Immobility and the self: a clinical-existential inquiry.

This article is a philosophical and clinical investigation of the existential meaning of immobility which takes as its starting point Erwin Straus 's writings on upright posture and movement. Physical restriction due to prolonged bed rest, traction, or confinement in an intensive care unit has long been recognized to have detrimental effects on the patient's overall physical well being ( Asher , 1947; Olson , 1967; Pollard et al., 1976; and Zubek et al., 1969). Nevertheless, the adverse psychological and existential results of immobilization for the hospitalized patient have received little attention until recent times (Hammer and Kenan , 1980, p. 124). Even today, more research has focused on psychological aspects of sensory deprivation than on those of immobilization. This essay is both a philosophical and clinical inquiry which will investigate the existential meaning of immobility; that is, perception of one's own body on the part of patients who are living through the experience of immobility due to traction. The "lived-body" is more than an "image" or "picture": it is also a means of perceiving the world, an instrument for action, a means of interacting with others, and a medium for expressing one's individuality ( Shontz , 1974, p. 465). In short, as Straus observes, the body is that "here" which is the ground for our ability to act in the world which is "there" ( Spicker , 1976, p. 149). These latter considerations will prove useful in an examination of the experience of immobility. This article is divided into four parts. First, currently held assumptions about movement and sensation will be outlined and their philosophical origins will be traced. Second, Straus 's own definitive writings on upright posture and movement will be discussed. Third, a clinical study involving immobilized orthopedic patients is described and its findings reviewed. Fourth, some ways of alleviating some of the concerns of immobilized patients are suggested.