Body Integrity Dysphoria / Body Integrity Identity Disorder

Mal_Adjusted

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At War With Their Bodies, They Seek to Sever Limbs

greets

(we have a thread about body dismorphia but that covers additional limbs etc.)

this about those who want fewer

At War With Their Bodies, They Seek to Sever Limbs
By ROBIN MARANTZ HENIG

Published: March 22, 2005


hen the legless man drove up on his own to meet Dr. Michael First for brunch in Brooklyn, it wasn't just to show Dr. First how independent he could be despite his disability.

It was to show Dr. First that he had finally done it - had finally managed to get both his legs amputated, even though they had been perfectly healthy.

Dr. First, a professor of psychiatry at Columbia University, had gotten to know this man through his investigations of a bizarre and extremely rare psychiatric condition that he is calling body integrity identity disorder, or B.I.I.D.

"This is so completely beyond the realm of normal behavior," he said of the condition, which he estimated afflicts no more than a few thousand people worldwide. "My first thought when I heard about it was, Who would think this could go wrong? Who even thought there was a function that could be broken?"

Dr. First is among a small group of psychologists and psychiatrists who are trying to define the disorder, understand its origins and decide whether to include it in the encyclopedic bible of psychiatry, the Diagnostic and Statistical Manual, or D.S.M., as a full-fledged disease. At the same time, the disorder is turning up as a plot device or documentary subject in a handful of films, plays and television shows.

The idea of having extreme elective surgery, even when it involves mutilation or removal of healthy tissue, has met at least some acceptance in cases like sex reassignment, or cosmetic surgery for those who hate their noses or breasts even when those body parts are objectively fine.

But an obsessive desire for a limb amputation - one that drives people to cut off healthy arms and legs - tests the tolerance of even the most open-minded.

Body integrity identity disorder has led people to injure themselves with guns or chain saws in desperate efforts to force surgical amputations. A few have sought out amputations abroad, including one man who died of gangrene after an elective amputation in a clinic in Tijuana, Mexico.

The disorder has been known by several names. In 1977, Dr. John Money, an expert on sexuality at Johns Hopkins University, named it apotemnophilia (literally, love of amputation). He considered it a form of paraphilia - that is, a sexual deviation.

In 1997, Dr. Richard Bruno of Englewood Hospital in New Jersey proposed the name factitious disability disorder, which he grouped into three types: people who are sexually aroused by amputees ("devotees"), those who use wheelchairs and crutches to make it seem as if they are amputees ("pretenders") and those who want to get amputations themselves ("wannabes"). In Dr. Bruno's taxonomy, those who manage to obtain amputations continue to be known as wannabes.

In 2000, Dr. Gregg Furth, a New York child psychologist and one of Dr. Money's co-authors on his 1977 paper, published a book about the disorder, calling it amputee identity disorder. In addition to his professional interest in the subject, Dr. Furth had a personal one: from early childhood, he had wanted to have his right leg amputated above the knee.

Dr. Furth wrote the book with Dr. Robert Smith, whom he met while searching for a surgeon who would perform the elective amputation. When Dr. Furth found him in Scotland, Dr. Smith had already done two such operations, and he agreed, after consulting with two psychiatrists, to operate on Dr. Furth. But in 2000 Dr. Smith's hospital, the Falkirk Royal Infirmary in Glasgow, prohibited any further procedures of this type. Dr. Furth never received his amputation.

The newest name, body integrity identity disorder, was first used by Dr. First of Columbia in the journal Psychological Medicine in 2004. In that paper, he described the results of a telephone survey of 52 people with the disorder: 9 of them had amputations and the rest yearned for it. He chose the name to distinguish the disorder from paraphilia, psychosis or body dysmorphic disorder (the false belief that a part of your body is ugly or abnormal).

To Dr. First, the closest analogy was to gender identity disorder.
http://www.nytimes.com/2005/03/22/health/psychology/22ampu.html

mal
 

CoffeeJedi

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i've read about this... portalofevil.com used to link to a lot crazy people with this fetish, many of them wanted prosthesis in place of their normal healthy limbs. i remember one woman's site where she would repeat the same bit about the steel hooks she wanted over and over again.

now... i've always thought it would be REALLY cool to have a cybernetic arm, but, that's just the sci-fi geek in me talking ('sides, they don't make 'em like in the movies yet!)
 

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Re: At War With Their Bodies, They Seek to Sever Limbs

Mal Function said:
greets

(we have a thread about body dismorphia but that covers additional limbs etc.)

this about those who want fewer
I hope this is the right place to put this similar story then. I seem torecall a few threads where this sort of thing is mentioned though.

BBC

Women are inventing family histories of breast cancer in order to have treatment, doctors have revealed.

Geneticists in Manchester say this can lead to patients having surgery to remove their breasts, only for doctors to discover that it was unnecessary.

