes you're the windshield, sometimes you're the bug. -Mary Chapin Carpenter