# Desire to Sever One's Limbs; another DSM category?!



## Dreamer (Aug 9, 2004)

*A moderator is welcome to move this to .... anywhere, but it was so astonishing an article I'm posting it.

I have no clue what to make of this.
Um, we are all VERY unique. And this again brings up the controversy over diagnoses and the DSM.*

FROM: 
*The New York Times
March 22, 2005
At War With Their Bodies, They Seek to Sever Limbs
By ROBIN MARANTZ HENIG*

*When the legless man drove up on his own to meet Dr. Michael 
First for brunch in Brooklyn, it wasn't just to show Dr. First how 
independent he could be despite his disability.
It was to show Dr. First that he had finally done it - had finally 
managed to get both his legs amputated, even though they had been 
perfectly healthy.

Dr. First, a professor of psychiatry at Columbia University, had 
gotten to know this man through his investigations of a bizarre and 
extremely rare psychiatric condition that he is calling body 
integrity identity disorder, or B.I.I.D.*

"This is so completely beyond the realm of normal behavior," he 
said of the condition, which he estimated afflicts no more than a 
few thousand people worldwide. "My first thought when I heard about 
it was, Who would think this could go wrong? Who even thought there 
was a function that could be broken?"

Dr. First is among a small group of psychologists and psychiatrists 
who are trying to define the disorder, understand its origins and 
decide whether to include it in the encyclopedic bible of 
psychiatry, the Diagnostic and Statistical Manual, or D.S.M., as a 
full-fledged disease. At the same time, the disorder is turning 
up as a plot device or documentary subject in a handful of films, 
plays and television shows.

The idea of having extreme elective surgery, even when it involves 
mutilation or removal of healthy tissue, has met at least some 
acceptance in cases like sex reassignment, or cosmetic surgery for 
those who hate their noses or breasts even when those body parts 
are objectively fine.

But an obsessive desire for a limb amputation - one that drives 
people to cut off healthy arms and legs - tests the tolerance of 
even the most open-minded.

*Body integrity identity disorder has led people to injure 
themselves with guns or chain saws in desperate efforts to force 
surgical amputations. A few have sought out amputations abroad, 
including one man who died of gangrene after an elective amputation 
in a clinic in Tijuana, Mexico.*

The disorder has been known by several names. In 1977, Dr. John 
Money, an expert on sexuality at Johns Hopkins University, named it 
*apotemnophilia (literally, love of amputation). He considered it 
a form of paraphilia - that is, a sexual deviation.* 
In 1997, Dr. Richard Bruno of Englewood Hospital in New Jersey 
proposed the name *factitious disability disorder, which he 
grouped into three types: people who are sexually aroused by 
amputees("devotees"), those who use wheelchairs and crutches to 
make it seem as if they are amputees ("pretenders") and those who 
want to get amputations themselves ("wannabes"). In Dr. Bruno's 
taxonomy, those who manage to obtain amputations continue to be 
known as wannabes.*

In 2000, Dr. Gregg Furth, a New York child psychologist and one of 
Dr. Money's co-authors on his 1977 paper, published a book about 
the disorder, calling it *amputee identity disorder. In addition 
to his professional interest in the subject, Dr. Furth had a 
personal one: from early childhood, he had wanted to have his right 
leg amputated above the knee.*

Dr. Furth wrote the book with Dr. Robert Smith, whom he met while 
searching for a surgeon who would perform the elective amputation. 
When Dr. Furth found him in Scotland, Dr. Smith had already done 
two such operations, and he agreed, after consulting with two 
psychiatrists, to operate on Dr. Furth. But in 2000 Dr. Smith's 
hospital, the Falkirk Royal Infirmary in Glasgow, prohibited any 
further procedures of this type. Dr. Furth never received his 
amputation.

*The newest name, body integrity identity disorder, was first 
used by Dr. First of Columbia in the journal Psychological Medicine 
in 2004. In that paper, he described the results of a telephone 
survey of 52 people with the disorder: 9 of them had amputations 
and the rest yearned for it. He chose the name to distinguish the 
disorder from paraphilia, psychosis or body dysmorphic disorder 
(the false belief that a part of your body is ugly or abnormal).

To Dr. First, the closest analogy was to gender identity 
disorder.*

"When the first sex reassignment was done in the 1950's, it 
generated the same kind of horror" that voluntary amputation does 
now, Dr. First said. "Surgeons asked themselves, 'How can I do this 
thing to someone that's normal?' The dilemma of the surgeon being 
asked to amputate a healthy limb is similar."

