Feminist Therapy: Pregnant body image, starting therapy, and therapy for kids

I am a therapist, but I am not your therapist. Therapy, in my opinion, is not just about the information I give, but also about the highly individualized relationship I build with each client, getting to know their unique needs, strengths, and challenges. This column is not meant to substitute individual therapy. When in doubt, speak to a therapist about these issues — preferably someone who knows you, who you feel safe with, and who is equipped to support you exactly as you are.

** All of the questions I received were complex, and profoundly honest. Thank you for your submissions. The questions answered in this month’s column were edited for length and privacy, while attempting to preserve the original question.

Dear Feminist Therapist,

I’ve never been to therapy before, but after reading your columns and the resulting conversations in the comments, I’ve realized that seeing a therapist doesn’t mean I’m weak or broken, but maybe the opposite? What should expect going in to my first session? What should I know about being a client?

– J

Dear J,

I’m with you. I think going to therapy takes an incredible amount of courage and, rather than being about weakness, is about strength and healing. It is a largely patriarchal construction of “strength” that implies doing things alone, relationally isolated, without acknowledging our need for each other, is somehow the best way to live our lives. So congratulations on taking this step. (Although, in some ways this is just the very beginning of the journey.)

Therapy really is a relationship, so it is guaranteed there will be some misattunements in the process of your personal work — times when you and your therapist seem to misread one another, or when your therapist isn’t able to give you exactly what you want and need. Believe it or not, having those hard conversations in the context of safety can be an important part of therapeutic work.

Here are some things I like to tell people about first sessions:

– We are getting to know each other. There will be a lot of information giving/receiving, so don’t expect your therapist to know everything about you by the end of the first session, or even after the first few sessions.

– You can be honest. It won’t always feel like a perfect fit right away, but if you feel like something is “off” or not right, you can ask for referrals, wait to book another appointment, or just straight up tell your therapist how you’re feeling.

– Give yourself some time before and after the appointment. Although there isn’t often a lot of therapeutic work that happens in the first session, inviting someone into your life to access all of the memory and emotion associated with what is bringing you to therapy can be a very intense experience. Make sure you don’t have to rush off to something after.

– If you haven’t already thought about it, it could help to have an idea of what you want from therapy. This could include your goals for therapy, what you want the outcome to be, or what you want from the therapist. For example: “Help me learn how to…” Or, “Please simply witness and hold space for me as I process…”

– Have an idea of how long you would like to work for. That is probably something the two of you can talk more about, but there is a big difference in how therapists work if you are planning on only doing three sessions, versus wanting to come weekly for years.

– Don’t be afraid to talk about your fears. Believe it or not, that can be an important way to feel heard, have your needs met, and build closeness. If you’re afraid of being judged, say so. If you’re afraid of not knowing what to talk about, say that too.

– You don’t have to rush into things, and it’s ok if it takes time for you to trust your therapist. Especially if you have trauma, one of the most important things is to go slow and not rush into areas of deep pain too quickly. A metaphor I use with my clients is of a patient going in for surgery within the first five minutes of meeting a surgeon. In reality, many consultations, tests, and diagnostic imaging need to happen before actual surgery, and there needs to be a recovery plan in place. A surgeon doesn’t just shake a person’s hand then cut them open. The same is true of therapy.

Here are some things I like to tell people about being a client, but your therapist might have different or better ideas:

– Honesty is one of the most important parts of making therapy work. If there is something you’re feeling pressured to talk about or if you are feeling unsure about telling the honest truth about something, tell your therapist. It is ok to say: “I’m finding it hard to tell you how many drinks I really had and want to tell you a lower number.” Or, “I don’t feel comfortable sharing that yet — it feels too soon for me. I think it will be easier once I know you better.”

– Keep notes. I like to do this with my clients, but maybe it is something you’ll want to do on your own. I often encourage clients to keep a therapy journal to jot down notes about things you want to bring up or to write down insights and ideas garnered in sessions so you don’t forget them.

– Sometimes things are painful to work through, and even when working through those things is productive, it may not always be fun. There is, however, a big difference between things feeling difficult and things feeling like they are creating more issues. I like to compare this to exercise: feeling a healthy burn in our muscles is a good sign, but it is a very different feeling from herniating a disc in our back. In therapy, we want the psychosocial equivalent of a good burn, with a lot of relational safety as well.

– You don’t have to be in therapy forever, but if you want to, that’s ok too, as long as therapy isn’t in some way decreasing your well-being or functioning.

– Being a client is a very brave thing. It is scary to let someone into the most painful or untidy parts of our life. I encourage clients to feel good about themselves for coming to therapy — there is no shame in asking for help and wanting to do the hard seasons of life with someone.


Dear Feminist Therapist,

Is a five-year-old too young to go to therapy? My friend’s husband died unexpectedly from a heart attack and her daughter found her dad dead in their home. I asked my friend how she her daughter are doing, and if they were going to go to therapy. She said they are getting by, then casually stated that kids who are five don’t go to therapy. Is that true?

–  D

Dear D,

I’m so sorry to hear about the loss of your friend’s husband and of someone who was likely your friend as well. My initial reactions to your friend’s comment are twofold.

