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In the early 20th century, there was a sharp increase in the number of people openly seeking to have one or more of their healthy limbs surgically removed from their bodies. It’s not a dramatic new weight loss program, but rather a disorder where a person is tormented by the overwhelming desire to have one or more of their limbs amputated. It is known as Body Integrity Identity Disorder (BIID) or Amputee Identity Disorder, and it involves an urge so powerful that it leads many sufferers to damage the offending limbs beyond repair in order to bring about amputation. Individuals who have this bizarre condition typically refer to themselves as “amputee wannabes.”
Sufferers of BIID often complain that they do not feel “whole” while in possession of the limbs in question. An amputee wannabe has a very fixed idea of which limb is unwanted, and what level of amputation will make them a “whole” person. The most commonly expressed desire is to have a leg removed above the knee, but sometimes the person is looking to rid themselves of an arm, a leg below the knee, or sometimes multiple limbs.
The disorder usually includes feelings of intense jealousy at the sight of an amputee. An individual stricken with BIID will commonly “rehearse” the amputated state in private and in public by pretending that the limb is not present, sometimes binding the arm or leg so it cannot be easily moved. Some even design and fabricate prostheses to allow themselves to appear to have the amputation they desire.
Since there are very few surgeons willing to separate a person from his or her healthy limbs, some sufferers of Body Integrity Identity Disorder go so far as to destroy the limbs in question so that amputation becomes the only option. There are reports of individuals freezing the unwanted arm or leg with dry ice, or creating a wound and deliberately infecting it. Some have used even more extreme measures, such as shooting one’s own leg with a shotgun, cutting off a limb with a chain saw or homemade guillotine, or allowing the limb to be run over by a train.
An ordinary person who must have a limb amputated due to injury or infection is typically emotionally devastated by the loss; but astonishingly, individuals with BIID who successfully banish the unwelcome limbs describe feelings of “completeness and enablement” after amputation, and rarely express regret even after many months. Some theorize that BIID is an extreme demonstration of Munchausen syndrome, a condition where the sufferer feigns or creates symptoms of illnesses in himself or herself in order to gain attention, sympathy, and comfort. The role of “patient” is a familiar and comforting one, and it fills a psychological need in people with Munchausen’s. BIID seems to have a similar pathology, where the subject seeks the special attention given to the disabled.
A number of people with this disorder also exhibit acrotomophilia, which is a strong sexual attraction to amputees. Considering this, along with the strong jealousy towards amputees and the complaints of not feeling “whole,” it seems that sufferers of BIID don’t want to lose a limb so much as they want to gain an amputation.
Most amputee wannabes describe feelings of shame and unworthiness, and a keen awareness that their ambition to abandon perfectly healthy limbs is bizarre. People with this condition gain little help from psychiatric or psychological therapy, and any treatment merely helps to control the desire rather than to abolish it. It is not a well understood disorder, and there is no known effective treatment aside from giving them the subject the amputation they desire.
A surgeon in Scotland named Robert Smith has amputated the legs of two otherwise healthy people who were suffering from BIID, but after some negative publicity the procedure was effectively banned by the National Health Service in the UK. But if nearly all sufferers of Body Integrity Identity Disorder report feeling much happier and more “complete” after the removal of a limb, and there is no other effective treatment, is it necessarily a bad thing to allow them what they desire?
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i dont think its a bad thing at all…its our body, not the governments…we can get tattoos and body piercings…of course i agree that they are less drastic but, i also feel that they fall into the same category.
Put your left leg in…
The Atlantic published a column on apotemnophilia (BIID) some years ago called A New Way To Be Mad that has remained one of the most interesting things I’ve ever read. It’s fallen behind a pay wall now but the interested or ambitious would be well advised to track it down.
