Mal_Adjusted
Justified & Ancient
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- Aug 6, 2003
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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
http://www.nytimes.com/2005/03/22/health/psychology/22ampu.html
mal
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