First, a lot of people adopt ideas about what therapy is based on how it is portrayed in the media. Therapy is not just about rich white adults talking about anything and everything that pops into their heads, while a therapist discerningly (and from a position of power and emotional distance) scribbles hypotheses onto a notepad. There are many different kinds of therapy, and not all of them are talk therapy as it is traditionally conceptualized. There is overwhelming empirical evidence in support of play therapy for children who have witnessed or experienced a trauma as a way of helping them process and resolve their distress. It is often more difficult for children than adults to verbally and intellectually describe their feelings or experiences, so non-talk therapy can be extraordinarily supportive in terms of helping a child resolve a confusing and traumatic incident.

Second, I’m concerned about the mother’s ability to support her daughter through this trauma given that she is likely struggling to cope with the existing realities of losing her partner herself. It could be important for her daughter to have someone to work things through with who is not also grieving and who is trained to help her find meaningful ways of processing and coping in a time of vast change. Often, comments like “kids don’t go to therapy” might be as influenced by a parent’s fear of inadequacy (“If my child needs someone other than me to support them, then I am ‘not enough’ as a parent.”) or by a sociocultural stigma against mental health supports and the perception that they necessitate out of moral weakness or a lack of emotional fortitude. Although not always true, people’s resistance to therapy can at times come from being uninformed or afraid.

If you or your friend have more questions, doing some more reading might help. The American Psychological Association’s International Journal of Play Therapy could be informative, as well as looking up resources on the website’s of trauma centres dedicated to working with children.


Dear Feminist Therapist,

I am about four months pregnant and my body has really started to change. I’m really looking forward to having this baby, but I’m realizing it’s bringing up a lot of issues. What if my body doesn’t go back to the way it used to be? And, maybe just as importantly, why do I care? I’m a radical feminist and feel totally foolish for caring about that. Argh.

– E

Dear E,

Thanks for mustering the courage to write this. Although not all of the individuals reading this are pregnant, I have read several comments and questions from readers that tell me many of us worry that the ways we feel, act, or think might stand in opposition to our politics. These worries can bring shame, embarrassment, anger, and fear.

Findings from the field of interpersonal neurobiology teach us that we are social creatures and that our brains are profoundly shaped by our sociocultural experiences and our relationships with those around us. Ultimately this is adaptive — early on, it helped us survive. However, when our culture is inherently oppressive to a group of people and those oppressive messages seep into the brains of all people, it does not feel very adaptive or useful… These harmful messages, especially when they’ve been fed to us from an early age, can get hard-wired into the fabric of our “self,” through the subcortical and cortical parts of our brain that make up who we are. So, although we know better intellectually, sometimes it takes a very long time for other parts of our brain to unlearn the things they have been rehearsing for a very long time, especially from early on when our brain is being shaped.

You are not alone — research about pregnant women shows that a lot of women feel frustrated and embarrassed in early pregnancy as their bodies are misinterpreted as being in “ambiguously chubby.” This is a reaction to our explicitly anti-fat bias in North America, and the seemingly ubiquitous shame women feel when they begin to take up more space in the world. Interestingly, as soon as women are identifiably pregnant, there is often a shift in attitude, and women report feeling like their new, larger bodies are celebrated, but seemingly belong to everyone else. Research on women’s experiences of pregnancy indicate that they can feel violated as strangers, without warning, come up to touch their belly or to provide advice about birth. I think this shift towards celebrating the pregnant body highlights the tensions within the embodied experience for women across the lifespan, including the classic Madonna/whore dichotomy: be sexy (usually thin, in the “right places”) until you are a mother, then you can never be sexy again, and your body does not belong to you anymore.

Your body may not “go back” to the way it used to be. Maybe it will. Maybe you will feel like a totally new body/self because becoming a mother — an event intimately tied to your experience of your body — might help you to connect with something within you that helps you see your power, beauty, and strength in a new way. Or not. Whatever happens, likely there will be some change and that will take time to adjust to and maybe it will be glorious and painful all at the same time. Research about the experience of birth indicates that some women feel stronger and more resilient than ever before through pregnancy and birth, reframing skin and stretch marks as a “badge of honour” marking their transition to parenthood.

Whatever happens, try to allow yourself to sit in the experiences you have, share them with those you trust, and see what you can learn about yourself and our culture through them, without judging yourself when you notice what comes up. Thank you so much for writing in.

You can send your questions for Hillary, our Feminist Therapist, to [email protected] or [email protected] with the subject: “Feminist Therapy,” or tweet her @hillarylmcbride using the hashtag, #feministtherapy. (We will anonymize your questions, unless you specifically ask us to include your name.)

Hillary McBride

Hillary McBride is a registered clinical counsellor working in the Vancouver area. She specializes in women's experiences and feminist therapy. Hillary is a PhD student at the University of British Columbia, where she researches women's experiences using feminist methodologies. She is the author of "Mothers, Daughters, and Body Image: Learning to Love Ourselves as We Are" and recently won the International Young Investigator Award in Human Sexuality from Taylor & Francis for her research and clinical work on sexuality in mothers.