The Body as Stage - Chronic Illness, Body Image & Body Grief : Episode 8

🎧 Episode 8: The Body as Stage - Chronic Illness, Body Image & Body Grief

What happens when your body changes in ways you didn’t choose, and you no longer recognise yourself within it?

Over the past seven episodes, we’ve explored how body image is shaped by culture, trauma, attachment, and neurodiversity. In this episode, we turn toward chronic illness and the psychological rupture that can occur when the body itself becomes unfamiliar, unpredictable, or altered.

Drawing on psychoanalytic thinkers including Joyce McDougall, Donald Winnicott, and Wilfred Bion, alongside the work of Gabor Maté and writer Sophie Strand, this episode explores a central idea:

Illness doesn’t just affect the body. It can become a stage on which something older, unspoken, and unresolved is finally given form.

If you’ve ever felt estranged from your body, or like your body is holding something you can’t quite name, this episode offers a way to begin thinking about that experience.

In this episode, we explore:

• How chronic illness can rupture the relationship between psyche and soma
• Why body grief emerges in the gap between who you were and the body you now inhabit
• How the body in breakdown can come to be experienced as a “bad object”
• Why medical encounters can sometimes deepen disconnection rather than hold it
• How the body can carry what was never able to be spoken or known
• Why body image disturbance in illness is often not new, but newly visible
• The difference between grieving what illness has taken vs. something older and unmetabolised
• What it means to create the conditions in which the body’s story can finally be known

Key Insight:

The body is extraordinarily faithful.
It holds what the mind cannot.

Healing is not only about grieving what illness has taken, it is about creating the conditions in which what the body has been carrying can finally begin to be known.

This episode is for you if:

• You are living with chronic illness or ongoing health changes
• You feel disconnected, alienated, or at odds with your body
• You’re navigating shifts in identity, appearance, or capacity
• You’re interested in psychoanalytic or depth-oriented understandings of the body
• You sense there is more to your experience than what can be medically explained

Take a breath, stay curious, and explore what it truly means to Mind The Body.