*Still, the analogy is imperfect. "It's one thing to say someone 
wants to go from male to female; they're both normal states," Dr. 
First said. "To want to go from a four-limbed person to an amputee 
feels more problematic. That idea doesn't compute to regular 
people."*

Dr. David Spiegel of Stanford said he believed that body integrity 
identity disorder *sounded closer to either body dysmorphic 
disorder or anorexia nervosa, though he added that he had not seen 
any patients with the integrity disorder. The connection to 
anorexia, he said, is that people with B.I.I.D. "have a clearly 
mistaken belief about their bodies."*

"It reminds me a little of anorexia nervosa," Dr. Spiegel added, 
"where people think they're fat when it's obvious they're not."

No one knows for sure what causes the integrity disorder or how it 
can be treated. Dr. J. Mike Bensler and Dr. Douglas S. Paauw of the 
University of Washington Medical Center in Seattle, writing in the 
Southern Medical Journal in 2003, said it was probably both sexual 
and emotional in nature. The condition is at its heart an "erotic 
fantasy," they wrote, with two components: "undergoing amputation 
of a limb, and subsequently overachieving despite a handicap."

*According to Dr. First, people with body integrity identity 
disorder are quite specific about how many limbs they want 
amputated, and where. The most common is the left leg above the 
knee; the least common is a finger or toe. "Some people actually 
know the exact spot where they want the amputation," said Dr. 
First. "Not just above the knee, but four inches above the 
knee."*
:shock:

Anything short of that specific site can be insufficient. One man 
from Dr. First's sample had a lifelong fixation on being a double 
leg amputee. After a shotgun accident, he lost his left arm. 
Amazingly, this did nothing to diminish the intensity of the man's 
desire to have his legs amputated.

*In Dr. First's study, just over half of his subjects had 
encountered amputees at a young age, and from that time on, they 
were fixated on getting their limbs removed.
"It wasn't so much that I wanted to be an amputee as much as I just 
felt like I was not supposed to have my legs," said Dr. First's 
brunch companion in a phone interview, which he granted on the 
condition of anonymity. The man also was a subject in Dr. First's 
study.

"From the earliest days I can remember, as young as 3 or 4 years of 
age, I enjoyed playing around using croquet sticks as crutches," he 
said. "I enjoyed thinking about what it would be like to be missing 
a leg. When we were playing cowboys and Indians, I seemed to be the 
person who always got wounded in the leg."

This man said his amputations cured his disorder. But Dr. Spiegel 
said most such operations would probably not do away with the 
underlying problem. "I don't think the answer is fitting in with 
the obsession or delusion," he said.*

Dr. Spiegel expressed more faith in psychotherapy, especially 
something called response prevention and thought-stopping. "It 
involves training the patient to try and block the thought when it 
comes up," he said, "and to keep him from trying to act on it."
None of the subjects in Dr. First's study reported being helped by 
therapy or medication, but Dr. First said that might be because 
they had not received "psychotherapy tailored to this disorder" or 
"high sustained doses" of medications used to treat related 
conditions like obsessive-compulsive disorder.

He said more research was needed into treatment options and into 
whether amputation was an acceptable treatment "as a last resort."
People who have lost limbs to accidents or disease are often 
horrified when they learn about healthy people who seek 
amputations.

"It's very difficult for people who have been through what they 
consider to be a devastating life experience to understand why 
anybody would want to mutilate himself in this way," said Paddy 
Rossbach, president of the Amputation Coalition of America, an 
advocacy and support group. "Especially when so many people are 
having tremendous problems with prosthetic fittings, or access to 
prostheses, and are living with pain every day of their lives."

Mrs. Rossbach, who has been missing a leg since childhood, said 
that some amputees are angry at people with body integrity identity 
disorder because they believe that the condition "is really 
minimizing what they themselves have been through."

*According to Dr. First, people with the disorder are basically 
normal. "They have families," he said. "They hold all kinds of 
jobs, doctors and lawyers and professors. They're not screwed-up 
people apart from this. You could spend an evening with them and 
never have the slightest clue."

But people with serious mental illnesses, even psychoses, often 
look normal on the surface, Dr. Spiegel said. Still, the surface 
can mask some profound problems. "It's often the case that people 
with this kind of delusion would pass a mental status screen," he 
said. "They can do abstract thinking, they're not disoriented, they 
look pretty good to the outside world as long as you don't trip 
over their delusion."*

Yet many with the disorder would go to extreme measures to get rid 
of the limb they consider extraneous.

