Does the body of the therapist matter when working with clients struggling with eating disorders and body image?

Psychology Blog by Diane McGeachy, July 2020

I have worked with people who have struggled with body image, eating disorders and complicated relationships with food and their bodies for 15 years. The first group I ever ran was made up of 90% Haida women on the island of Haida Gwaii, in remote northwest Canada. These were strong, beautiful, fierce and intelligent women. They were also grappling with the ever-pervasive issues around guilt, shame and self-loathing towards their bodies.

I have never been skinny. In fact, I was often teased growing up. In grade three my friend Sarah, beautiful and thin squeezed through a narrow gap between a desk and bookshelf. As I followed her, squeezing through, my hip bumped the desk. Sarah turned to look at me and said “you’re fat”. Without missing a beat, I hitched a smile on my face and sang “I know”, meanwhile, internally I was filled with shame. In my family, being the youngest of four siblings, I also found myself to be the largest of my siblings, a fact that was not so subtly pointed out to me by my now deceased grandfather. So, it is no surprise that I found myself drawn to work in the area of body image and relationship with food when I was in such turbulence around this topic myself.

I have experienced feedback from all angles, some explicit and some implicit from the people I have worked with. Some along the lines of, you have the perfect body to be doing this work “not too thin and not too big”. In other words, just like Goldilocks and the Three Bears “just right” dependent, of course, on each person’s perspective. Others strayed into the realm of scrupulously taking in my body and determining I was either OK or that I was bigger than them and therefore how could they trust what I had to say about food and body image? Or, if I was noticeably smaller than them, how could I possibly understand what they were going through? They were coming out of their second bariatric surgery in order to shed the weight and keep it off – so what would I know about their pain and shame?

There is what happens within the client which then manifests between the therapist and client. There is also what happens for the therapist and the way they experience their body which then manifests between client and therapist.

So, to answer the question of the title of this blog, yes, the body of the therapist matters. Though, perhaps not in the way one might assume it does. Therapists don’t need to be thin, fit, toned or the postcard for the epitome of health.

The body matters in the way the therapist is attuned to, and aware of their own feelings of discomfort, acceptance, shame, confidence, judgement, etc. If the therapist pretends that their body is not relevant in the course of therapy with their client, they are disowning a part of their experience and what may become useful dialogue in the therapeutic process. In Gestalt Psychotherapy we refer to this as the phenomenology of the therapist. Which, in simpler terms means the way the therapist tunes into their own experience, reactions, feelings and impulses as a means of contributing to meaning making with the client.

This is an area that within the profession has not had much open dialogue. Why not start now.

Questions for you

  • What do you look for in a therapist?
  • Does the size of the therapist’s body matter to you?
  • Do you openly talk about bodies and contrasting sizes with your therapist?
  • Are you looking to lose weight, become healthier, learn to accept yourself, none of these or all of the above?
  • Who do you learn about accepting self from?

Diane McGeachy
Child and Adolescent Psychotherapist
Accredited Gestalt Psychotherapist

Phone: (03) 6285 8592

Hobart Counselling Centre
Level 1,
181 Elizabeth Street
Hobart TAS 7000