Subtract to be Whole

Is there a difference that matters between wanting to have your breasts or genitals removed and wanting to have your legs chopped off? Under what conditions is excision, extraction, and removal necessary for wholeness? Is this castration gone awry and if so how and why? What does it mean to find one's body alien and excessive?

In Rewriting the Soul, Ian Hacking considers the interconnections between some mental illnesses and their time. It appears that some illnesses depend on particular cultural practices and carriers in order to appear as illnesses. When these practices and carriers are no longer available, the syndrome might vanish or mutate into something else. So, there is a perhaps unexpected overlap between the trances of hysterics channeling spirits and multiple personality disorder. Both are carried by women (primarily) and induced (made to speak) via hypnosis.

I begin with Hacking because I've been wondering for a while now whether body integrity image disorder is somehow symptomatically interconnected with the present moment and if so how that moment and that interconnection might be understood. Body integrity image disorder involves the sense that one is not whole with the limbs one has and that to be whole requires that some of them be removed.

I started thinking about this after reading Carl Eliot's, "A New Way to Be Mad," in the Atlantic in 2000. I recall a line in the article to the effect that "I had always imagined myself as having two shiny stumps where my legs are." I also recall that those who wanted amputation were quite disgusted by their excess limbs--as if somehow they were compelled to live their lives dragging around a severed limb, an old, dead, foreign piece of flesh. Around the same time I read How We Became Posthuman as well as novel Hayles discusses, Limbo, by Bernard Wolfe. In this sci-fi, overtly freudian novel, people take disarmament seriously--and literally. And, there is of course a fantastic coincidence of opposites wherein the quads are most dependent and most powerful. Those who persist in baby buggies are sexually desirable and morally superior to those who go for extreme prosthetics.

I then started looking around for other accounts of amputees. I figured they would be more visible during and immediately after wars, but I didn't do any research to establish this. Flannery O'Connor's short story of desire, theft, and a prosthetic leg came to mind. Starship Troopers has at least one powerful amputee. And there is ampulove, a semi-pornographic site with information for amputees, wannabees (those with BIID), and devotees (those erotically attracted to amputees). Less extreme is amputee-online.

At any rate, one of my questions is what is making the desire for amputation more visible? Carl Eliot details some of the institutional factors I loosely grouped into the categories of 'carriers and practices' above:

Anyone with a rudimentary familiarity with the history of psychiatry cannot help but be struck by the way that mental disorders come and go. Conditions like social anxiety disorder, post-traumatic stress disorder, attention deficit-hyperactivity disorder, gender identity disorder, multiple personality disorder, anorexia, and chronic fatigue syndrome were once seen as rare or nonexistent, then suddenly they ballooned in popularity. This is not simply because people decided to "come out" rather than suffer alone. It is because all mental disorders, even those with biological roots, have a social component. While these new conditions are very different from one another, they share several important features.

First, the conditions are usually backed by a group of medical or psychological defenders whose careers or reputations depend on the existence of the disorder and who insist that the condition is real. Second, there is usually no hard data about the causes or the mechanism of the condition. Third, no independent lab tests or imaging devices are available to provide objective confirmation of the diagnosis, which is usually made solely on the basis of the narratives and behavior of their patients. Finally, there is often (but not always) a treatment for the condition even in the absence of knowledge about its causes and mechanism. The diagnosis of social anxiety disorder, for example, was driven by the development of profitable medications to treat it, such as antidepressant drugs.

Soon the new conditions are discussed in journals and at conferences; clinicians start to diagnose the disorder more and more commonly; the conditions themselves become part of popular discourse and are discussed in support groups, therapy sessions, Internet venues, and in articles like mine and films like Whole. Patients begin to reinterpret their own psychological histories in light of what they hear, and their behavior changes to match what is expected of people with the condition they believe they have. Often they diagnose themselves and decide on the proper treatment. "I want you to accept that this condition exists," Baz says emphatically in the film, "and that the only way it can be sorted out is surgery."

Perhaps, but this can only be determined through careful study. What needs particular attention are the reasons why some people come to be sexually attracted to amputees or to the image of themselves as amputees. The form paraphilias take differs not merely among individuals, but from one culture and historical period to another. When Richard von Krafft-Ebing was writing about paraphilias in 19^th-century Vienna, he described men who were sexually obsessed with handkerchiefs. That paraphilia has largely disappeared. Yet many others have emerged. What is it about our own time and place that has helped create an obsession with amputees?

By all indications, the number of people identifying themselves as wannabes is growing. Robert Smith, the Scottish surgeon, has six more acceptable candidates for amputation. A popular wannabe listserv, whose membership was 1,400 two and a half years ago, has 3,670 subscribers today. A group of clinicians at Columbia University has set up a Web site to provide information about the condition. They are redefining it as "Body Integrity Identity Disorder." In the meantime, psychiatrists are no closer to understanding the condition, and they are proposing no therapy other than amputation.

In looking at the emerging medical discourse on BIID one discovers that

The triggering event for this "disorder" appears to be the sight of an amputee at an early age. Many individuals can clearly recall the first amputee they saw resulting in a strong desire to have their own bodies modified in this way, and a sense of "recognition" of their unconscious desires. This may be as early in life as age 4 or 5.

