Newsweek has a fascinating article on ‘body integrity identity disorder’, a condition where people feel they need to have a limb amputated to become normal and often go to extreme lengths to have their arm or leg removed.
BIID, otherwise known as apotemnophilia, is often confused with amputee fetishism, where sexual gratification is linked to ideas of amputation. However, they seem quite distinct in most cases.
Although its not widely studied, the desire seems to be much more about the feeling of being comfortable in one’s body rather than anything explicitly sexual.
The Newsweek article discusses the condition and looks at some of the latest scientific research on this seemingly strange desire, but suffers from some rather sloppy thinking about the mind and brain. For example:
BIID is attracting the attention of researchers who suspect that the condition may be related to other body image disorders—including anorexia, body dysmorphic disorder, and gender identity disorder—that at first glance may seem entirely psychological, but may be linked to physical differences in the brain.
All psychological changes are related to physical differences in the brain, so this is a completely bogus distinction.
Whenever you read a sentence like this translate it into the language of theories and evidence.
In other words, ‘[conditions] that might seem better explained by solely psychological theories now need to be updated as evidence on biological brain changes becomes available’.
The piece then goes on to repeat a common but trashy fallacy that you can describe any brain difference as something that is ‘hard wired’.
Despite these disastrous misunderstandings of the fundamentals of neuroscience, the piece is actually quite good.
It’s interesting that while the medical viewpoint is that BIID is linked to other body image disorders, the people who have these desires do not feel it is a disorder at all.
I was struck by the fact that a couple of people who have acquired amputations anecdotally report that they feel much better afterwards.
This is in marked contrast to people with body dysmorphic disorder who after plastic surgery to ‘fix’ their self-perceived distorted body part typically do not feel ‘cured’. Or those with anorexia who do not feel satisfied even when they are at a near-fatal point of emaciation.
It would be fascinating to follow-up people who have BIID after they’ve acquired a successful amputation to see how they fare.
If their desires disappear, they do not become newly fixated on amputating another limb, or experience improved mental health and life-satisfaction as a result, how far can we go in saying its a mental illness?
I’ve had a search and, sadly, found no such studies.
Link to Newsweek article ‘Cutting Desire’.
Mind Hacks 
Hello,
A few points of clarification.
Body Identity Integrity Disorder is not apotemnophilia. The later used to be the name used, but it is not accurate. Apotemnophilia denotes a sexual deviance (philia), whereas people with BIID do not need to be amputees, paraplegics, blind or deaf for (primarily, nor predominently) sexual reasons. Some do, but the vast majority doesn’t.
BIID is indeed quite different from BDD (Body Dysmorphia), in that we know that our bodies are “normal”, we just happen to feel that “normal”, for us, is wrong.
It is not correct to state that people who have BIID do not believe it is a disorder. Some disagree, others believe it is. I happen to think that it *is* a mental illness and should be included in the DSM-V. Many share my viewpoint.
There are numerous people who have managed to acquire the amputation they needed. None of them regret it. In fact, the only regret they state is to not “have done it sooner”.
Why nobody has bothered doing extensive interviewing of these individuals is beyond me. It’s a bit as if the medical community choses to ignore the evidence, hoping that they won’t have to end up admitting that surgery *is* currently the only viable option for those of us who suffer from BIID.
You may find the majority of what has been published about BIID on http://biid-info.org. You may also be interested in my multi-author blog that discusses the experience of living with BIID: http://transabled.org.
Most interesting to me is the final point you bring up about being “cured.” While BIID doesn’t resemble anorexia or body dysmorphic disorder in this regard, it does share the “cure” with gender identity disorder- for most people, once the shell is altered to suit the internal identity, they feel a-okay, or at least closer to perfect.