They say the women, 1% of patients, are likely to have a psychological disorder similar to Munchausen's Syndrome.

Around 5% of the 40,000 cases of breast cancer diagnosed in the UK every year are linked to high-risk genes.

The geneticists at St Mary's Hospital said a small number, around 1%, of women claiming the most serious family risk of breast cancer - where three of four relatives develop the disease when young - were inventing the history.

Women who do have this kind of family history sometimes opt for preventative treatment, which may include surgery to remove the breasts.

But experts warn that, if patient's claims are not investigated, they may undergo unnecessary surgery, and cause fears among relatives that they may have a high risk of cancer.

Professor Gareth Evans, a consultant in medical genetics at St Mary's hospital in Manchester, said: "The women should go through a process of risk assessment with a geneticist, and also have a psychological assessment.

"With all of those in place women should no longer be getting surgery in that situation.

"Unfortunately it appears that women still are getting surgery, so some surgeons are still not going through the protocol as they should."

Professor Evans said restrictions under the Data Protection Act have made it harder for doctors to verify what patients are saying if they will not consent to having their family histories investigated.

"What we are concerned about are people who actually are fabricating it, know they're fabricating it, and they're the last people who are actually going to sign a consent form that's going to let you find out that they haven't actually had what they say they've had."

Melease Crosby, from Partington in Greater Manchester, has the flawed BRCA1 gene which makes her susceptible to breast cancer.

She was diagnosed with the disease five years ago, and has had several operations, including both breasts removed. Her mother, Sandra, has also had breast cancer.

Next week her daughter Louise will be tested to see if she has inherited the faulty gene. Melease is shocked that anyone might invent a family history such as hers.

"Until they tell you that you've got this faulty gene you don't want to think about it. And then when you are told that you've got a faulty gene it's a shock. But then you've got to deal with it.

"I think it's communication, the way you are with your children, how open you are with them. And I think we've been that with our children."

Simon Wessley, a professor of psychiatric medicine at King's College London, says it's much more common for patients to say things that are true and doctors don't believe them.

But he says some people do invent family histories in this way to draw attention to themselves.

"There are one or two people who actually enjoy the privileges, as it were, of being sick....the fact that people are nicer to you, you get sympathy, you get seen as the brave patient, and so on and so forth.

"There are one or two people who do get a perverse pleasure from assuming this role to which they are not entitled."

Sarah Rawlings, Breakthrough Breast Cancer's Policy Manager, said: "Preventative surgery should only be offered to women with a strong family history who have gone through professional risk and psychological assessment.

"It's essential that this takes place to ensure that only those women that need these services are able to access them.

"Women with a family history should not be afraid to discuss their issues with a GP and get the support and advice they need.

"It is also important that relatives talk to each other about their health so they are aware of any diseases that run in the family."
:?
 

Mighty_Emperor

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Bizarre case of self mutilation



July 6, 2005

Albany-- A cross-dressing man took a circular saw and purposely cut off his foot. Believe it or not, this isn't the first time the man has sawed off a body part.

His neighbors told firefighters that five years ago, he cut off his other foot with a circular saw.

People in the Banner Oaks mobile home park say they weren't surprised to learn that ambulances were on their way to Wendal Nason, Junior's home. They say he's struggled with mental problems for years and his amputation is not a shock.

Neighbors and emergency workers say the 47-year-old Nason's amputation was definitely planned. "She had been talking about five months about cutting off her right leg because she did cut off her left leg," says a neighbor.

They call him "she" because Nason is a transvestite who goes by the name "Sandra." "She has breasts. She wears dresses, makeup. She does everything like we do," Nason's neighbor says.

Around 9:00AM, Firefighters say Nason placed a trash can under his right foot, got a tourniquet ready to stop the bleeding and turned on his saw. After he had severed his foot, Nason called 911 and told them he had cut off his foot with a circular saw. He cautioned them that his door was locked and they'd need to send someone to break in to rescue him.

Firefighters and paramedics rushed to the scene, and once inside, discovered Nason had cut off his right foot, just above the ankle. Neighbors say they aren't surprised. "She cut her left leg off in 2000. She said that she just firmly believes she doesn't need legs and she doesn't want her legs," the neighbor said.

Neighbors say Nason has a history of self-mutilation and enjoys hurting himself. They say he's been in and out of mental hospitals for years.

Still, the group says Nason isn't a bad neighbor and even invited them over Tuesday. "I had to get ready for work and I didn't have time to come down here yesterday. Now I feel bad because I didn't come down here yesterday like she wanted me to, but I couldn't have stopped her," adds another neighbor.

Neighbors say Nason began self-mutilating when he was around 11 years old. They say he just spent about two weeks in the hospital being treated for mental illness and was released less than a week ago.

