Perspectives in Practice: Conversations with Health Psychology Professionals
Co-written by Yvette and Bernie, featuring insights from Dr. Alicia Carter, with support from AI-generated content (ChatGPT).
Welcome to Perspectives in Practice, a series dedicated to sharing real-world insights from professionals in health psychology. In each installment, Bernie, a registered psychologist and health psychology registrar, sits down with peers to explore how health psychology shapes their work.
In this conversation, Bernie speaks with Dr. Alicia Carter, a health psychologist in private practice, academic, and researcher whose work centres on compassion-focused therapy and body weight shame. Together, they discuss how health psychology takes shape in practice, the impact of weight stigma in healthcare, and how compassion can open a path toward healing.
Introducing Alicia
Alicia is a psychologist, researcher, and educator, seamlessly blending science and practice in her work. She holds a Master Degree in Applied Psychology (Health) and a PhD, where she focused on Compassion-Focused Therapy and body weight shame. Her doctoral research involved the first randomized control trial of Compassion-Focused Therapy, exploring group processes, physiological responses like heart rate variability, and outcome assessments at post-intervention as well as 3-month and 6-month time points. Her research confirmed the benefits of Compassion-Focused Therapy for those struggling with body weight shame in addition to mental health outcomes (i.e., symptoms of anxiety, depression, shame and self-criticism).
From Brisbane to Cairns, Alicia continues to see clients while teaching, researching and supervising students. At Central Queensland University, Alicia teaches into the Honour of Psychology and Master of Psychology courses and supervises research Honours and Master students in research and practice as well as supervises PhD students (as a secondary supervisor). She brings theory vividly to life in real-world practice.
Alicia reflects on the combination of her roles in research, teaching, and clinical practice:
"I really enjoy that science-practitioner kind of avenue—teaching, research, and practice."
The Interplay of Mind and Body
For Alicia, health psychology is all about the intricate interplay between mind and body. “Our mental health is impacted by our physical health, and our physical health actually also impacts our mental health,” she explains. It’s not just about behaviors or disease—it’s about understanding humans as whole beings, where the environment, our surroundings, and even our daily experiences shape both mental and physical well-being. At its core, Alicia highlights a holistic view: the mind, body, and spirit are deeply intertwined, each influencing the other in ways that matter in real life.
Body Weight Shame: Understanding Its Impact
Body weight shame is more than a fleeting feeling—it’s a complex social emotion tied to how we see ourselves and how we believe others see us. As Alicia explains, “Shame is a social emotion that piggybacks on disgust—it’s about making sure we’re liked, accepted, and protected.” Disgust, she notes, is designed to keep us safe. “If you think about something disgusting, like off milk, the first thing you do the moment you smell it is pull away. Shame piggybacks on that emotion. It’s internal and external; it makes us want to pull away, hide things and parts of ourselves because we fear rejection.”
While shame is an emotion experienced by everyone, what we experience shame about, is specific to when and where we are born. “Centuries ago, a larger body often meant wealth and abundance. Now, in Western societies, the narrative has flipped” Alicia observes. What once helped humans navigate social safety and belonging now fuels a culture where body weight becomes a marker of value. This type of shame is particularly visible. “In other forms of shame, even when you feel disgusted, you might want to hide it—avoid thinking about it—because it causes discomfort. But it is very hard to hide out bodies. Often they are the centre of conversations.” The effects extend beyond self-image. Shame influences not only thoughts but actions—skipping the beach, worrying about how one is perceived, or feeling judged at the dinner table. Fat-shaming is so normalized in daily conversations that it often goes unchallenged.
The impact isn’t just social. In healthcare, weight stigma can directly affect care quality. Alicia recounts a personal experience with a GP who attributed her high blood pressure solely to her weight, overlooking stress and genetics. “In my 20 years of practice, I’ll tell you that if you if you lose 5 kg your blood pressure will go down,” she said—a remark that undermined her trust. Clients across the weight spectrum often encounter similar experiences, which can discourage them from returning to healthcare providers. “Not once did that GP consider the fact that I was completing a PhD, Master Degree, Teaching, doing RA work and COVID-19 was starting”.
Research supports these lived experiences. Alicia cites Joanna Rothberg’s PhD, showing that doctors’ understanding of symptoms can shift depending on a patient’s weight, often redirecting attention toward weight even when unrelated to the consultation. “That can be a barrier to somebody not going back to a healthcare professional as well. When we talk about accessibility and treatment to health services, we rarely acknowledge that sometimes, the practitioners themselves are the barrier.”
Compassion as an Antidote
For Alicia, compassion is not just a therapeutic technique—it’s a way to directly counter shame and self-criticism. Her PhD in Compassion-Focused Therapy (CFT) examines how compassion can address body weight shame, particularly for those living in larger bodies, though it applies to anyone experiencing shame related to their weight.
“Compassion-focused therapy isn’t just one modality. It’s having a compassion focus to approaches and frameworks of care,” she explains.
Compassion works by soothing the threat system. Alicia illustrates with a familiar example: “Think of a child who falls off their bike. They cry and run to a caregiver. Even if the injury isn’t serious, the caregiver’s care soothes the child’s threat system. Compassion works in the same way for adults. It’s the sensitivity to suffering within ourselves and others, with a commitment to alleviate or prevent further suffering.”
She breaks compassion into key components: noticing suffering, attuning to it cognitively and emotionally, and responding in ways that ease distress without causing overwhelm. “Sometimes that’s direct support, like comforting a child. Other times it’s helping people develop the skills to soothe themselves. The key is tuning in to what’s needed, without letting our own distress take over.”
Alicia highlights that compassion is a flow—giving and receiving compassion to others, from others and towards ourselves. “Often, but not always, we find it easy to give compassion to others. There are fears, blocks and resistances to this.
Looking Forward — Training and Advocacy
Alongside her clinical and research work, Alicia is committed to training practitioners and using compassion in her supervision work.
Alicia highlights that body weight shame affects many clients. “A lot of women have been cultured to suppress parts of themselves, and change themselves, weight is another aspect of that—wanting them to be smaller,” she explains. This context underscores why Compassion-Focused Therapy is such a valuable tool for practitioners helping clients navigate these pressures.
The training in Compassion Focused Therapy is relevant not only for those working directly with body weight shame but for any practitioner interested in working with shame and self-criticism. Participants gain practical mind-training techniques to cultivate compassion, alongside self-care strategies essential for sustaining their ability to support others. “The skills you'll take away regarding how targeting shame and self-criticism, I think, will be that vital as well,” Alicia notes.
For those interested in future workshops, Alicia shares updates and registration details on her professional channels and social media—making it easy to find out when and where the next session will be. If you’re a practitioner looking to expand your skills in supporting clients with shame, this is a training you won’t want to miss.
The Takeaway
For me, what stands out most in speaking with Alicia is how naturally she brings compassion into every part of her work. Whether in research, teaching, or practice, she reminds us that supporting clients is not only about addressing symptoms but about helping people feel safe, connected, and understood. Her perspective reinforces why health psychology matters—it offers a way of working that is both evidence-based and deeply human. Listening to Alicia, I’m reminded that compassion is not an optional extra in our work, but a vital pathway to resilience and healing.
For Alicia, health psychology is more than a specialty—it’s a way of working that places compassion at the centre. By weaving together research, teaching, and clinical practice, she demonstrates how evidence-based approaches can remain deeply human. Her focus on compassion and body weight shame highlights the value of meeting clients with understanding rather than judgment. In her hands, health psychology is not only about managing distress but also about fostering resilience, connection, and growth.
