Body Awareness in Chronic Illness

Source: Photo Taken by Katie Willard Virant

We don’t just “live in” our bodies; we are our bodies. Our thoughts, feelings, sensory experiences—our very awareness of ourselves—all rely on the body. Infants come into the world and quickly learn that sensations can be unpleasant or pleasant. As they grow, they learn to name these sensations. The pain in one’s midsection is called hunger, for example. The people who envelop us in hugs and warmth are called parents. I am remembering, at this moment, my 1-year-old tasting ice cream for the first time. She shivered at the cold feeling on her tongue while her eyes widened in joy at the sweet taste. She simultaneously recoiled from the spoon while pulling it closer for another mouthful. Her experience, bodily-based, was rich and multi-faceted.

As adults, the way we live in our bodies changes. Our minds are filled with work and relationships, worries and responsibilities. We may not pay attention to how the sun feels on our skin. We may ignore fatigue or pain to complete various tasks. Our body still provides us with signals, but we have learned to turn down our receptivity to them.

To live well with chronic illness, we need to develop a renewed sensitivity to body signals. Health researchers call this “body listening,” defined as “a process in which patients come to utilize bodily sensations as information (St. Jean, Jindal, and Chan, 2018).” Through trial and error, people living with chronic illness learn to use bodily sensations to track the presence of flares and the efficacy of treatments (Chen, 2015). We pay attention to diet (this food seems to set off symptoms), rest (if I take a nap when I start to feel tired, I can often avert symptoms), and medications (my body responds better to this medication than that one). This body listening becomes so fine-tuned that it can feel automatic for many people who live with illness. However, it is a hard-earned skill. If you’re reading this and recognize yourself as a body listener, be proud. You’ve worked hard to develop this attunement with your body.

If you want to improve your body listening skills, think about where you typically sit on the continuum of body awareness. Do you pay too little or too much attention to your body signals? Both are ways of coping with fear, anger, and overwhelm about illness. We pay too little attention when we want to forget we’re sick; we pay too much attention when being sick is the most notable thing about us. When we don’t register or choose to ignore body signals, we can get very sick. When we are paying too much attention to body signals, we can get lost in anxiety and fear: an alarm system that is constantly going off is an alarm system that is broken. If you see yourself in either of these categories, it’s valuable to consult with a therapist in understanding and working through the obstacles impeding optimal body listening.

It’s important to note that we all move dynamically on the continuum of body awareness. When we’re feeling particularly well, we may ease off being so responsive to our body signals. And when we’re in distress, we’re highly and perhaps anxiously attuned. Even when we’re sitting in the sweet spot of “just right” body awareness, we have feelings about it. We may be resentful of the attention we have to give to our bodies to take care of ourselves, effort that non-ill people don’t have to expend. We also may become so accustomed to viewing the body as a source of illness information that we forget to attune to it as a source of pleasure.

I offer the following exercise as a way to awaken presence in the body, body listening as a way to spark joy. Make a list of sensory experiences that you enjoy. Ideas include taking a warm bath, sitting outdoors looking up at the clouds and listening to the birds, sipping a mug of hot tea, laughing with a friend, drifting off to sleep, or stretching your arms over your head. Choose one experience and, as you’re engaged in it, imprint it on your consciousness. Pretend you have a slow-motion video camera in your mind and capture everything about it. Record the way things look, sound, taste, smell, and feel. Record the way that the pleasure you’re taking in through your senses affects your body. Record the ways in which well-being changes your body: Perhaps your muscles relax, your heart rate slows, your thoughts untangle. Savor all of these sensations. You’ve listened to your body and you’ve captured the joyful feelings it’s brought you. Repeat as needed, and play back the video in your mind at any time.

Where do you usually sit on the continuum of body awareness? What feelings come up when you think about your attunement to your body? Can you experience your body with joy, as well as with responsibility?