Psychotherapists' personal appearance and the therapeutic relationship : a grounded theory of client perspectives

• Main Author: King, Catherine L.
• Published: University of the West of England, Bristol 2018
• Online Access: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.742285

Research conducted in the fields of sports psychology, psychiatry, nursing, complimentary medicine, social and cognitive psychology, and business psychology, suggests that appearance influences how others perceive the other to be, and in some instances, how this impacts on behaviour. However, within the broad psychotherapeutic literature there is little information about how the personal appearance of one individual affects the behaviour of another and within the field of counselling psychology, which focuses on the centrality of the therapeutic relationship and on intersubjectivity, this topic has yet to be explored. This study aimed to explore clients’ responses to their therapist’s personal appearance; how this is constructed and if these constructions and experiences influence the therapeutic relationship in anyway. The second objective of the study was to construct a grounded theory of this process. A constructivist grounded theory methodology (Charmaz, 2006) was adopted and 16 participants who were currently in therapy or had recently ended therapy were recruited to the study, 14 participants took part in in depth semi structured interviews; a further two participants completed a qualitative survey. The basic social psychological process constructed from the interview and survey data highlights how important the therapist’s appearance is in the formation and maintenance of the therapeutic relationship. Participants appeared to monitor their therapists appearance closely as they engaged in: Searching for cues and clues; and Constructing and reconstructing the therapist in what appeared to be a process of seeking a secure base and Becoming attached. Ruptures and distractions caused by the therapist’s personal appearance seem to provoke hypervigilance in clients and could lead to rupture and detachment. Furthermore the findings suggest that the therapist as a whole is considered, rather than focusing on specific aspects of appearance; it seemed to be difficult for participants to isolate appearance. The findings illustrate how individuals utilise their therapist’s appearance in order to establish safety, trustworthiness and a sense of belonging within the therapeutic relationship. It is clear that multiple aspects of the therapist’s appearance, which contribute to the whole object, play a big part in the therapy, including fixed and changeable characteristics, as well as nonverbal communication.