[ScarletPimpernel]

In yesterday's session, L offered to send me her notes so that I can remember what we talked about and to connect more with her and our relationship. I have never seen a therapist's notes. I have accidentally seen ex-Pdoc's and current Pdoc's notes (they were fixing the portal and accidentally showed my notes). It was really weird reading L's notes. Client xyz, therapist xyz. The last part of her notes was called assessment. Part of it said: "Client appeared comfortably dressed, groomed, and oriented x4." Is she judging my appearance?!?! Is this a normal thing? I'm super self conscious, and I really struggle with my appearance especially due to my weight. I have never liked video or pictures of me. H and I only have 4 pictures of us together in the 14 years we've been together. The only reason I now allow my picture to be taken is because I want my nieces to know that their auntie was there and loved them. I'm just shocked L is paying attention to how I dress.

[chihirochild]

As a medical professional, I can tell you that this "commenting on appearance" is a standard part of any psych note. For example, some clients come in disheveled or smelly and since that is clinically significant they write that down. Other clients are so buttoned up that they come in full suits all the time, and that is clinically significant too.

I don't think she's judging you on your appearance but rather noting that you are clean and appropriately dressed for the situation.

ETA: the "oriented x4" part just means that you know your name, where you are, the date, and the situation.

[Rive.]

In this context it is not about judging but yes, a client's appearance can be indicative of e.g. a distressed state of mind or a decline in how they are doing emotionally. It is an additional source of information.

So, in the context you mention, it is more as clinical assessment then judgment.

[Omers]

My Pdoc has a form she fills out with a scale. Appearance is on there. I have shown up to meet her in everything from business (as dressed up as I get) to just left the barn and still get “full points” so it isn’t a judging or fashion thing. To be honest if I showed up with my hair done wearing a dress she would likely be highly concerned. Jeans with a slight horse odor and a few odd stains... no big deal... it is my “normal”.

[LonesomeTonight]

I've also read it's used to assess mental health status. So I don't think it's judging, but just another piece of data. I know ex-T used to write down things like "appears anxious today" or "Seems tired" (I asked her before what she jotted down on occasion), which isn't quite the same as appearance, but similar (I imagine she took at least mental note of that as well, if it differed from the norm).

[divine1966]

It’s standard. I am not a therapist but deal with assessments/evaluations of individuals. Reports do have to include basic description of how the person appeared. It wouldn’t include if someone is overweight or doesn’t wear designer clothes. Just basic description

It doesn’t mean that your appearance 100% matches your mental state, it could be completely opposite but some of the observations could help interpret data etc and just simply provides extra observation that could be useful

[Salmon77]

If you're "groomed" and "comfortably dressed" that's a sign you're taking care of yourself and you're tuned in to the weather, your surroundings, your body, etc. As opposed to someone in a deep depression might show up in dirty sweatpants, for example. She probably isn't judging whether you look cute or fashionable or anything like that. Just whether you're clean and appropriate to the situation.

Recently I wore a new pair of pants to session and mentioned to T that I liked them but I think they make my as.s look kinda big. Then he said I was "emphasizing my as.s," which I thought was pretty unfair, I was just talking about clothes the way I would talk to a girlfriend. So I guess they also judge whether you might be trying to show off your hot bod for them or something like that.

[ArtleyWilkins]

It's normal. Part of the assessment of overall well-being. Are you able to take care of daily needs, etc. It isn't a judgment.

[LonesomeTonight]

Salmon's reply made me think of something. I was wearing distressed jeans to session once (like intentionally distressed), and T was like, "Things so bad you have holes in your jeans?" He was joking of course. But I admit I avoided wearing them there for a while because I didn't feel like dealing with the joke. There was one time I wore them and he said that again, and I said, "Actually, yes" (because I wasn't in a good place. He'll also comment if I'm wearing new shoes (they're all sneakers of some sort generally) and made a comment once that showed he knew which purse I generally carry. And he's asked if a necklace I was wearing was new and if there was a particular significance to a beaded bracelet I kept wearing (I said I basically use it as a fidget toy during session). So he's clearly paying attention. And would notice if something changed dramatically, though I have been more casual and not bothering with makeup (which I made a comment about) since we've been doing teletherapy (well, I did put on makeup the first time, but then the next time was like, "Eh, why am I bothering?")

ETA: I think he also uses some of the comments, like "Oh, are those new shoes?" as an icebreaker, particularly if I seem overly nervous that day.

[Crook32]

I believe this falls under the ADLs (activities of daily living). My T has discussed them before. These are the types of things they look for while you are in the hospital.

There are six basic ADLs: eating, bathing, getting dressed, toileting, transferring, and continence.

[LonesomeTonight]

Originally Posted by Crook32

I believe this falls under the ADLs (activities of daily living). My T has discussed them before. These are the types of things they look for while you are in the hospital.

There are six basic ADLs: eating, bathing, getting dressed, toileting, transferring, and continence.

Out of curiosity, what's transferring?

[Crook32]

Originally Posted by LonesomeTonight

Out of curiosity, what's transferring?

I believe it is like the ability to move from a chair to a couch for example. A lot of these checklist are made for nursing homes.

[LonesomeTonight]

Originally Posted by Crook32

I believe it is like the ability to move from a chair to a couch for example. A lot of these checklist are made for nursing homes.

Oh, I see, that makes sense. Thanks!