I would be very worried if there were more than a handful of doctors willing to amputate perfectly good limbs. Not only would these procedures tie up an operating room, surgeons, attendants, anaesthatists(sp), and nurses, but then the required physical therapists and prosthesis technicians as well. Not to mention putting an unneeded burden on the already unwieldy health care system. I’m sure that someday a psychological treatment can be found.
Re: “i dont think its a bad thing at all…its our body, not the governments”
Ultimately, our bodies belong to God, and we should not mutilate them. Moreover, removing a healthy body part is strictly against all codes of medical ethics. No doctor can morally participate.
If one is an atheist, and wants to try to amputate their own leg, that’s fine, but doctors should not participate in this any more than in executions.
Would this guy qualify?
http://news.bbc.co.uk/1/hi/uk/1477289.stm
Dave
This story is from 2001, and I can dig up no evidence that he actually went through with it. There is much talk that it was a hoax, or at the very least only a handful of people paid for the priveledge of watching this guy chop his own feet off.
John M. said: “Re: “i dont think its a bad thing at all…its our body, not the governments”
Ultimately, our bodies belong to God, and we should not mutilate them. Moreover, removing a healthy body part is strictly against all codes of medical ethics. No doctor can morally participate.
If one is an atheist, and wants to try to amputate their own leg, that’s fine, but doctors should not participate in this any more than in executions.”
While I would agree with Marius that it would be troubling if more than a scant handful of physicians were participating. I think a case could be made that if a patient is so troubled by what he sees as an unwanted limb that he is willing to shoot, freeze, or deliberately neglect himself in order to get rid of it, then amputation could count as preventative medicine. It would obviously be preferable to be able to treat the disorder at the mental level. Nonetheless, I could see the argument that a medically controlled amputation of a healthy limb would be preferable to massive self-mutilation by the patient. Especially as the evidence seems to be that the treatment works.
That said, I would be concerned if there were more than a very tiny number of physicians willing to reason that way.
There was a VERY interesting episode of Nip/Tuck about this not too long ago. Worth looking at if you’re intrigued.
-L.
Nip/Tuck is a great show. Anyone read the Flannery O’Connor story “Good Country People?” Here’s a brief description of the story: http://endeavor.med.nyu.edu/lit-med/lit-med-db/webdocs/webdescrips/o.connor1654-des-.html
Better yet, has anyone seen the movie “Hostel?”
Cynthia said: “It would obviously be preferable to be able to treat the disorder at the mental level. Nonetheless, I could see the argument that a medically controlled amputation of a healthy limb would be preferable to massive self-mutilation by the patient”.
If the problem is that severe, then part of treating the disorder on a mental level should be to institutionalize the patient on suicide watch. Massive self-mutilation carries risk of death, so this is justified.
John M. said: If the problem is that severe, then part of treating the disorder on a mental level should be to institutionalize the patient on suicide watch. Massive self-mutilation carries risk of death, so this is justified.”
This is true. However, I think it could be argued with some justification that it is less disruptive of the life of a patient to amputate a limb then it is to institutionalize them indefinitely for a disorder that has no current cure other than amputation.
Do I think this should be the common reasoning? No. I think amputation of a healthy limb should be such a measure of such last resort that it is virtually impossible to attain – attainable only if you are down to a choice of perform the operation, institutionalize the patient on suicide watch for life, or let them mutilate themselves until an amputation becomes medically required. If the institutionalization would only be temporary, than amputation would definitely not be the answer.
But I think a doctor could make that call without inherently being unworthy of their profession.
Geez puts a new meaning to I’d give my right arm for a …………….prosthetic one(?)
Hmm, interesting. I never thought people would go to such drastic measures. Though I would like to see how the Paralympics is like…
This could be handled in the same vein as those people with Gender Identity Disorder who can have their bodies altered through surgeries and drug therapy to reflect the gender they identify with. Basically you would go through a period of counseling and consultation with doctors, so both you and the medical professionals can be sure that you really won’t regret the choice, and that it will improve your condition.