In May 1998, the urge drove one man to a California surgeon who had 
lost his license more than 20 years earlier for several botched 
attempts at sex reassignment surgery. At a clinic in Tijuana, the 
surgeon, John Ronald Brown, 77, cut off the left leg of Philip 
Bondy, 79, of New York, who had paid him $10,000. Then Mr. Brown 
sent Mr. Bondy to a motel in a run-down section of San Diego to 
recover on his own.

Two days later, Mr. Bondy was dead of gangrene, and Mr. Brown was 
charged with second-degree murder. *During the trial, newspaper 
reports said that Mr. Bondy had sought the operation to satisfy a 
"sexual craving." Mr. Brown was found guilty in October 1999 and 
sentenced to 15 years to life in prison.*

Mr. Bondy was not alone in his desperation. Among the body 
integrity identity disorder sufferers in the documentary "Whole" by 
Melody Gilbert, broadcast on the Sundance Channel in May 2003, is a 
Florida man who shot his own leg so it would be amputated in the 
emergency room, and a man from Liverpool, England, who packed his 
leg in dry ice for the same reason. The man who froze his leg 
referred to the resulting amputation as "body correction surgery."

*The condition is slowly making its way into popular culture.* 
At the New York International Fringe Festival last summer, an award 
for best overall production went to "Armless," a play about a 
middle-aged suburbanite with the disorder. The playwright, Kyle 
Jarrow, said his goal was to explore "the line between gross and 
spooky and funny and poignant."

In November, an episode of "CSI: New York" featured a man with the 
disorder who bled to death after he tried to saw off his leg. And 
last month, a screening was held in the East Village of 
"Pretender's Dance," a short film by Tom Keefe about a young 
choreographer and her boyfriend who wanted amputation.

Dr. Smith, the Scottish surgeon who removed the legs of two men 
before his hospital forced him to stop, is trying to get the 
disorder formally recognized so that the amputations can be covered 
by the National Health Service.

"The Hippocratic oath says first do your patients no harm," he said 
in the film "Whole." But maybe the real harm, he said, is to refuse 
to treat such a patient, "leaving him in a state of permanent 
mental torment," when all it would take for him "to live a 
satisfied and happy life" would be to amputate.

Dr. Smith's American co-author, Dr. Furth, is trying to get body 
integrity identity disorder added to the D.S.M., the textbook 
compiled by the American Psychiatric Association that lists all 
mental disorders considered distinct, pathological and worthy of 
reimbursement by health insurance companies.

*Dr. First of Columbia is on the board of editors for the next 
edition of the textbook. Even though he is one of the few 
psychiatrists who studies the disorder, he still has not decided 
whether it should be included. Putting the disorder into the manual 
could generate research interest into its origin and possible 
treatment, he said.

But, he added, "the D.S.M. already is a very big book."
"And as far as clinical utility," Dr. First said, "the thicker it 
gets, the less useful it gets."

And while the disorder is genuine, he said, he has to recognize 
that it may be too rare for mention in a book that is already 
buckling under the weight of its inclusiveness.*

*Copyright 2005 The New York Times Company*

*Dreamer is speechless. Any thoughts on this one?* :shock:


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## Guest (Mar 24, 2005)

Well, Janine is almost speechless as well....if it shut BOTH of us into deadly silence, that's pretty damned impressive.

strangest thing I've ever read. EVER.

I have to mull this one over. My first (psychoanalytic) thought of course, is that it might unconsciously be some kind of perverse castration delusion....but hell, I don't know, lol.

The one thing that occurred to me is that this is NOT something that I've ever read of before - not from the literature, not from centuries gone by. I wonder if in ANY way it is connected to the times we live in - we read about limbs being severed (or heads!), we see it in movies, we play it in video games. Long ago, this hyper-stimulating visual trauma wasn't in front of our faces..

I don't know.
Yes...you left me nearly speechless! :shock:


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## Dreamer (Aug 9, 2004)

Dear Janine, LOL, I really am dumbfounded here,
I wonder as well, what do we know about the history of this phenomenon. But it says



> "This is so completely beyond the realm of normal behavior," he
> said of the condition, which he estimated afflicts no more than a
> few thousand people worldwide. "My first thought when I heard about
> it was, Who would think this could go wrong? Who even thought there
> was a function that could be broken?"


A few thousand people worldwide? WORLDWIDE. It is astounding this has been written up.

