Body integrity identity disorder: symptoms, causes, and treatment

This disorder causes the urge to amputate body parts to the point of obsession.

At the age of 30, Jewel Shupping decided to spray her eyes with plunger fluid to fulfill her desire to go blind. Jennins-White, on the other hand, is known to have spent half her life fighting to get rid of what she considers a heavy burden: her healthy legs.

Although at first glance these may seem like two isolated cases, the truth is that it is a disorder known as identity disorder. a disorder known as body integrity identity disorder (BID).. Throughout this article we will discuss the characteristics of this disorder, as well as its possible causes and existing treatments.

What is body integrity identity disorder?

Body Integrity Identity Disorder (BIID) is a psychiatric disorder in which the sufferer suffers from a compelling need or desire to amputate some healthy areas or limbs of his or her body. need or desire to amputate some healthy areas or limbs of their body..

Although it has traditionally been called apotemnophilia, the reality is that Body Integrity Identity Disorder does not include any sexual component or motivation for the person to want to amputate any part of his or her body.

Therefore, a clear differentiation must be made between the two concepts. While in apotemnophilia the person feels sexual excitement or pleasure at the idea or image of an amputated limb, in body integrity identity disorder there are other types of motivations.

Specifically, one of the main motivations of this type of patients is that they have some type of disability.. But not for economic reasons, but for the mere attraction that causes them to live in this state.

Another motivation is to achieve a certain physical appearance that is particularly pleasing to these people. This motivation would be the extreme equivalent to that felt by some people who undergo any type of cosmetic surgery with the intention of modifying some part of their body that they find unattractive.

However, in body integrity identity disorder, people experience the feeling that certain parts of their body are unattractive. experience the sensation that certain parts of their body do not belong to them, they feel that they are not their own and that they do not belong to them.They feel that they do not belong to them and this causes them great discomfort.

This disorder tends to manifest itself at a very early age, when children tend to feel that certain parts of their body do not belong to them.During this time, children tend to imagine that some part of their body is missing or disappears.

Finally, this disorder can be confused with Body Dysmorphic Disorder (BDD). However, in the latter, the person experiences a deep anguish about the appearance of a specific part of their body which they consider defective or unattractive, and although they feel the imperious desire to modify it, they never consider that it will disappear completely.

What is the symptomatology?

The main symptoms of body integrity identity disorder are the following.

Cognitive and emotional symptoms

Within the symptomatology of this disorder, which could take the form of the desire to amputate some part of the body, as well as the attempts or self-injuries that a person may provoke for this purpose, people with body integrity identity disorder tend to behave or think in a certain way that characterizes them.

This symptomatology, mostly of a cognitive nature, is manifested by repetitive and intrusive irrational ideas in which the patient feels incomplete in which the patient feels incomplete with his body as it is or, on the other hand, does not feel identified with certain parts of his body.

The intensity of these ideas can be such that they often become obsessions, which result in high levels of anxiety and low mood. These thoughts, as well as the anxious symptoms, are relieved or disappear once the amputation has been performed.

As a rule, patients are very clear about which part of their body is to blame for their anguish and even report a certain feeling of envy towards those who have had a limb amputated.

People with body integrity identity disorder tend to experience high levels of loneliness and feelings of incomprehension of their needs. Aware that the rest of the population is incapable of understanding them, they tend to feel a great sense of shame, even to the point of social self-exclusion. Finally, once their wishes have been fulfilled, these patients never feel or identify themselves as invalids, but experience a sense of satisfaction and liberation. experience a sense of satisfaction and liberation after having gotten rid of what was a burden to them.

Behavioral symptoms

In terms of behavioral symptomsIn terms of behavioral symptoms, people with body integrity identity disorder often engage in numerous self-injurious behaviors with the intention of having their leg amputated. These behaviors can range from injuring themselves in their own home to getting run over or shooting themselves with a gun.

The objective of any of these behaviors is to inflict a series of injuries of sufficient severity that the damaged limb must be amputated by medical professionals. However, there have also been cases in which the However, there have also been cases in which the patient himself has attempted to amputate or "free" himself from some part of his body on his own. on their own.

Likewise, although the area, limb or body part that causes this aversion in the patient may vary from person to person, the most common demand is to amputate the left leg above the knee or to amputate one of the two hands.

What causes this disorder?

The exact origin or causes of the body integrity identity disorder are, for the time being, unknown. However, there are, however, several theories, both psychological and neurobiological based, that have attempted to that have attempted to find the genesis of this disorder.

One of these theories raises the possibility that, during infancy, the child is so deeply marked by the image of a person with an amputated limb that he or she may come to adopt this image as an ideal bodily archetype. as an ideal bodily archetype.

On the other hand, a second psychological theory hypothesizes that, faced with the feeling of lack of attention or affection, the child may come to think that, by amputating one of his or her limbs, he or she will obtain the attention he or she so desperately needs.

As for the neurobiological theory, a lesion or abnormality in the cerebral cortex associated with the limbs could explain the reason for this phenomenon. If so, the body integrity identity disorder could be considered a type of somatoparaphrenia, which can appear after a stroke or embolism in the parietal lobe.

Furthermore, if this theory were true, it would explain the fact that this disorder has a higher incidence in men than in women, since in women the right side of the parietal lobe is significantly smaller. It would also clarify that in most cases the area to be amputated is on the left side of the body.

Is there a treatment?

Since the symptoms of this disorder are primarily cognitive, cognitive behavioral treatment can be particularly effective with integrity identity disorder. with body integrity identity disorder. However, the ideas of these patients are so deeply ingrained that it is very difficult for symptoms to resolve with psychological therapy alone.

In cases where the patient or family members choose to pursue psychological treatment, response prevention techniques, as well as thought-stopping, can be used to prevent the symptoms.are usually the most effective.

The goal, in either case, is for people with body integrity identity disorder to accept their bodies as they are, eliminating the desire or need to undergo amputation.