Psychology of patients with cosmetic and anatomical defects: the cognitive dimension


Defects in the external appearance, which may suffer people, in the most General form are divided into cosmetic, which primarily include defects of the face (ear, nose, forehead, eye orbits), and anatomical, including reamputation (associated with various disorders of the musculoskeletal system), and amputation (remove limb).

While the cosmetic, and, moreover, the anatomical defect seriously change both emotional and cognitive, the requirement of motivational and behavioral spheres. First of all, they experience the limiting effects associated with the impairment of the patient, especially in cases where its position (e.g., postamputation) quite dramatically different from the earlier injury lifestyle. That is, cosmetic or anatomical defect affecting the personality in the part, first of all, her self-image and self-esteem and building appropriate relations with the outside world. If the perception and evaluation have a self-deprecating, samoubiytsy, or the world-blaming in nature, connection with the external environment become patholophysiology character.

Any cosmetic defects, and defects that destroy the integrity of perception and self-image are extremely difficult from a psychological point of view. The very concept of "disfigurement" indicates the etiology of mental experiences of the patients with cosmetic and anatomical defects of the face and body. Disfigurement is the deprivation of the image. Image you for yourself and for the world. For all his deficits of awareness, our perception operates with integrity, a kind of conventionally finished gestalte that cause and maintained the illusion of the world accessible to our influence, and if these "wholes" are detected or there are gaps, broken the subjective harmony of the world, which usually leads to increased basal anxiety.

My self-representation and the perception of me by others usually, as you know, different - others may think about me better or worse than I think of myself, at the intersections of these perceptions happen one day and large and small individual opening. However, in the case of defects of the face and body, including amputation defects, these two loci as being identical - a violation of the integrity of the causes about the same feeling of incompleteness or destruction of the image as its media, and perceiving that the reason, in my opinion, with the existence of certain shared rules and standards concerning, in particular, to the phenomenon of the body. As normal looks very proportional and symmetrical body with all four limbs, crowned with two dozen fingers. Note in this connection that all kinds of atavism, and polydactyly (which) was also perceived (and possibly perceived) as a violation of the image, with appropriate reactions from the social environment. That is, the concept of integrity applies not only to anatomical deficiencies, but also to anatomical excess.

thus, cosmetic and anatomical defects, both from the point of view of their media, and from the point of view of the perceiver, is a violation of certain rules and harmony. That is why the media often detects defects among their emotional reactions are also a certain shame or even guilt, and perceiving often demonstrates not only the compassion but also fear, and an associated desire to avoid.

N. D. Lakosina drew attention to the fact that the man who lost an arm or a leg, seriously suffers from the fact that his defect pay attention to the surrounding, although it is much less frequent than in other diseases recorded the self-loathing. [Lakosina 2003]. As pointed out by V. D. Mendelevich, "By contrast, people with disfiguring changes in the face react to a greater extent self-deprecating. They become touchy, irritable, sensitive, afraid to appear in public, severely limit contact with others, often thinking about suicide. In cases of skin lesions and facial deformities in patients with the listed psychological manifestations with feelings of shame, disgust and fear that others will avoid them because of fear of Contracting" [Mendelevich 2002, p. 277].

the Specific relation to cosmetic and anatomical defects acquire and socio-constitutional and individual psychological factors. The first (gender, age, profession) define the degree of dramatization or even catastrophically defect. In particular, women, oddly enough, inclined to a lesser extent than men, appreciate the integrity of the body and, therefore, to dramatize the anatomical loss [Sokolov 1995]. At the same time, cosmetic defects for the beautiful half of the human race are, of course, more problematic. For men adulthood the loss of limbs is a almost catastrophic fact, in contrast to older males, which is obviously associated with the role of breadwinner, the need to provide family resources, which becomes complex when disability. Second, a number of factors, including the properties of temperament, character traits and personality, also defines a particular relevance to cosmetic and anatomical defects, affecting the emotion, the enduring of pain or persistent uncomfortable States, the necessity of restriction of movements and immobility. In particular, extroverts perceive all the levels of stimulation, including pain, less intense than introverts; in choleric and melancholic lower pain thresholds than those of the sanguine and the phlegmatic; the tendency to stoicism or hypochondria (which are often the result of family and cultural upbringing) determines the perception of the disease and the degree of pay attention to her.

it is Known that any psychopathology is both inverted form of protection of the individual against stressful circumstances. In this regard, the typical clinical picture of individuals – carriers of defects. As pointed out by E. O. Gordievsky and B. Ovchinnikov, "the Average values for the whole sample was the highest on scales of schizoid, personality disorder, depression and hypomania. ...These results may indicate maladjustment, manifested in behavioral reactions asocial or antisocial direction (conflict behavior, low conformance, aggressive reactions). ...Along with this, there is a combination of personality mixed trends (indicators as hypersthenic and hyposthenic), which may indicate a state of chronic stress, which involves a variety of protective mechanisms and multiple compensatory function of mental activity aimed at the solution of maladjustment" [Gordievsky 2008, p. 340-341].

Coping behavior of carriers of cosmetic and anatomical defects is determined by all the above factors, including the actual cognitive (self-perception and self-assessment with regard to the "ideal" image of the body), emotional (related to the type of character, temperament and personality), behavioral and motivational (associated with features of education and socialization, including ethnic, cultural and religious aspects).

Coping with traumatic circumstances can take a destructive nature to the chosen tactics of overcompensation in the form of aggressive reactions, self-deprecating or Mir-derogatory behavior, alcoholism, or anesthesia. To give relief for a short period, in the long dimension of these tactics, of course, lead to mental as well as physical destruction of the individual.

Constructive coping with cosmetic and anatomic defects is, of course, most preferable. This strategy is certainly, in my opinion, needs to be linked with cognitive restructuring, life experience and perception of the world, a kind of rescripting ("rewriting") incurred or existing defective features, along with challenging and debunking of beskonechnost any "perfect images". Of course that constructive coping mode can and should receive appropriate support and the support of the psychologist-consultant, or therapist can "not notice" a discrepancy between the external appearance of the last "normative sample," and to see in detail the gaps and injury its internal content.


Gordievskaya E. O., Ovchinnikov B. V. the individual-psychological characteristics of persons with amputations of limbs as a significant factor in their rehabilitation // Vestnik of Saint Petersburg University. Episode 12. - 2008. – Vol. 2. – S. 339-344.

Lakosina N. D., Sergeev I. I., Pankova O. F. Clinical psychology. A textbook for medical students. - Medpress-Inform, 2003. – 416 s.

Mendelevich V. D. Clinical (medical) psychology: a Practical guide. - M.: Medpress, 2002. - 592 s.

Sokolova E. T., Nikolaeva V. V. Peculiarities in borderline personality disorders and somatic diseases. Moscow: SvR-Argus, 1995 - 359 p.

Oleg Karmadonov
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