In this article, clinical psychologist and psychotherapist Nathalie Neyrolles sheds light on the psychological aspects of lipedema.
Si le lipœdème peut se manifester après une grossesse ou lors de la ménopause, c’est surtout au moment de la puberté que cette maladie chronique et évolutive apparaît.
It’s not just a question of coping with the physiological and psychological upheavals that puberty imposes, but also of taming this intruder who has come to live inside us.
Puberty marks the transition from an identity formed in childhood to a new, adult identity awaiting definitive reference points.
The image of the body is disrupted, particularly as a spatial reference point:
“The teenager is a bit like a blind man moving through an environment whose dimensions have changed » (A. Haim).
Pulsive activity awakens psychologically and physiologically, and the body undergoes a metamorphosis that the adolescent must integrate without taking it for granted.
At puberty, this familiar body becomes a stranger, and if having and being a body – that is, both feeling in possession of one’s body and embodying this body, experiencing oneself through it as a subject – seems self-evident, it’s a different story not only in adolescence, but becomes all the more problematic when the subject suffers from lipedema: With the accumulation of fat mainly in the lower limbs, leading to a dichotomy of the body, how can one make one’s own a body that does not seem unified, with blurred contours? How can we make this body our own when it seems elusive, disquieting or even frightening? How can we make our own a body that doesn’t correspond to the body image we’d like to have? The link between the body and the ego is threatened, as is the subject’s identity.
A body to tame
The subject suffering from lipedema will try to control this elusive body, to have a hold on it, to control both the sources of impulse excitations and the physiological changes taking place in the adolescent passage, but also to try to delimit those contours left blurred by the lipedema.
Despite all the efforts made to reconcile the ideal body with the real one, the body doesn’t respond: despite draconian diets and physical activity, a disproportionate body remains, with areas of the body that escape all control: when the body betrays itself, it seems difficult to maintain the link between the ego and the body, to feel good “in one’s skin” ».
The transformations and oddities of adolescence already shake this narcissistic unity for a time, but lipedema amplifies this fracture, and the subject risks collapse.
Deprived of control over their bodies, lipedema sufferers submit them to health professionals, no longer knowing what to think of them, in order to find out how they function, what their possibilities are, and so on.
Lipoedema and healthcare professionals
Lipedema is a rare condition that is largely unknown to healthcare professionals, who often confuse it with simple obesity. It often takes years of medical wandering before a patient suffering from lipedema meets a professional specializing in the condition, and is finally given a name.
However, the diagnosis of the illness does not erase the psychological suffering it causes; it only explains it from a medical point of view, and provides a reference point that must be appropriated: suffering from this chronic illness is a characteristic that the subject will have to inscribe in his or her identity.
The body, our being in the world
The body is not just this physical reality of flesh and bone, “it is also the support of the Self and who I am for others » (Birraux,2004) For Schilder, the body represents the vehicle of “being in the world », it is at the center of affective relational exchanges between individuals.
In a society that cultivates the cult of performance, of the svelte, muscular body, the body that doesn’t meet standards represents an aggression; it is rejected as if it represented a threat to one’s own integrity:
“A feeling of aggression takes over, as if the vision of a deviant morphology carried a violence comparable to physical aggression » (P.Ancet, 2006).
We don’t accept this damaged image of ourselves in him.
There’s also a misunderstanding when it comes to overweight people: the report that appears every year on the evolution of obesity in France (Obepi) correlates poverty and low levels of education as determining factors in obesity. This has led to prevention campaigns focusing on nutrition education and physical activitý in other words, if a person is overweight, it’s because of laziness, lack of willpower or even gluttony.
So we understand just how much suffering people with lipedema can experience in their relationship with the world.
To conclude this article: lipedema – psychological aspects
Lipedema disrupts a person’s image of and relationship with their body. This chronic disease is a particularity that the subject will have to inscribe in his or her identity.
The psychological suffering associated with living with lipedema can be immeasurable: the person with lipedema is often judged, mocked and misunderstood, which fosters low self-esteem and undermines confidence. Distraught in the face of this, the lipedema sufferer may experience episodes of depression, anxiety and eating disorders.
Illness is a subjective experience, both a physical and a psychological event, which is why psychological care for lipedema sufferers is just as fundamental as physical care.
Psychological support throughout the surgical procedure will aim to restore the disease to life, but also to come to terms with the constraints imposed by this disease, to strengthen the identity that has remained shaky, to regain self-esteem and self-confidence, and finally to tame and appropriate one’s own body.
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