As our technological capabilities increase our bodies are becoming more and more malleable. If the human species survives long enough, a complete upheaval will occur with people changing every aspect of their anatomies. Men will give birth. Brains will be transferred into bonobo bodies. Bodies will be altered for survival on other planets. Even the mind itself will be subject to the specialized knowledge of neuro-engineers (I.Q. Identity Disorder.)
And it’s not like such body alteration is entirely unprecedented. Ask a eunuch.
My girlfriend has this problem….except its with this “supposed” fat on her butt.
I suggest doing a serach for a wonderfull movie called Long Jean Silver [nws]
Cynthia said: “I think a doctor could make that call without inherently being unworthy of their profession”. Obviously you are putting careful thought into this, but I must disagree on this point. A doctor is absolutely rendered unworthy when he/she violates codes of medical ethics. If you are arguing for a change in ethics standards, that is a seperate matter. On this level I would still oppose a change in standards, because people’s control over their own bodies should not extend to self-harm. This includes amputations, suicide, and sex change (if you’re familiar with sex change procedures, you know it is essentially mutilation). There are two reasons: First, nobody lives in a vacuum. We depend on relationships with other people. Such blatant acts of self-destruction carry consequences for society beyond the individual involved. Second, I contend that our bodies ultimately belong to God, and we don’t have the right to destroy them.
Hmmm… if BIID has become such a widespread phenomenon that it’s made its way into public notice, one has to wonder whether it, like abortion, will eventually spawn a social/political movement for its legal recognition? Is a Roe v. Wade-equivalent event for “amputee wannabes” in the offing?
John M. said: “Cynthia said: “I think a doctor could make that call without inherently being unworthy of their profession”. Obviously you are putting careful thought into this, but I must disagree on this point. A doctor is absolutely rendered unworthy when he/she violates codes of medical ethics. If you are arguing for a change in ethics standards, that is a seperate matter. On this level I would still oppose a change in standards, because people’s control over their own bodies should not extend to self-harm. This includes amputations, suicide, and sex change (if you’re familiar with sex change procedures, you know it is essentially mutilation). There are two reasons: First, nobody lives in a vacuum. We depend on relationships with other people. Such blatant acts of self-destruction carry consequences for society beyond the individual involved. Second, I contend that our bodies ultimately belong to God, and we don’t have the right to destroy them.”
Nowhere when I was born was a stamp or certificate stating I was not the sole owner of said body nor that my body is a donor on lend from god. Any god for that matter. Whatever millions there are. And nothing short of the big man cracking the sky in half and giving me a high five will change that.
Kindly leave your god at the door, and be sure to pick it up on your way out.
Robert waugh says: “As our technological capabilities increase our bodies are becoming more and more malleable. If the human species survives long enough, a complete upheaval will occur with people changing every aspect of their anatomies. Men will give birth. Brains will be transferred into bonobo bodies. Bodies will be altered for survival on other planets. Even the mind itself will be subject to the specialized knowledge of neuro-engineers (I.Q. Identity Disorder.)”
That thought scares me.
First of all, I cannot see this as any different from getting a facelift or liposuction. Both are cosmetic procedures involving the removal of otherwise perfectly healthy body parts in order to fulfill a need. Facelifts and liposuction are common practice, and are usually done to help boost a person’s self image and self esteem.
Now, if these procedures are acceptable, how can you argue that amputation is not? Especially considering that these people are suffering from a mental condition, not just self esteem problems.
John M., you are worried about placing a burden on the health care system, yet you suggest the indefinite institutionalizing of these people? You’re a little backwards on that train of thought.
If there are doctors willing to do this, and I guarantee there are, there should be no reason it cannot happen. If a patient is paying for this, just as someone would pay for a boob job, there shouldn’t be a problem.
Oh, and fuck God.