If it has a history, which I imagine it does, I think?, it would be very difficult to ferret it out. I would think in centuries past, anyone without a surgeon who did this to him/herself would die. It would be a sort of suicide?

OMG :shock:


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## nemesis (Aug 10, 2004)

Youve just given us OCD'ers something else to worry about.


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## Dreamer (Aug 9, 2004)

> According to Dr. First, people with body integrity identity
> disorder are quite specific about how many limbs they want
> amputated, and where. *The most common is the left leg above the
> knee; the least common is a finger or toe. "Some people actually
> ...


OK, I'm done, but that is even more........ the most common is the LEFT LEG?

Well, yes, :shock: LOLOLOLOL


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## Dreamer (Aug 9, 2004)

nemesis said:


> Youve just given us OCD'ers something else to worry about.


ROARING! HOLY TEWELKUS!


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## Guest (Mar 24, 2005)

Well...duh! lol...yes, you made an excellent point - in centuries gone by, of course the person would die/bleed to death. Didn't think of that.

The only thing I've read about this is from a novel, about 7 yrs. ago, I think. Author is Wally Lamb and the book is "This Much I Know Is True" a story about one normal man and his schizophrenic brother - their lives together, etc. and it is supposedly based on Lamb's real life and real relationship with a mentally ill sibling. The first chapter ends with the psychotic brother chopping off his own hand (intentionally).

Is this thread making all the dp people feel good and comfy? lol...man, this is just fascinating. I may have to inquire to my analyst buddies if they're familiar with this at all.


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## Dreamer (Aug 9, 2004)

> Is this thread making all the dp people feel good and comfy? lol...man, this is just fascinating. I may have to inquire to my analyst buddies if they're familiar with this at all.


HOWLING.

But seriously intersted in what the analysts have to say. I'm.... well, .... OMG!

I can only say :shock: 
*Please, I'm willing to hear ANY theory that comes within 500 miles of explaining this at all!

OK, it is time to watch the telly, but it could be on C.S.I., ROARING!*


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## Martinelv (Aug 10, 2004)

Sweet holy jesus, whatever next ! What do you do with your spare time Dreamer ? :shock:

To be honest, if I were to remove part of my body, I think I'd go for my big toe. Deep fry it and - hey presto, KFC chicken drumstick. Slobber, drool.


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## Guest (Mar 25, 2005)

I read an article written by a woman afflicted with this disorder. For her it was an aesthetic motivation. If you ever read up on heavy body modification (BME's website is a good 'un), you'll see that amputations (usually of fingers) are used as a way to enhance and change the appearance of the body. I remember viewing a picture of man's tattooed arm while looking for my own inking ideas and seeing that his fingers went down in uniformly largest to smallest, rather than the usual uneven pattern. He had amputated the tips of some to achieve this.

I doubt sensationalizing this does any good. Has it occurred to you that if some message board read an article about our illness, they would find it just as unfathomable as you find this one?

"How can you leave your body? WTF?OMGLOL"


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## Dreamer (Aug 9, 2004)

Triste said:


> I read an article written by a woman afflicted with this disorder. For her it was an aesthetic motivation. If you ever read up on heavy body modification (BME's website is a good 'un), you'll see that amputations (usually of fingers) are used as a way to enhance and change the appearance of the body. I remember viewing a picture of man's tattooed arm while looking for my own inking ideas and seeing that his fingers went down in uniformly largest to smallest, rather than the usual uneven pattern. He had amputated the tips of some to achieve this.
> 
> I doubt sensationalizing this does any good. Has it occurred to you that if some message board read an article about our illness, they would find it just as unfathomable as you find this one?
> 
> "How can you leave your body? WTF?OMGLOL"


Triste,
I aplogize if it seems I am laughing at such people, I'm not. And I don't mean to sensationalize it. I am fascinated by the brain. I want to understand why people do what they do, feel how they feel. This was in The New York Times! Are they sensationalizing it by reporting about such a rare thing that is actually being studied?

Understanding the very unusual helps us understand the everyday pathological. That is the POV of many scientists, doctors, researches, etc. (Particularly my favorites, Oliver Sacks, and V.S. Ramachandran.)

To me, I see this as more food for understanding the incredible complexity of the brain.

I suppose I shouldn't have laughed or put the shocked look. I got carried away.

Hey, I'm a person her who hates the word "schizo" that is used liberally here on the board. If I could, I'd give everyone who uses the word "schizo", a talking-to! I find it an insulting slang word that implies schizophrenics are not human beings.

