The amputation of a limb requires substantial physical and psychosocial adjustment to a changed life situation. As a prosthesis often facilitates this process, its integration into one’s body representation, referred to as prosthesis embodiment, has been proposed as a marker of adjustment. Building on previous evidence that negative consequences of limb amputation are reflected in how the own body is experienced in dreams, this study examined whether prosthesis embodiment mitigates such effects.
In 192 prosthesis-using individuals with acquired lower limb amputation, dream recall frequency, recalled body appearance in dreams (impaired, intact, or not remembered), and indicators of psychosocial adjustment were assessed. Dreams most frequently featured an intact body. In 113 dream recallers, higher prosthesis embodiment, unlike other psychosocial indicators, was significantly associated with a lower likelihood of recalling an impaired body.
No association emerged for recalling an intact body or for absent body recall. This asymmetric pattern supports the continuity hypothesis of dreaming, suggesting that an embodied prosthesis loses salience as an amputation cue, thereby reducing waking concerns about impairment reflected in dreams. The findings provide empirical evidence that prosthesis embodiment represents cognitive integration of the device into the self-model, marking the transition from salient foreign-body representation to non-salient self-representation.
The amputation of a limb requires affected individuals to make extensive adjustments to physical and psychosocial limitations1. Prostheses may play a crucial role in coping with these limitations2. However, there is considerable variability in prosthetic adjustment3.
Prosthesis embodiment, defined as the degree to which an individual incorporates the device into their body representation4, is discussed as a key factor in the adaptation process. This concept extends beyond the prosthesis’ mere functional role as a (more or less) helpful tool, instead reflecting the extent of successful body-prosthesis interaction5 where the device perceptually becomes part of the bodily self. Prosthesis embodiment has been repeatedly linked to positive rehabilitative outcomes6,7,8 as well as to changes in basic cognitive functioning9,10,11.
A key aspect of these cognitive changes relates to the mental representation of the body, which extends even into dream content. Interestingly, previous studies indicated that amputated individuals report dreaming of themselves more often with an intact rather than with an impaired body (for a historical overview, see12). Mulder et al.13 found in a heterogeneous sample of 187 limb amputees that 21% reported exclusively dreaming of an impaired body, 31% exclusively of an intact body, and 37% recalled their bodies in recent dreams in a mixed fashion, meaning impaired in some dreams and intact in others.
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