The way I see it, John M., you are trying to force your beliefs and religion on everyone else. That is wrong. If you think it’s wrong to have a healthy limb removed, fine, I wouldn’t do it either. Obviously neither one of us has this mental problem. However, that does not mean we have the right to tell other people how to live their lives.
I agree with mHagarty. Amputations of legs above the knees are a bit more radical than a face lift, but essintially the same idea.
The way I figure it, do what you want. If you want to blow off your own arm with a shotgun, by all means, help yourself. If you want to believe your body belongs to God, fine. I can’t dispute that; by believing you are giving your body to God. That’s fine, I don’t care. But don’t you dare tell me that my – MY – body belongs to theoretic being that I’m not yet sure truely exists at all.
I still find it amazing how many things on this site end up hitting the brick wall of religious fundamentalism…
That being said, I read an article somewhere about a set of twins having various body parts interchanged…one receiving an extra digit on their finger from the other, and eventually one receiving the other’s left(?) arm.
Reasonably sure it’s all a hoax and some damn good Photoshop work, but I’ll see if I can’t find a link or two.
NewEvolution said: “Reasonably sure it’s all a hoax and some damn good Photoshop work, but I’ll see if I can’t find a link or two.”
Well, that was easy enough: http://www.bmezine.com/news/people/A10101/addsub/
Warning, some images of surgery for those that are a bit squeamish.
And yes, though theoretically possible, it IS a hoax: http://www.bmezine.com/news/people/A10101/addsub/fools.html
Some of the email responses, however, are comedic gold.
In any event, adding extra digits to my fingers would be concentrated awesome…
I have met the person who did the double leg amputation in the car with hand controls. At that time he was doing the year of time before gender reassignment surgery and was living life as a woman with full hormone treatment. The way I heard it from him>> her >> him was that his wife and kids him accepted as a wanabee who had achieved his dreams but couldn’t take him turning into her.
His wife and kids were more important than his the gender portion of his identity crisis.
I do think that this should be treated as no more odd than extreme breast implants which require significant life and clothing alterations. ie no more shopping for tops, everything has to be custom made.
Just goes to show you. Good and bad are just words.
Oh yeh I watched a documentary about a sex surgeon in america who tried to amputate the leg of a man with this fetish. he ended up messing up, dumped the leg on some deserted roadside whilst the amputee was left to bleed to death in his bed. sick.
acrotomophilia, which is a strong sexual attraction to amputees.
I love learning that there are actually names for these types of things. I used to know the word for the fear of having penut butter stuck to the roof of your mouth. (yep, there’s a word for that)
Arachibutyrophobia
Why is a leg amputation any differnet from breast implants or butt implants??? You still have to get use to doing things in a different way.
The way I see it; it would be a greater cost to undergo life long therapy to get treatment for this rather then a lump sum of having the leg amputated. People with this “Issue” should have to just pay everything up front. If you want it amputated; you pay the whole cost; if you need a proth; you pay the whole cost; just dont have the healthcare system cover any of it. Unfortunately; when you put them into a mental health institute; the gov’t does end up paying the majority of it. It’s not their fault that they feel this way towards something. It’s just something upstairs that’s wired different.
As long as it doesn’t affect the general population’s health insurance rates in a negative way then I, personally, am not concerned. Although I would love to hear the thoughts of a person who was born without an extremidy and/or someone who lost a body part. Are you offended by what they are doing? Do you think the people with BIID are wrong for getting these surgeries done? Maybe someday technology would allow people who don’t want a leg, for instance, to give it to someone born without one or a person who had an leg amputation due to an accident. A win-win future.
