Coping with Amputation

Abstract

Surgery of any kind is accompanied by fantasies of helplessness, mutilation, loss of control, body image distortion, castration, rejection and death. All of these fantasies, in or out of awareness, create massive anxiety leading to certain behaviors characteristic of an individual's coping style. For the lower limb amputee, a number of these fantasies become real. The person who has lost a leg needs to depend upon others at least until he has mastered a prosthesis. He must confront not only the physical reality of mutilation, but also the body image changes associated with it and the personal meanings they carry. He must integrate the idea of being "different" so that he may comfortably continue with life. In their work with amputees, both authors have found that some people have greater difficulty than others in accomplishing these tasks. The coping styles which lead to successful coping with an amputation and the other variables that contribute to this success have not been clearly described in the literature. In fact, there is very little on lower extremity amputation and even less on preoperative evaluation, which might be useful in identifying these significant variables.