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I should like to begin with a cautionary tale.
Some years ago, a very frightened and suspicious gentleman came to see me for a consultation. Mr. W. told me immediately that he had already tried to engage with a psychotherapist once before, but that he found my colleague to be reprehensible. I inquired delicately as to the nature of his discontent, and he responded, “Well, she kept analysing my baseball cap.”
Apparently, the patient had come to his first consultation with this highly regarded colleague, wearing his headgear throughout, and the psychoanalyst in question had made a number of remarks about this. The patient recalled, “Within seconds of meeting me, she made some really clumsy comments. She told me that by wearing my hat in the session, I didn't want her to know what might be going on in my head. Can you believe the arrogance? Anyway, I found this very intrusive, and so I left her. I'm not going to have my clothes psychoanalyzed.”
The patient had told me the name of the colleague who had, purportedly, psychoanalyzed his baseball cap. I know this woman to be a decent and thoughtful person who would not, I suspect, make gratuitous interpretations to a patient, and certainly not in the very first moments of the first consultation. But, nevertheless, Mr. W. felt intruded upon, and consequently he bolted.
This vignette raises a number of questions relating to the way in which we as clinicians make comments about patients' clothing, or refrain from doing so. I suppose that one could host a very interesting seminar on the baseball cap incident