Physical integrity identity disorder

According to Sophocles, King Oedipus killed his father and had sex with his mother. However, it was not until many years later that Oedipus discovered that he had committed the crimes of paternal killing and incest-at first he did not know that his father was his father and his mother was his mother. After Oedipus found out what he was doing, he dug out his eyes. The cause of Oedipus’ blindness involves guilt and is allegorical: he initially turned a blind eye to the brutality he committed.

The ancient Greeks may not be able to understand that someone blinded themselves without a tragic reason like the crime of Oedipus. However, in modern society, a small number of people show “ownership” issues for specific body parts and are obsessed with disability. These people suffer from a disease called Body Integrity Identification Disorder (BIID) and usually require surgery after years of pain, resulting in amputation, blindness, deafness, or paraplegia.

As you might imagine, few surgeons are keen to intervene in disease-free organs or limbs. However, BIID is a complex problem, and some experts advocate radical surgery as an effective treatment.

BIID review

In the late 1700s, a French surgeon was forced to amputate a man’s healthy limb at gunpoint. After the operation, the man sent payment and a thank-you letter to the surgeon, stating that the operation made him feel much better.

In 2000, the public discovered that a Scottish surgeon named Robert Smith had performed leg amputations on two patients whose limbs seemed normal. When the CEO of Smith Hospital figured out what Smith was doing, Smith was forbidden to perform any amputations. However, after these amputations, controversy about healthy amputations and other seemingly “unnecessary” and debilitating surgeries intensified.

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In 2015, 30-year-old Ms. Zhu Shuping said that she asked a psychologist to pour sewer cleaner into her eyes so that she could realize her lifelong vision of blindness. In all fairness, the authenticity of Shu Ping’s claims is controversial; however, this description of assisted blindness once again highlights BIID.

People with BIID complain of feeling “too complete” and distanced from body parts (such as eyes or limbs). These feelings are lifelong obsessions and can cause considerable mental pain and trauma.

It is not clear what causes BIID. In some people, physical identity or ownership issues can be traced to a clear pathology, such as brain tumors. However, in most BIID patients, the etiology or cause of the disease remains to be elucidated.

Researchers studying BIID have observed brain changes in individuals with this disease. Specifically, the parietal cortex, premotor cortex, and insula seem to be involved. However, it is not clear whether these brain regions cause BIID or are the result of BIID.

Treatment of BIID

If the cause of BIID is not clear, it is difficult to treat the disease. Antidepressants and psychotherapy have little effect on this disease. In addition, heavier psychotropic drugs such as antipsychotics have not been tested in this patient population.

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Interestingly, it is hoped that BIID patients with amputation will feel better after surgery and report an improvement in their quality of life. It is worth noting that the two people who underwent the operation by Scottish surgeon Robert Smith felt significantly better after the operation and continued to live a happy life with the prosthesis.

Many people with BIID practice living with disabilities. These people were labeled “pretenders.” By pretending to be living with a disability, these people will experience some short-term relief, similar to the temporary relief of obsessive-compulsive patients.

Most surgeons who encounter BIID are shocked by the prospect of using radical surgery to treat the disease. These surgeons claim that anyone who wants to amputate a “healthy” limb has mental illness and limited insight, which compromises her ability to give informed consent.

Most people with BIID have no mental illness and no delusions. In addition, some people with BIID experience depression after suffering from BIID. This is most likely the result of this situation, not the cause.

In a paper entitled “Body Integrity Identity Disorders After Amputation: Consent and Freedom,” the author Amy White claimed that the decision of a person with BIID to undergo selective surgery to remove a body part is not necessarily forced, Incompetent or unaware; therefore, after a comprehensive screening process, BIID patients may be candidates for radical surgery.

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White also likens BIID to gender dysphoria, and radical surgery for BIID patients to sex reassignment surgery. Specifically, people with gender dysphoria and BIID feel that they are trapped in some kind of wrong body and hope to correct this problem through surgery.

On the contrary, in a paper entitled “Body Integrity Disorders-Is Amputation of Healthy Limbs Reasonable?”, the author Sabina Müller argues that the cost of BIID radical surgery is too high for those who receive it. Will no longer be able to work and will require lifelong care and rehabilitation.

Müller also questioned whether BIID patients who requested radical surgery lacked knowledge of their disease and suggested alternative treatments:

Very good sentence

BIID may be a neuropsychological disorder, including lack of insight and lack of autonomy in disease. Rather than curing the symptoms at the cost of irreversible physical damage, it is better to develop a causal therapy to incorporate the alien limbs into the body image.

We may be a long way from figuring out how to accurately help people experiencing BIID. First of all, the research on BIID is low-power, because few people have this situation. Most of our knowledge of BIID is based on anecdotes. Second, BIID may involve complex neural processes that we have not yet elucidated; after all, the brain is extremely complex. Third, BIID’s radical surgery is deeply involved in ethical considerations, which further confuses our understanding and appreciation of treatment.

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