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Transcript

0:48

Hello and welcome back to Mind The Body. Today we're going somewhere that I think is long overdue body image and chronic illness because what I notice in culture, in clinical spaces, even in the conversations we have with the people we love, when someone is seriously ill, body image gets treated as something you're not supposed to care about. When there are bigger things at stake. But in my experience, both clinical and personal, nothing could be further from the truth. When your body changes profoundly through illness, something happens that goes far deeper than appearance. You stop recognizing yourself, not just in the mirror inside. The body that was your home that you moved through the world in, that people knew you by, that you knew yourself by, has become somewhere unfamiliar and nobody is really talking about what that does to a person. That's what today is for. Sophie Strand who writes about chronic illness and the body offers an image I keep returning to. She writes that the body is a doorway, and for those who carry early trauma, that doorway is always open, wide open. I find that image so moving because so many people living with illness will recognize it instantly. A body that can't quite shut out the world, that registers everything, that never fully lets its guard down, down GABA mate in when the body says no. It helps us understand how deeply this is woven into our bodies. The connection between early emotional experiences and later physical illness isn't just a metaphor. It's about a nervous system that never learned how to rest a self that had to ignore its own signals. These patterns leave real lasting marks in the body. So when we talk about body image and illness today, we are talking about what happens to your sense of self when the body that housed it changes beyond recognition. We are talking about a particular kind of grief that rarely gets named and let alone witnessed. Today I wanna explore three interconnected threads. First, how illness disrupts your most fundamental relationship, the one with your own body, and what that does to how you see and experience yourself. Second, how the body in breakdown can come to feel like a bad object. Something persecutory, external and no longer yours. And what happens when the medical system consolidates rather than holds that experience? And third, a question that goes deeper than grief. What has your body been trying to say that has never yet had words? Let's begin. I wanna start with something very simple and very human. You catch a glimpse of yourself unexpectedly in a mirror, in a shop window, in a photograph someone has taken. And for a moment, something doesn't quite fit. The person looking back doesn't match the person you carry inside that gap. Between the inner felt sense of yourself and the body reflected back is one of the most quietly devastating experiences of chronic illness. And it is at its core a body image experience, but not in the way we usually talk about body image. It's something more disorientating than that. It's the experience of your body becoming in some fundamental way, a stranger to you. Before illness. Most of us have what you might call a stable bodily sense of self. We know how we move, how we feel from the inside, how we take up space in the world. We don't think about it consciously. It's simply there like a background. Hum. Our body is the ground we stand on. Illness pulls that ground away. Winnekot wrote about what he called the psyche, Soma, the living dynamic relationship between mind and body. In health, these aren't two separate things. The self is housed in the body, the body. Is inhabited by the self and that integration, that felt sense of being at home in your own skin develops through early experience, through being held responded to, known through having your bodily experience received by another person in a way that says, you are real. You are here. When illness ruptures that integration, when the body becomes unreliable, painful, or profoundly altered, it doesn't just feel like a physical crisis. It feels like a crisis of self because the body wasn't just the vehicle, it was the home, and this is where body grief begins. Body grief is the mourning for the body you used to have. For the way you used to move to feel, to recognize yourself. It is the grief for the life that was predicted on a body that worked differently, the plans you made, the identity you built, the future, you assumed. And it has a quality that makes it particularly hard to process because you are grieving something you still inhabit. You cannot bury your pre-illness body and move on. You have to mourn it while living inside what remains, while managing it, medicating it, negotiating with it every single day. That is an almost impossible psychological task, and it's made harder by the fact that almost nobody around you knows how to acknowledge it. People say at least you are alive or you have to stay positive. And those responses, however well-meaning close down the grief before it has had a chance to breathe. They ask you to skip straight to acceptance without passing through loss, but loss that cannot be mourned, doesn't resolve. It goes somewhere else. It settles, and often it settles back into the body into avoidance, disconnection, a kind of cold distance from your own physical experience that can feel like the only bearable way to live inside a body that keeps letting you down. There is also the question of what illness does to how others see you, and therefore how you see yourself. Because body image is never formed in isolation. It develops in relationship and being looked at, recognized, reflected back when illness changes your body visibly, when you lose your hair, when your body changes shape for medication, when you carry a scar or move differently, the way people look at you changes, sometimes subtly, sometimes not at all subtly, and that changed gaze land somewhere. It becomes part of how you see yourself. The person who used to move through the world, largely unseen, just a person, maybe unremarkable, but comfortable, can suddenly feel exposed, marked, defined by their illness before they've even spoken. And the person who built part of their identity around their physical capability, their strength, their fitness, their energy, can experience its loss as something close to bereavement. So here's what I would like you to consider. What part of yourself are you missing? Not just your body, but the life and sense of self that went with it? It is natural to miss what has changed because that grief is real and it deserves to be named and naming it. It is where everything begins, which brings me to the second thread, and this is where I want to introduce a concept that I think named something Many people living with illness will immediately recognize even if they've never had a language for it, the body as a bad object in object relations theory, a bad object is not simply something we dislike. It is something we experience often unconsciously as as attacking persecutory outside our control something that feels as though it is working against us rather than for us something that was supposed to be safe and isn't. And for many people with chronic illness, this is precisely how the body comes to be experienced. Not consciously, perhaps, but underneath in the flinching way from the mirror, in the hostility towards the body that won't cooperate in the exhausting daily negotiation with a physical self that feels less like you and more like. Someone else you are trapped inside the body has become in the deepest psychological sense, bad. Winnie Court helps us understand how this happens. He wrote about the body that cannot be held, that exists in an environment without adequate containment. When early experience doesn't provide a holding environment that can receive and metabolize the infant's bodily distress, the body can remain psychically as something unintegrated, something external, something not fully owned. Illness can reactivate that. Or for some people it can produce it for the first time, stripping away whatever integration had been achieved, and leaving the body feeling once again, like