Wyona Freysteinson made her career choice at the age of 2.
“I knew I was going to be a nurse,” said Freysteinson, associate professor of nursing at TWU’s Houston Center. “My grandmother was my first patient.”
Her grandmother had diabetes, and as a young girl, Freysteinson helped take care of her. The two would sit in front of a large, oval mirror while Freysteinson combed her grandmother’s hair. When her grandmother was hospitalized, nearing the end of her life, young Freysteinson found a comb and mirror. The older woman’s calm reaction to seeing her reflection would be the inspiration for Freysteinson’s future research.
“It was the beginning of my thought process about the mirror image,” she said. Mirror viewing was the focus of Freysteinson’s 2011 dissertation at Texas Woman’s and became an important part of her nursing practice, which has spanned emergency, neurosurgery, intensive care, medicine, home health and hospice.
Freysteinson’s research focuses on the experience of individuals who have suffered visible disfigurement when viewing themselves in the mirror — primarily those who are terminally ill, individuals who have had limbs amputated, women who have had a mastectomy, and women veterans. For many, she said, it’s an emotionally charged experience. Understanding this can help nurses adopt interventions that help patients deal with those difficult moments and, eventually, accept the loss, she added.
In 2015, Freysteinson was invited to the Lotus House shelter to help homeless women veterans who were having body image issues.
“The women believed they had a medical condition, visible or not, due to service in the military,” she said. “It quickly became obvious that the issue wasn’t physical scars; it was military sexual trauma.”
Military sexual trauma (MST) is psychological trauma resulting from physical assault or battery of a sexual nature, or sexual harassment that occurred while the veteran was serving on active duty, active duty for training, or inactive duty training, according to the U.S. Government Publishing Office.
Freysteinson and her fellow researchers concluded that, for these women, the invisible scars of MST were worse than physical scars. The women said that looking in a mirror was like looking at a stranger. The veterans also said they wore a “fake face” to mask their anguish around others, including their families, and said they felt “broken,” according to Freysteinson.
The research project was the first known study to both note a correlation between shame and MST and to indicate that those who have suffered MST have difficulty viewing themselves in the mirror.
Freysteinson’s work currently is on two different research tracks. One study involving three Houston hospitals is testing a Mirror Image Comfort and Acceptance Scale for individuals (150 civilians and 150 veterans) with amputations. She’s receiving support from the National Women with Disabilities Empowerment Forum, of which she serves as co-founder and vice president.
The second track of her research focuses on MST. Freysteinson will work with Grace After Fire, an organization committed to helping female veterans transition back into family life and the workplace. She met members of the organization while researching MST and recently was asked to join the board. A Mirror Image Comfort and Acceptance Scale also is being developed for veterans who have suffered physical or emotional trauma.
“The more I talk with women who have suffered sexual abuse, the more I believe this is the type of intervention nurses ought to be doing,” Freysteinson said.

Wyona Freysteinson
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By Karen Garcia
Marketing & Communication
kgarcia@twu.edu