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Among those workers whose primary interest resides in the psychological adjustment of physically disabled persons, there are several who have stressed the importance of the body-image concept. Berger (1), for example, in reference to paraplegic patients emphasizes the necessity for the integration of the disability into the body-image, and further hypothesizes that the long period of withdrawal, depression, and lack of interest following the bodily insult is due to the great amount of psychic energy that is needed for this reintegrative process. Similarly, Grayson (3) states: “The image has to be reorganized so that the deformed, absent or useless member of the body can somehow fit itself into the individual's image of himself.” He also points out that many patients who display “a complete inability to understand what the disability is all about” do so “because they cannot find any place in their body-image for the deformity.” He attributes such symptoms as depersonalization, feelings of unreality, and resistance to the use of orthopedic appliances to “a defence which the ego unconsciously sets up to maintain its integrity in the face of body-image disturbance.”
Our purpose in this paper is to present some of our ideas and clinical material regarding the process of reorganization or reintegration of the body-image. This, according to our viewpoint, consists in the development of a new and different body-image that takes into account the changed physical structure of the body.5
By body-image we mean that composite picture which the individual has of his own body. This picture is a multiply determined, continuously-developing and therefore constantly changing, condensed representation of the individual's current and past experiences of his own body. It has both conscious and unconscious aspects; it is under certain conditions, extensible into space; it is largely a function of the ego and through the ego it not only exerts a profound influence on t