I am *fascinated* by this. I am not making fun of it. I am a research junkie as many on the board know.

I want to understand this as much as I want to understand DP/DR.

I am not making light of this.

I've had DP/DR essentially my whole life -- age 46. Perhaps a bit jaded, but no less interested in the workings of the mind after all these years.

Apologies.
Dreamer
Edit: x1


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## Guest (Mar 25, 2005)

No hard feelings, m'dear.


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## Dreamer (Aug 9, 2004)

Thanks Triste.
Strange week for me.
Best,
D


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## Sunshine Spirit (Feb 22, 2005)

Oh, dear...trust me to be the odd one out here! I have to say that I honestly didn't feel in the slightest bit shocked while I read this, and I did read it thoroughly. I was more surprised to read that Janine and Dreamer were almost speechless immediately after reading it! I found it extremely easy to imagine what their thoughts are and I can clearly understand why these people would want to make such drastic actions.

I'll quickly mention that I'm open minded enough to accept the possibility that I'm being delusive, should this be what any of you are wondering? I can see that I must sound like it. However, time will quickly tell...

Dreamer, if you would like me to try and explain, then I'll try my best. I know it'll be quite a struggle for me to put my comprehension of this disorder into words - especially as my vocabulary is limited - but bear with me and I should hopefully get there in the end.


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## Guest (Mar 25, 2005)

I was under the impression that part of what they may be feeling is alienation to their bodies similar to what some of us may feel. I don't think I am alone in having not recognizing parts of my body, causing harm to myself and, embarrassing to admit, suffering desires for castration when in an episode of DP/DR.

Well, perhaps I am alone in the last one. But I think my point is proven.


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## Homeskooled (Aug 10, 2004)

Dear Dreamer, 
I remember reading about this phenomenon about two years ago. It strikes me that if you scanned the brains of one of these patients, you might find some odd wiring in the parietal lobe. The body map is here, and often stroke patients with damage to one of the sides end up denying that the other half of their body even exists. They comb half of their heads and dress only their right or left halves! Children who have had overactivity in their parietal lobe have been shown to be very, very sensitive to touch or noise (as it also processes some hearing). If the wiring which let you feel your right leg had developed poorly, was damaged because of forceps at childbirth, etc...I dont think it would ever feel right to you. It might feel misplaced. It struck me that this disease is practically the opposite of phantom limb pain. Instead of losing a limb and having your brain refusing to beleive it is gone, you have a person who has a limb which his body refuses to tell him belongs there. You might be able to use a phantom limb treatment in reverse for treatment, or what immediatley came to my mind, biofeedback. I also wouldnt put it past these patients having OCD. I know many people with it have had obsessive thoughts about hurting others, and more to the point of this post, hurting themselves in some grotesque way. Supposedly, a person with these symptoms would have overactivity in their cingulate gyrus. Maybe a mild SSRI with biofeedback would be a valid treatment option? Anyways, its very interesting, and yes, exceedingly rare. I think that OCD can run the whole gamut of ruminations. There was a case of a man in Japan some years ago who had an obsession with how it would taste to eat someone. He was actually jailed for trying to pull it off ( with the other person's permission) but was let out of the asylum he was in about two years ago. He was diagnosed with OCD bordering on psychosis, and him living in Japan and all, he is quite a celebrity. They've made a joke of the whole thing, which is kind of sick and pretty scary. He is a food critic for a magazine, and they do photo shoots of him with young pretty japanese women, holding their outstretched legs with his mouth open....Sigh.....Anybody can be a celebrity nowadays. Just look at Paris Hilton. Okay, hope this helped.

Peace
Homeskooled


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## Dreamer (Aug 9, 2004)

Dear Homeskooled,
This is why I was :shock: over this particular disorder as it seemed in some way to apply to the distorition in perception of Self. Maybe a little tad more information to get a grasp on what we're fighting.

What struck me was exacty the bit about the most common complaint being that of the left leg -- how in the world, would only a few thousand people all over the world statistically have this problem which not only involved a desire to amputate a limb, but the left limb, and in a precise location.

Yes, I thought of "Phantoms in the Brain" and the studies of phantom limbs. Fascinating that this could be something like "backwards phantom limb pain." I was always struck by reading that *some people born without limbs can experience phantom limb pain*. It's stuff like that, and this incredible story that lead me back to incredible subtleties in the structure of "Self" as portrayed in the brain.

