Body Integrity Identity Disorder

Working in the mental health field allows me to learn about human interaction, reaction, and brain activities in ways I never imagined. It never ceases to amaze me how our brain stores and shares details of information based on our safety and needs. There are hundreds of studies to evaluate a variety of mental health issues, their causes, symptoms, and treatments. At this point in time, Body Integrity Identity Disorder (BIID) is not as well researched which makes it difficult to categorize and makes it a continuous source of frustration.

BIID is our brain rejecting part of our body, for whatever reason. It is the belief of some able-bodied individuals that they were meant to be disabled in some way or viewing their “limb” as a foreign object.  I know that idea may sound bizarre to some and I imagine that many individuals struggling with any disability may feel upset by this but we all have different ways of processing our “issues.” I can only speak about this from the ‘trauma’ point of view.  

For many of my clients, history of any sexual assault or abuse has created self-loathing and hatred for their own body.  Trying to understand the reason for their experiences had led them to poor self-care methods as well as self-injurious coping skills.  I initially came across BIID specifically with a client who experienced extensive years of sexual trauma. For as long as I had known the client, he/she appeared to have a physical disability – they were short of limb.  One day, after working together for some time, I learned that my client was not missing a limb but hated it for the part it had played in his/her abuse. That was the clients’ way of perhaps controlling whatever little part he/she could to feel less powerless.

Though there is some confusion regarding whether this is actually a psychological or neurological issue, we can’t overlook the fact that living with so much discomfort in your own body comes with overwhelming emotions. When an outfit does not fit us properly, we alter it. Unfortunately, when the discomfort is unbearable, some individuals in the past have altered their bodies to match their brain’s understanding of how their body should be. This is beyond plastic surgery- there are people who have poured chemicals in their eyes because they believed they were meant to be blind or cutting off their arm or leg because they “should not” have had them.

A major ethical concern for the medical field is regarding voluntary amputation. Because amputation is a permanent decision, is there any way to truly understand if that would enhance the quality of life for one? The difficulty with making that decision is that an individual is definitely struggling with emotional turmoil but completing the amputation does not guarantee an easier lifestyle. Finding a qualified medical professional who would agree to complete the surgery/process is difficult and impulsive actions could lead to more dangerous health complications or death.

In my quest to help my clients led me to learn that at times some SSRIs and CBT have been suggested but there is no specific method present that can “cure” this. Perhaps challenging the thoughts associated with the negative belief about the specific limb is why CBT was a possible route. For those clients whose struggle with BIID started due to past sexual abuse, I feel that treating the root cause- the trauma of abuse- may be more helpful than to focus on symptoms resulting from it.

As a mental health professional, my focus is to be available for individuals struggling with difficulties and allow a safe space to process those feelings. BIID is not something that is very well known and as mentioned earlier, is still in the process of assigning the appropriate field of study. Along with discussing possible helpful steps, part of my goal is also to continue educating myself and others with mental health disorders in hopes of increasing empathy for each other.  My treatment method comes from understanding the impact of abuse and trauma in one’s life. If you are struggling with BIID or any other mental health trauma, I am available to discuss specifics when you are ready to seek treatment.

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