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

Although at first glance these seem like two isolated cases, the truth is that they are both a disorder known as Bodily Integrity Identity Disorder . Throughout this article we will discuss the characteristics of this disorder, as well as its possible causes and existing treatments.

What is Bodily Integrity Identity Disorder?

Body Integrity Identity Disorder (BIID) is a psychiatric disorder in which a person suffers from a compelling need or desire to amputate healthy body parts or limbs .

Although it has traditionally been given in the name of apotemophilia, the reality is that bodily integrity identity disorder does not include any type of sexual component or motivation for which a person wishes to amputate any area of his or her body.

You must therefore make a clear distinction between the two concepts. While in apotemophilia a person feels sexual excitement or pleasure at the idea or image of an amputated limb, in bodily integrity identity disorder there are other types of motivations.

Specifically, one of the main motivations of this type of patient is to have some kind of disability . But not for economic reasons, but for the mere attraction of living in this state.

Another motivation is to achieve a certain physical aspect that these people particularly like. 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 is not attractive to them.

However, in Bodily Integrity Identity Disorder, people experience the feeling that certain parts of their body do not belong to them , they feel alienated from them and this causes them great discomfort.

This disorder tends to manifest itself already at very early ages , during which children tend to imagine that some part of their body is missing or disappeared.

Finally, this disorder may be confused with Body Dysmorphic Disorder (BDD). However, in the latter, the person experiences deep distress over the appearance of a specific part of their body which they consider defective or unattractive, and even though they feel the urge to change it, they never consider that it will disappear completely.

What are the symptoms?

The main symptoms of bodily integrity identity disorder are as follows.

Cognitive and emotional symptoms

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

This symptomatology, mostly of a cognitive nature, manifests itself through repetitive and intrusive irrational ideas 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 turn into obsessions, which lead to high levels of anxiety and a low state of mind. These thoughts, as well as the anxious symptoms, are relieved or disappear once the amputation has been carried out.

As a rule, patients are very clear about which part of their body is to blame for their distress and even go so far as to refer to a certain feeling of envy towards those who have an amputated limb.

People with bodily integrity identity disorder tend to experience high levels of loneliness and feelings of misunderstanding about their needs. Aware that the rest of the population is unable to understand them, they often feel a great sense of shame, even to the point of social exclusion. Finally, once their wishes are fulfilled, these patients never feel or identify themselves as invalids, but rather experience a sense of satisfaction and liberation after having rid themselves of what was a burden.

Behavioral symptoms

In terms of behavioural symptoms , people with Bodily Integrity Identity Disorder often engage in numerous self-injurious behaviours with the intention of having their leg amputated. These behaviors can range from injuring themselves in their own home to getting hit by a car or shooting themselves with a gun.

The goal of any of these behaviors is to inflict a series of injuries severe enough that the injured limb must be amputated by medical professionals. However, there have also been cases in which the patient has attempted to amputate or “free himself” from some part of his body on his own.

Also, 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 at the top of the knee or to amputate one of the two hands.

What causes this disorder?

The exact origin or causes of the bodily integrity identity disorder are, for the moment, unknown. However, there are various theories, both psychological and neurobiological , that have tried to find the genesis of this disorder.

One of these theories raises the possibility that, during the infancy stage, the child may be so deeply marked by the image of a person with an amputated limb that he may adopt this image as an ideal body archetype .

On the other hand, a second psychological theory hypothesizes that, when faced with the feeling of lack of attention or affection, the child may think that, by amputating one of his or her limbs, he or she will get this much needed attention.

As for the neurobiological theory, a lesion or anomaly in the cerebral cortex associated with the extremities could explain why this phenomenon occurs. If so, the identity disorder of body integrity could be considered as a type of somatophrenia, 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 greater incidence in men than in women; since in the latter, 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 mainly cognitive, cognitive behavioural treatment may be particularly effective with the Body Integrity Identity Disorder. However, the ideas of these patients are so deeply rooted that it is very difficult for the symptoms to remit with psychological therapy alone.

In those cases in which the patient or their relatives choose to follow a psychological treatment, the techniques of prevention of response, as well as the stop of thought , are usually those that present the greatest effectiveness.

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

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