It's a bizarre and rare disorder, but its consequences can be horrific. One man with body integrity identity disorder (BIID) dumped his lower leg in dry ice for several hours until doctors were forced to amputate. Others have resorted to wood chippers and gunshots to do away with healthy limbs they never wanted. Now a study of four men with BIID suggest their condition is linked to reduced activity in a brain area involved in forming a mental body map.
The disorder, also known as apotemnophilia, was first described in 1977 by the American sexologist John Money. He classified it as an intense sexual desire to have an amputation, hence its original name, which is Greek for love of amputation. Most patients, however, don't describe their desire to be amputees as sexual, says Michael First, a psychiatrist at Columbia University in New York who has conducted extensive interviews with dozens of patients. "It's very, very rare," First says of all forms of the disorder. "I've been working on this condition now, researching it for 8 years, and I almost never get calls from therapists saying 'I have somebody with this. I need your advice.' "