Fibromyalgia is a widespread chronic pain disease characterized by generalized musculoskeletal pain and fatigue. It substantially affects patients' relationship with their bodies and quality of life, but few studies have investigated the relationship between pain and body awareness in fibromyalgia. We examined exteroceptive and interoceptive aspects of body awareness in 30 women with fibromyalgia and 29 control participants. Exteroceptive body awareness was assessed by a body-scaled action-anticipation task in which participants estimated whether they could pass through apertures of different widths. Interoceptive sensitivity (IS) was assessed by a heartbeat detection task where participants counted their heartbeats during different time intervals. Interoceptive awareness was assessed by the Multidimensional Assessment of Interoceptive Awareness (MAIA). The “passability ratio” (the aperture size for a 50% positive response rate, divided by shoulder width), assessed by the body-scaled action-anticipation task, was higher for fibromyalgia participants, indicating disrupted exteroceptive awareness. Overestimating body size correlated positively with pain and its impact on functionality, but not with pain intensity. There was no difference in IS between groups. Fibromyalgia patients exhibited a higher tendency to note bodily sensations and decreased body confidence. In addition, the passability ratio and IS score correlated negatively across the whole sample, suggesting an inverse relationship between exteroceptive and interoceptive body awareness. There was a lower tendency to actively listen to the body for insight, with higher passability ratios across the whole sample. Based on our results and building on the fear-avoidance model, we outline a proposal that highlights possible interactions between exteroceptive and interoceptive body awareness and pain. Movement based contemplative practices that target sensory-motor integration and foster non-judgmental reconnection with bodily sensations are suggested to improve body confidence, functionality, and quality of life.

This paper is a critical analysis and overview of body image conceptualization and its scope and limits within the field of eating disorders (eds) up to the present day. In addition, a concept ofemotional bodily experienceis advanced in an attempt to shift towards a more comprehensive and multidimensional perspective for thelived bodyof these patients. It mainly considers contributions from phenomenology, embodiment theories and a review of the empirical findings that shed light on the emotional bodily experience in eating disorders. It proposes an ‘embodied defense’ that leads patients to experiencing their own bodies as objects. This proposal highlights the need for new psychotherapeutic tools in the treatment ofeds that take into account the bodily resonance of emotions and their use for improving adaptive responses to the environment: it calls for helping patients to recover the subjective experience of their bodies.

Background: Delusional characteristics have been largely ignored in patients suffering from anorexia nervosa (AN). Objectives: To review the literature on delusional features in AN from phenomenological, neurobiological, and clinical viewpoints. Methods: Data were obtained through searches of Medline, PubMed, SciELO and Cochrane Library. Results: Distorted beliefs in AN may range from an overvalued idea to an overt delusion, involving affective, personality and/or psychotic disorders. Studies confirm alterations in monoaminergic systems. It has also been seen a decreased integration of visual/proprioceptive information, and alterations in neural networks involved in body processing. It is known that body image distortion may present "delusional proportions" as a consequence of great concern about body. Concomitantly, "embodied defence hypothesis" has been proposed. Restrictive AN exhibits higher levels of delusionality, and a particular delusional type of AN has been suggested, associated with a worse long-term outcome. Low doses of atypical antipsychotics are recommended combined with cognitive techniques. Discussion: Delusional thinking in AN is likely a dynamic and dimensional phenomenon that can vary, both in nature and/or severity, whereas high insight levels, before and after refeeding, result in positive outcomes. Neurobiological research on this topic must be encouraged, since clinical and phenomenological approaches are comparatively more frequently reported.

The tension between reflection and experience has been highlighted by Buddhism as the origin of human suffering, described as an undercurrent and constant feelings of restlessness, grasping, anxiety, and dissatisfaction or disease. This universal suffering experience called Dukkha refers to the failure to find a Self in reflection or the frustrated desire or craving to have or to be something. For Buddhism, not only the desired object is illusory, but so is the desiring self. Further, Varela et al. (1993) integrate these ideas into the development of cognitive sciences and the understanding of human experience from an embodied and selfless mind perspective. The present article attempts to apply the Buddhist notion of suffering or Dukkha along with Varela, Thompson, and Rosch’s contributions to the understanding of the embodied sense of Self that characterizes symptoms of Depression. The expression of the self-grasping suffering experiences and the tension between reflection and experience for depressive patients will be discussed from an enacted and embodied perspective. Further, new research ideas along with possible new psychotherapeutic approaches are discussed.

This article is a methodological proposal for Body Mapping application in transgender population framed by a phenomenological approach and aimed at exploring the implicit and pre-reflective embodied cues of the experience of discordance between the felt body (the body I am) and the objective body (‘the body I have’) that opens a space in which words do not have easy access to. In order to describe our protocol of phenomenological exploration and application of Body Mapping, we detail the complete process in a single case. It corresponds to a female-to-male participant of 18 years old undergoing hormonal treatment with testosterone for 12 months before engaging in our study. Reflections about the potential of using art-based research methods for accounting of pre-reflective bodily experience of discordance in transgender population are detailed. The combination of the Body Mapping art-based research tool with a phenomenological approach for the study of experience seems promising for studies aimed at exploring experience from an embodied approach. It represents a radical first-person research method in which the images talk by themselves. Furthermore, including the researchers as beholders of the resulting artwork, assuming the role of inter-corporality of the aesthetic bodily resonance as part of the data collection procedure seems innovative but loyal and honest with what an Art-based research paradigm is.

Desde mediados del siglo XX, la investigación focalizada en la imagen corporal ha adquirido particular relevancia, no sólo desde el punto de vista del cuerpo subjetivo, vivido o fenoménico, a partir de la visión del propio individuo, sino que también desde la repercusión profunda y holística que implica en su salud, pues se trata de una construcción que recibe aportes de lo fisiológico, lo psicológico, lo espiritual, lo social, lo cultural, lo político, lo religioso y lo histórico. Al escoger un instrumento de evaluación de variables abstractas, como es la imagen corporal, es menester considerar las limitaciones en el intento de operacionalizar dicho constructo. Por ende, en el presente capítulo se reseña el desarrollo del concepto, que aún en la actualidad carece de consenso teórico, clínico y empírico, representando ello una dificultad al momento de analizar sus diferentes alternativas de medición, tales como las medidas de siluetas corporales. Sin embargo, existe cierta coincidencia entre los modelos comprensivos de la imagen corporal, al identificar tres componentes de ella: el perceptual, el cognitivo y el actitudinal/afectivo. Entre los procedimientos empleados para la ponderación de la afectividad orientada hacia el cuerpo y sus segmentos, vale decir, la satisfacción/insatisfacción corporal, se dispone actualmente de numerosos cuestionarios que se analizan a detalle en secciones posteriores de este trabajo. El presente capítulo se centra en la descripción de los instrumentos dirigidos a estimar la distorsión en la percepción de la forma corporal, particularmente ante la exposición de siluetas estandarizadas que varían en su corpulencia y características físicas, con el objetivo de mensurar la auto-percepción y, mediante ésta, la factible discrepancia (o inexactitud) que puede existir entre la dimensión corporal real y su apreciación. Por último, se analizará el rol de este tipo de medidas en estudios clínicos, poblacionales y transculturales.