Body Integrity Identity Disorder: The Amputation Obsession

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Body Integrity Identity Disorder: The Amputation Obsession

Body Integrity Identity Disorder (BIID) is the love for amputation / Photo by Getty Images


Some people desire to be amputated and are absolutely fascinated with the idea of getting their limbs severed. They voluntarily undergo surgery not to repair their broken body parts, but to dismember their perfectly healthy ones. Without having an amputation, they may be preoccupied with wanting to have surgery until it becomes a reality. This describes individuals who are affected by the condition called Body Integrity Identity Disorder (BIID). The name of this condition has undergone many changes since the 1970s.

From Apotemnophilia to Body Integrity Identity Disorder

Dr. John Money, a scientist who specializes in research about sexuality, first called it Apotemnophilia, literally translated as the love of amputation. Money, who was from John Hopkins University, classified it as a sub-category of paraphilia.

About 20 years later, that is, in 1997, it was renamed by Dr. Richard Bruno. He called it Factitious Disability Disorder. Furthermore, he said there were three kinds of sufferers: devotees, pretenders, and wannabes. Devotees are those who get aroused but limbs that have cut off, pretenders are individuals who try to look as if they are amputated by using wheelchairs and crutches, and wannabes are those are wishing to be amputated.

Fast forward to the year 2000. Dr. Gregg Furth, a child psychologist, altered the name of the disorder and labeled it as Amputee Identity Disorder. He was not only eager to learn about the topic professionally, but he also wanted to have an elective amputation surgery himself. To be able to follow through with his plan, he discussed it with Dr. Robert Smith, a surgeon who co-authored a book about the said condition.

Ever since he was a child, he longed to have his right leg cut off, beginning from above the knee. Dr. Smith, who had already done two elective amputations, consented to his request. Although he had agreed to do the surgery on Dr. Furth, the hospital he was working at, the Falkirk Royal Infirmary, did not permit him to proceed. In the end, Dr. Furth was not able to have his right leg amputated.

It was in 2004 when the disorder was finally named Body Integrity Identity Disorder by Dr. Michael First, a professor of clinical psychiatry at  Columbia University, who coined the term in his study. It was published in the journal Psychological Medicine. He conducted his research by surveying 52 participants on the telephone. Out of all the people he had surveyed only 9 had amputations. The remaining participants were only wishing to get amputated, The New York Times says.

Current Findings About BIID

Continuing from the results of Dr. First’s study, he said the elective amputation was similar to a gender reassignment procedure. Just like how some individuals feel they were born in the body of the wrong gender and try to fix it by being subject to an operation, amputees want to do away with body parts they feel should not be there. It was why Dr. First had likened BIID to gender dysphoria. He states that Apotemnophilia is not an appropriate name for the disorder since it implies that it is driven by sexual arousal. He believes it is more of an identity problem.

According to Naveed Saleh, a freelance health writer, people who suffer from Body Integrity Identity Disorder complain about being too complete or feel estranged from a particular body part like arms, eyes or legs. She also says that it has been a lifetime dream for them that if unfulfilled will make them feel agonized.

This is supported by Dr. First’s statement which is “People live with this lifelong burning desire to be an amputee, if they’re getting older they start getting to a point where they’re like, listen I have 20 years left of life, it’s now or never.”

Experts are unable to trace the real causes of BIID. However, they theorize that it may involve having a brain tumor. Amputees have some brain variations from normal brains. Experts have found that there were changes within their insula, premotor cortex, and parietal cortex.

Can BIID Be Treated?

As of now, there are no known treatments aimed at Body Integrity Identity Disorder. Metro says that medication is not effective for treating BIID. Cognitive Behavioral Therapy (CBT) may also not be useful in treating the condition since it is less focused on the disorder and concentrates more on the patient’s way of life and their motivations. Most amputees who have gone through elective surgery said that they have been cured of BIID, which may lead it to possibly being a treatment option for patients.

Fox News says it is currently not yet officially in the Diagnostic and Statistical Manual of Mental Health Disorders, but Dr. First is who is also an editor of last two editions of the DSM is working towards its inclusion. He says that labeling it as a mental illness may cause it to have a stigma, but it may also push therapist to search for possible treatment approaches and let patients know that they are not alone in their suffering.


Elective surgery may cured patients with BIID / Photo by Getty Images




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