Wendal Nason underwent surgery and is in good condition.

As bizarre as this whole thing sounds, it's something psychiatrists are familiar with. Dr. Wanda Gobin says she's seen a lot of patients who mutilate themselves, even though this case is extreme. She says the earlier patients start that type of behavior the worse it becomes.

There are several mental illnesses that include amputation of limbs. "Simply that particular amputation or mutilation doesn't point to any specific diagnosis. You have to take the totality of the behaviors. You have to talk to the person to understand what led the person to that behavior," says Gobin.

She says people who mutilate aren't trying to commit suicide, but have constructed what they believe to be a logical reason for their actions. Gobin says about 30% of her patients engage in some type of self-mutilation or amputation.
www.walb.com/Global/story.asp?S=3562855&nav=5kZQbt5r
 

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The Guardian has a first person account of body dysmorphia. Not for the squeamish!

I won't be happy until I lose my legs


Ever since she was little, Susan Smith has felt there is something wrong with her body. Her determination to 'fix' things has twice landed her in hospital

Monday January 29, 2007
The Guardian


I was six when I first became aware of my desire to lose my legs. I don't remember what started it - there was no specific trigger. Most people want to change something about themselves, and the image I have of myself has always been one without legs.

To the general public, people like me are sick and strange, and that's where it ends. I think it is a question of fearing the unknown. I have something called body identity integrity disorder (BIID), where sufferers want to remove one or more healthy limbs. Few people who haven't experienced it themselves can understand what I am going through. It is not a sexual thing, it is certainly not a fetish, and it is nothing to do with appearances. I simply cannot relate to myself with two legs: it isn't the "me" I want to be. I have long known that if I want to get on with my life I need to remove both legs. I have been trapped in the wrong body all this time and over the years I came to hate my physical self.

As a teenager, in the privacy of my own home, I used to play by myself at being an amputee. I would pretend I had one leg, strapping the other one up behind me and wearing oversize trousers so there was no shape. I knew even then that it wasn't normal, that it wasn't something to share with friends or my parents. But, trussed up like that, I would be quite happy and satisfied for a while.

At 23, I met my future husband and we were very happy together - but I was leading a double life. He did not know about my BIID at first so it wasn't easy to pretend. I went through periods when having him around was very disturbing. I gradually withdrew into myself, becoming private and secretive.

There is no instruction manual for those who want to remove their own limbs, but I always knew I would do it. I had eventually, told my husband that one day I would lose my legs. It took many years for him to understand why, but he did realise it was part of me, and I suppose he accepted it.

Two years ago, I told him that now was the time and I was going to remove my left leg. My first attempt was in March 2005. Of course I was scared of dying, but I had got to a point in my life where I could no longer fight it.

First I needed to freeze and kill the leg so that surgeons would amputate it afterwards. I ordered dry ice pellets from a company near Edinburgh (the same stuff that is used in discos for the smoke effect). Nobody asked what it was for. I bought 40kg - it evaporates very quickly, so you have to buy a great deal. I put on layers of pantyhose, because you do not want it sticking to you, spread it in the back of the car and sat with my leg immersed in it for one hour. The pain was indescribable: it hurt so much I passed out a few times. I was scared, but more so of failure. I am that kind of person - I never fail.

I had not damaged the leg enough to have it amputated in hospital, so the following September I made a second attempt, and this time I stayed in the dry ice for four hours. I was sat with my legs across the back seat of the car, the windows wide open and the footwell filled with dry ice, covering the leg and topping it up as it evaporated. When I could bear no more I called my husband, who came and pulled me out. The leg was hard as stone. I had third-degree burns and the pain was horrible. But it wasn't enough: I now know you need a minimum of six hours to kill a leg completely.

My husband drove me to hospital, but they refused to amputate. Incredibly, they said the wounds were superficial and that I would be walking within a few months. I really thought this time that the surgeon would give me the amputation I needed, but they seemed resolute. I went through all sorts of stages as they worked on my leg to save it. Sometimes I found the whole thing very funny, at other times I was crying, and sometimes I didn't think I would live through it. I reached my lowest point when they discharged me from hospital four weeks later, after eight sessions of surgery, with the leg still attached. I thought I was going to have to make a third attempt. But this time I would have to do it differently, perhaps put my leg under a train so they would have nothing more than a stump to stitch up.

I slowly recovered my strength back at home. I had dropped from 9 stone to under 7 stone during the operations and wanted to give myself time physically to recover before trying again. But the leg became so infected that there was a danger of the bacteria getting into the bloodstream and killing me. I had so much fever I was sleeping 24 hours a day. My mum sat by my bedside, waking me every hour to make sure I was still alive. She has known about my condition since I was a teenager, but I know it shocked her to see me finally make an attempt. After nine months of agony, I told my GP that if I didn't see someone fast, I would take off the leg myself. Within two days I had an appointment with a different surgeon.

