I have very low self-esteem. Every therapist I have seen in my life has made a point of telling me I am homely and unattractive, whether I brought up the subject of my looks or not. In a group they were intent on assuring another patient how pretty she was, but at the same time putting me down. We both had short hair and no makeup. Other therapists have put me down as unfixable unattractive, even when I had long hair, makeup, and a basically fit body. Male and female therapists alike expressed this opinion, even when they liked me as a person and enjoyed working with me. I know I’m not a supermodel, but I think I’m pretty enough for people in general. Why would providers tear down a vulnerable patient like this? (From of USA)
There are several elements of your question that I think are very interesting and important to explore. I’d like to focus on three of them.
The first is the fact that you’ve written to us about this issue. It demonstrates bravery, honesty, and humility in taking what sounds like a long-standing issue and putting it front and center. Since the issue is self-esteem you’ve begun with the most important feature, which is learning to speak up and having a voice about your needs. Bravo!
Our very own Marie Hartwell-Walker has written an excellent book on self-esteem that can be very helpful in continuing to develop your strength and voice. You can learn more about the book here and here.
The second of your concerns has to do with the fact that there is universality among different therapists at different times, in different formats, across gender. You identify the phenomenon as life-long, in group and individual psychotherapy, with every male and female therapist, and coming at you unsolicited. This is important because it means that no matter where you look in the therapeutic community there is one recurring theme happening — they are all pointing out how unattractive and homely you are.
Whenever there is a universal theme that pops up in therapy, particularly when the matter is life-long and with multiple activators, the first question to entertain is what could be causing this? If someone told me everywhere they are looking the world seems colored in an orange tint — the first thing I’d look to see is if they are wearing orange-colored glasses.
To test this out you’d want to ask yourself two questions. First, did this type of put-down occur in your family of origin or in other significant relationships? If it has, then this becomes a very fertile ground to explore because it means that there have been other incidents where the people who should have loved you treated you poorly. If this is the case, the therapeutic environment is where it is happening again. This changes the understanding of the phenomenon because it is a recurrence — not a first-time happening.
The second question you’ll want to ask is if there is any incidence where this wasn’t happening in therapy. Look for the differential. See if there were times when this wasn’t happening, or people that it didn’t happen with that could be explored. Understanding where it doesn’t occur is as important as understanding where it does.
Finally, I would highly recommend that whatever the results of your thinking on this topic produce that you bring it back into therapy. Tell the therapist immediately when you feel it has happened. This gives both empowerment to you, and insight for the therapist to work with in making a change that can be helpful.
Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral
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