Have you ever felt like a healthy part of your body, maybe even an arm or a leg, didn't belong to you, like it wasn't supposed to be there? It can be a very strange, and heartbreaking, experience that you can't even tell anyone about. Today we're going to talk about a rare but very serious mental condition called Body Integrity Identity Disorder (BIID) .
What exactly is BIID?
Simply put, Body Integrity Identity Disorder (BIID) , sometimes called Body Integrity Dysphoria , is a mental health condition in which you feel that a healthy part of your body, such as an arm, leg, finger, or eye, does not really belong to you. The important thing is that you know that part of your body is healthy, you can feel it, use it, and move it. But there is a strong compulsion inside you that says, "This is not mine, this can't be here." You desperately want to live without that part of your body.
Therefore, you may ask a doctor to surgically remove the healthy part of your body (amputation). Or, unable to bear the pressure, you may try to remove the part yourself. This is very dangerous and can be life-threatening. The end result of BIID is physical disability.
The desire to remove this part of your body, or to become physically disabled, may make you feel like you are “complete” – as if your physical body has finally aligned with your inner self. But, unfortunately, there is no way to know whether amputation will help you achieve this goal. There are non-surgical treatments to manage this condition.
What parts of the body are affected by BIID?
BIID can affect any part of your body. Often, these are the parts of your body that feel like they don't belong, like they're not part of you:
- A leg
- A hand
- A finger
- A toe
- Eyes (one or both)
- Ears (one or both)
- Teeth
One study found that the left leg was the most affected limb in this way. Some of the participants in that study said that their right leg was useful to them, for example, because they needed their right leg to drive a car, so they wanted to keep it. So they preferred to keep their right leg. Imagine how complex this feeling is!
How common is BIID?
BIID is actually a very rare condition . Many people don't seek treatment for it, or they hide their symptoms from others. Because it's something that's difficult for society to understand, it can cause things like shame and fear. So it's hard to say exactly how widespread this condition is in the world.
What are the symptoms of BIID?
A person with BIID may exhibit symptoms such as:
- There is a strong desire to be physically disabled or to live without a body part. This is not just a wish, it feels like a heavy burden on the heart.
- It can be very uncomfortable and difficult to feel that a healthy part of your body doesn't fit you or belong to you.
- Because they constantly think about these personal desires, they distance themselves from social interactions, relationships with others, and even the things they enjoy doing.
- Even though they are not actually disabled, they tend to behave like they are disabled. Maybe they use a wheelchair or crutches.
- They are tempted to self-harm or destroy a part of their body that they feel does not belong to them (self-mutilation).
These symptoms can be very mild for some (just intense feelings about your body), or very severe for others (to the point of trying to harm yourself). It varies from person to person.
How does someone with BIID feel?
If you have BIID, you may experience the following:
- A feeling of "hyper-perfection" or a feeling that something is missing/overwhelming about your current body shape. That is, a feeling that the body is "too full" due to that part that feels "unnecessary".
- They feel very tired and exhausted because they try to hide their true feelings from others.
- You constantly think about your body (obsessive thoughts).
- You feel a lot of stress or anxiety about not being able to show your physical body to the world as you see yourself.
- Depression can arise from not being able to live in one's true self without physical change.
When do these feelings start?
Often, these feelings begin in childhood and early adolescence , usually between the ages of 5 and 10.
What causes BIID?
To be honest, doctors still don't know exactly what causes BIID. But current research suggests that it may be due to structural abnormalities in the parts of the brain that control our body perception. More than one part of the brain is involved in our perception of our body. For example:
- Somatosensory cortex and parietal lobe.
- Insula (located between the occipital and frontal lobes).
It is currently suspected that some change in the functioning of these parts of the brain may be the cause of this condition.
What are the possible complications of BIID?
BIID can make you want to harm yourself to achieve your goals, such as removing that "unwanted" body part. You may not see it as "self-harm," but it can lead to serious complications, such as:
- Uncontrollable bleeding.
- Infection.
- Nerve damage.
- Severe pain.
- Phantom limb pain after amputation.
Trying to cut off body parts yourself is very dangerous. It can even be life-threatening. Perhaps the desire you feel at the time is so strong that these risks may seem secondary to you. But please understand, the damage this can cause is beyond imagination.
If you feel like harming yourself, please see a doctor immediately, or call your local emergency number. In Sri Lanka, there are organizations like Sumithrayo (0112692909, 0112696666, 0112682535) that you can call and share your thoughts. They will help you.
How do you find out if you have BIID?
A psychiatrist is usually the one who diagnoses BIID. He or she will talk to you about how you feel about your body and perform a physical exam to make sure the body part you want to remove is healthy.
Often, people with this condition go undiagnosed, or they are only diagnosed after they have self-harmed and end up in an emergency room or when they seek help from a surgeon to remove a healthy part of their body.
