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Body Integrity Identity Disorder
July 19, 2012 10:20 AM   Subscribe


 
Obligatory. Well maybe not.
posted by weapons-grade pandemonium at 10:30 AM on July 19, 2012


I do like that "semantic contagion", I bet that's why drug ads on TV work so well. I'd not heard of that phenomenon before.
(Those first bunch of comments on the [previously] link here are harsh.)
posted by Blake at 10:31 AM on July 19, 2012


BIID is something that's fascinated me since I first heard about it in the 90s.

There's an exceptional film about about the topic called Whole.
posted by dobbs at 10:33 AM on July 19, 2012 [2 favorites]


Yeah. See also the Werther Effect. (Trigger warning: suicide.)
posted by Zarkonnen at 10:33 AM on July 19, 2012




If we let the lizard guy do what he does, why not let someone remove an arm or leg?

Sure, therapy is a good thing and should be tried first, but at the end of the day, so long as you can support yourself and do what you need to do, it's your leg (or lack thereof).
posted by madajb at 10:47 AM on July 19, 2012 [1 favorite]


Needs an "Arturism" tag.
posted by carsonb at 10:48 AM on July 19, 2012 [2 favorites]


Why don't these people ever feel they should have only one kidney, let's say?
posted by spitbull at 10:54 AM on July 19, 2012 [3 favorites]


Has there been any cases of people who want surgery to get extra limbs?
posted by jonmc at 10:57 AM on July 19, 2012


Spitbull: because humans generally can't sense the presence of their own kidneys, I would guess.
posted by Matt Oneiros at 11:02 AM on July 19, 2012


Why don't these people ever feel they should have only one kidney, let's say?

You can't willingly control or experience your kidneys?
posted by tittergrrl at 11:03 AM on July 19, 2012


No, but I can wiggle my spleen.
posted by Pyry at 11:08 AM on July 19, 2012 [1 favorite]


Replace kidneys with things that you can see and experience, and it still seems kind of unusual. As far as I can tell, no one goes around saying, "I want to have a cat allergy," or "Chrone's disease would really suit me," or "I want to have thick skin that gets easily infected and constantly needs to be moisturized."

I've seen some stuff about transabled in the past, and poked around on the site for a bit, I'm not an expert on them, but it always seemed curious to me that all of the sought-after impairments were almost always the major comfort/nurture inducing ones- blindness, amputee-ism...Maybe I'm missing something?
posted by jumelle at 11:12 AM on July 19, 2012


I've seen some stuff about transabled in the past, and poked around on the site for a bit, I'm not an expert on them, but it always seemed curious to me that all of the sought-after impairments were almost always the major comfort/nurture inducing ones- blindness, amputee-ism...Maybe I'm missing something?

Same reason otherkin are always wolves or dragons or tigers or suchlike, and never carp or wasps. Because it's attention-seeking delusion.
posted by kafziel at 11:20 AM on July 19, 2012 [14 favorites]


Has there been any cases of people who want surgery to get extra limbs?

How about twin brothers who amputed an arm from one and implanted it on the other?

I really don't see this as being so different from other surgical body modifications, such as breast augmentation or reduction. It would make sense to me to put a protocol in place, such as the one required for SRS (although I think that could stand to be pared back a bit) to ensure that the individual is both committed to and prepared for the outcome of their decision. I'd think it would be ideal to try to match up these people with others who have lost a limb (or digits, or skin, or whatever parts could be successfully matched) and run the surgery like an organ transplant.

But then again, when my sister was pre-teen, disability was her favorite fantasy play, so I've had decades to get used to the idea.
posted by notashroom at 11:21 AM on July 19, 2012


Do transgender people get diagnosed as BIID? If not, why not?

Not trying to start a fight, am genuinely curious
posted by Confess, Fletch at 11:23 AM on July 19, 2012


notashroom's article is about a photoshop and an april fool's gag.
posted by jepler at 11:24 AM on July 19, 2012 [3 favorites]


As far as I can tell, no one goes around saying, "I want to have a cat allergy," or "Chrone's disease would really suit me," or "I want to have thick skin that gets easily infected and constantly needs to be moisturized."

Isn't some of this reflected in somatoform disorder? Or is that different?
posted by jetlagaddict at 11:25 AM on July 19, 2012


Replace kidneys with things that you can see and experience, and it still seems kind of unusual. As far as I can tell, no one goes around saying, "I want to have a cat allergy," or "Chrone's disease would really suit me," or "I want to have thick skin that gets easily infected and constantly needs to be moisturized."