something foreign, something that was supposed to be a part of you and no longer is. And then there is the acute experience of breakdown itself, the body in crisis, in a flare in the immediate aftermath this is where beyond is helpful. Beyond wrote about experience that cannot be processed, raw and metabolized sensation that floods the system before it can be thought. He called these beta elements and the body in breakdown produces them in abundance, pain that cannot be named, fear, that cannot be located. A physical experience so overwhelming that the mind simply cannot hold it. What happens to that experience without a container, without a relationship, a therapeutic space, even an internal capacity to hold it. It doesn't get processed, it gets expelled, split off, and the body as the site of that overwhelming experience consolidates as bad. As the source of attack, as something to be managed, controlled, kept at a distance rather than inhabited. This is the understanding at the heart of so many experiences with chronic illness, the sense of being disconnected from your body, the urge to monitor every symptom, that confusing mix of hypervigilance and numbness and the kind of body image struggle that isn't just about appearance, but feels more like longing to escape your own body or wishing you could just simply step outside it for a while. And here is where the medical system becomes particularly important because medicine at its best. Can function as a holding environment, can receive the body in breakdown and metabolize some of the fear. But medicine at its worst can do the opposite. It can treat the body as an object of intervention while leaving the person entirely unattended. It can produce its own overwhelming experiences, painful procedures, clinical language that strips the humanity from what is happening, the experience of not being believed about your own pain decisions made about your body without adequate explanation or consent. For people who already carry early relational wounds, whose bodies were never quite held, never quite received, the medical encounter can reactivate the bad object relationship with devastating precision, the body becomes once again, something that is acted upon rather than cared for something outside the self rather than part of it. And the visible changes that treatment leaves behind the scars, the hair loss, the surgical alterations, the body that looks and moves differently, however they are treated. In abstract terms, it can feel as if the body is the bad object, made visible, written on the surface of you. And being asked to absorb these changes with gratitude to stay positive, can feel like you're being told to disconnect completely from your body as it is now. The grief is real. The losses are real and healing begins not with reaching acceptance, but with the gentle patient process of having your experience witnessed and held until it feels possible to be at home in your body once more. And this brings me to the third thread, and this one goes somewhere perhaps unexpected because up till now I've been talking about loss and grief. The experience of feeling estranged from your body as if it's become something foreign or even turned against you. These feelings are real and they matter deeply. But the psychoanalyst invites us to ask a different question, not just what have you lost, but what was never able to be known in the first place. In her book, theaters of the Body, McDougall proposed that the body can become a stage a theater. For emotional experience that has never been symbolized, never made it into language or conscious thought. Not repressed, exactly. Not buried and waiting to be uncovered, but something more fundamental than that. When something cannot be processed psychologically, when it is too overwhelming, too primitive, or when no relational container was ever available for it, it doesn't disappear. It finds another form. And that form is often the body. The body becomes the stage on which something is performed that has never been spoken, never been thought, never been known. Now, what does this have to do with body image and chronic illness? I think it offers something that grief alone cannot quite reach because for many people living with illness, particularly those who carry early relational wounds, the body image disturbance they experience isn't only about what illness has changed. It's about something that was always there. A relationship with the body that was already complicated already carrying something long before the diagnosis arrived. The illness becomes a stage on which something much older is finally given form. This isn't about blame. It isn't about suggesting that you caused your illness or that your symptoms are not real, or that healing is simply a matter of finding the right words. McDougall was not making that argument and neither am I. She was making something more nuanced and more compassionate. She was observing that the body is extraordinarily faithful that it holds what the mind cannot, that when emotional experience has no psychological home, no language, no relationship in which it could be received and known. The body offers itself as the only available container. And so the question she invites us to sit with is not only what am I grieving. It is, what has my body been trying to say that I have never had? Words for what? Relational conflict, what early experience, what Overwhelming feeling found its way into the body because there was nowhere else for it to go. This reframes body image and illness in a quietly radical way. Because it means that the way you relate to your changed body, the avoidance, the disconnection, the hostility, the strange grief that seems larger than the loss itself may not only be about the illness, it may be the body finally having a stage large enough to perform something it has been carrying for a very long time. The loss is obscure heavy. Difficult to locate. The person cannot quite name what they are grieving because what they are grieving was never fully known to begin with. It feels too large for what it is because it is, it is carrying more than the illness. It is carrying what was un mentalized long before the illness arrived the slow relational, deeply human work of healing involves not just grieving what illness has taken, it involves something more patient than that, creating the conditions in which what the body has been performing gradually, finally begin to be known, to be felt, to be given language perhaps for the first time. Our deepest need is not to be fixed, but to feel truly met. What most soothes our pain is having someone receive our experience with warmth and humanity, making even the hardest feelings bearable. This is what the body longs for most, not just a diagnosis or treatment plan, but the gentle presence of an empathic witness. Let me bring this together. Today we've explored body image and chronic illness through three interconnected threads. First, how illness ruptures the psyche, soma relationship, pulling away the grounds the self stood on, and how body grief begins in that gap between the person you were and the body you now inhabit. Second, how the body in breakdown can consolidate as a bad object persecutory, external, not mine. And how the medical encounter can deepen that rather than hold it. And third, how the body can become a theater for what was never able to be spoken, carrying not just the grief of illness, but something older and deeper that finally has a stage large enough to be known if you are living with illness, I want you to know that you are allowed to grieve the body you had. You are allowed to find your changed body, unfamiliar. You are allowed to feel both, grateful to be alive and deeply affected by what survival has asked of you. Those things are not contradictions. They are the full truth of what you are living. Coming back into relationship with your body, no matter how changed or unfamiliar it feels, no matter how distant it has seemed, begins gently with a willingness to simply notice. Thank you for being here. Next time we'll build on this episode by exploring the fascinating intersection of gaming, chronic illness, and virtual embodiment. Until then, stay curious. I.