How Do Fibromyalgia Patients With Alexithymia Experience Their Body? A Qualitative Approach

Patients suffering from chronic pain such as fibromyalgia (FM) not only experience change in their physical bodies but also in their embodiment. There are two forms of disturbed body awareness (BA), namely, "disembodiment" and "hyperembodiment." This study describes how patients with FM experience their body and whether there is a difference in BA with or without alexithymia. Based on two self-report questionnaires (Toronto Alexithymia Scale [TAS]-20 and Hospital Anxiety and Depression Scale [HADS]), a purposeful sample of FM patients with and without alexithymia was included. Two focus groups were conducted with nine alexithymic and six nonalexithymic FM patients and were analyzed by a Interpretative Phenomenological Analysis. Body experience appeared in two themes: "the lived body as hyper present" and "alienation from the lived body." A third theme emerged as "the lived body in interaction with others" and indicates the importance of the interpersonal aspect of BA. We found no differences regarding BA between the alexithymic and nonalexithymic patients. These results suggest that BA in FM patients cannot exclusively be classified under the constructs of hyper-or disembodiment. The authors suggest to consider embodiment in FM, subjected to intra-as well as interindividual influences, as a dimensional construct whereby the equilibrium tends to hyper-embodiment. Still, a temporary shift of this equilibrium from hyper- to disembodiment due to certain emotional state or stress is possible. As alexithymia had no influence on the description of BA, it seems that FM patients primarily fail to express their BA without in fact being disembodied.