Massage Therapy and Body Image

Body image or the conscious sense of our body, is our perception of and beliefs about our own body’s appearance. Or simply the feeling we have of our own body. Constructed by the brain from past experience and present sensations, the body image is a mental representation of our physical appearance and is a fundamental aspect of self-awareness and self-identity. Body image depends on our internal ‘body maps’ that are modulated by somatic and proprioceptive input.

The term “body image” was introduced in 1935 by Paul Schilder, an Austrian-American neurologist, which refers to the mental pictures we have of our bodies or the way our bodies appear to us. It is the set of beliefs we hold about ourselves. The topic of body image is covered extensively in recent popular books: The Body has A Mind of Its Own by Sandra and Matthew Blakeslee and The Brain that Changes Itself by Norman Doidge. Distorted body image Body image can be disrupted in people with pain disorders, and the disruption can have profound physical and psychological effects. For example, body image distortion is implicated in people with eating disorders (such as anorexia nervosa). Anorexics experience their bodies as fat even when they are on the edge of starvation.

Body image can be distorted in people suffering from chronic pain, as complex regional pain syndrome, phantom limb pain, and back pain. Pain is commonly experienced as projected into the body. People say “My back is killing me!”, but not “My pain is killing me.” However, people having phantom limb pain show that we don’t need a body part or even pain receptors to feel pain. The only factor that controls this pain is our body image. Physician VS Ramachandran said that pain is an opinion on the organism’s state of health rather than a mere reflexive response to injury. The brain gathers evidence from many sources before triggering pain. Pain, like the body image, is a construct of our brain. Therefore he successfully used a mirror box to modify a body image and eliminate the phantom and its pain.

Dr. Lorimer Mosely, a scientist from Australia, have demonstrated visual distortions of the body image in patients suffering from chronic pain can significantly affect their perception of painful sensations. People with CRPS and phantom limb pain were shown to have decreased tactile acuity and distorted body image for the affected limb. CRPS and phantom limb pain patients tend to perceive the painful or phantom limb as being bigger than it really is. Lorimer also tested to use the mirror box to make chronic pain in a real limb disappear. He asked his patients to simply imagine moving their painful limbs, without executing the movements, in order to activate brain networks for movement. The patients also looked at pictures of hands, to determine whether they were the left or right until they could identify them quickly and accurately. They were shown hands in various positions and asked to imagine them for fifteen minutes, three times a day. After practicing the visualization exercises they did the mirror therapy, and with twelve weeks of therapy, pain had diminished in some and had disappeared in half. Lorimer also demonstrated that people with chronic back pain has disrupted body image. The patients were unable to clearly delineate the outline of their trunk and stated that they could not ‘‘find it”. This finding raises the possibility that training body image or tactile acuity may help patients in chronic spinal pain.

Massage is well known to make people feel more relaxed and better about themselves. While there are many evidences that suggest positive effects of massage on psychological health, several studies now showed the positive effects of massage on body image. Researchers have started to investigate massage as a way of improving body image. Thomas Pruzinsky in his book Body Image: A Handbook of Theory, Research, and Clinical Practice, writes that massage therapy is a somatic approach that is helpful in positively affecting body image “by helping the client reconnect to the body in a very concrete manner.” Dr. Marcia Hutchinson, the author of the book Transforming Body Image, suggested that since body image is a product of the imagination, it can also be changed using the imagination. Hutchinson describes an exercise called “imaginal massage” in which you visualize massage occurring allowing the hands of the massage therapist to transfer healing to your bodymind allowing acceptance of your body.

A study conducted by the Department of Nursing, Wonkwang Health Science College in South Korea evaluated the effect of massage on abdominal fat, waist circumference and body image of post-menopausal women. The participants received a full body massage once a week and massaged their own abdomens twice a day during a six-week experiment. Half the group received massages with grapeseed oil. The other half received an aromatherapy massage with a blend of essential oils. Both groups felt better and improved body image after the treatment, but the group receiving aromatherapy massage showed significant changes across all areas – body image, waist circumference and abdominal fat.