Body Awareness in fibromyalgic patients with alexithymia: a qualitative study.

Abstract

INTRODUCTION: Chronic pain alters the way patients experience their bodies and interact with the world they live in. Especially, when the origine of their suffering is vague or unknown as in fibromyalgia, the relation with the body deteriorates.

OBJECTIVE: The primary goal of this pilot-study was to describe the way patients with fibromyalgia (FMP) experience their body as more hyper- or disembodied and how their body awareness (BA) might change during daily life. Secondary, we were interested in possible differences between FMP with (FMPA) and without (FMPnA) alexithymia.

METHOD: To gain thoroughly insight in the subtle proces of BA and it’s expression we worked with a qualitative methodology: two focusgroups (FMPA, n=9 and FMPnA, n=6) were interviewed and analysed from a phenomenological-hermeneutic perspective.

RESULTS: It was not possible to differentiate the BA of FMP exclusivily as hyper- or disembodiment. Core elements of both concepts are present in FMP and were clustered as two basic themes, ‘the hyperpresent lived body’ and ‘the aliënated lived body’. A third theme we discovered, described as the lived body in interaction, indicated the interpersonal aspect of BA, normally approached as a mainly intrapersonal proces. Regarding these basic three phenomenological themes there was no difference between FMPA and FMPnA. However, subthemes like ‘feeling insecure in the it’s own body’ and ‘experiencing misunderstanding from others’ were strickingly more present in narratives of the alexithymia group, together with verbal reactions indicating poor mentalisation capacity.

CONCLUSION: This study tried to clarify the meaning of BA in FMPA and FMPnA. Experiences of BA aren’t exclusivily expressed as hyper- or disembodiment. If we take embodiment as a dimensional construct, BA in FMP bends more towards the pool of hyperembodiment.