Identity disorder of body integrity or xenomelia

The identity disorder of body integrity (TIIC) is a rare condition, in which the subjects who suffer from it manifest an intense desire to amputate some of their health even as his "enemy"; Sensoperception is so strong, that a real disabled situation can be generated and effectively, putting their physical integrity and life at risk.

These patients are often called "Biid", for its acronym in English: "Body Identity Disorder", even in Spanish.

Content

• BIID: Somatooparafrenia or xenomelia?
• Identity disorder of body integrity over time
• Xenomelia: possible neurological etiology
  • Focal neurologic disruption
• Disabled by choice, discriminated by exclusion
• Gender Identity Disorder & Biid
• Xenomelia and Social Learning
• Lethal similarities: body dysmorphic disorder & identity disorder of body integrity
• BIID treatment
  • Electronics references

BIID: Somatooparafrenia or xenomelia?

To the identity disorder of body integrity, it has sometimes been confused, with the SomatoParafrenia, People who have this condition show a marked aversion by a limb, denying that it is yours And attributing it to another person, even if it is not present, somatoparafrenia, is associated with damage to the upper parietal lobe (LPS).

While in the Xenomelia, The subjects have The feeling that some part of your body is not your property, aversive feelings are presented with less intensity and the property is not attributed to someone external as with SomatoParafrenia.

In addition to this, people with BIID have obsessive ideations about the amputation of the "intruder" in their body, in that excessive reverie or "Maladaptive Daydreaming (MD), they find some relief, it is not until they realize that they realize that Emotional discomfort does not decrease, on the contrary: it continues to increase, coupled with that terrible feeling of alienation:

"People with Xenomelia have a delusional desire for specific amputation or disability, do not lack the property judgment, while individuals with somatoparafrenia also lack the feeling of property."

Identity disorder of body integrity over time

Currently, in neurosciences, this condition is better known as the disorder of the identity of body integrity or xenomelia, which is an "oppressive feeling that a member does not belong to the body", Michael First, defined it as "a unusual dysfunction in the development of the sense of the person's anatomical identity".

Money and collaborators (1977), classified this type of pathology within paraphilias, calling him: apothemophilia, Because they studied only some cases associated with the same.  However, the identity disorder of body integrity implies the desire of an amputation or the suppression of some important capacity and is not usually driven by erotic fantasies.

Xenomelia: possible neurological etiology

The identity disorder of body integrity is a dark issue, since the etiology of the condition is still in darkness, there is a lot Skirt hope for these patients.

The most recent investigations point to a Dysfunction of central nervous system circuits. Vilayanur Ramachandran, a studious neuroscientific of your own body ".

Measuring skin conductance responses and brain activity in patients with BIID, scholars observed that when they stimulate these subjects below the “desired amputation line”, their magnetoentefalographies, they recorded a response from greater conductivity, as well as reduced activity in The parietal lobe (LPS) upper right. Hiti (2013), found neuroarchitectural abnormalities in the right LPS, in the right anterior insul The primary somatosensory representation of the left leg is located. 

Focal neurologic disruption

Van Dijk also did research with patients with the disorder of the integrity of body identity or xenomelia, the findings found in the somatosensory network indicated a same altered functioning that they associated with the feeling of “non -belonging” or of strangeness, of some member.

In turn, Hänggi and collaborators observed that in patients with BIID there are differences in volume in the Putamen areas, the caudate nucleus, the pale and the thalamus, which contribute to the Sensoriomotora integration of body parts (2016). They found hyperconnectivity subnets Between: Paracentral lobe, supplementary motor area, post -central circumvolution, basal ganglia, cerebellum and the upper parietal lobe, primary and secondary somatosensory bark, as well as in the pre -agent cortex, basal ganglia, thalamus and insula.

"Hyperconnection patterns could be the brain compensation response to a focal neurological alteration or disruption"

Disabled by choice, discriminated by exclusion

People who due to life circumstances are temporarily or definitively disable His brothers with other disabilities, there is a lot of work to do in all countries, because there is still much "Capacitism”, Which is a form of prejudice or Social discrimination towards people with disabilities: especially in countries and between groups where ignorance and violence predominates.

Next, I present some social groups of people seeking belonging, especially through social networks and are related to Xenomelia:

"Devotee Wannabe": healthy individuals who feel attracted psychosexually Towards people with disabilities, Generally with mobility problems, their preferences are usually very specific in relation to the type of disability that interests them.

"Amputee pretenders": People who act as if they had a disability imitating their movements, using crutches, wheelchairs, prostheses, plaster, canes, glasses for blind, among others.They suffer from a factitio disorder, previously known as Münchhause's syndrome, characterized by the appearance of symptoms deliberately produced by the patient to receive medical care, assuming the role of "sick".

"Transabled" or "Amputee Wannbes": Subjects that being physically healthy, wish to be disabled, some of them have reached the extreme of becoming homemade amputations when the doctor has refused to respond to their need.

