Neurocognitive Model of Mirror-Viewing

Contributor: Wyona M. Freysteinson
November 29, 2020

Wyona M. Freysteinson, PhD, MN

Year First Published – 2020

© 2020 Wyona Freysteinson
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© 2020 Wyona Freysteinson
Major Concepts

Mirror-viewing
Mirror comfort
Mirror discomfort
Mirror trauma

Typology

Middle range nursing theory

Brief Description

Voluntary and involuntary mirror-viewing is primarily a neurocognitive activity. When there is an actual or perceived change in one’s body, the key motive to view oneself in a mirror is curiosity about how one looks. Other motives include using the mirror as a tool to perform self-care (e.g., care of an incision site) or to care for one’s appearance. An example of involuntary mirror-viewing is being pushed in a wheelchair toward a large mirror (e.g., in an elevator, lobby, or home).

In mirror-viewing comfort, mirrors are merely tools that function as an extension of the body, like eating utensils or watches. There is an ease or comfort experience when performing daily routines in a mirror as the mind registers a consistent self-recognition. A minor visible change (e.g., cold sore, small incision) may induce increased mirror self-scrutiny and a short-term decrease in mirror comfort. A perceived or actual visible body change may result in an extended period of decreased mirror comfort and anticipatory fear or concern before mirror-viewing may be experienced.

When there is a perceived or actual radical visible change to one’s body (e.g., blast injuries, severe burns, sexual trauma, being teased or bullied about one’s body), disruption within the prefrontal neural network occurs during initial mirror-viewings. This disruption leads to a negative mirror-viewing experience ranging from decreased mirror comfort to mirror trauma with ANS dysregulation, i.e., fright/flight or faint. The traumatic mirror image transfers to long-term memory, where it may be intrusive and readily recalled years later. Mirror avoidance may occur. Supported repeated mirror- viewings may improve mirror comfort, and unsupported repeated mirror-viewings may lead to persistently decreased mirror comfort or mirror trauma.

Primary Source

Freysteinson, W.M. (2020). Demystifying the mirror taboo: a neurocognitive model of mirror viewing. Nursing Inquiry. Advance online publication. https://doi.org/10.1111/nin.12351

Additional Sources

Freysteinson, W.M., Sarbacker, L., Gobeli, L., Tristan, K., Esquela, M.A., Wellington, C., Gonzalez, K.E., Thayer, B., & Yeatts, P. (in press). Educating nurses on supported mirror viewing for patients after amputation and other visible disfigurements. Rehabilitation Nursing Journal.

Thayer, B., Freysteinson, W.M., &Thomas, L. (2020). Transforming the experience of mirror viewing for individuals faced with disfiguring injuries, Clinical Nurse Specialist, 34(2), 132-136. https://doi.org/10.1097/NUR.0000000000000518

Freysteinson, W.M., Thomas, L., Thayer, B.V., Lelek, N., & Lee, I. (2018). Assisting individuals to view self in the mirror after an amputation. Produced by Texas Woman’s University. https://www.youtube.com/watch?v=H6dpzDHuefM

Freysteinson, W. M., Deutsch, A., Davin, K., Lewis, C., Sisk, A., Sweeney, L., Wuest, L., & Cesario, S.K. (2014). The mirror program: preparing women for the post-operative mirror viewing experience. Nursing Forum, 50(4), 252-257. https://doi.org /0.1111/nuf.12108

About the Author

Wyona M. Freysteinson (1957 – )

Dr. Freysteinson is a professor in the Nelda C. Stark College of Nursing at Texas Woman’s University in Houston, Texas, where she teaches in the Ph.D. nursing science program. Dr. Freysteinson is a generalist with extensive clinical care experience in medicine, emergency, neurosurgery, intensive care, home health, and hospice.

In service to the profession, Dr. Freysteinson is a Sigma Theta Tau Faculty Scholar and Past President of the Sigma Beta Beta Houston Chapter. In service to the community, Dr. Freysteinson is founder and past director of the Saint Elizabeth Anne Seton’s Parish Nursing Ministry, the second-largest parish in the United States; Vice President and a founder of the non-profit organization – National Women with Disabilities Empowerment Forum; and a board member for Grace After Fire, a women’s veteran organization. Dr. Freysteinson’s work with homeless women veterans has led to a greater understanding of military sexual trauma’s embodied shame experienced in the mirror, in society, and intimate relationships.