Most individuals with BIID present a combination of the following symptoms:

1.    A feeling of “incompleteness" as a four limbed individual but a strong certainty that having an amputation would lead to feelings of "wholeness".

2.    A strong concept regarding the limb involved and the level of amputation desired.

3.    Feelings of intense jealousy at the sight of an amputee.

Is it possible that wannabees retroactively construct a narrative of origins in order to convince doctors to cut off the offending limb? Is it possible that they install a false certainty into their image of their stump in order to assure doctors that they won't sue them for malpractice?

And, outside these factors intrinsic to medicine/psychiatry, what might be larger cultural factors contributing to the visibility of wannabees now? BIID has appeared on television shows--Nip/Tuck and last night's Prime Time Live (I think that's the name). And, as Eliot mentions, there is the movie, Whole.
Is it possible that BIID has legs, as it were, because it clicks on the way that consumer culture is excessive but not whole? Is it a way of experiencing the body as non-All, as not everything because incomplete?

Comments

[Keith]

Jodi - you might be interested in the films of Matthew Barney here. The last installment of his *Cremaster Cycle* has an amputee as a main character, and *Drawing Restraint 9*, which just entered commercial release in NY, has Barney and his wife Bjork severing each other's legs at some point during the film:
http://www.artforum.com/diary/id=10715

[hugh]

Possibly related, in a converse way, is the way that people adjust to prosthetics. I have heard -- somewhere reputable, I think, but I have no idea where -- that part of successful adaptation to a prosthesis is managing to assimilate it as really part of one's body. One technique that I have heard of is imagining that one has a ghost limb retracted in one's stump, which one can extend into the prosthesis once the prosthesis is in place. People have rituals to do this (rapping on the stump, for example).

The connection I'm trying to draw is that the people with this disorder sound like unsuccessful prosthesis users.

[Evan]

Also along the lines of mysterious illnesses that sweep into the culture at a particular time, take the example of the hikikomori in Japan - young people (men mainly I think) who live as virtual shut-ins, perhaps with occasional forays to the supermarket at night for frozen food sustenance. Perhaps we could connect this to the amputee's as a "cutting-off" of the person's mobile trajectory. Is this part of post-human (d)evolution in which we are morphing into limbless shut-ins, fit only for sitting in front of computers and plugging into virtuality?

See Maggie Jones article in NY Times 1/15/06, "Shutting Themselves In."

Evan

[David]

What if the opposite tendencies have something do with the irreconcilable conflict between the desire for imaginary wholeness and its transgression by way of bodily mutilation? I think one can read all this in terms of the fine line that a neurotic threads between alienation and separation, the desire of coming to fully conform with one's ideal ego and a desire to destroy the ideal so that the space of desire & lack remain open. Freud's "Rat Man" spends his life conforming to what he interprets are his father's desires (embodied in the metonymic chain spun from the 'Ratte' signifier) and yet keeps having these dreams of cutting his little finger so it hangs only by a thread. The closer he comes to unconsciously satisfying the father's wishes, the bigger sacrifice of the proverbial pound of flesh is exacted from him. Talk about the superego paradox.

[Bill Wilson]

The brain has a lot on its mind. In a neurological study I read decades ago, a patient was described who had earlier suffered amputation of his left leg from the knee down. He felt phantom pain in the phantom section of his left leg, in effect receiving messages from part of his body that wasn't there. Later he suffered a cerebral infarction, the kind of stroke called "left-neglect," because the victim of that specific stroke denies that he or she has a left side. After the left-neglect stroke, this patient with a leg amputated from the knee down denied that he had a left side, but said that he had his left leg from the knee down, because he felt pain from it. I was lightly acquainted with Lincoln Swados, an amputee, whom I suspected of having amputated his leg and arm, though I didn't ask. My guess was that he was punishing himself because his sexuality pained his father. In one conversation, he said that he was sexually pleased only if he felt that he was desired in spite of his condition. Your post suggests that he might have been desired because of his condition. Following the body as a construction of images, he also, if he had cut off his own right leg, had become unable to put his best foot forward. The body is a poem, but often a bad poem, with parts of the body like literary images that can convey ideas if they are read correcty. To render oneself unable to dance is a philosophic condition: "I won't dance, Don't ask me." Perhaps self-amputees should grant a hearing to the challenge of another song: "Let's face the music, and dance."

[ROZ]

in regard to "bill wilson's" posting of april 8, 2006.
specifically in regard to lincoln swados, who i knew from late grade school.
most unfortunately, it turns out lincoln was a schizoprehenic and was quite disabled. during one of his "episodes," he threw himself under a subway, which resulted in his leg and arm being severed. i don't think he was looking to be amputated, but rather to kill himself.

[Daniel Kojta]

Interesting article. I am having an interesting time developing prosthetic aesthetics, both physical and psych. The work is part of a very interesting project you will all enjoy. Ubiquitous computing etc.
See: www.anat.org.au/reskin
Enjoy. Dan.