Well it's not framed as being an issue about self-identification, but there are plenty of people who for whatever reason either believe they are suffering from or feel compelled to pretend they are suffering from strange illnesses and subject themselves to unnecessary surgery and other possibly harmful treatment. So people who feel more comfortable being a patient with a disease than being healthy exist at least.
posted by burnmp3s at 11:28 AM on July 19, 2012


Jetlagaddict, I feel like somatoform disorder is different. With SD, the person is stressed out to the point where their body starts to emulate the symptoms of an illness that they don't have. They start to worry they have it, but presumably don't want it.

Someone with BIID is cognizant of the fact that they aren't actually ill or impaired, but they want to be so that their sense of "self" matches with the state of their physical health.
posted by jumelle at 11:33 AM on July 19, 2012


Do transgender people get diagnosed as BIID? If not, why not?

In the article, one of the people discussed (briefly) is a transsexual with BIID.
posted by tittergrrl at 11:33 AM on July 19, 2012


An adult who is otherwise of sound mind (i.e. for the purposes of this argument I reject that someone can be categorized as "unsound by definition" simply because of a specific desire) should be permitted to do pretty much anything they wish with their own body. If that includes removing one's limbs at one's own expense, so be it.
posted by chimaera at 11:37 AM on July 19, 2012


Because it's attention-seeking delusion.

My inner cane shaker agrees with that, but I do think that there's something real going on here. I don't think it's at all similar to e.g. being transgender or that the best treatment is necessarily amputation, but something is going on.

It's not that surprising that there are stranger things going on in our brains than having the feeling that you're born with the wrong gender, what with the complexity of our brains and bodies and having some seven billion people alive means there's a lot of room for outliers.
posted by MartinWisse at 11:38 AM on July 19, 2012 [1 favorite]


Someone with BIID is cognizant of the fact that they aren't actually ill or impaired, but they want to be so that their sense of "self" matches with the state of their physical health.

Like the transgendered, those with BIID - or "transabled" as they often call themselves on the internets - have brains telling them that their bodies are wrong. They like to use this to draw parallels between the two states. But unlike the transgendered, who have specific anatomical signatures in the brain for identification of a genuine transgender case, when the transabled brain is saying this, it's because it is malfunctioning.

It's not that surprising that there are stranger things going on in our brains than having the feeling that you're born with the wrong gender, what with the complexity of our brains and bodies and having some seven billion people alive means there's a lot of room for outliers.

Brains are freaky as hell, it's true. But a purely psychological disorder that causes delusions can still be identified as such.
posted by kafziel at 11:41 AM on July 19, 2012 [2 favorites]


Adding to tittergrrl's comments, Anderson Cooper did an interview with a transgender lady named Chloe who also has BIID. There's clips of her talking about it on youtube, but I don't feel comfortable linking them.

Here's another article on the Transabled website where another person who is transgender on top of being transabled talks about the comparisons between the two.
posted by jumelle at 11:43 AM on July 19, 2012


A relative of mine recently came to me to tell me about an acquaintance of his who had begun having her toes surgically removed. She had apparently found someone through an online support community who not only removed two of the woman's toes, but also taught her how to help others remove their own unwanted body parts.

It is an ethical quandary. I in theory support people doing whatever the hell they want to their bodies. But back-alley toe-cutting is a dangerous thing, and I have a big problem with people who aren't medical professionals performing these kinds of acts.
posted by Bookhouse at 11:52 AM on July 19, 2012


Same reason otherkin are always wolves or dragons or tigers or suchlike, and never carp or wasps. Because it's attention-seeking delusion.

Or maybe because the carp and wasp people find it easier to integrate into society as recreational swimmers and attorneys.

I think "attention-seeking" is one of those accusations that reveal more about the accuser than anything else. It sounds like such a junior high thing, the need to hunt down anyone who could be considered in some light to consider themselves special, and stomp them down.

I'm not psychologist, but I'd bet these disorders are more about hiding than showing off.
posted by fleacircus at 11:52 AM on July 19, 2012 [6 favorites]


I would have somewhat more confidence in this article if it didn't try to draw an analogy between this condition and "autogynephilia", that old canard about how trans women who are attracted to women want to transition as a sexual fantasy and that therefore their desire to transition is a fetish and not, like, an autonomous thing. The scholarship on this harmful idea has been discredited - it's a framework that has routinely been used to deny trans people medical care and has been used in framing these trans women as pathological. Blanchard's theory is pretty widely loathed by actual trans women.

Blanchard and his ilk have a bunch of other dumb beliefs too that are tied up with this theory - no such thing as male bisexuality, all women are bisexual, etc etc.

It strikes me that when you're writing outside your field, you really need to look at the status of the theorists you cite - it's very easy to read someone's work and be convinced because you aren't familiar with the terms of the debate and they seem plausible.

(Although frankly any grown up should be skeptical of research of the "trans people are icky and sexually perverse" kind.)
posted by Frowner at 11:54 AM on July 19, 2012 [6 favorites]


I really enjoyed the last article (A New Way to Be Mad). Thanks for linking to it.

