Body Integrity Identity Disorder

Ever felt like cutting off your own leg? I didn’t think so.


Body Integrity Identity Disorder (BIID), also known as Amputee Identity Disorder, is one in which the sufferer is adamant that a limb of theirs does not belong to them and needs to be amputated. There is a sort of alienation of the limb, usually a leg. The sufferer’s view of their leg is reduced to that of an object that is unrelated to the person. These individuals do not feel “whole” with four limbs, instead, they believe they are incomplete and can only become “whole” is the affected limb is amputated.


BIID may be associated with apotemnophilia, or self-demand amputation that is related to sexual arousal at the idea of one being an amputee. There may be erotization of the stump after amputation, and there may be conceptual connections to masochism and transseuxalism. Some have argued that the desire for limb amputation is related to sex reassignment of transsexualism.


The documentary Whole describes sufferers of BIID. One man named George had become so desperate to get rid of his leg that he shot it off with a shotgun. In terms of the injury, he said that he felt “absolutely transformed,” and that he’s “fine,” and doesn’t care because he has realized himself, and has “become whole.”


The disorder typically begins in childhood, and the desire to amputation becomes a life-long obsession, until amputation takes place. What is interesting is that even though BIID sufferers are adamant about their feelings, they know it is strange and shouldn’t be so. But they can’t help themselves from feeling the way they do.


The etiology of the condition is not fully known, and there is no treatment plan that professionals agree upon. The only treatment that seems effective is amputation, and there is a growing ethical concern about such a drastic treatment. Is it right to allow an individual to have a limb amputated, even though the limb the healthy? Is it ethical to deprive them of amputation if the procedure will bring the sufferer comfort and peace of mind? Some physicians believe that amputation of the healthy limb goes against their Hippocratic Oath to not do harm is possible. Clearly there is a debate centered on this issue that will be considered in the years to come.


Try this exercise: Imagine that running down the center of your body is a line. This line bisects your body into a left and a right. Now with your left hand, raise over your left eyebrow. Again with your left hand, pat your left thigh, your left shoulder, your left neck. You are able to tell all your body parts and where they lie in space because of the brain’s body map of yourself. The spatial relationships of all the parts of the body are matched in the brain, that is, the area of the brain relating to the foot is next to the ankle is next to the shin is next to the knee and so on.


Some neurologists and psychologists believe that the disorder arises when the brain is not able to provide an accurate depiction of the body. Each of us has a “body map” in our brain allowing us to know where our limbs are in space and which belong to us. The BIID sufferer’s brain is not able to do this properly and sees the limb as an offending object to be removed. Some believe that the sufferer thinks that being an amputee will bring them more attention or love, but many BIID sufferers claim that that is not the case. Many BIID sufferers will seek out, if they do not do it themselves, surgeons to perform the amputation of the limb, or even to ask for a transection of their spinal cord, to allow for paralysis.

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