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What Is Body Integrity Identity Disorder?

Medically Reviewed by Dany Paul Baby, MD on April 08, 2022

Body integrity identity disorder is a very rare condition. It occurs when your mental body image doesn’t match your physical body. If you have body integrity disorder (BIID), you may have a strong desire to amputate a limb or seek to become paralyzed. 

What’s the Impact of BIID on Your Health?

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. 

When you don't feel right in your body, depressive symptoms and mood disorders can occur. These coincide with BIID's stressful and emotional toll on your mental health. 

BIID is considered an identity disorder, and some research has been done to suggest that it could be congenital.

People with BIID want to be their "true self," which often comes with a desire for amputation or disability to help them feel "complete" inside. Recent research has started linking this feeling to certain psychiatric and neurological reasons. There are strong similarities between BIID and other identity disorders like transsexualism and gender identity disorder

BIID is linked to chronic dysphoria, with those affected feeling like their bodies are not what they should be. In severe cases, people with BIID will go to extreme lengths to amputate or disable themselves without medical help. 

An obsessive need to amputate a limb can be deadly if the amputation is not done correctly, and unfortunately, people with BIID can turn to self-mutilation if they can't find proper help. 

If someone you know has BIID, you may notice repeated, unexplained injuries to the same part of their body. 

What Are the Causes of Body Integrity Identity Disorder?

Body integrity identity disorder isn't well understood. There isn't one specific cause of BIID, but there are theories about its origins. 

Some researchers believe the following factors could cause BIID: 

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. 

Body mapping occurs in your youth, when many people with BIID report their first feelings of discomfort with their body. 

However, BIID is such a rare condition that there's not enough research on the condition. 

What Are Body Integrity Identity Disorder Symptoms?

People with body integrity disorder feel like a particular limb doesn't belong to them. They may have a healthy arm or leg that they don't feel is right for their body and want to have amputated. For some patients, keeping the limb they don't identify with causes intense emotional pain.

Body integrity dysphoria makes people feel overcomplete in their bodies. In one study, people with BIID couldn’t correctly describe the leg that they wanted gone. The officiators of the study asked them to assess the size and shape of their legs using vision, touch, and the perceived feeling of their leg.

However, the desire to cut off a limb is not merely an idle wish. People with BIID have an obsessive need to get rid of the alien appendage on their bodies. 

People with body integrity disorder have distressing thoughts that can harm their social, personal, and work life. People who can’t afford surgery or find a surgeon willing to perform the amputation might try to get rid of the appendage on their own. This self-mutilation can have deadly consequences.

How Is Body Integrity Identity Disorder Diagnosed?

Body integrity identity disorder is hard to diagnose. The desire for amputation has been given a name, but diagnosis requires individuals suffering from the condition to open up to their doctor.

If you’re feeling disconnected from your body, your doctor may first look into activity in your brain. They’ll try to determine if a benign brain tumor or other underlying condition is the cause of this disconnect between mind and body.

Treating body integrity disorder. The most challenging part about this condition is that there’s no cure. Treatments like cognitive behavioral therapy and selective serotonin reuptake inhibitors (SSRIs) help reduce the distress and depression related to the condition; however, they don’t fully remove the desire to get rid of the appendage.

In some cases, amputation can result in remission of BIID. This can improve the quality of life if done safely. If you have BIID, you can potentially find a doctor or psychiatrist willing to acknowledge your desire for amputation. This can help you get medical care and decrease your emotional strain.

How Many People Get BIID?

Body integrity identity disorder is a very rare condition. The specific number of people affected can be difficult to judge, though, as some may hide their condition. People with BIID may disassociate themselves from their physical body parts that they don’t feel are connected to them and avoid discussing the issue.  

How Can You Keep BIID from Affecting Your Health?

Body integrity dysphoria can cause life-long suffering, potentially starting in childhood. Identifying this condition and reaching out to a doctor or psychiatrist, though, can help you start managing the symptoms. 

Talking to a trusted friend or family member can also help you understand your condition. This opens up conversations about finding the right treatment or symptom management. In certain cases, amputation can help alleviate the pain of the condition. This needs to be done in a legitimate and safe environment performed by a licensed surgeon, though, following appropriate psychiatric consultation and assessment.  

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. 

If you or someone close to you is experiencing BIID, talking to a doctor is the first step. Finding proper, safe help can prevent self-harm or worsening depression. While this condition is very rare, there are others who also experience these feelings. 

Show Sources

SOURCES:

BJPsych Advances: “Body integrity identity disorder: clinical features and ethical dimensions.”

BMJ Case Reports: “Body integrity identity disorder using augmented reality: a symptom reduction study.”

Frontiers in Human Neuroscience: “Could Brain-Computer Interface Be a New Therapeutic Approach for Body Integrity Dysphoria?”

Frontiers in Psychiatry: “An investigation of lower limb representations underlying vision, touch, and proprioception in body integrity identity disorder.”

GoodTherapy: “Body Integrity Identity Disorder (BIID).”

PLoS ONE: “Body Integrity Identity Disorder.”

The American Journal of Bioethics: “Body Integrity Identity Disorder (BIID) – Is the Amputation of Healthy Limbs Ethically Justified?”

the GIST: “Body Integrity Identity Disorder: The Desire for Amputation.”

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