In What Ways Might a Counselor’s Own Body Image Impact on Patient Work?

I would describe body image as the perception one has about one’s body, and the negative or positive thoughts and feelings that are derived from this perception.

Learning to love myself holistically, with a focus on body image, has had a constructive impact on my patient work. It has increased my bodily awareness, which in turn has enabled me to notice more non-verbal cues from patients and has increased my empathy for their body issues.

My feeling is that there is a need for counselors to apply the humanistic values of unconditional positive regard, empathy and congruence1 not only to our emotional selves, but also to our attitudes towards our bodies.

Some beliefs we have about ourselves are not verbal and part of a counselor’s task is to bring a patient’s belief systems into a more malleable form in order to understand them. Many patients I have worked with felt victimized by their bodies. They had not learned to listen to what their body was telling them. I have seen this in sexual trauma, where often people detach themselves from their body as the site for traumatic events and deny or delay their body’s needs. Often, their body is simply trying to heal and clamors for attention to parts that have been neglected or harshly used.

I believe that patients with body issues are not vain, but struggling to feel acceptable in a harshly critical environment that fosters discontent with the body.

Body Issues

Some  patients believe that if they change their size or shape, their emotional problems and conflicts will be solved and they will feel better about life. Often, they feel disappointed when they reach this ideal weight or shape and realize that some issues are more complicated than they thought. Societal pressures to conform to contemporary beauty standards robs our bodies of their due essence and value and often this sense that our body is undesirable causes pain for what could be a simple and natural rejoicing in being alive.

It can be revelatory for people to realize how they habitually address their bodies and even reject parts of them. To feel more grounded, and to empathize with clients’ body image issues, counselors could explore how they see their bodies, how much power they feel over their own self-care and body image and how much their thoughts affect their bodies.

Is it not incongruent if a counselor encourages his or her client to thank her body for the miraculous things it can do, to love it unconditionally, when the counselor has her own harsh body critic and does not listen to what her own body needs?

To create security externally in our lives but also for our clients, it is necessary to first and foremost feel confident in our own bodies, otherwise it is difficult to create an environment for the patient that is based on self-respect and kindness. In client work as in wider life, when something feels consistently ominous or perplexing, I trust that I will listen to myself and try to be as congruent as I can be in my response to it. I now allow myself to experience emotions through my body before making sense of them intellectually, for example, screaming or crying with rage.

Follow a Feeling

Through counseling, patients can learn to listen to what their bodies are telling them, to re-experience their bodies. I have worked with clients who have gradually allowed themselves to follow a feeling (for example, wanting to cry or laugh), rather than stopping it in its tracks and this act has been an emotional release for them.

By learning to sit with uncanny sensations without immediately needing to understand them intellectually, clients can work through challenging, angering and anxiety-inducing experiences that have not been addressed openly, but that stagnate under the surface, draining energy.

For some people, coming face to face with what their bodies are really saying or working out what their poor body image really means to them, can bring up a disquieting self-critical voice. In these times, we can hear that voice and gently support the client to overcome it and move towards self-acceptance. Many themes in counseling work include the body, in direct and indirect ways, such as ‘sexuality […], concerns about eating, digesting, defecating, being big or small, being attractive or ugly […], fertility, being ill, dealing with the loss of functioning of parts of the body and the encounter with death’.6 These topics bring up questions around the denial or acceptance of the body.

Many people have a troubled and complex relationship with their bodies and may hold distress or humiliation about their bodily needs. Counselors are not immune to these issues. Once we are aware of our bodies and feel more at ease with them, we can feel more animated and focused in our client work and flourish in our lives generally.

If we can communicate a sense of enjoyment of our own bodies, less hampered by social expectations, growing towards self-acceptance and self-compassion, we can perhaps inspire confidence in our clients about the feelings they have towards their bodies.


 1.     Rogers C. “On Becoming a Person: A therapist’s view of psychotherapy.” London: Constable and Robinson Ltd; 2004.

2.     McLeod J. “Qualitative Research in Counselling and Psychotherapy.” London: Sage; 2001. (p. 380)


Alison Sharman is a qualified, BACP-registered Humanistic and Integrative Counselor, working in Bristol, England. She works at a charity that specializes in counseling for survivors of sexual abuse and assault; as a school counselor and has a private practice. Her research interests include trauma, abuse and body issues.


In What Ways Might a Counselor’s Own Body Image Impact on Patient Work?


APA Reference
Sharman, A. (2019). In What Ways Might a Counselor’s Own Body Image Impact on Patient Work?. Psych Central. Retrieved on October 29, 2020, from


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Last updated: 21 Sep 2019
Last reviewed: By John M. Grohol, Psy.D. on 21 Sep 2019
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