The amputation, last June, went without a problem, and my left leg was removed from just above the knee. I felt better as soon as I came round. In fact, I felt so good in hospital that I was ready to go home straight away had they let me. My bag was packed and I was ready to leave. The Tuesday after the operation I drove myself home in an automatic car, and the next day I was almost back to my normal life.

I already feel more complete now that one leg is off. I have always been an outgoing kind of person, but my confidence is much higher now as my body is more like I want it to be. For the first time I feel able to move on and lead the life I have always wanted. In many ways I am starting again. I know it sounds odd, but it is incredibly exciting. Running the house, doing the gardening, going shopping - these are all things I manage easily by myself, even though now I might use a wheelchair or crutches. My husband has been supportive. He thinks I look a little strange missing a leg but says that, after all he has seen me go through, he accepts it. For now, he is just happy that I am happy, and I have promised to leave the remaining leg on for as long as possible; I know that losing that will be really difficult for him.

My youngest child is 10 and the eldest 15, and they do not know the truth about the removal of my leg yet. I told them I had a problem back in March and have had complications since. As a mother, I felt bad about not telling them the truth, especially when I was so ill I thought I might not make it. But now I feel it is better to protect them until they are old enough to understand that this was my choice. They will probably be in their 20s before I reach that point. Maybe they will figure it out for themselves before then, anyway. But I have given so much to my home and family that I feel entitled to do this for myself.

Only a handful of people know the truth about what I have done, and some of them call me crazy or mad. I suppose it is understandable. Even my sister doesn't accept me as an amputee. She lives just up the road but hasn't come to see me in months. In her eyes I am not a complete person any more. But I can't let that affect me; the problem is more hers than mine.

I think BIID will stay taboo until people get together and bring it out. A hundred years ago, it was taboo to be gay in many societies, and 50 years ago the idea of transsexuals was abhorrent to most. I have tried to make the condition more understood but it is difficult to get a case out in the open by yourself. My psychiatrist went to a meeting last year in Paris, and many doctors there told her that they had operated on people who needed an amputation under mysterious circumstances, and how happy the person was when they woke up. It led them to believe that perhaps BIID is more prevalent than people think.

Removing the next leg will not be any easier than the first; the pain will be horrendous. But I have no regrets about the path I have chosen. In fact, if I regret anything, it is that I didn't do this sooner. For the first time in my life, I can get on with being the real me.
 

ogopogo3

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I won't be happy until I lose my legs

:splat:

http://society.guardian.co.uk/health/st ... 91,00.html

I won't be happy until I lose my legs


Ever since she was little, Susan Smith has felt there is something wrong with her body. Her determination to 'fix' things has twice landed her in hospital

Monday January 29, 2007
The Guardian

I was six when I first became aware of my desire to lose my legs. I don't remember what started it - there was no specific trigger. Most people want to change something about themselves, and the image I have of myself has always been one without legs.
To the general public, people like me are sick and strange, and that's where it ends. I think it is a question of fearing the unknown. I have something called body identity integrity disorder (BIID), where sufferers want to remove one or more healthy limbs. Few people who haven't experienced it themselves can understand what I am going through. It is not a sexual thing, it is certainly not a fetish, and it is nothing to do with appearances. I simply cannot relate to myself with two legs: it isn't the "me" I want to be. I have long known that if I want to get on with my life I need to remove both legs. I have been trapped in the wrong body all this time and over the years I came to hate my physical self.

As a teenager, in the privacy of my own home, I used to play by myself at being an amputee. I would pretend I had one leg, strapping the other one up behind me and wearing oversize trousers so there was no shape. I knew even then that it wasn't normal, that it wasn't something to share with friends or my parents. But, trussed up like that, I would be quite happy and satisfied for a while.

At 23, I met my future husband and we were very happy together - but I was leading a double life. He did not know about my BIID at first so it wasn't easy to pretend. I went through periods when having him around was very disturbing. I gradually withdrew into myself, becoming private and secretive.

There is no instruction manual for those who want to remove their own limbs, but I always knew I would do it. I had eventually, told my husband that one day I would lose my legs. It took many years for him to understand why, but he did realise it was part of me, and I suppose he accepted it.

Two years ago, I told him that now was the time and I was going to remove my left leg. My first attempt was in March 2005. Of course I was scared of dying, but I had got to a point in my life where I could no longer fight it.

First I needed to freeze and kill the leg so that surgeons would amputate it afterwards. I ordered dry ice pellets from a company near Edinburgh (the same stuff that is used in discos for the smoke effect). Nobody asked what it was for. I bought 40kg - it evaporates very quickly, so you have to buy a great deal. I put on layers of pantyhose, because you do not want it sticking to you, spread it in the back of the car and sat with my leg immersed in it for one hour. The pain was indescribable: it hurt so much I passed out a few times. I was scared, but more so of failure. I am that kind of person - I never fail.

