Body Integrity Identity Disorder: Selective Self-Amputation


[edit] Original article

Body Integrity Identity Disorder: Selective Self-Amputation

[edit] Author(s)

Swindell, Marian

[edit] Source

Both the original powerpoint presentation (in PDF format) and the text of the presentation are available on our site.

[edit] Abstract/Overview

A solid overview of BIID, with comments from transabled individuals. Intended to introduce the concept of BIID to a group of Social Workers.

[edit] Comments/Analysis

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"In 1997, Dr. Richard Bruno of Englewood Hospital in New Jersey proposed this [Factitious Disability Disorder] name"

We have major problems with the name of "Factitious Disability Disorder". In fact, we have major problems with the entire paper written by Dr. Bruno, one of them being that the subjects he chose for his studies are not representative of the majority of individuals who have Body Integrity Identity Disorder.

"Wannabes are usually non-disabled individuals that want to become someone with a physical disability."


"Pretenders are non-disabled people who live as if they have a disability."

The author seems to make a marked separation between those who "wannabe" and those who "pretend". Perhaps this is a reflection of using Dr. Bruno's paper. Though it is our experience that the overlap between pretenders and wannabes is significant.

"These individuals are 'not psychotic.'"

That's right, the majority of transabled individuals are not psychotic. Yet another article that outlines this fact.

"BIID survivors engage in help-seeking behavior, but many are unsuccessful."

We do seek help from the medical community. Many of us are asking for help from psychotherapists, or psychiatrists, but the condition is poorly known and even less understood. Many people are telling us "you're sick, go get help", but there is no help to be gotten.

"Many BIID survivors struggle in silence, suffering in agony and isolation."

Most of us don't realise we're not the only ones in the world struggling with our feelings. As a result, we don't know to ask for help. And when we do, we face the incomprehension of the medical community, as explained above.

"People with BIID live everyday with thoughts about not feeling comfortable in their own skin."

Indeed, we are like fishes out of water.

"Because most surgeons refuse to amputate a healthy limb, some people with BIID go to extreme measures to get rid the limb."

Does this not go against the hippocratic oath? Because surgeons are refusing to assist, we have to resort to extreme actions that jeopardise our very lives.

"Participants who received amputation reported after amputation, they feel better than ever and lose the desire for further amputation."

In other words: Surgery works!

"Surgical intervention is controversial because of the Hippocratic Oath"

We've already stated our opposition to the Hippocratic Oath argument.

"We need to expose the condition to medical science, and that in turn should lead to more understanding and maybe even an entry in the textbooks."

There is no doubt in our mind that including BIID in the textbooks is the first step to appropriate treatment options for transabled individuals.

"Many Drs. think we are uneducated, unrealistic and/or that we idealize the outcome of our actions."

This misunderstanding is not limited to the medical profession. So many people seem to think we don't know what we're asking for, that we couldn't possibly have a clue. Yet, most people who have BIID know as much about their needed impairment than anyone possibly could, without having the impairment in question. In fact, many transabled individuals know more about their needed condition than many general practitioners.

"But if I have to choose between physical health problems that result from appropriate, efficacious treatment for my disease and the life-long physical, mental and emotional torment I have had to contend with for lack of that treatment, I will gladly choose the former with all its risks."

Most of us would chose that. I would prefer a short, happy life with my needed impairment than a long, unhappy and agonising life without it.

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