Wednesday, March 21, 2012

I Dream of Deenie

I was recently diagnosed with a medical condition. I’ve got a mild case of it, but it brings a few troublesome complications regardless, nothing serious. And as one might well do, the first thing I did when I got home upon receiving my diagnosis was Google it to learn more. The list of symptoms included what took me to treatment in the first place, a good number of troubles I don’t have, and a surprising entry: poor body image. The diagnosis? Scoliosis.

Now, if I’m being officially diagnosed for the first time at age 35, obviously my scoliosis isn’t terribly problematic. I was monitored for it as a child (do they still do those annual scoliois screenings at school? It somehow seems like a remnant of the ’70s, like the Dorothy Hamill haircut) but it was so mild that it barely qualified as scoliosis, and it didn’t warrant treatment—certainly not intervention like surgery or a brace. Basically, my muscles compensate for my wonky spine, running me through varying degrees of pain; I treat it with exercise, occasional ibuprofen, massage, and masturbation. (Deenie in da house!) In other words, it’s not a huge deal, and it’s not something that weighs on my mind a lot.

But there it is, that symptom far down on the list—below the physical pain, below the visual cues—poor body image. There’s a whole body of work devoted to studying the psychosocial effects of scoliosis, particularly in adolescents, but it boils down to this: Something about your body is “wrong,” and chances are it’s not something you ever thought was a problem, and you really can’t do much of anything about it. Wearing a brace may or may not have an impact on patients’ body image, but there’s evidence supporting a correlation between scoliosis and body image, regardless of treatment.

Now, the people being studied aren’t people like me: I’m an adult, for starters, and one with a very mild case of scoliosis. Though I’ve been told repeatedly by chiropractors, tailors, and osteopaths that there’s something irregular about my form, nobody until recently has used the word scoliosis about my body since the sixth grade. Whatever body image problems I have come from the usual suspects—perfectionism, media, growing up girl—not my spinal curvature.

But it’s not hard for me to see how my body image has shifted ever so slightly in the past few weeks. Part of it was the pain that drove me to seek treatment; it’s difficult to feel like your body is something to be proud of when you’re wincing whenever you take off your shirt. But more than that, I’ve learned that—and this is an unkind term—I’m misshapen. I found myself complaining of feeling “broken” and “twisted”—words I’ve never used to describe myself. Whenever I’ve had a problem with my body, there’s been a part of me that has known it’s in my head, because the concerns I had were solely about about how I appeared. If I thought my thighs were unappealing, there was still a part of me that understood that "unappealing" was subject to interpretation. With a twisted spine that was causing me pain—that wasn’t in my head, that was in my bones.

But in a way, whatever feelings I had are beside the point here. My literal body image—that is, the visual projection I have when thinking about my body—had shifted as well. My new mental drawing of myself was small, dropped onto a large white canvas, drawn in a combination of pencil and ink, and, yes, crooked. In my head, I went from looking somewhat like this:

(No, I do not look like Suzuki Beane in my head; she is far cooler than I could ever wish to be. It's just that Louise Fitzhugh is a far better illustrator than I am.)

to looking more like this:

Most of the time when I refer to body image, I’m really referring to negative self-talk. The image part doesn’t come up much, not for me; I’m pretty sure that my actual mental drawing of myself is reasonably spot-on. Even at my lowest, I don’t actually envision myself with elephantine thighs or a ballooning waistline; it’s more that I see roughly the same body in my mind that I saw the day before when everything was fine, but suddenly it’s unacceptable for one reason or another. I can dissect that all I want, but what it comes down to is that the interpretation of the image is what’s poor, not the body image itself.

But with the specific and decidedly dysmorphic shift in body image that accompanied my diagnosis, I’ve become aware that there is a body image living inside my head, one that’s plastic and that can shift according to new information it receives. And I don’t necessarily have any conclusions as to what this might mean, because in my case I don’t think my mental projection is erroneous. (Yes, I recognize that that’s sort of the point—that the very idea of body image means that you don’t think your mental projection of yourself is erroneous. I’ll never know how close my mental image actually is to the real deal. At least not until brain scan image projection is a helluva lot more developed, and when that happens I am using all my brain scan image technology to be able to put my dreams on YouTube.) It was only when there was new information presented—the information about myself as someone with a spinal curvature that causes me some troubles every so often—that a disconnect appeared. (For the record, once I recognized what was going on I felt fine mentally, and physically it’s really not a problem now that I’ve learned some corrective exercises.)