I don't think we talk often about how our perceptions and experiences give us "permission" to do/be/say/think things that otherwise would have been unimaginable. What does that have to say about the legitimacy of those acts and thoughts? What does it have to say about our proper response to them?

I've never been a big fan of the simplicity of concept in "our bodies our choice" rhetoric; it seems that we are much too interconnected for that to be workable or sensible, for one thing. I understand that others might disagree.

In any event, if this is the kind of world we are going to make together, I kind of hope it hustles along so I can see a significant amount of its progression before I move on to other things.

Sometimes I suspect that Transmetropolitan won't have known the half of it, and I just want to know where we're going to steer this crazy thing with all of our hands on the tiller.

It's gonna get weird, that's all I know.
posted by Poppa Bear at 11:54 AM on July 19, 2012


"But unlike the transgendered, who have specific anatomical signatures in the brain for identification of a genuine transgender case, when the transabled brain is saying this, it's because it is malfunctioning."

I don't think there are any studies around that confirm what, exactly, is going on with transabled brains. So what you're claiming seems like kind of...unfounded?

I'm curious to know what your opinion is on people who er..."transgender" themselves into neutrois, as opposed to one of the two existing sexes?
posted by jumelle at 11:55 AM on July 19, 2012


My inner cane shaker...

I've heard of stick shakers, but cane shakers are new to me....
posted by Confess, Fletch at 12:04 PM on July 19, 2012


Wow, this makes me uncomfortable.
More understandable was the title character in Machine Man, which was fiction, and somewhat funny, but still made me feel uncomfortable.
posted by MtDewd at 12:14 PM on July 19, 2012


I'm curious to know what your opinion is on people who er..."transgender" themselves into neutrois, as opposed to one of the two existing sexes?

Huh. Were they always insisting as dressing as eunuchs as small children?
posted by sebastienbailard at 12:14 PM on July 19, 2012


Sebastienbailard, I don't think most small children are aware of what eunuchs are. Nor am I aware that eunuchs are a common enough occurence in this day and age to warrant their own distinct style of dress. But I have heard some of them mention that they never felt comfortable in standard boy or girl clothing. Not that clothing choice is considered a reliable determinant of gender identity, anyway. :p
posted by jumelle at 12:43 PM on July 19, 2012 [1 favorite]


How about twin brothers who amputed an arm from one and implanted it on the other?

WHAT IN THE NAME OF GODDAMN HOLY FUCK SHIT AAAAAAAA??!!!

srsly, this just broke something deep inside my brain
posted by Slarty Bartfast at 1:06 PM on July 19, 2012


Do transgender people get diagnosed as BIID? If not, why not?

Those who wish to transition (in the U.S., anyway) must be diagnosed with Gender Identity Disorder (GID). BIID is a different type of body dysmorphia, and as others have said, someone can have both diagnoses.
posted by notashroom at 1:07 PM on July 19, 2012


How about twin brothers who amputed an arm from one and implanted it on the other?

WHAT IN THE NAME OF GODDAMN HOLY FUCK SHIT AAAAAAAA??!!!

srsly, this just broke something deep inside my brain


Oh thank god, Snopes says it's a hoax. Don't *do* shit like that to me.
posted by Slarty Bartfast at 1:09 PM on July 19, 2012 [3 favorites]


Because it's attention-seeking delusion.

This may be right but it's definitely dismissive.

If scientists can stimulate a part of a person's brain to make them think a limb is there when it isn't (which they can, imitating phantom limb syndrome), then who's to say that it's impossible for a brain to be "deformed" or "damaged" in such a way as to make it think the presence of a limb is unneccessary?
posted by dobbs at 1:20 PM on July 19, 2012 [4 favorites]


Shoulda lurked longer, but this scratched an itch.
  1. Problems with body integration are a hallmark of some diagnostic algorithms for schizophrenia. People feeling their arm isn't part of their body or that it was quietly swapped for another. This isn't strictly DSM-IV, but there's a whole world surrounding America, and the one time there was a controversy about overdiagnosing F90 it was about the soviet subcategory "sluggish", or slow-developing schizophrenia. There's a general, if quiet, agreement here. In a more general sense, classical theory -- mostly non-psychodynamic; psychoanalysts fear this stuff -- understood schizophrenia as what the word implies: a disease of integration -- psychosis as disintegration from the running commentary of self-consciousness, hallucinations as disintegration of visual processing from meaning.
  2. Once, as part of the med-go-round that goes with trying to treat your particular kind of manic depression while avoiding the particular side effcts that would bum you out the most, I took Topamax (topiramate) for a while. I looked at my feet and they looked like the feet I feel when walking. I looked in the mirror and could see myself, not a stranger. So there's this -- a host of subclinical dissociative disorders and non-Grand Mal epilepsies that go undetected.
  3. 3. A temporal lobe epilepsy would explain my so-called subclinical dissociative symptoms, particularly because it's so comorbid with epilepsy, but alas, there's no epilepsy to be found in the tests. But I have known way too often the feeling of a homunculus controlling a body in a world that's unreal, being entirely aware of my decision algorithms. Depersonalization attacks with me sometimes arise as a reaction to anxiety, sometimes as the result of being sleepy -- since epilepsy is ruled out and my pdoc's criteria for full-blown DPD are higher than what my symptoms appear to be, our current theory is some parasomnia, and modafinil (a sleep suppressant) has indeed reduced the frequency of my attacks. But notice how even without identifiable DPD I can experience symptoms that are closer to "this entire body isn't mine".