I had not damaged the leg enough to have it amputated in hospital, so the following September I made a second attempt, and this time I stayed in the dry ice for four hours. I was sat with my legs across the back seat of the car, the windows wide open and the footwell filled with dry ice, covering the leg and topping it up as it evaporated. When I could bear no more I called my husband, who came and pulled me out. The leg was hard as stone. I had third-degree burns and the pain was horrible. But it wasn't enough: I now know you need a minimum of six hours to kill a leg completely.

My husband drove me to hospital, but they refused to amputate. Incredibly, they said the wounds were superficial and that I would be walking within a few months. I really thought this time that the surgeon would give me the amputation I needed, but they seemed resolute. I went through all sorts of stages as they worked on my leg to save it. Sometimes I found the whole thing very funny, at other times I was crying, and sometimes I didn't think I would live through it. I reached my lowest point when they discharged me from hospital four weeks later, after eight sessions of surgery, with the leg still attached. I thought I was going to have to make a third attempt. But this time I would have to do it differently, perhaps put my leg under a train so they would have nothing more than a stump to stitch up.

I slowly recovered my strength back at home. I had dropped from 9 stone to under 7 stone during the operations and wanted to give myself time physically to recover before trying again. But the leg became so infected that there was a danger of the bacteria getting into the bloodstream and killing me. I had so much fever I was sleeping 24 hours a day. My mum sat by my bedside, waking me every hour to make sure I was still alive. She has known about my condition since I was a teenager, but I know it shocked her to see me finally make an attempt. After nine months of agony, I told my GP that if I didn't see someone fast, I would take off the leg myself. Within two days I had an appointment with a different surgeon.

The amputation, last June, went without a problem, and my left leg was removed from just above the knee. I felt better as soon as I came round. In fact, I felt so good in hospital that I was ready to go home straight away had they let me. My bag was packed and I was ready to leave. The Tuesday after the operation I drove myself home in an automatic car, and the next day I was almost back to my normal life.

I already feel more complete now that one leg is off. I have always been an outgoing kind of person, but my confidence is much higher now as my body is more like I want it to be. For the first time I feel able to move on and lead the life I have always wanted. In many ways I am starting again. I know it sounds odd, but it is incredibly exciting. Running the house, doing the gardening, going shopping - these are all things I manage easily by myself, even though now I might use a wheelchair or crutches. My husband has been supportive. He thinks I look a little strange missing a leg but says that, after all he has seen me go through, he accepts it. For now, he is just happy that I am happy, and I have promised to leave the remaining leg on for as long as possible; I know that losing that will be really difficult for him.

My youngest child is 10 and the eldest 15, and they do not know the truth about the removal of my leg yet. I told them I had a problem back in March and have had complications since. As a mother, I felt bad about not telling them the truth, especially when I was so ill I thought I might not make it. But now I feel it is better to protect them until they are old enough to understand that this was my choice. They will probably be in their 20s before I reach that point. Maybe they will figure it out for themselves before then, anyway. But I have given so much to my home and family that I feel entitled to do this for myself.

Only a handful of people know the truth about what I have done, and some of them call me crazy or mad. I suppose it is understandable. Even my sister doesn't accept me as an amputee. She lives just up the road but hasn't come to see me in months. In her eyes I am not a complete person any more. But I can't let that affect me; the problem is more hers than mine.

I think BIID will stay taboo until people get together and bring it out. A hundred years ago, it was taboo to be gay in many societies, and 50 years ago the idea of transsexuals was abhorrent to most. I have tried to make the condition more understood but it is difficult to get a case out in the open by yourself. My psychiatrist went to a meeting last year in Paris, and many doctors there told her that they had operated on people who needed an amputation under mysterious circumstances, and how happy the person was when they woke up. It led them to believe that perhaps BIID is more prevalent than people think.

Removing the next leg will not be any easier than the first; the pain will be horrendous. But I have no regrets about the path I have chosen. In fact, if I regret anything, it is that I didn't do this sooner. For the first time in my life, I can get on with being the real me.

· Susan Smith is a pseudonymn. As told to John Cantlie.
How is it that this woman hasn't been committed? This seems a pretty clear-cut case of "poses a danger to oneself," no?
 

JamesWhitehead

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I think she's great! I got her first by the way and she's in Body Dysmorphia or something right now so she cannot answer your call.

You know that moment usually when you first show them the saw and they run off . . . well this one will just fall over and it's like wow the best thing anyone ever did for her!