It's like the brain creates the image of a glove, that's us, but sometimes we don't "fill out the glove" -- our hand/Self feels smaller. At other times, we sense the thumb of the glove is missing when it is there, sometimes perhaps in this amputation disorder, yes, the individuals feels they have "one thumb too many" and it "doesn't feel right."

I really have no clue, but your explanation about phantom limbs in particular sounds right to me.

I can only say, the brain is absolutely, incredibly fascinating. If I have the brains 8) sometimes I wish I could be a neurologist.

Thanks,
I could go on, but am tired.
D


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## sebastian (Aug 11, 2004)

If i wasn't such a basketcase, i would think that would be one of the strangest things i ever heard about. Although, Triste is right. Our disorder must sound pretty loopy to some people too.

In any case, this seems to fall into the same arena as the whole pozz sensation that was sweeping the nation a few years ago. This being a person who wants to be infected with the AIDS virus.

I'm just imagining explaining to my family that i'd like to have my limbs amputated. Man, that is just bizzarro. (And yes, i'm perfectly comfortable with everyone else thinking my problems are bizzarro as well. God knows i do.)

s.


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## Guest (Mar 27, 2005)

Politically correct or not, I suggest for those of you are so afraid to tell your family members about your dp, etc....try telling them you have for a long time now been fighting powerful urges to sever one of your own limbs, and you feel your resistance is weakening. When they're calm enough to hear words again, tell them actually that's not true. But you do have a strange little symptom called depersonalization. They will be happy to hear all about it. grin

One of my analyst friends had only this to suggest: there is some similarity in the mindset between this disorder and any of the self-mutilating obsessions, such as the overwhelming compulsions to pull out one's hair or scratch relentlessly until scabs form on the scalp, etc....there is no itching, or any physical stimulus - the person is attacking their own body with a kind of compulsion - they feel they "HAVE TO" to do (similar to OCD compulsions of rituals, counting, etc. except in these cases the drives all center on body).

The person becomes convinced that they will feel tension relief ONLY once the body part is sufficiently attacked....they are chasing some unattainable state - as if ONLY when I've DONE THIS will I feel finally free. Oddly enough, some transexuals fall into this category - not all, but some. The urge is really not based on a desire or need to be the other sex/gender, but an obsession that the removal of an organ (or limb) will CHANGE them intrinsically, as if they need to "remove" the real pain, the real tension producer. Sadly, it's of course an illusion, so the transexual may feel NO better afterwards and often commit suicide.

Fascinating thread, though. I truly thought I was hard to shock, but this one tossed me, lol...


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## voidofform (Jan 31, 2005)

my shrink had a particular professional interest in the apotemophiles. "its an identity thing" he said. i.e. a pictured state in the mind that is "right" and "fits".

the brain can associate "good" and "bad" with anything given enough pressure through obsessing, one just needs to look at anorexia, or even the oddball that ocassionly turns up here looking for dp.

i am _certain_ i could be an apotemophile if i allowed myself to be and fed and grew the mindset. but that can of worms is NOT one i want to open.

as a post-op transsexual, i can definitely relate. this is how i believe my TSism formed, perhaps starting with idle curiousity about which side of the fence i belonged socially and physically, eventually snowballing into a unshiftable integral part of my identity. i can see the limb removal people developing along exactly the same path (with the obvious difference of it being purely physical for them).

by the way, the high suicide rates amongst post-op transsexuals, is due i believe to the depression that seems utterly rife in this population. virtually no-one expects surgery to change their life and fix their problems, but the fight to get and pay for it, does provide something to live for in the meantime. after surgery this focus is gone, the distraction is gone, leaving the residual depression to do its nasty work with the rest of life's 'little' problems.

my TS roommate attempted suicide 3 weeks after her surgery, classic major depression, complete with suicide note riddled with depressive cognition. i spoke to her afterward about it, and she confirmed that she was never under the illusion that the surgery would fix her depression.

it didn't fix my depression either, but there _is_ a huge sense of mental relief remaining that what had to be achieved was achieved and can never be taken away for me. being able to see myself in a mirror and not be utterly disgusted anymore is an incredible feeling.

for this reason i am an enthusiastic supporter of surgery for apotemophiles, provided that they have to fight reasonably hard to get it (in order to cement the "this is what i always wanted" mindset).


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## Guest (Mar 27, 2005)

VERy interesting, thanks for posting that.

