Psychology Facts

▼ Body Identity Integrity Disorder ▼

》Body integrity dysphoria is a psychiatric condition characterized by a persistent desire to acquire physical disability. Subjects suffering from BIID have an intense desire to amputate a major limb or severe the spinal cord in order to become paralyzed. Body integrity dysphoria is also termed as body integrity identity disorder, amputee identity disorder, and xenomelia.

》Body integrity identity disorder has been found to start in early childhood. As a result of this condition, you have a feeling that your body needs to be modified to help you feel complete or satisfied.

》Some researchers believe the following factors could cause BIID:

Early childhood trauma
Obsessive-compulsive tendencies
Over-identification with amputees

》Psychologists and neurologists, however, have one primary working theory: BIID is caused by your brain not mapping your body correctly. Your brain believes your body should be and feel different than it does.

》BIID is not currently recognized as a mental health condition or listed in the Diagnostic and Statistical Manual (DSM). However, some doctors are trying to make a case for its broader recognition. If BIID was included in the manual, that would help lead to further interest in the condition, more research, and better treatment options than what's available now.

》Those with BID have less brain connectivity in specific areas
Researchers who study BIID have observed brain changes in individuals with the disease. Specifically, the parietal cortex, premotor cortex, and insula seem to be involved. However, it's unclear whether these brain regions lead to BIID or occur as a consequence of BIID.

》Interestingly, people with BIID who desire leg amputation feel better after the procedure and report improved quality of life. Of note, the two people on whom Robert Smith, the Scottish surgeon, performed surgery, felt remarkably better after surgery and went on to live happily with prostheses.

》Most people with BIID aren't psychotic and don't have delusions. Moreover, the depression that some people with BIID experience develops after living with BIID. It is likely a consequence, not cause, of the condition.

》There are only about 200 cases of BID recorded in the medical literature, but it's expected to be included in the 11th edition of the International Classification of Diseases (ICD-11), as a "disorder of bodily distress or bodily experience," the researchers said. The new revision is set to take effect in January 2022.

》The disorder can even be deadly: those who cannot afford or cannot find a willing surgeon may mutilate themselves, for example, by shooting into a leg, sawing off a finger or toe, placing the offensive limb in the way of an oncoming train, or packing the body part in dry ice in an attempt to freeze it to death

》Treatments such as cognitive behavioral therapy and selective serotonin reuptake inhibitors (SSRIs) can often reduce the distress and depression associated with BIID, and some clinicians find treating the symptoms exhibited by those with obsessions and compulsions can help reduce symptoms.