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Borderline Personality Disorder: Naked Therapy

vampire-seductress-costumeWhen you go to your therapy session what do you wear and why do you wear it and what does it mean to you?

Many years ago I would spend a week deciding what to wear. Should I wear this skirt because it was bold and flowing or these jeans because they were tight and hugging – leather or lace, denim or Doc Martens? What stylish, stunning threads would be the right ones in order to illicit the response I wanted? It all depended on my intention – was it to entertain and seduce, defend and demand or gain hope and heal?

Years ago I used to dress according to the role I wanted her to play with me, whether it be best friend, favourite aunt, smart sister, emotionally devoid mother, or secret lover and I would spend an inordinate amount of time getting my clothes and hair just right to illicit as many compliments as possible. When I was more regressed and should have been wearing a onesie to therapy, she would always comment on my hair and I’d forgotten about that until she mentioned how nice my new hairstyle looked recently and the memories came flooding back. In the past she always appeared to have a special weakness for my long blonde hair, one that I used to exploit mercilessly for her attention and approval. I always gave her compliments the more sinister interpretation of a seduction scenario.

Whether a cigar is just a cigar depends if you have a psychoanalytic bent or a cognitive-behavioural one. I finally realised that I had a therapist who prefers to stay in the present moment and lets you know that your hair looks nice today and that her compliments should be met with a simple “thank you.” Ever since that time ten years ago I have met similar compliments from other people with a similar response. Much of her firm, common sense therapy has sunk in over the years.

Since I stopped worrying about impressing her and more time asking her to challenge my belief systems, we spend a greater proportion of the time in authentic therapeutic connection. Our conversation has become real and genuine, warm and vulnerable – on both sides. It is what happens on the inside with therapy not what you wear on the outside. The intimate connection happens when you let that hard shell soften because the therapist wants to connect with your inner beauty and not your fashion sense. Clothes can be the barrier you unconsciously choose to protect yourself from hurt and harm when sharing your dark and dangerous past.

Even Freud in his quest for answers to turning neurotic misery into everyday unhappiness failed to realise that what we wear matters and can be an implicit coping/defence mechanism, along with splitting, projection and regression. Do we wear low cut lacy tops to seduce our therapists because we are afraid to let them see the raw viscera of our broken hearts, the naked, vulnerable self that was once so badly damaged? What lies beneath the surface of what Victoria’s Secret covers up is far more important to the curious inquiring therapist.

I do however, notice everything my therapist wears, which is usually baggy, shapeless, black and flowing garments with long strands of pearls, mismatching rings and bracelets. It has always puzzled me because from the back she appears to have a dynamite figure, pretty much the same one she would have had at 18, so she is not covering up issues and secrets between rolls of fat. She eats well and exercises regularly, yet chooses not to show her svelte figure (stunning for her sixth decade) off during business hours. Does she do this so her clients do not know who she is really is, so that they have more of a chance to express who they are? This dramatic attire appears to be de rigueur for the elderly, aging middle-class, wise-witch old-crone therapists who are finally comfortable with who they are. Black is her favourite colour. I sit on a long black couch surrounded by a seething tsunami of black scatter cushions, but her therapy is many shades of cool, calm and collected grey.

In summer off comes the shoes and she sits cross legged in the chair, and so do I. Our mirroring body language connects us at a more intimate level which occurs when I am not fixated on how attractive and pretty I need to appear in front of her. It’s easier to cry when you are not worrying about whether your mascara will run. Cortisol and adrenaline levels rise during therapy so scratching my forehead and cheeks is easier without fear of spoiling my foundation. I constantly play with my hair scrunching my fingers through it, pulling the strands from side to side in order to emphasise a point or to elicit the same hair-pulling and lock-playing transference from her – which ALWAYS happens.

No matter how we wear our hair or dress to impress there is always that ultimate defining moment in the therapy hour where we unwittingly, accidentally expose our deeply protected secrets and realise we are not wearing Gucci or Prada but The Emperor’s New Clothes rendering us raw, naked and vulnerable – and that is where the real therapy begins.


Borderline Personality Disorder: Naked Therapy

Sonia Neale

Sonia Neale was recently awarded the Inaugural Barbara Hocking SANE Australia Fellowship to study and research Borderline Personality Disorder overseas in the USA, Canada, UK and Ireland. Her previous Psych Central blog was called Therapy Unplugged. She is the author of two books, The Bad Mother’s Revenge and Death by Teenager, both published by ABC Books/Harper Collins. She lives in Western Australia, is married with three adult children, has studied psychoanalytic psychotherapy, has a Certificate IV in Mental Health and is studying for a Psychology/Counselling degree. She currently works as a peer support worker in the mental health field.

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APA Reference
Neale, S. (2013). Borderline Personality Disorder: Naked Therapy. Psych Central. Retrieved on October 27, 2020, from


Last updated: 21 Sep 2013
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