I agree fully that a pre-operative transexual should have all the right in this world to go through with a chosen operation. But counseling is crucial - to help the person really determine if indeed, the disgust they feel at self is gender-based, or if that is a red herring, a trick of their own mind to attempt to "undo" something that seems like the source of self-hatred, only to later find out that wasn't it.

Different for each person - each TS person, like the rest of us, must be viewed on a case by case basis.


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## Dreamer (Aug 9, 2004)

Dear voidofform,
Like Janine I really appreciate your sharing your experience re: this.

I agree with Janine who said:


> Different for each person - each TS person, like the rest of us, must be viewed on a case by case basis.


Absolutely, this is my mantra, we are all unique.

voidofform I am curious by what you said:



> it didn't fix my depression either, but there _is_ a huge sense of mental relief remaining that what had to be achieved was achieved and can never be taken away for me. being able to see myself in a mirror and not be utterly disgusted anymore is an incredible feeling.
> 
> for this reason i am an enthusiastic supporter of surgery for apotemophiles, provided that they have to fight reasonably hard to get it (in order to cement the "this is what i always wanted" mindset).


So you are pleased with your transformation? You feel this has resolved _some_ issues for you?

I have about 8 million questions for you, but, could you say how long you felt the desire to change sexes? Was this from childhood? Do you feel there were any specific events in your life that contributed to this feeling -- some event/events, trauma? ... I don't even know what to ask...

They mention that the amputee disorder is something soemone knows since they can recall -- from childhood. Is this how you felt? Also, 99% of people I know who are gay for instance (and I know this is NOT the same as TS) say they felt that way since childhood.

Also, where do you think your DP fits into all of this? When did that come on? What do you think triggered it. Is it integral to your TS. I would imagine so, but could you clarify.

I'm sorry if you've written this up. I forgot to look in the stories section.

Thank you for posting. Interesting that there is such a huge spectrum of feelings we have re: our "SELVES" -- appearance, not feeling "right" in our own skin, etc.

And you certainly don't have to answer any of my questions, but I am fascinated by your experience. It takes courage to do what you have done, and to talk freely about it as well.

I have always believed (but what do I know?) -- from reading -- that there are indeed people who literally ARE in the wrong body sexually, and that being TS is not a pathology. Do you feel this way?

I hope none of these are idiotic questions, but I'd gather they are.

Thank You,
Dreamer


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## person3 (Aug 10, 2004)

I personally don't think it's ANYTHING like anorexia...

the person wanting to remove a limb still seems to be of normal self esteem; the person with anorexia is wanting to annihilate themselves whilst simultaneously remaining alive to experience delicious nothingness.


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## voidofform (Jan 31, 2005)

> Different for each person - each TS person, like the rest of us, must be viewed on a case by case basis.


absolutely.



Dreamer said:


> voidofform I am curious by what you said:
> 
> 
> 
> ...


it definitely has resolved some issues. i feel a great weight off my shoulders now in this respect. the transformation is incomplete of course, restricted both by available medical technology, but i can look at myself in the mirror now without the urge to destroy my reflection, which has to be a positive. socially its better too, but not perfect.

but having been such a huge part of my life for so long, now that its over and done, it has left me very empty and very unsure of myself, with a weak sense of self, which has brought out my schizoid traits - i.e. being alone in the world protects what sense of my identity i have left.

and depression has a neat little way of expanding problems to fill the available space.



Dreamer said:


> I have about 8 million questions for you, but, could you say how long you felt the desire to change sexes? Was this from childhood? Do you feel there were any specific events in your life that contributed to this feeling -- some event/events, trauma? ... I don't even know what to ask...
> 
> They mention that the amputee disorder is something soemone knows since they can recall -- from childhood. Is this how you felt? Also, 99% of people I know who are gay for instance (and I know this is NOT the same as TS) say they felt that way since childhood.


i'm happy to answer whatever questions you have. the earliest i remember vocalising anything to myself was around age 13-14. i remember being at school, watching the boys doing their thing, and the girls doing their thing, and being racked with jelously about being born in the wrong boat. i basically pulled away from socialising around this time, what friends i did have were mainly geeks, i guess i only felt comfortable around those without heavy masculine/macho behavioural traits (looking for some sort of mirroring?). at that stage girls didn't seem to want anything to do with me - they could sense i wasn't a "normal guy", which left me even more alienated and lost - "looking in from outside".

life went on regardless, and i grew up. attempted to bury it all, trying to be normal enough to make my way in the world, and put my "childish incompatible with the world fantasies" behind me. mananged to have a reasonable career. mid 20's depression set in, and by late 20's it began to eat me alive. everything began to remind me that i hated my role in society and my body and it became a literal "do or die" situation.

the really odd thing, is that despite a feeling that i was born in the wrong boat, i have turned out to be be a somewhat geeky tomboy. i enjoy messing with electronics, computers and cars as much as i enjoy clothes shopping for instance.

i don't recall any trauma, i had good parents (though they divorced when i was 8), a pleasant enough environment for upbringing etc.



