Beauty, The Beholder, and Body Image
Beauty, youth, vigor, and health are extolled in our society. It's impossible to watch television, view a film, or read a magazine without seeing idealized models or actors portraying what is supposed to represent the height of physical and material perfection. We are taught to believe that outer appearance is everything. By having enough of the right material stuff (i.e., the right body, the right clothes, the right car, a house in the right neighborhood) we will be happy, successful, and fulfilled. The emphasis is thus on having rather than being.
Therefore, amputation may deal a devastating blow to your body image; for, no matter what you achieve in terms of physical recovery, the simple fact is that your limb is still gone. For the rest of your life, you will live with physical deformity. Prior ideals of physical perfection are now impossible to achieve. However, there are ways to improve your self concept and accept your body.
Elements of body image
Body image is your internal concept of how you appear on the exterior. Your body image is based upon more than just your actual physical characteristics; it reflects your subjective perception of your outer physical self. Since it is generated inside your mind, your individual filters of experience will contribute to your internal concept of your physical self. Self image is based on emotional, psychological, and socially influenced considerations, including your visual appearance, how you think and feel about your appearance, kinesthetic considerations (i.e. how you sense and control your body), and your life experience.
Normally, body image includes having all four limbs. It may also include external objects you associate with yourself, such as clothes or the automobile you drive. Body image is not static. It changes with your age, the current fashions, how you feel about yourself, your state of health, and how you are seen by family, friends, and others in society at large.
Body image physical state or state of mind?
Since body image is generated inside your mind, and that image is affected by so many subjective factors, it is very likely to be inaccurate. The judgments you make about whether or not you like or approve of your own appearance can impact your well being. When you view your body in a positive light, you'll tend to feel better about yourself. When you don't like what you see, you'll tend to feel bad about yourself.
As is dramatically illustrated by the case of individuals with eating disorders, we tend to superimpose our own perceptions onto physical reality. A person with anorexia may appear emaciated, and yet continue to starve herself because she believes she is too fat, and therefore unattractive. Sometimes individuals, with or without physical impairments, become obsessed with a particular body part which they think ruins their appearance, such as belly or hip size. In a similar way, self-concept may be distorted in some persons with limb loss, especially if their amputation is recent.
Being "different" in the eyes of others
With social emphasis on ridiculous standards such as being skeletally thin and always looking youthful (no matter what your chronological age) it is no wonder that having a body which does not meet social standards may prove a cause of distress for those with amputation. It is harder to camouflage loss of an upper-limb than loss of a lower one, since arms cannot be as effectively covered up by clothing as can legs. This may prove harder for females than males because of societal images of perfection.
As you have no doubt discovered, being physically different has social consequences. One of the most "handicapping" aspects of physical difference is the attitude of people who consider physically different individuals to be somehow "special" set apart from so-called "normal" people. This can impact your body-image and self-concept. The "able-bodied" frequently appear to be less comfortable when interacting with those who are physically different. In turn, those with physical differences may be exquisitely sensitive to the reactions of others and, therefore, become very self-conscious. As an individual with apparent limb loss, you will gradually evolve your own way of dealing with the self-consciousness that may arise in your interactions with others. It is a sign of inner strength and self-confidence when you do not allow the reactions of others to get in the way of activities you enjoy.
Marcy: "I am very conscious about my body. A lot of that is just because of the way our society is. I am very aware of being an amputee. I like athletics I really like swimming and weight-lifting. If I go some place where people haven't seen me before, I get stared at, but I am not hesitant to take my bathing suit off and take a shower. Sometimes kids start shouting, 'Mommy, Mommy, she's got one leg!' My attitude is: I have to take a shower; I am not going to sit there and hide. I would be embarrassed to hide. I am educating the public."
Know that you are not alone. Every person with visible differences has experienced a wide variety of obnoxious reactions from others, including staring, rude questions, insensitive comments, and thoughtless actions. It is important you not take any of this behavior personally, but recognize that it says far more about the ignorance and social ineptitude of the "offender" than anything about you.
The effects of amputation on body image
Very young children may not be concerned about how they appear to others, but as they age, they tend to become more self-conscious. This is greatly heightened in their teen-age years as adolescents become more aware of their changing bodies and those of the opposite sex. Adults can be just as self-conscious. When you don't match up to social or personal standards, it may be hard to accept yourself or to be accepted by others.
A Reminder of Mortality
Amputation inevitably reminds us of our mortality. In any of us, a change in body image produces anxiety. The psychological impact of amputation greatly heightens this anxiety, since loss of limb is a permanent condition, and there can be no return to former body image.
As a person living with amputation, you must redefine your self-concept as well as your body image. This is in addition to the fact that your trauma must be considered in terms of death, disability, disruption of your normal lifestyle, reforming your sexuality, and dealing with society's responses. Nobody said adjusting to loss of a limb would be easy!
When you have recently lost a limb, it may indeed seem that your entire life revolves around the physical impairment. Due to the many medical and prosthetic requirements which follow amputation (and sometimes the underlying medical conditions which require care) this makes sense. There can be a tendency to continue to place the amputation in a central role in your life. These factors can contribute to difficulty in accepting your change in appearance. Over time, your limb loss should gradually recede in importance and become just one aspect of your life. Most individuals learn to take limb loss in stride; it's not that they're happy about it, but they accept the reality of their altered body and move on:
Mark: "My body is my body. Having one leg makes a difference, but I don't think any less of my body. I wish I had a bigger chest but I don't. I'd like to have two legs but I don't. That's just the way it is."
Listen for Messages
It has been said the only material thing we truly possess is our body. We are born with it, and only relinquish it when we die. It is the foundation of our physical existence, and provides the housing for all our emotional, mental, and spiritual experiences. We must learn to respect it, listen to the messages it has for us (pleasure, pain, fatigue) and learn to care for it. Viewing ourselves with compassion and a loving eye can truly improve the quality of our lives.
As you learn to accept yourself as you are, regardless of the size and shape of your body or the number of limbs you have, you will find you enjoy yourself. When you have the courage to embrace your uniqueness as a human being, you will be comfortable with whom you are, and discover that the differences that make you, you, can be a source of strength and satisfaction.
In October, Part II of this article will discuss how wearing a prosthesis can affect body image.
Note: The second half of this article appeared in the October/November, 1996 issue of inMotion. Go to Part II.