I'm just a patient, but this looks more like an integration disorder (and thus treatable as F90) than something in the F40 family. (ICD codes. The ICD is badly outdated, but americans aren't doing themselves any favor with DSM tunnel vision). It doesn't look like a previously ignored kind of suffering (like in high-functioning autism) that deserves "respect for neurodiversity", but rather a situation in which we respect people by acting in their best interest.

This gets very tricky and I'm aware of the whole consumer/survivor concept of being a mental health patient, but if I'm clearly manic and try to fly to Vegas I want someone to pour a bucket of ice water on me and tell me to calm the frell now, not to drive me to the airport.
posted by syntaxfree at 1:26 PM on July 19, 2012 [12 favorites]


Don't *do* shit like that to me.

Sorry about that, Slarty Bartfast. It is a hoax, but it was the closest story I knew of to meet the request of anyone with limbs added rather than removed.
posted by notashroom at 1:39 PM on July 19, 2012


(ICD codes. The ICD is badly outdated, but americans aren't doing themselves any favor with DSM tunnel vision)

This sounds like the basis of an interesting FPP.
posted by anigbrowl at 2:05 PM on July 19, 2012


The 'semantic contagion' idea fascinates me. I first came across the concept in Jamil Nasir's short story Black Memes. It's available in this anthology of his short fiction. An interpretation is that 'memes are alive' - parasitic to the human mind and spreading like disease. And some parasites caused their hosts to injure or kill themselves and others.
posted by j_curiouser at 2:18 PM on July 19, 2012


j_curiouser: An interpretation is that 'memes are alive' - parasitic to the human mind and spreading like disease.

Ha ha, but that's silly! All you have to do is not think about them and... oh shit, I lost The Game again. Oh god, I see what you mean.
posted by gilrain at 2:25 PM on July 19, 2012 [2 favorites]


(ICD codes. The ICD is badly outdated, but americans aren't doing themselves any favor with DSM tunnel vision)

This sounds like the basis of an interesting FPP.


Ohh. there is some scary scary stuff in there.
 
posted by Herodios at 2:28 PM on July 19, 2012


j_curiouser: The 'semantic contagion' idea fascinates me.

'Semantic contagion' is just signifiers getting decoupled from their meaning, becoming empty word-shells but retaining the aura of ideas -- and getting blindly propagated, like "sustainable development" and so forth. Thus Gilles Deleuze's perpetual admonishment: qu'est que ├ža veut dire?
posted by syntaxfree at 2:50 PM on July 19, 2012


> If we let the lizard guy do what he does, why not let someone remove an arm or leg?

Because of the possibility that they'd regret it, and the chance that a new therapy or medication or what have you could get rid of the urge.
posted by The corpse in the library at 3:01 PM on July 19, 2012 [1 favorite]


Huh. Were they always insisting as dressing as eunuchs as small children?

I didn't.

But I have heard some of them mention that they never felt comfortable in standard boy or girl clothing. Not that clothing choice is considered a reliable determinant of gender identity, anyway. :p

Correct on both counts. It's a little bit like coming to realize that you're gay; a small feeling of disquiet in the back of your mind as you try to match societal and familial expectations of your interests, until at some point along the road to maturity you realize that the reason you don't match is because you just don't fit into one of the two check boxes provided. Understanding the concept of agender requires thinking outside of the box.
posted by Estraven at 8:12 PM on July 19, 2012


Ah, sorry if I came off as a bit (or a lot) glib.
posted by sebastienbailard at 9:15 PM on July 19, 2012


syntaxfree: (ICD codes. The ICD is badly outdated, but americans aren't doing themselves any favor with DSM tunnel vision)

anigbrowl: This sounds like the basis of an interesting FPP.

I agree!

Thanks for the FPP - there's a lot to chew on, in the links and in the comments here. I've been interested in BIID for years (I probably first read about it on BME, wow, ten years ago.) I don't have anything to add to the discussion right now but I'll be checking this thread through the day.

Welcome to MetaFilter, syntaxfree!
posted by daisyk at 3:48 AM on July 21, 2012


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