hmmm…. i always thought i’d be a REAL man if i had two penises (penis’?) heh heh jk
OK, there’s been a lot of comparison with cosmetic surgery here, and I completely agree. Let’s say a woman wants to have breast enhancement surgery… She may choose to do this for several reasons, but it’s plausible to think that many women have had similar surgeries due to low self-esteem (a mental condition, if not really a disorder). So this woman feels bad about herself and desires the attention that more well-endowed women receive. So she subjects herself to a painful surgery and recovery to emerge feeling more complete and whole as a female. Now, is the doctor that performed the surgery doing something unethical? Certainly not by legal standards, otherwise cosmetic surgeries wouldn’t be as common as they are. How is wanting to remove a limb any different? A healthy person who doesn’t feel comfortable with the way their body looks and wishes to receive the attention that amputees do. It’s pretty much the same thing in my book. If the government wants to control it, just require a psych evaluation prior to the surgery, similar to cases of gender reassignment. That’s just my opinion…
A couple of things to respond to here.
Amputation and gender reassignment are NOT the same as cosmetic surgeries. Perhaps on a logical or emotional level you can equate them but not on a medical one. Cosmetic surgeries are performed on relatively unimportant areas of the body. Mortality rates from the myriad cosmetic surgeries vary but none exceed 0.2%. A transfemoral amputation (leg), carries with it a 40% mortality rate within the first 5 years. Granted those numbers may be somewhat skewed since most amputations are done out of medical necessity (i.e. there was already something wrong). However there is no denying that the strain on the body is far greater from amputation than a breast augmentation. Full gender reassignments are a conglomeration of medically risky procedures including hormone therapy, various genital surgeries, chest reconstruction, neck surgery (voice), and others that are more optional. A doctor who takes his oath seriously should be hard pressed to make a case for elective amputation.
I have sympathy for these people but eventually we have to balance what they want with what society needs. The time comes when we should ask if we want doctors to continue moving from “First do no harm” to “First make sure the check clears”.
Another note, I personally have no trouble responding to someone with a different belief system than me. Frankly I’m tired of anyone that expresses their belief in God getting flamed to a crisp here. All the guy did was respond honestly to the story. There’s no need to get huffy just because he happens to have a religion. There’s no difference between that attitude and the evangelists who tell strangers they’re going to Hell. It shows both intolerence and disrespect for others that borders on bigotry. Also, saying f*ck God is in bad taste and completely unneccessary. Change your ways or the flying spaghetti monster will grasp you all in his noodly tendrils and fling you into the simmering pot of everlasting tomato paste.
Let’s just suppose: There was a surgeon who was willing to perform amputational proceedures on demand. What would Wannabee’s be willing to pay? This is a “supply and demmand” industry correct? To pay a surgeon adequately the Wannabee would need to pay for the surgeon’s time because the surgeon couldn’t really “set up shop”. A proceedure could only be performed about once a month because of the security problems. The Average surgeon makes about $250,000 so would the “Wannabee” be willing to pay $20,833 for the proceedure? How about $2,083 ? or $208?
The ethics of the situation mean nothing, and are not worth discussing. The request is from the patient.
The security is surmountable.
The usual proceedure ends with “I’m sorry we had to amputate…” With the Wannabee the endresult would be I please to inform you the level of amputation was exactly what we predicted and it was a complete success..
Where are all the retires surgeons who could make a nice living performing cosmetic surgery?
the answer is the surgery is more complicated than it appears.
OH yea I read the bullshit comments about dumping the leg by the road? …. gangrene…. bled to death…..
bogus stuff. A first year intern (not even a surgeon yet) could amputate any appendage with complete impunity.
Harvey Cushing was performing transphenoidal pitutitary ablation proceedures in 1898 and claiming a 98% success rate (probably not true more like 25%… :-) ) … This proceecure was performed without anesthesia or antibiotics. What’s the surgery? —- Brain surgery. Pituitary gland for acromegally.
All these alarmist comments are complete baloney. I have seen complete accidental amputations in cesspools, autorepair shops, people swimming and run over by boats, sharks, gorillas, chimanzees, animals.. ….. get a grip folks.