Dreamer said:


> Also, where do you think your DP fits into all of this? When did that come on? What do you think triggered it. Is it integral to your TS. I would imagine so, but could you clarify.


i'm not DPd/DRd. i only turned up here when i was looking for a means to dissociate (depression fueled mental "suicide"). obviously DP is just worthless trash, and not the answer i am looking for, but i'm still here because you, Janine, Melissa, and dozens of others keep posting stuff that i find helpful to understand myself. i would like to help too, there are so many good people here suffering, but without insight there's not much i can realistically offer.



Dreamer said:


> I have always believed (but what do I know?) -- from reading -- that there are indeed people who literally ARE in the wrong body sexually, and that being TS is not a pathology. Do you feel this way?


it doesn't feel pathological. society makes it hard though. a thought experiment: if a "sex-change pill" was freely available, 100% safe, effective and reversible, providing a totally convincing change overnight, and society didn't disapprove, how many people would take it? i suspect LOTS.

supposedly there is two groups of TS people. the "primary" and "secondary", depending on what initial gender identity they formed, i.e. the primary people never thought of themselves as their birth sex, the secondary people on the other hand, revise their opinion of their gender later on, often early adolescence, though sometimes later.

i fit into the secondary category. these days though i've lost any solid definition i ever had of what makes someone inherently male or female mentally. at best they are statistical categories, with such broad overlap and diversity as to make them nearly worthless. i have little idea of what i am anymore.



Dreamer said:


> I hope none of these are idiotic questions, but I'd gather they are.
> Thank You,
> Dreamer


not at all. glad to be of interest.

my current area of intellectual interest is the similarities between schizoid and borderline personalities. are you interested in discussing this? (not that this forum is the place to do it...)


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## voidofform (Jan 31, 2005)

person3 said:


> I personally don't think it's ANYTHING like anorexia...
> 
> the person wanting to remove a limb still seems to be of normal self esteem; the person with anorexia is wanting to annihilate themselves whilst simultaneously remaining alive to experience delicious nothingness.


i only meant that as an example of how something seemingly abhorrent to most i.e. "annihilation" can be embraced as "wholly good" by some.

did your anorexia have anything to do with sense of achievement? a sense of having achieved something amazing, becoming special and unique and exotic?

i still remember the day i first hit 17.5 BMI and i become officially "anorexic" (by the APA standards). i was so proud of myself - prancing around the room grinning from ear to ear. didn't last long of course, and the next target of 17 was set almost immediately. probably a very good thing life got in the way, and i never made it to 17.

at the time i know i was attempting to feel weightless and free, i didn't realise it at the time, but yes, thinking about it - that's annihilation.

it was also a substitute for me for doing anything about my TSness.


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## person3 (Aug 10, 2004)

Yeah, it all is like you have described BUT...

it seems with TS and limb removal the person HATES themselves for some perceived object that they know can be operated on and that is just what they want. 
anorexics don't always have a weight goal (they might START with one, i didn't check my weight because of some weird OCD thing) but they don't say "i feel i have always really been a skeletal person" like a TS would say "I feel as if I have always been a man", etc. They are doing it to take everything away from themselves possible; to become another being with no regards to the self, while I think TS and people wanting to remove limbs still want the full life just in a different form. Anorexics don't want that. They want total control.


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## university girl (Aug 11, 2004)

Their brain chemistry is altered in some way ...... hehehe.... my explanation for everything.

Oh yeah, a psychologist told me they are going to put coffee withdrawal in the DSM.


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## voidofform (Jan 31, 2005)

person3 said:


> the person with anorexia is wanting to annihilate themselves whilst simultaneously remaining alive to experience delicious nothingness.


funny that this subject should crop up today. the following link just arrived in my inbox: http://www.tragleart.com/hunger.htm

food in this parable is of course a metaphor for any kind of pleasurable activity (including eating).

i thought that this might be of interest. it certainly resonates with crystal clarity to my life.

if you don't mind me asking, do you think your DP is driven by the same base need for the elegent perfect void?


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