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Does my bum look big in this?

Updated: May 5, 2019

This is a question often heard asked in jest, but often it’s asked in earnest as well. Is it asked because someone has an image issue, maybe they are unhappy with their size or even have they been told they look amazing, but could lose a little weight, so many times, they have lost confidence in themselves. Maybe they could talk to someone about it, someone who won’t judge them?

Do you get your car serviced regularly?

Do you have a skin cancer check?

Did you get that broken bone seen too, or did you walk around and hope it heals straight all on its own?

Would you talk to a psychotherapist or counsellor about your doubts and fears in life?

When we have something going on in our heads why do we feel the only option is to go to a GP, seek out a psychologist, and/or take the medication prescribed. We might not need medication. We might not need a diagnosis. We might just need to talk about the problem with a non-judgemental professional, that will help us find the way to the answers we already have.

Of course, in some cases, you might need medication and/or a diagnosis, but in many cases, talking through the issue in one to 10 sessions may be all you need to go on your way.

But counselling and psychotherapy has a bit of an image problem. This is for a number of reasons, but these might be considered the main ones:

1. TV and Film

Regrettably the portrayal of our profession in TV and film is often less than favourable. It is often portrayed with unfavourable images, unrealistic standards or promotes negative stereotypes. Often clients fall in love with their therapist and it is returned (It’s Complicated 2009, The Prince of Tides 1991), unprofessional staff (One Flew Over the Cuckoos Nest 1975, Anger Management (2003), Couples Retreat 2009), get involved in clients lives outside the therapy room (Analyze This 1999, The Sopranos (1999 – 2007), In Treatment (2008 - 2010). Of course we also see Hannibal (2013 – 2015) kill and eat his clients.

This isn’t to say all movies and television programmes show the negative, and it’s actually vastly improved over the last few years, with films like It’s a Beautiful Mind (2001), Little Miss Sunshine (2006), It’s Kind of a Funny Story (2010), and Prime (2005).

From a viewing point, I think it can be tough to separate the art of the theatrical from reality. In real life counsellors rarely play it for laughs, it’s guaranteed we’ll won’t help you with information about your business competitors, we may fall in love with you or you fall in love with us, but we’ll refer you to someone else. I can only speak for myself here, but I lack the physical strength to take you down to eat you, plus, I’m a terrible cook.

All Counselling Associations have ethical guidelines we have to adhere to. Here’s the Australian Counsellors Association guidelines for a little light reading.

2. Stigma

There is still a stigma about going to see someone about mental health issues. This might be a really good time to remind you about a therapist’s commitment to confidentiality and privacy.

We keep all records locked away behind locks and keys or passwords. No one can access your records without your written permission.

If we see you out and about we are legally not allowed to acknowledge you first, for privacy reasons. Imagine if you will, I see a female client at an event and she’s with her family. She may not have told her partner that she’s seeing a counsellor because he thinks they are a waste of time. I say hi and he asks, ‘how do you know her then?’ I’ve started a conversation that could be dangerous in some circumstances. I never say Hello to clients useless they say Hi first, and I’m never upset if they walk on by.

I have my practice in a private, anonymous place. This allows clients to come and go with the knowledge that no one know why they are there. They are just visitors as far as the neighbours are concerned, if they are even noticed.

There’s no stigma about getting a physical ailment treated, most Doctor’s Surgeries have big signs boldy announcing their presence and purpose, and yet, it’s unlikely you’ll feel shame or embarrassment walking through their door. A therapist’s door, provides the same levels of confidentially, privacy and commitment to your health.

3. Previous poor experiences

I often hear that clients have had previous attempts at therapy, but it was a ‘horrible experience’, or ‘it was a waste of time’, or ‘we really didn’t ‘click’’.

Just like any service, you need to find the right provider. This may require a little shopping around.

With therapy, there are a number of things to consider. Methodologies used, location, hours of operation, area of speciality and, finally, character fit. If you do not feel your therapist ‘gets you’ it’s unlikely the therapeutic relationship will form well and sessions will feel wrong. Leading to a poor experience, one where ‘I just didn’t click with the therapist’.

If a therapist feels they aren’t the right person to help you long term, they might suggest they refer you to another therapist or service. This isn’t because they don’t like you, it’s often because they feel that they can not provide you with the correct level of assistance or the correct type of assistance. They want the best for you. A therapist will always discuss their reasons for suggesting a referral, and I know from experience, it’s tough to see a client go, knowing you may never know what happened next. We care enough about our clients to see they get the best help, and that’s not always the first person you see.

4. They don’t have any qualifications

True, but these days most therapists have spent many years at university to gain degrees, masters and PhDs to be a therapist.

University Canberra, University of New England, University of Queensland, Jansen Newman Institute and Australian College of Counselling all offer Bachelors and Masters programs. Australian National Uni, Curtin and Sydney Uni all offer counselling specialist programs at Bachelors and Masters level.

Most professional associations require members to complete at least 25 hours of ongoing professional development every year. This can be generalised or specialist training. For instance, I recently attended over eight hours of suicide awareness training and earlier in the year I attended a two day grief and loss experiential workshop (I was required to learn from my own losses).

If you are concerned about a therapists qualifications, you can ask to see proof. They will likely happily show the certificate. It often took many years and much effort to obtain.

5. It can be expensive

Yes it can be, but most therapist will operate a sliding scale for clients in need

But before you consider asking for a discount consider this. Annually therapists need to be insured ($250 – 500 depending on level of cover), registered with at least one professional association ($260 – 400 depending on level and assoc.), at least 10 hours of clinical supervision regardless of whether they see clients ($150 – 250 per hour), minimum 25 hours of ongoing professional development (average $100 per hour), plus printing, advertising, rent, book-keeping, report writing, accountants fees etc. Just because we care, and we really do, doesn’t mean we don’t have considerable costs to allow us to care.

I need to see clients for 55 hours (at my full hourly rate), just to cover my costs. Now consider most therapists only work part-time hours because this can be a very mentally draining work, it can take time to recoup. Especially if you consider therapists will often discount up to 100% in some situations.

If you get a mental health care plan (MHCP) from your GP, it isn’t free either, in fact the gap is usually about the same as the cost of a fully qualified and accredited counsellor or psychotherapist. The benefits of seeing a therapist is that you can form a long-term relationship that doesn't have an enforced end date after six or 10 sessions.

I hope this has answered some of the questions you may have about why counselling and psychotherapy might have a bit of a bad reputation.

We’re qualified, caring, dedicated, and all for working with you, and now, more than ever we are needed to help folks navigate the 21st century.


This post was written as part of National Psychotherapy Day on September 25th. Since 2012 this day has been celebrated to help raise awareness of the benefits of psychotherapy, help to break down mental health stigma and encourage you to give constructive feedback to professionals all year round.

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