I guess the real proof is answering the question…… “any regrets”… (probably not)
ShowerRockGod — What a pompous post! The post is not internally consistent. You parade like a doctor but I KNOW you are a nurse and a first class Baptist. Meet me in the Carribean for a little post doctoral brush up?
What’s the problem? Wannabee’s are not proposing YOUR body part be amputated are they?
Are you in charge of MY body parts?
Shower Rock God….. How did I know you were NOT a doctor? You said if a doctor takes his “oath” seriosly….
doctors don’t take “OATHS”.. only NON-MD’s believe that one.
First off, I never said I was a doctor. I simply know a bit about how amputation affects the body since I’ve had a brother and a grandmother that needed them. One for osteosarcoma and the other for diabetes. It’s not a decision any doctor should make lightly or a responsibility to be taken on a whim. It can be deadly.
Next, while most medical universities do not require the Hippocratic oath (which I assume you are referring to and admittedly the one I had in mind) many have a revised version that they have new doctors swear too. While these may vary in form and phrasing, all of them follow the spirit of the Hippocratic Oath. The argument I was making is that doctors should be held to these standards because we cannot afford as a society to let them lapse.
Hello Allen Bellows my name is handy i saw the pictures of proshesis and i have the same problem how can i get the contact of the people that do this proshesis i look forward to your reply please..
Handy
I agree with you – I feel we also need to problematise the ways in which such things become pathologised. (Apologies for British English spelling)
If something is difficult to understand or contradicts the ways in which so called normal people think and do – we have a need to categorise such things as a form of madness of perversion.
What if we stopped trying to interpret the things people do and attempt to actually understand it? What if we allow people true ownership of their bodies and stopped telling people how they should look, or how to adhere to current trends of beauty and so on?
I think this article is written in a really problematic way – that allows us to just bracket such people within narratives of madness – as we still consider trans people in the same way, and as we once used to consider gay people.
It is my belief, and has been for most of my life that:
“You (meaning all humans) have the right to do what you want as long as what you want does not deprive or harm anyone else.” That means you have the right to do things that other people would consider harm to yourself, as long as you are not harming other people.
There is, of course, grey areas in this philosophy. – ie suicide or doing hard drugs until your life spins out of control.
After much thought I personally believe in many cases(not all) you have the right to commit suicide, even though it does harm your loved ones with your loss.
But if your pain is so severe that you cannot bear to exist anymore, I would hazard a guess that the pain of you existing is greater than the pain caused by your loss.
And for people that do hard drugs, they are obviously trying to escape or numb themselves to…something…
Like, I said…Grey areas. However, overall I would say the philosophy is decent.
After all, any good life philosophy will have many grey areas to be puzzled out based on an internal compass and the circumstances of the moment. Its when humans start creating absolute truisms that we run into trouble.
So in the context of the article, who am I or anyone else to tell a person what they want is wrong?
If people are unhappy with their limbs, and the fact that they have certain limbs is destroying their joy in life, who am I or anyone else to try and force them into a concept of “right’?
“If your foot causes you to stumble, cut it off. It is better to enter [everlasting] life crippled than to have you and your two feet tossed into the burn pit.” — Yeshua of Nazareth, Mark 9:45
If someone having such a disorder is curable of the psychological state the doctors willing in removal of the clients requested limb or limbs can seem quite strange, yet in reality who is it really hurting? The client? No. To them removala a life saver.The doctor/doctors? No. Need to see potential in lim b donation. Think possitive. Society? No. Only when people look down upon illness strange or not.
Personally suffering from this, I’ve got a pair of crutches off amazon, and I’d be willing to pay for the amputation. No regrets.
It’s got a lot of stigma attached though – it’s hard explaining to an amputee, for example. I don’t want sympathy or to be cared for, and I hate that there are people who lose limbs that they want to keep. But for me, taking the leg away would be like removing a tumour – a massive relief, and a necessity.
I hope I’m not phrasing any of this badly, I don’t mean to cause offence after all. Just hoping I can help explain.