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What Should a Therapist Wear?

When your clothing is meant to help patients heal.

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“Don't wear blouses and skirts with prints or patterns. Plain colors like beige, navy, and white work best. Choose simple accessories like silver stud earrings and small pendants. Never wear black.”

A personal stylist didn’t share this fashion advice with me; my psychology professor did.

Psychologists like me are trained to pay close attention to subtle non-verbal cues that emerge during a client’s therapy hour. To do this, we try to eliminate visual distractions by curating a serene space that resembles a cozy yet barren living room.

Some therapists — like my former professor — also believe that wearing patterns and vibrant colors can be a distraction. They suggest erring on the side of caution and only wearing solid, neutral colors, except for black. Black is a depressing color that many people associate with funerals.

I was a compliant student, but I didn’t follow this advice.

I’ve always enjoyed the art of dressing, and fashion is a form of creative expression that sparks my soul. As a kid growing up in Nebraska in the 1980s, I eagerly awaited the arrival of the J.C. Penney catalog every season. I’d flip to the girl’s section and cut out pictures of pink and green tops, black and white ruffle skirts, and fancy lavender taffeta dresses, then work the individual photos into paper outfits of my own making. While other kids spent their allowance on Cabbage Patch Kids and Care Bears, I saved my money for a pink and blue satin jacket. When I graduated with my doctorate, I rewarded myself with a pair of black leather Marc Jacobs Mary Janes.

Of course I wanted to be the best therapist I could be, but I didn’t want to negate my passion for fashion — or my personality — by exclusively wearing boring, monochromatic colors to work. In fact, on my first day of work as a psychologist in the San Francisco Bay area, I wore a green A-line Anthropologie skirt adorned with birds and pale green sandals decorated with delicate white daisies.

At the time I worked with young adults, many of them female. Most of these women had never seen a therapist before. They sought help because of crippling anxiety, major depression, and relationship struggles. Often, they were hesitant to open up to me. But some of these patients commented that they liked my clothes, and the prints became visual prompts that infused life into our sessions.

One of my former patients, a shy, young woman with social anxiety, struggled to express herself. In our initial sessions, there were long, painful silences. I sensed how difficult it was for her to open up.

But during one session, she began the hour by commenting on my bird skirt.

“I like those birds,” she said.

“What do you like about them?” I asked.

She told me they reminded her of freedom. Using the metaphor of flight, we explored how her anxiety kept her from feeling carefree. She told me how her worries prevented her from traveling abroad, dating, and accepting invitations to parties.

“Birds can fly alone, but they never seem lonely,” she said.

The bird became a focal point of our sessions. Even when it was difficult for my patient to talk about her anxiety, she could talk about the bird’s plight with ease. We began to explore what changes she needed to make in order to feel freer, too.

My patients haven't always responded positively to my sense of style, though. A decade ago, I had been treating a young woman who was struggling with body image concerns. During one of our sessions, I wore a bright pink vintage-inspired skirt and a black cardigan with miniature rosebuds on it. My patient looked at me and said she couldn’t stand my outfit.

“What bothers you about it?” I asked.

She told me it was too “cutesy” and that she had imagined working with an older therapist, like Dr. Frasier Crane from Frasier.

We discussed how my clothing prevented her from taking me seriously and thus trusting me.

“You just don’t look like a real therapist,” she said.

In our future sessions, I toned down my look. I still refused to embrace bland white, beige, and black. But I steered away from whimsical printed skirts and floral cardigans, instead opting to brighten up navy tops with colorful necklaces.

I later learned that my patient’s mother had been a clotheshorse. During adolescence, her mother had criticized her sense of style, which she had labeled as "frumpy."

I made the connection between her childhood experience and my “cutesy” style and asked if the two were related. We laughed at the cliché “mother” transference interpretation, but she didn’t disagree.

Criticizing the way I dressed, she was able to voice feelings that she’d never been allowed to share with her own mother. Feeling comfortable enough to critique my outfit helped her work through her anger at her mother for always trying to control what she ate and what she wore. It also helped her recognize how her mom’s judgment had affected how she felt about her own body. She had always felt inferior to her mother, and my outfit had triggered similar feelings. She told me it helped that I had listened and allowed her to express her opinions.

Recently, I was talking to a friend who was graduating with her master’s degree in psychology. As I told her about the nuts and bolts of beginning a private practice, she also asked me for advice about clothes.

“Should I watch the way I dress when I begin my practice?” she asked. “My advisor told me to dress in solid colors to maintain a ‘neutral’ stance. He also mentioned that if you wear things like designer shoes, patients might see you as a certain ‘type’ of therapist, or ask overly personal questions,” she explained.

“You don’t have to be a blank slate,” I said, thinking back on how, over the years, my refusal to adhere to that standard-issue advice had helped both me and my clients grow.

I told her that a therapist’s outfit is similar to the classic Rorschach inkblot card: It’s a visual image that can invite and ignite our patients’ projections, helping them tap into different parts of their psyches. “Actually, I think it’s most important to be yourself.”

Details have been altered to protect patient privacy.


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