Mastectomy, Spatial Perception and Movement

Recently a former Rolfing client who has moved to another city wrote to ask my advice about exercise and movement for pre-and post-surgery. She has been diagnosed with breast cancer and is facing mastectomy.

What I told her had to do with how the perceived space around the body is affected by trauma.  In 2001, researchers in Italy reported on an 8-year study of physical and psychological damage in women who had mastectomies. What they found was that most of the women lost the swinging movement of the arm during daily activities on the same side as the operated breast. The women were able to use the arm normally when asked, but when not thinking about it, they held their arms still.  Eventually, in many cases, this led to a compensatory movement pattern and pain in the opposite side hip.  

Another set of experiments showed that many women diagnosed with breast cancer stopped swinging their arms even before surgery. Further studies observed that patients lost awareness of their bodily positions relative to their spatial surroundings, and were unable to strongly project movements through space on the affected side (like throwing a ball). Their loss of spatial attention resulted in loss of strength and coordination. The aim of these studies was to improve rehabilitation by noticing an individual’s perceptual organization. (You can read about this study here.)

After explaining these phenomena to my client, I suggested she notice any sense of diminished movement on the affected side. To become more aware of the space around her body she could imagine a sphere—something like a snow globe—and standing within it, notice differences her sense of the qualities of the space on each side. She could compare size and shape, but also light and dark, textures, and density. Then I suggested a simple gesture of pointing at a nearby object. Could she notice the energy, authority, confidence, etc. with which she made gesture on the affected compared to the non-affected side?  If so, she could then try to “teach” the affected side the more dynamic way of moving. But first she’d need to expand or brighten her sense of space on that side.

The important point here is that awareness matters. Noticing how she uses her body in everyday activities matters just as much as doing an exercise routine that will keep her tissues mobile and hydrated. Using those tissues normally-—not just during exercise-—completes the rehabilitation.

The space immediately around our bodies is coded in our brains by special spatial neurons.  This peripersonal space is a real feature of our bodies. Trauma can shut it down around the areas of the body where trauma occurs. This applies to any perceived traumatic event, not just breast cancer.

Further, closing off our perception of the space around us can happen through mundane daily affairs such as sitting at your computer. I write about spatial awareness as a factor in physical and emotional support in my forthcoming book, Your Body Mandala.  Click here to read an excerpt from the book. This post from 2012 suggests a practice for ramping up your spatial awareness.