In this issue


In search of mother’s love
What unconscious phantasies may be at work when a person chooses to go under the scalpel to enhance their body?

Manifesting men
Should men take collective responsibility for past mistreatment of women? A manifesto aims to raise men’s consciousness.

Reclaiming diagnosis
The medical model has transformed the metaphor of illness into a reality but are there any advantages to the diagnostic approach?

Epilepsy and emotional wellbeing
What are the links between epilepsy and mental health and what sort of emotional support might those living with epilepsy need?


From the chair
Amanda Hawkins: Full of hope for the future

In practice
Julia Bueno: Breaches of confidence

In the client's chair
Caitin Wishart: Awkward silences

Mick Cooper

A dress code for counsellors?

Day in the life
Werner Kierski

The Wednesday Group

Cover of Therapy Today, November 2011

Articles from this issue are not yet available online. Members and subscribers can download the pdf from the Therapy Today archive.


Going under the scalpel in pursuit of youth and beauty is increasingly commonplace these days, not to mention the trend in lunchtime Botox injections, fillers and chemical peels. Programmes like 10 Years Younger in which some bedraggled, exhausted-looking woman is led around a shopping centre where people are invited to guess her age – the humiliating verdict usually being that she looks 56 instead of her actual 40 – make primetime viewing. She is then taken to a Harley Street cosmetic surgeon who diagnoses her ‘problem’ and recommends face lifts, teeth whitening or hair transplants, all of which are followed through on camera.

Of course there are many reasons why people might choose to enhance their appearance – not least because these things are available – and there has been much comment about the cultural influences of supermodels and celebrities at play here. But less has been written about the unconscious drivers that motivate people to actually risk modifying their bodies through cosmetic surgery or indeed simply being overly preoccupied with their appearance.

A new book by psychoanalyst Alessandra Lemma explores this subject in terms of early maternal responsiveness on the developing sense of self. In an extract from Under the Skin, she draws on her experience as an advisor to reality TV shows where, for example, young girls were invited to improve their appearance (albeit without the use of cosmetic surgery). One recurring and striking theme in the stories of the girls – who Lemma was assessing for their psychological fitness to take part – was the wish to present themselves in a way that would secure the loving gaze of their – in most cases absent – mothers.

Lemma also describes how she declined to advise on another TV show where participants were to undergo complete surgical makeovers as she felt uncomfortable with the ethics of the programme. She noticed however that a significant number of the women who had put themselves forward for this makeover were adopted – a fact which she felt might support her theory that the motivation to remodel the body may disguise an unconscious desire to heal a wound from early attachment.

Sarah Browne