She's really groovy. But my aim is better now. :wow:
 

OneWingedBird

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How is it that this woman hasn't been committed? This seems a pretty clear-cut case of "poses a danger to oneself," no?
poss. the disorder is classed as psychological rather than psychiatric, in which case, it's seen as a choice to act that way, rather than as 'mad' per se, in the sense that she knows what she's doing, and is in control of her own actions...

...that and there's b*gger all beds left in this country for mental health patients... at least according to a friend who's training as a psychiatric social worker, there are no beds left at all in my city for voluntary admissions or pre-emptive admissions, and even people on 28 day 'sections' i.e. committed, are being released after a week...

...it's all a bit up sh*t creek...
 

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LINK
Getting Off . . .
by chopping off your fingers and toes. For tips: ask David.
by Lee Bailey

Crossing St. Marks Place, David seems like a fairly ordinary veteran of the East Village, with several visible tattoos and a backpack slung across his shoulders. In conversation, he is gentle, thoughtful, and clearly well-read; many of his sentences start with, "There was an article in the Atlantic . . . " He enjoys modern classical music, and has a particular liking for the works of Philip Glass and Steve Reich. He also has a fondness for disposing of his fingers and toes, most of which he has removed himself, unaided by doctors or friends. A closer look at his hands reveals stumps of varying length where his fingers belong, with only his thumbs and right index finger left intact. Most of his toes, except for the two big ones he needs to walk, are cut down to stubby knobs. And his perfect pearly whites aren't God-given—he wears dentures, having yanked out his real teeth with pliers several years ago.

David's predilection for amputation is an occurrence of a well-documented condition to which the medical and psychiatric establishment has applied several labels, including apotemnophilia, amelo- tasis, and body integrity identity disorder. However, David and many like him don't feel they suffer from a disorder at all.

Over a bowl of lamb soup, David calmly recounts the first time he chopped off a toe. After icing his foot, he placed it in the bathtub. He positioned a chisel over a joint in his toe with one hand, and used the other to strike the chisel with a hammer. "It was so painless that I went ahead and took off more of the toe, at the next joint closer to my foot," he recalls fondly. "It bled more than I thought it would, though." He says he dealt with the ensuing shock by returning to bed and "sleeping it off." It took almost two months for the self-inflicted wound to heal.

For a long time he saved the severed body parts in his freezer, where they slowly shriveled, until a girlfriend made him throw them out.

Most of David's amputations healed by a process called granulation, the body's natural, unaided response to injury. Lately, though, he has started suturing the wounds, which can cut the healing time from eight weeks to two, but requires the assistance of someone with some surgical training. He is reluctant to identify his helpers, but implies that piercing artists have sewn him up in the past.

Most people who voluntarily remove body parts have longed for the separation since childhood. David, who asked that only his first name be used in this article, is not one of them. He says the desire was born in the 1990s after he read a couple of articles about the phenomenon in men's magazines like Penthouse and Nugget.

David first removed a toe in 2000, five years after he separated from his wife of 25 years. He says that their relationship started to fall apart when he first took an interest in body modification, which started with tattoos and piercings. (The two share a daughter who believes that David's missing digits are the outcome of peripheral artery disease, a fiction that he promulgated so as not to disturb her.)

David performed his first few amputations without anesthetic, but has since relied on lidocaine to help numb the target areas.

Though he admits that he finds amputation sexually arousing, his overall rationale for parting ways with his fingers and toes is artistic. A longtime painter, he conveys the joy he feels on sunny days when he looks at the shadow cast on the sidewalk by his hand and admires it for its incompleteness. "This is an aesthetic pursuit," he says. "I see myself as a sculptor." He equates his incomplete physique to that of an excavated, limbless Roman statue, an image he finds beautiful.

Now that David has severed most of his fingers and toes, he is looking to the future. He has been told that there are doctors in the Philippines and in India who will sever healthy limbs for about $10,000, and says he might be interested in removing his legs and maybe even a hand.

David acknowledges that most consider his habit bizarre. "When people ask me about my fingers, I never tell them it's voluntary," he says. "They would be horrified. I mean, little children stare at me already. Big deal."

Though he acknowledges that most people are repulsed by his practices, David is hopeful that he might still find a companion. "Tomorrow I'm meeting a woman I found on Craigslist," he says. "We haven't actually met in person yet. Who knows? Maybe she'll put up with my nonconformity."
 

JamesWhitehead

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"Over a bowl of lamb soup, David calmly recounts the first time he chopped off a toe."

"Yum, nice soup!"
"Ingrowing lamb, raised it myself! Just leave the sock-bits on the side of your plate." :?
 

