Body integrity identity disorder (BIID): wanting to be disabled
Body Integrity Identity Disorder (BIID): the abyss of human feelings is often inscrutable and surprising
This was well known by the psychologist who poured detergent into the eyes of Jewel Shuping, a 30-year-old American woman.
What the psychologist did was not a criminal act – at least not in the common sense we give to the term – but the decision to realise the wish his patient had been hatching since she was a child, namely to go blind.
The woman waited a few hours before going to the hospital to make sure that she would suffer permanent eye damage.
The girl lost her sight within the next six months. “I feel that this is the way I should have been born,” explained the woman, who is now 30 years old.
Body Integrity Identity Disorder (BIID)
The disorder from which Jewel suffers is called BIID, which stands for Body Integrity Identity Disorder, and indicates a psychological condition similar to Gender Identity Disorder, in which, however, the subject has the feeling of living inside a body that does not correspond to his or her idealised image.
This disorder encompasses a large number of different types of patients.
Jewel Shuping recounts: ‘When I was three or four years old, my mother found me walking in the dark corridors of the house at night.
During her teenage years, she wanted to learn the alphabet for the blind and then started to pretend to be blind by using a cane and black glasses.
After a long and unsuccessful therapy, the psychologist who had been treating her decided that the time had come to fulfil his patient’s wish’.
Xenomelia
A similar episode involves Chloe Jennings-White, a 58-year-old American woman who constantly lives with the desire to become disabled.
In this case, the patient’s desired body corresponds to an amputated limb (‘foreign limb syndrome’, also known as ‘xenomelia’).
Subjects like Chloe desire the amputation of a leg or an arm in order to achieve the completeness they feel they lack.
“Something in my brain tells me that my legs are not supposed to work,” Chloe explains.
“It was a huge relief to find out that I’m not a monster, there are hundreds of other people like me.”
The same concept expressed by Kevin Wright, a British patient who managed to have his much-hated left leg amputated by surgeon Robert Smith: “I didn’t want it. It wasn’t part of me.
I didn’t understand why, but I knew I had to get rid of it,’ said the man who was operated on in 1997.
Usually this feeling of estrangement with one’s own body occurs in childhood, often associated with the sight of disabled people, whose image is somehow ‘processed’ by the still-forming child’s brain as the ideal one to be pursued.
This is also what happened in the case of Chloe, who at the age of 4 went to visit her aunt after a car accident and was forced to use crutches for convalescence.
Apotemnophilia: the erotic desire for amputation
The prevalence of this strange disorder is unclear, although it is likely to be more common than we think.
Indeed, it is possible that the desire for disability is sometimes hidden in cases of accidental amputation of limbs that occurred under unclear circumstances.
Sometimes the disorder deviates on erotic grounds. In fact, the term apotemnophilia defines the erotic and sexual desire to have one or more limbs amputated or to appear as if they were.
The causes of Body Integrity Identity Disorder (BIID):
As for the causes, apart from the hypothesis of a kind of childhood ‘imprinting’, there is also the possibility that the condition stems from neuropsychological factors, with problems in the cerebral cortex connected to the limbs.
The famous Indian neurologist Vilayanur S. Ramachandran has proposed a link between BIID and somatoparaphrenia, a condition that occurs following a stroke in the right parietal lobe and causes the patient to deny a limb on the left side of the body, in most cases an arm.
Since the condition is associated with damage to the parietal lobe, Dr. Ramachandran hypothesises the involvement of this area of the brain in the correct tuning of one’s body image.
According to the Indian doctor, the fact that the condition appears in childhood is consistent with a genetic problem that would cause a functional disorder of the parietal cortex.
This dysfunction would be at the root of the failure to form a complete body image, which is why patients feel the presence of the leg, but at the same time they feel it is extraneous, something that should not be there.
The theory seems fascinating, although other experts have proposed objections.
First of all, in the case of brain dysfunction, it is highly unlikely that the only real symptom is that of the strangeness of one’s own limb: there should be others, in fact, first and foremost the real difficulty in using the leg.
Moreover, the theory does not explain, for example, the case of Chloe, who does not want amputation, but a condition of paraplegia, asking for the severing of the spinal cord for this, or those of others who want to become blind or deaf.
It is important to remember that the patients ‘grouped’ in this article may in fact be very different from each other: as you have guessed, not all of them ‘want to become disabled’, but some simply want to get rid of something they do not feel is part of their body.
Body Integrity Identity Disorder (BIID): Difficult Therapy
It is a fact that these patients live in a very difficult condition, often approaching psychotherapy, but without success.
Many of them are so eager to acquire disabled status that they try to do themselves the damage necessary to achieve the goal.
A few years ago, David Openshaw, an Australian man, after repeatedly being refused by doctors to amputate his left leg, decided to immerse the limb in ice for a few hours, forcing the doctors to perform the operation because of the now irreparable damage caused by his act.
The extreme pain to which the man subjected himself in order to achieve his goal can give an idea of the true extent of the discomfort felt by those who experience this strange condition.
Self-amputations’ are extremely dangerous: the patient may face dangerous local and systemic infections or, in the worst cases, often fatal haemorrhages.
Therapy must necessarily involve various figures including a psychiatrist, neurologist and psychotherapist.
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