[SummerTime12]

This is typical! When I’m doing crisis assessments, there’s a whole section called ‘mental status exam’ dedicated to things like this. I make note of things like cleanliness, eye contact, and (for kids) if they appear large or small for age, if they’re orientedx4, tone of voice, affect, and lots more..

[sophiebunny]

They evaluate your level of self-care not your fashion sense.

[ScarletPimpernel]

Originally Posted by sophiebunny

They evaluate your level of self-care not your fashion sense.

I have no fashion sense. I wasn't worried about that.

[ScarletPimpernel]

Thank you all. I asked L as well and she explained it to me similarly. She understood where I was coming from and reassured me that my fears were not the case. But she did say that my fear would be a good topic to talk about in a session.

[Mountaindewed]

I’m not sure about judging but she does comment about my appearance but everyone does so I guess it doesn’t matter. I came in wearing a plain black shirt one time and she said “oh this is the first time I’ve seen you in a non cartoon shirt.” Also one time she asked me what my shirt meant. I was sitting down and our session had been going on for awhile. So she must have been looking at me if she was trying to figure out my shirt. I had an open jacket on too.

I just take it that she’s paying attention to me.

[RainbowSadness]

Originally Posted by LonesomeTonight

Salmon's reply made me think of something. I was wearing distressed jeans to session once (like intentionally distressed), and T was like, "Things so bad you have holes in your jeans?" He was joking of course. But I admit I avoided wearing them there for a while because I didn't feel like dealing with the joke. There was one time I wore them and he said that again, and I said, "Actually, yes" (because I wasn't in a good place. He'll also comment if I'm wearing new shoes (they're all sneakers of some sort generally) and made a comment once that showed he knew which purse I generally carry. And he's asked if a necklace I was wearing was new and if there was a particular significance to a beaded bracelet I kept wearing (I said I basically use it as a fidget toy during session). So he's clearly paying attention. And would notice if something changed dramatically, though I have been more casual and not bothering with makeup (which I made a comment about) since we've been doing teletherapy (well, I did put on makeup the first time, but then the next time was like, "Eh, why am I bothering?")

ETA: I think he also uses some of the comments, like "Oh, are those new shoes?" as an icebreaker, particularly if I seem overly nervous that day.

My T does this to me too, comments every time I have something new. I know he sees it as a casual conversation starter but I honestly don't like it. Makes me feel like I'm getting myself too much. I'm also oddly shaped so many items end up being donated and never seen again cause they didn't fit proper or just didn't rub my self-esteem the right way. I'd much rather him just ignore my clothing situation. No one but me and the bank account needs to know how much I waste on clothes.

If I ever show up looking completely different, that's something interesting he can comment on, lol. I've actually been making a lot of changes during the lock down so this might happen when we eventually meet again.

[nottrustin]

I wouldn't say they are judging our appearance but rather assessing to see where clients are compared to the "norm". Sonce normal is a pretty wide spectrum, the providers at my job usually qualify what they are seeing.

As far as our personal providers go, I believe, they compare it to what our normal is. I normally leave work to see T so I am normally dressed pretty formally and pretty well groomed. If I sudden started showing up in total disarray then it would be cause for concern for her because it is not MY norm. Now of I were to normally show up after working at a job like my husband has in dirty jeans and a t-shirt that would be my normal and appropriate for my job so that would not be cause for concern.

[susannahsays]

If by judged, you mean they note whether we're taking care of ourselves, yes. I mean, if I show up with greasy, unwashed hair, that tells my therapist I'm struggling with basic ADLs (like someone else said, activities of daily living). Conversely, if I show up and am looking particularly nice - I have bothered to wear something other than sweats and have put on earrings and makeup, for example, the therapist might conclude that I'm doing particularly well and may be even feeling social since I suddenly care about my appearance.

Honestly, I don't rule out that they also judge our appearance in the way that you meant, either. They're people just like everybody else, and people are constantly judging. It's how our minds work. However, based on having worked in a mental health agency, the only thing related to this that really seems to make a negative impression on a personal level with therapists is when clients have poor hygiene in such a way that they smell really bad. We're talking about severe body odor which makes it hard to be in the same room as the person and that lingers after they're gone.

[Mountaindewed]

I wore an oversized red hoodie today because I thought I looked hot in it and I kind of wanted her to notice. Especially since all she’d see would be the hood part. So yeah I was kind of dressing to impress today. Did she care? I doubt it.

[SlumberKitty]

I can only imagine what the psych doctors and social workers thought of my appearance when I was in IP. My parents brought me the oldest clothes to wear and my hair was all wild because I couldn't blow dry it or straighten it. When I got transferred from the ER to the mental hospital, I hadn't showered in three days so I'm sure I looked like a hot mess. Generally, I think my therapists just look to see if I look clean and neat and wearing appropriate clothing for the climate (except I always wear long sleeves) even in 100+ degree heat.

[Fuzzybear]

Definitely T1 said I had a ''good figure'' and later on he harshly criticised my clothes

T2 said I had ''put on weight'' I was on some meds that are notorious for weight gain. I didn't even ''need them'' - I had got by just fine without them. I was put on them for reasons of cost.... so that it appeared I was receiving ''care'' (as that was all they offered, meds and nothing else. and a label) And they were almost impossible to wean off. But eventually I did...

T1 and T2 were both paid for privately.