If you have persistent, distressing, and uncontrollable thoughts about changing your body, please see a doctor. They are there to help you manage these thoughts and find a treatment plan that works for you.
Is the condition BIID in the DSM-5?
BIID is not listed as a separate disorder in the current Diagnostic and Statistical Manual of Mental Illnesses (DSM-5-TR) of the American Psychiatric Association. However, the DSM-5-TR does include BIID in conjunction with a condition called Body Dysmorphic Disorder .
However, in the World Health Organization's International Classification of Diseases (ICD-11) , a list used by doctors to diagnose and classify diseases, this condition is named 'Body Integrity Dysphoria' .
What are the treatments for BIID?
To be honest, treating BIID is a bit challenging . There is no specific treatment for BIID yet. Doctors usually try to prevent the removal of healthy body parts and to help you stop engaging in harmful behaviors. This can involve a combination of treatments. These may include:
- Cognitive Behavioral Therapy (CBT): This is a type of psychotherapy that helps you identify and change your thought patterns and behaviors.
- Medications to reduce depression and anxiety: These medications can help reduce the stress that comes with BIID.
- Wearing a prosthetic, using a wheelchair or crutches: Some people may find temporary relief from experiencing "disability" in this way.
- Using Virtual Reality (VR): This technology allows you to simulate what it would be like to live without a part of your body.
In many cases, medication and therapy can help reduce some of the symptoms of BIID. The important thing is that these treatments won't completely eliminate the desire to live without a part of your body. But they can help you reduce the stress you feel, reduce the frequency of these thoughts, and help you live with the condition in the long term.
Your doctor may also suggest that you participate in clinical trials or research studies to learn more about the condition and find new treatments.
Does amputation cure BIID?
This is a very difficult and sensitive question to answer. You may think that amputation will fulfill your desires and cure BIID. You may not regret having a healthy limb removed. But it can make your life more difficult and stressful than it already is. There is no guarantee that removing a healthy limb will bring you a sense of wholeness. This is why surgical removal of body parts for BIID has become a highly controversial issue in the medical community.
Ethically, surgeons and doctors do not remove healthy body parts without a clear medical need. It goes against the medical principle of "do no harm." The consequences and risks of surgically removing a body part can be lifelong, dangerous, and even fatal.
Removing a body part may not completely resolve the underlying psychological challenges you face. It may seem like the only solution to you right now, but there's no way to know if removing your body part will have the results you're hoping for.
Amputations are permanent. You can't reverse a surgery like this if you're not happy with the results.
What should someone with BIID expect?
BIID is a very challenging condition to manage on a daily basis. It can separate you from your loved ones and the things you enjoy. Amputation is a permanent and often dangerous consequence of BIID. Never attempt to remove body parts yourself.
If you have persistent, distressing thoughts that make you want to harm yourself, see a doctor. While current treatments may not completely eliminate your urges, they can make them easier to live with and reduce the amount of distressing thoughts that interfere with your daily life.
When should I see a doctor?
If you have frequent, distracting thoughts of cutting off a healthy part of your body, please talk to a doctor. If you are in an emergency, or if you are afraid of harming yourself, call emergency services immediately.
What questions should I ask my doctor?
When you see a doctor, you can ask questions like these:
- What kind of treatment do you recommend for me?
- Are there any side effects of the treatment?
- Will amputation make me feel better?
- What do I do if counseling and other treatments don't work?
Is BIID a mental illness?
Yes, Body Integrity Dysphoria , or Body Integrity Identity Disorder (BIID), is a mental health condition . Research suggests that the cause of this condition may be related to the way your brain developed during childhood. That's why symptoms often start in childhood. Abnormal development in certain parts of the brain can affect the way you view your body, or your body image.
Living with BIID can be a difficult and isolating experience. If you've ever taken the risk of telling friends or family about your desires, you've probably received surprised looks and negative reactions. They may have dismissed your thoughts as "delusional" or "crazy." But that's far from the truth.
Your thoughts and feelings are real. There's a reason for that. You simply want to make your own image, your own physical reality, a physical reality. This can be very difficult for someone else, even a doctor, to understand unless they've been in your shoes. But remember, you're not alone, and help is available.
In summary, things you need to remember
Okay, so, from what we've talked about, these are the most important things you need to remember:
- BIID is a real mental condition. It's not just a figment of your imagination.
- A key characteristic of this condition is the feeling that a healthy body part does not belong to one and that it needs to be removed.
- Do not attempt to remove body parts yourself for any reason; it is life-threatening.
- Medical treatment, especially psychological counseling and, if necessary, medication, can help manage this condition and reduce the stress you feel.
- You are not alone. Don't be afraid to talk about this and seek help from a trusted doctor or mental health counselor .
If you have any further questions about this, or if you have any of these feelings, please seek medical advice.
` BIID, body integrity identity disorder, mental health, body integrity, body part removal, depression, body image
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