DougalLongfoot

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What an incredibly bizarre thing the human mind is. I can't imagine what it would be like living with this condition:
Narration:
One morning, Robert Vickers purchased a large quantity of dry ice, and set about destroying his perfectly healthy left leg

Robert Vickers:
Initially there was a bit of pain. But I guess knowing the outcome, the endorphins or whatever were probably running rampant through my body. And then later in the day when I thought it was just about done, I rang my wife, asked her to come and collect me. My leg was frozen stiff. So she arranged for me to be taken to the hospital. And the next time I woke up it was absolute ecstasy. The leg that I'd wanted to get rid of for all those years was ah just reduced to a, you know, a neat little bandaged stump.

Narration:
By now, you’re probably thinking this man is crazy. But the truth is far more interesting and strange. From as early as he could remember, Robert had the strongest feeling his left leg didn’t belong.
Catalyst: Body Identity
 

James_H

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I once saw a really interesting talk on this subject, and the medical ethics surrounding it. It's a tricky one, as much as a doctor is not allowed to inflict useless harm on someone, people are quite capable of injuring themselves horrifically in the hope that it will get rid of their legs - the lecturer mentioned a case where someone dipped themselves in liquid nitrogen, and another where they got themselves run over by a train.
 

whiner

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Hello, i remember watching a tv programme about the condition, it showed the lenghs that people would go to to get their limbs removed, from packing a leg in ice, to thinking about lying on a train track, to hacking at their own leg with a saw,hoping to do enough damage so that they'd have to remove the leg. Their was one woman, that spent her days moving around in a wheelchair, just waiting for the time when she'd be able to have both legs amputated. She said that she felt that her legs didn't belong to her, and that she thought about having her legs removed all the time, and that she knew that her life would be how it should be if they were gone.
I know that in some countries they will do the operations, but people have to go through a long process, of psychological tests.
Makes me wonder, what if they realise afterwards that it was the wrong thing to do :?: Weird.
 

Rushfan62

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I can think of more enjoyable ways to get legless :_pished:
(Sorry, I'll get me coat)
 

BeatrixKiddo

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I think that comment was totally armless....

:oops:
 

whiner

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If these people did regret having a limb removed, and they went to court to sue the dr that did the operation. Do you think the'd have a leg to stand on? :D
 

ramonmercado

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Is Compulsion to Amputate Healthy Limbs Mind or Matter?
By Alexis Madrigal

One day, after years of agony, an Australian man took a large quantity of dry ice and intentionally damaged his left leg, so that a surgeon would have to amputate it.

The action was intentional and the man, Robert Vickers, described the feeling of waking up in the hospital without his leg as “absolute ecstasy.” He’s one of a small number of people who have what psychiatrists have come to call body integrity identity disorder in which patients report the desire to have one or more of their limbs amputated because the extremities don’t feel like they “belong” to their bodies.

The disorder is the subject of a debate between psychiatrists and neuroscientists about whether the brain physiology causes the psychiatric condition or whether the causality runs in the other direction. New research by both sides has yielded fresh ammunition for both interpretations, highlighting how difficult it is separate biological from psychological phenomenon.

Columbia University psychiatrist Michael First helped pioneer the identification of the disorder and his latest research suggests it’s just a subset of a larger psychiatric condition in which people become fixated on being disabled.

On the other hand, Paul McGeoch’s recent work at the University of California, San Diego seems to explain the disorder as a purely neurological disease resulting from a malfunctioning right parietal lobule, which appears to maintain the mind’s body map. His lab used fMRI to determine that four self-reported BIID patients’ right parietal lobules didn’t light up when their unwanted limbs were touched. Normal people’s did.

“Oh this is certainly a breakthrough. We were stunned by the results,” David Brang, a graduate student who coauthored a paper on the study with McGeoch, said recently on the Australian television show on which Vickers told his amazing story. “It’s very clear that this is a neurological phenomenon when it always been thought of as a psychological issue.”

First, though, disagrees. He’s in the midst of a new study about a small group of people who don’t want their limbs amputated, but do want to be disabled in some other way. Some of the 47 people First has interviewed want to be paraplegic, for example, and feel that their healthy bodies are mismatched with their internal representations of themselves.

The study is a follow-up to an similar set of psychiatric evaluations First did on people who wanted their limbs amputated. The new group turns out to have a lot of the same feelings and desires as people with BIID.

“The vast majority of people that I interviewed are very similar to the BIID group,” First said.

Both groups express a life-long desire to be disabled. They pretend to be disabled. They occasionally injure themselves in an attempt to reach that state, although First said only one person reported an attempt to make themselves paraplegic by injecting alcohol into the spine.

His findings could indicate there is a deeper psychiatric disorder underlying the neurophysiological observations from UCSD.

“It suggests that the common factor has to do with the desire to be disabled,” First said. “As children, we see disabled people all the time and for whatever reason. For certain children, they see people who are disabled and decide they want to be that way. The nature of the disability is variable, but the desire is common.”

First doesn’t rule out the importance of the fMRI study, but he disputes that they are the cause of the illness.