I guess what I’m wondering here is A) What the “image” part of “body image” means to you, and B) How your body image is affected by medical conditions that have nothing to do with weight or conventional attractiveness. (You could argue that severe scoliosis affects conventional attractiveness, I suppose—but hell, Marilyn Monroe was rumored to shave half an inch off one high heel of each pair to lend a sway to her step, and I've got that naturally, so I’m at an advantage here, oui?) Do you have an actual visual image in your head of what your body looks like? Is it in a distinct medium—like photography, drawing, animation, video—or is it too indistinct to single that out? Does the image change? Do you think your body image matches up with what’s really there, in a visual sense if not on the level of judgment/perception? Could you draw or otherwise externally project your body image? And have you ever found your body image being formed by things outside the normal trajectory of body talk?


  1. There's nothing quite like being told you've got an unexpected medical condition, and will have forever, to shift perspective. Sending you lots of hugs and positive energy, Autumn.

    I guess I do have a mental image of my body, because there are times when I look in the mirror and am surprised by what I see. But it's not a drawing, just a vague idea. And, interestingly, although I have medical conditions that certainly could affect my body image - and do cause me to feel frustrated and cheated at times - they don't really dent my general feelings about my body overall. Strange, now that you mention it.

  2. I have to concentrate to make an image of myself form, but visualization was never my strong suit. My interpretation of body image was more a combination of good feelings, indifference, and negative feelings; like you said, an interpretation of my features.

    I have personal experience with a medical condition changing my perception of my body, but also how others (men) would perceive it if they knew about the condition. Like you, I've used the term broken to describe myself, and because there was a medical diagnosis and failed treatments to back it up, I didn't or couldn't see anything wrong with it at the time. Now I'd like to think that I know better and am working hard to change those feelings/thoughts.

    Thank you for writing about your experience. It helped me put into words connections that I wasn't able to fully describe before. All the best to you Autumn!

  3. I was diagnosed with scoliosis and spondylolosthesis at age 33, and I don't think it has affected my body image in terms of how I *look* as much as it has in terms of how I think about what I can *do*. I wasn't athletic as a kid, but I took up fitness running and cycling (for more than transportation) in my 20s and I couldn't do any of that any longer. Back pain after running was one of my early symptoms. I had even started playing intramural soccer at the university where I teach! That was out immediately after diagnosis, and many things that I used to do easily now cause me pain -- like being on my feet for a two-hour (or longer) class. (I'm a university professor.)

    The pain has gotten worse as I get older, despite a few years with a TENS device, physical therapy, and regular exercise. My current physical therapist is a genius, no lie. His initial assessment of the damage to my spine helped me pinpoint a trauma that almost certainly caused it -- basically, stupid human tricks when I was 17 -- and knowing that makes me want to build a time machine to go back and kick my own ass once for the stupid stunt and then again, harder, for not getting medical attention at the time.

    But in terms of body image, my adjustment has been in seeing myself as someone who can no longer DO things. It's not just sports. I can't vacuum or sweep -- the motions are painful. (I don't miss the housework, but I'd like to live in a tidier house.) I can't carry anything very heavy, so I often say yes when the teenager bagging my groceries asks if I'd like help out with my groceries -- especially when there's a 20 lb. bag of dog food. Instead of carrying a stylish messenger bag, I have to use one of those obnoxious rolling briefcases to haul my laptop and teaching materials around campus. There's more, of course, but I've gone on long enough.

    It has taken me years to come to terms with being disabled. I'm still adjusting.

    (Oh -- I can still ride a bike, but those 30-40 mile rides are out. I recently switched from a cross-bike to a road bike, and I'm building up stamina again, hoping to be able to ride more than 75 minutes or so this season, once the snow is off the roads. But I'm also a lot older now. :-) )

  4. That's interesting that scoliosis is associated with poor body image. I have lordosis (curvature of the spine that goes inward instead of to the side- aka "swayback") and body image-wise it's kind of a good thing- it makes my butt stick out in an attractive fashion, and I've been told the curve of my lower back is quite sexy... But on the other hand, it causes me a lot of pain when walking/standing for more than an hour or so (and I've been told this will be greatly exacerbated should I ever become pregnant), so I'd rather not have it!