These social groups are usually strongly discriminated against, even among the same disabled ones, because they believe that they only seek to benefit from the privileges and special treatment that they should have - in theory - the disabled people.

Patients who do not have other serious psychopathology, know that these desires are not "normal" for others, as well as seen, so they begin to isolate themselves, many times since childhood, mainly due to stigmas and fear of exclusion, leaving thus more space for excessive revering or maladaptive daydreaming (MD) what do they fantasize? Many say that more than once they had imagined or pretended to be: paralitic, blind, deaf, among other dscapacitantes conditions, or as "Amputee pretenders".

This type of people is strongly rejected, many think that they only do it for their need to attract attention, have recognition and be treated in a "special" way. Although this is actually part of their fantasies, although more as a consequence secondary to the realization of their obsession: "get rid of the body part that generates so much discomfort".

This emotional suffering reaches such degrees of lethality, that people with biid are able to crush a leg or place a limb under a moving train or perform extremely risky acts, attentive against his body integrity. (Dyer 2000; First 2004; Furth and Smith 2000; Skates soon 2005).

Gender Identity Disorder & Biid

There are parallels between the BIID and the gender identity disorder: ChildrenThings are not going well”E  discomfort to a specific anatomical identity. In gender identity disorder, it is not until they modify their bodies according to the sexual image that they have introjected, that they feel better, such as BIID patients, who refer to feel “complete and happy” after mutilated or disabled in some way.

Xenomelia and Social Learning

Since decades ago, the etiology was even more unknown, psychological causes were attributed, although there is now psychological evidence, it is important to take into account the following:

What behaviors do we reinforce in our children?, Are self -sufficient behaviors? or perhaps we are reinforcing those behaviors that foster dependency. Some patients say that they had some figure during their early childhood, which represented some kind of authority or someone they admired and was mutilated from a member or disabled in some way. Several of them felt envy or jealousy, due to the attention that people in wheelchairs - for example - and They had fantasies, sometimes obsessive, of being treated in the same way as people with disabilities.

Certain memories can become memories of pain. The lack of attention in early stages, makes children more susceptible to developing some identity disorder, as well as other psychological problems What memories do you build in your children day by day?  It is necessary, teach them emotional management and face vital circumstances, so that emotional suffering and other problems do not go from generation to generation by modeling or social learning.

While it is true that they seek recognition and empathy do not pursue this as the last goal in their longedInvasive enemy".

It is important that the same be done, to try to help build a self -concept and a healthy identity in children, They can learn to disable and be victims of circumstances or train them to face the challenges of life with the best adaptive strategies.

Lethal similarities: body dysmorphic disorder & identity disorder of body integrity

People with BIID and those who have a very marked body dysmorphic disorder, such as those who perform many procedures and aesthetic surgeries, want to fulfill their dark desire, even if they put their health at risk and even the doctor advises the opposite.

When health professionals refuse to help them, they often look for someone to help them fulfill their wishes: modify their body seeking to feel better ... even outside the framework of legality or ethics. Both patients are able to look for an unscrupulous person who Lucre taking advantage of their condition and exposing themselves to big risks. In the case of Body dysmorphic disorder, They can become addicted to aesthetic procedures and surgeries. In people with biid, many cases of attempts automutilation or mutilations in clandestine conditions, they have ended in death (Bayne and Levy 2005).

BIID treatment

It must be multidisciplinary, including: psychiatrist, because they often require psychopharmacological treatment, it is advisable completely eliminate:

"Antidepressants, such as serotonin reuptake inhibitors and behavioral therapies, in some cases could reduce, in a way, compulsive amputation desires, but never suppress itS ". Wise and Kalyanam, 2000

Psychological treatment can help reduce Emotional discomfort And to treat the mood disorders and the depression, that many patients with biid experience.

FAQ: identity disorder of body integrity or xenomelia

Electronics references

• Hänggi et al (2017). Structural and functional Hyperconnectivity Within The Sensorimotor System in Xenomelia. Brain and Behavior, 7 (3): E00657.
• SEDDA A, BOTTINI G (2014). Apotemnophilia, Body Integrity Identity Disorder or Xenomelia? Psychiatric and neurologic etiologies face each other. NEUROPSYCHIATRIC Disease and TREATMENT, 10: 1255-1265.
• Hilti LM et al (2013) The Desire for Healthy Limb amputation: Structural Brain Corlates and Clinical Features of Xenomelia. Brain, 136 (1): 318-329.
• McGeoch PD et al (2009) Apotemnophilia: The Neurological Basis of Psychological Disorder. Nature precedings: 1-5.
• Rang D, McGeoch PD and Ramachandran vs (2008). Apotemnophilia: a disorder neurological. Neuroreport, 19: 1305-1306.
• Hilti LM et al (2013) The Desire for Healthy Limb amputation: Structural Brain Corlates and Clinical Features of Xenomelia. Brain, 136 (1): 318-329.
• https: // journals.lww.com/neuroreport/abstract/2008/08270/apotemnophilia__a_neurological_disorder.eleven.ASPX.