Body Image: Anorexia, Bulimia...Cutting Off Your Arm?
By Dariyan Adams
“Off with his hand” used to be a common phrase overheard when individuals were caught stealing. Historically, amputation used to be a form of torture and is still used in some countries as modern punishment. Now try and imagine yourself having the desire to cut off your own arm! For some people this is their everyday. Apotemnophilia is the desire to eliminate a perfectly healthy limb from your own body. Individuals affected by this disorder may attempt to amputate their own limbs or damage the limb to the point where surgical amputation is necessary.
Now take a breath, because this disorder will most likely never be an issue for you. Many studies have been done to try and understand where this disorder stems from. Research has shown that damage to the right parietal lobe (in particular the right superior parietal lobule) causes this condition. The right parietal lobe is the area of the brain that receives and interprets information gathered by different parts of the body. One example would be your skin. The parietal lobe’s main function is to process sensory information. This portion of the brain is responsible for integrating sensory information from the hands, legs, feet, toes, and any other part of the body. This information helps your brain gain a sense of body image. Therefore, when there is damage to the right parietal lobe, it results in the brain being unable to form a unified body image. As a solution to this discrepancy the brain denies ownership of the limb.
Apotemnophilia is also known as body integrity image disorder (BIID), and can have lifelong effects. Individuals with this disorder are drawn to a specific limb and the constant need to remove it. You’re probably wondering if there is a treatment for this disorder. Currently there is no medical treatment available. However, often times, patients with Apotemnophilia become distressed, depressed, and anxious. Although this is saddening, there is some light at the end of the tunnel. Patients with this disorder can be treated with cognitive behavioral therapy and a selective serotonin inhibitor that can offer more stability. Selective serotonin inhibitors or SSRI’s effect the serotonin levels in the brain. SSRI’s block the reabsorption of serotonin in neurons which makes more serotonin available. This allows the transmission of messages between neurons to improve. Serotonin is an important chemical and neurotransmitter that plays a significant role in regulating an individual’s mood and social behavior. It is proven to help regulate and increase patient’s well-being. Selective serotonin inhibitors are also known as antidepressants, and are prescribed to patients with depression, anxiety, PTSD, and many other mental illnesses. Again, often times this won’t resolve the problem for individuals with Apotemnophilia, but it will give them some stability and normalcy in their life.
How devastating would it be to find out that Apotemnophilia will likely haunt you for the rest of your life? How would you feel if a doctor came back and told you that there was no treatment? Well, researchers are trying to resolve this issue by suggesting that there are clear similarities between Apotemnophilia and Somatoparaphrenia. Somatoparaphrenia, is caused when an individual has a right sided parietal stroke, usually the patient rejects their left arm as “alien.” Somato is defined as having paranoid delusions about your body. Because the two disorders are so similar, scientists are trying to test the hypothesis that cold-water vestibular caloric stimulation, which is known to temporarily treat Somatoparaphrenia, could also help treat Apotemnophilia. Vestibular caloric stimulation, simply defined, is using cold water to trigger the feeling of head rotation, like looking to the left or right. Rearranging how your inner ears function, makes it possible to change how your brain views an individual’s body image. Overall, this theory has not yet been proven to work, but is a possible option for patients dealing with Apotemnophilia.
A professor at Columbia University interviewed a 71-year-old man from California who has been living with this disorder his entire life. He talks about how the feeling has always been there, but it is more apparent at different times in his life. He suggests that when life gets more stressful the feeling is much more present, but when he is distracted it is more manageable. When asked to describe the feeling the patient stated that:
“It’s a strong feeling that I should have been born without my left leg. If I make eye contact with it and I’m not fully concentrating on something else, I obsessively think: This leg shouldn’t be there. And it’s very disturbing because I know that’s not normal. It’s like my brain perceives my body without a left leg.”
Imagine beginning to doze off and suddenly get an urge that your leg, just above the kneecap, needs to be removed. Or maybe you are talking to someone and suddenly unable to focus on what they are saying because you’re thinking about your leg and how you wish it wasn’t there. These are all situations that professor Michael got in response when he asked the patient how it felt to live with this disorder. Although this is not an extreme version, it still would be a constant battle to live with.
Overall, the disorder is gaining attention and researchers are trying to find a treatment. Whether they discover a solution or not, there is still a lot to learn about the disorder itself, and the area of the brain that it originates from. So take some time and think about how it would feel to not be afraid of losing a limb, but rather prefer it?
Resources
Brang, D., McGeoch, P. D., Ramachandran, V. S. (2008). Apotemnophilia: a neurological disorder. Cognitive Neuroscience and Neuropsychology, 19 (13), 1305-1306.
Healthline. Serotonin: What You Need to Know. https://www.healthline.com/health/mental-health/serotonin
Mayo Clinic. Cognitive behavioral therapy. https://www.mayoclinic.org/tests-procedures/cognitive-behavioral-therapy/about/pac-20384610
Mayo Clinic. Selective serotonin reuptake inhibitors (SSRIs). https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825
Ramachandran, V. S., Brang, D., McGeoch, P. D., & Rosar, W. (2009). Sexual and food preference in apotemnophilia and anorexia: Interactions between ‘beliefs’ and ‘needs’ regulated by two-way connections between body image and limbic structures. Perception, 38 (5), 775-777. https://doi.org/10.1068/p6350.
Ramachandran, V. S. & McGeoch, P. (2007). Can vestibular caloric stimulation be used to treat apotemnophilia? Medical Hypotheses, 69 (2), 250-252. https://doi.org/10.1016/j.mehy.2006.12.013.
Tsoulis-Reay, A. (Jan. 28, 2015). What it’s like to crave amputation. The Cut: New York Magazine. https://www.thecut.com/2015/01/what-its-like-to-crave-amputation.html