  5. YES! They still do those scoliosis tests at school! (I'm a teacher, and I take my ninth-graders down to the nurses for their scoliosis and hearing tests every year.)

    And interesting, I don't think I do have an image in my head of my body. Funny -- even when I tried, after reading this post, I can't really see myself in my mind. This may be because I broke my full-length mirror last summer (trying to kill a wasp when it's landed on your mirror? BAD IDEA!), and have yet to get a new one...I'm off this year on maternity leave, so I guess I haven't felt I needed to look too put-together yet. Or, I guess it could be because I've just had my second baby and I'm not sure what my body is now (the last time I saw myself, I was just a few months past pregnancy).
    But, this post has made me realize that I think these months without a full-length mirror have made me think of my body as myself and as something that interacts with the world instead of as something that is gazed at by the world.

    Huh. I hadn't realized these things until now. Thanks for that!

  6. I do think I have a body image and it is based on an internal sense of its fitness. I know when I am carrying stress (usually in my shoulders) and the pinched feeling I get. I know when I've thickened for the winter months...and when the weight begins falling away. I imagine I could draw a fairly accurate picture of my body, but it would not get at this vague, kinesthetic sense of "fitness" I feel.

    Hope that with the diagnosis, there was also some relief.

  7. I was diagnosed with scoliosis in junior high, right in the middle of already-overly-dramatic early teendom, and I made them check me again to be sure, and I even tried to 'cheat' the test so they would admit they made a misdiagnosis. I went home and cried that night for my 'deformity' (how would my 8th grade crush, Jason B., ever love such a freak?!), and never told my parents. Many years have passed since then, and I have since realized I have way bigger fish to fry than worrying about that. It did come back to haunt me a couple of years ago, when I read my medical record of x-rays taken after a fall on hospital property.... to see it in "Official Medical Terminology" made me feel deformed all over again. Something about '25% lateral curvature with mild rotoscoliosis, resulting in mild muscular atrophy on the L (some back muscle). Mild degenerative process.' So I was going to continue to 'degenerate'?! Even after coming to terms that this did NOT make me John Merrick's long-lost twin, I did not like seeing it in such impersonal, clinical terms. Then, like a karmic sign for me to 'Get Over Yourself', the elevator stopped, and who should board, but an adorably fresh-faced teen with an entirely prosthetic leg, confidently rocking a cute mini-skirt outfit. OK, Universe, I get it.

    I share this, not to minimize anyone's feelings about being diagnosed with a medical problem, but just to put some of these things in perspective. It's OK to grieve our lack of perfection, but ultimately we have to refuse to be overtaken or defined by it.

    That being said, I laughed out loud about the Deenie prescription for relieving pains! :)

  8. I was diagnosed with scoliosis in the 7th grade and wore the da*n brace (yeah it made me swear all the time) that covered from under my boobs to the top of hips for two full years - 23 hours a day and 6 more months at night. Plus I had to wear a cotton undershirt underneath because of the sweating from the fiberglass. Talk about being self conscious in jr high.
    But after I was done (and I had two elderly relatives who were never treated and I saw their discomfort and hunched backs and understood) I let it go. So totally. Until as an adult and gaining some weight and I can see the unequal distribution of my body. And I have nerve damage from the brace.
    But really when I remember what it was like to be in jr high and cry over that stupid brace, I feel bad for kids that are "different" and more sympathetic to what all young teens go through. It sucked, I survived, I moved on and yes, things could be worse.
    Best of luck with your back issues! Chris

  9. I was diagnosed with scoliosis at 14 and I'm now 65. The body image problem was at its worst in high school. Nobody noticed but my mother, who made all my clothes and told me to never tuck my shirts in at the waist. Sigh. I wrote a book about it called Off Kilter, in which I used the curve as a metaphor for my life. I've always thought of myself as 'off kilter'. LOL.

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