“You are seeing a brain manifestation of a psychiatric illness,” he said. “I find their work exciting, but I’m dismayed at how they came to their conclusion.”

One area where the neurological results could be helpful is to change the treatment regimen for BIID patients who want amputations to include remediation exercises to retrain the brain into readopting a limb as its own. How such a treatment could be accomplished for people who want to be paraplegic is unclear.
http://www.wired.com/wiredscience/2009/07/biidbiid/
 
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kamalktk

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'I use a wheelchair but I'm only pretending to be paralysed': The woman who desperately wants to be paraplegic

She has a rare condition called Body Integrity Identity Disorder which means she desperately wants to be paraplegic – paralysed below the waist

http://www.mirror.co.uk/news/real-l...lchair-pretends-to-be-paralysed-chloe-1553850

Edit to Add the following introductory snippet:

For most people, being told they need a wheelchair would be their worst nightmare.

But for Chloe Jennings-White, it was a dream come true.

The 57-year-old suffers with a rare condition called Body Integrity Identity Disorder, a rare psychological complaint which means she desperately wants to be paraplegic – paralysed below the waist.

So when she was finally diagnosed in 2008, and doctors suggested she tried using a wheelchair to control her urges to damage her own spine, she was more than happy to give it a try.

Now Chloe, a research scientist in psychiatry, chooses to live her life on four wheels, pretending to be paralysed.

“Being able to use a wheelchair is a massive relief, and the closest I will probably ever come to being paraplegic,” says Chloe.

“BIID is a serious condition and for years I had no idea what was wrong with me.

"Now, finally, I know I’m not alone, and using a wheelchair helps to curb my desire to break my own back, so it has probably saved my life.”
 
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EnolaGaia

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Body integrity dysphoria (BID, also referred to as body integrity identity disorder, amputee identity disorder and xenomelia, formerly called apotemnophilia) is a disorder characterized by a desire to be disabled or having discomfort with being able-bodied beginning in early adolescence and resulting in harmful consequences. BID appears to be related to somatoparaphrenia. People with this condition may refer to themselves as "transabled". ...

SOURCE: https://en.wikipedia.org/wiki/Body_integrity_dysphoria
 

EnolaGaia

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Newly published research suggests there's a linkage between BID / BIID and certain aspects of brain architecture and / or interconnectivity.
The feeling a limb doesn't belong is linked to lack of brain structure and connection

People with the mental health condition known as body integrity dysphoria (BID) often feel as though one of their healthy limbs isn't meant to be a part of their bodies. They may act as though the limb is missing or even seek its amputation "to feel complete." Now, researchers reporting in the journal Current Biology on May 7 have found that these feelings that a limb doesn't belong are mirrored in the brains of people with this condition.

"The feeling that a limb belongs to us relies on the extent to which the sensorimotor limb area is functionally connected to all the other brain regions," says first author Gianluca Saetta, a doctoral student at the University of Zurich. "Crucially involved in this feeling are also the functional connectivity and the density of gray matter in the most crucial area for the representation of how our bodies should look -- the right parietal region of the brain."

"Interestingly, we found that the less gray matter in the right parietal region of the brain, the stronger the desire for amputation, and the more BID individuals acted as if they were amputees," Saetta adds. "This simulation behavior helps them to cope with the distressing mismatch between how they want their body to look and how they see it."

To explore the brain mechanisms associated with BID in the new study, Saetta and senior author Peter Brugger of the Psychiatric University Clinic (PUK), Zurich, enrolled 16 men who wanted to remove their healthy left legs and sixteen healthy controls. The question was whether the men with BID would show changes in the brain's functional connectivity or structure -- and the researchers found that they did.

Their studies revealed alterations in two key regions associated with BID. The right paracentral lobule (rPCL), which houses the primary somatosensory representation of the affected left leg, showed reduced intrinsic functional connectivity to other parts of the brain, they report. The right superior parietal (rSPL) also showed reduced intrinsic functional connectivity and a reduced concentration of gray matter. That's especially notable because this brain region has been previously identified as a critical hub for body image.

Interestingly, the researchers report, there were no structural alterations evident in the rPCL. In other words, there was no evidence that the men lack the ability to feel or move their left legs.

"We show clear associations between a mental state and changes in brain structure and functionality," Brugger said. "Whether the neural signature of BID comes first and hampers the development of normal limb ownership or whether decades of concern about the lack of such ownership modulate cerebral circuits mediating bodily awareness cannot be answered."

In other words, it's hard to say whether BID leads to a lack of functional connectivity in the brain or vice versa. Nevertheless, the new findings suggest that the desire for amputation in BID individuals may be related to specific anomalies in brain architecture. ...
FULL STORY: https://www.sciencedaily.com/releases/2020/05/200507131311.htm
 
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