Tuesday, June 17, 2008
Got to give 'em a hand for trying
Science is still in its kindergarten stage, and religion is in its geriatric stage. Can someone ship us some solid grown-up humans, please? (Kirk? Picard? Y'all out there?!?)
Read: "Cutting Desire: A rare condition compels its sufferers to want to amputate, or paralyze, their own healthy limbs. Inside the strange world of what sufferers call Body Integrity Identity Disorder." It came up in a thread where someone wondered why God doesn't appear to ever heal amputees.
I wish Dr. ER hung around here more often, experimental psychology, and the connections between brain parts and behavior, being her forte. I find the following fascinatin':
They've only been able to conduct three brain scans on those with BIID, so far, but in those, they have found some variation in the right parietal lobe, the area of the brain responsible for creating a "map" or the image of where one's body exists in space. "What's suggested from this is that because of this dysfunction in the right parietal lobe, this sense of unified body image isn't formed," says McGeoch. "The senses don't coalesce. So, for a leg, for example, they can feel that it's there but it doesn't feel like it should be there. It feels surplus. Something's gone wrong."
So, got any surplus parts you don't talk about?
To me, this information gives a general idea of the mechanics behind a specific problem, implies that there are a few good directions of inquiry, and gives hope that some sort of treatment might someday be available.
As Doc put it the other day, science can explain how. Science cannot explain why.
Neither can religion, or the spiritual-philosophical way, actually. But it can at least ask the question. And I am comfortable with the answers being more questions.
I don't think science is equipped even to pose the why question, and it seems to me that science is averse to the idea that something can't ultimately be "settled."
And so, to insist that they continue lugging around an unwanted limb would be akin to forcing someone to carry around a cement block and keep pretending it's a leg.
Or forcing someone to keep lugging around society's expectations-understanding of natural sexual orientation, even if it seems as invasive of oneself as an unwanted leg.
This opens up an amazing kettle of ethical and moral fish, this story does.
What would a spiritual answer be to a suffer of BIID. What should a pastor say to someone contemplating cutting of a foreign body part just like it was a giant mole? Got any Biblical text to address this one?
As a pastor, though, if asked, I might quote the verse referring to the body as the temple of the Holy Spirit. But only if pressed.
Similar admonitions to me when I was a young'un did not keep me from dipping Skoal and Copenhagen. Preacher told me once that taking a dip was like wheeling a wheelbarrow full of manure up to the front door of the church and dumping it in.
First, kudos on the cool topic. I have treated two patients (that I know of) with this illness. It is quite unique it its “pure” form, which constitutes a feeling that the offending limb does not belong on one’s body, but that the rest of the body is just fine. A pure state of the disease should not have any desire for self mutilation. There are likely many who are labeling themselves as having BIID who are suffering from psychosis or severe, chronic decompensations of underlying personality disorders. I’ll limit my thoughts to the “pure” state of BIID:
1. Could people please stop referring to the DSM-4 as “the Bible” of the psychiatric profession? No one should use the bible this way!
2. It’s unusual that the sufferers wish to be included in the DSM. This inclusion gives BIID official status as a “mental illness.” Compare that to those diagnosed with Gender Identity Disorder, many of whom want the diagnosis removed from the DSM.
3. Does the slippery-slope argument hold water regarding the so-called normalization of sex change surgery? That is, will we be defining amputations as rational treatment for people who should not be normally with functional limbs (per their self definition)? Or will we move back towards redefining sex-change operations as treatment of mental illness?
4. I believe “pure” BIID is primarily neurogenic, and is also very similar to alien hand syndrome- another sensory (and movement) illness where the limb (arm or leg) “behaves” independently from the rest of the conscious brain. It usually occurs in the non-dominant hand. The right parietal are of the brain is the area that manages the withdrawal and excitability motor responses. In alien hand syndrome, parietal involvement causes a hand to retreat, and has a higher level of discomfort. I hypothesize that a similar sensation occurs in BIID, without the motor activity.
5. DrLobo: “If a person were born with three arms, or a tail, we wouldn't think twice about them cutting it off would we?” We might, if we thought it was acceptable or preferable. Consider the eight-limbed girl in India, named Laxmi,. Many there claimed she was an avatar of the goddess Laxmi, and didn’t want the limbs removed. (They were in November, much to the two year old’s confusion and after a lot of debate.)
Uno, re: "Well, now, I guess I have to write a new post on my blog about cats, cigars, steaks and tornadoes!"
Uh, do what?
Two-o. I just added you to my Blogroll. I thought I'd done to previously!
Three-o. I never heard of Koop until I saw that video at yer plasce, and I've since bought the CD with "Koop Island Blues" and it fits my new Baby Car, and the soundtrack playing in my head as I drive it, to a T. Believe it, or not. :-)
Sorry, was obtuse in my approach: was alluding to the fact that your post was on one of my favorite topics (neuropsychiatry), so I'd offer quid pro quo, by appropriating some of your favorite topics. I forgot baby car.
Thanks for the add.
Glad you like Koop- I listen quite a bit to the "chill-out" genre, especially with sultry female vox. Explains my, um, preoccupation, with Ms. Norah Jones.
Agreed. In a way that exception proves the rule. Most of the world stood amazed that they would even think about leaving the extra limbs intact. Of course economics sometimes intervenes as well, such as in the JoJo the Dog Face Boy and
those who deformity make them excellent "beggars".
Who should have the right to tell me what to do with what I have determined to be my body, besides me? I agree it is a slippery slope to euthanasia, "easy" abortion, willy-nilly sex-change operations (oh, what a turn of phrase, especially is referring to male-to-female changes!) and other things people really don't want to have to deal with.
And to the question of whether I have any unwanted body parts? Nah. I got rid of those in the divorce from my husband-wanna-be-wife in 1990.
...and nothing has been said about the possibility of treating the perception (reasearch to figure out if the mechanics of the brain can be adjusted to bring perception in line with reality).
I dont think it's out of line to ask this, given some of the research being done WRT autism and the hope that one day functionality not possible for people with autism can be one day be possible for them.
Whether or not a person "feels" like the limb is part of their body...if certainly is.
And I DO think that gender reassignment is appropriate for this discussion, because perhaps some day we will be able to adjust a person's perception of their gender...rather than changing their gender.
Which would be more invasive...changing a person's physical gender, or changing their personally percieved gender?
Which would be more invasive? Removing a leg that is not percieved as part of the body, or changing the perception of the body to include the leg?
It's pretty invasive to medically change one's perception of oneself -- because that would be, in my opinion, actually, changing the self itself.
Point: I don't think these people are saying that they feel a limb is not part part of their body; they're saying that it there when it should NOT be.
Which is why this is about science, and medicine, and psychology, and ethics, and morality, and for those who dig it, religion even. And, it's about liberty.
We should be glad that all our parts seem to be in the igth place, and on the right bodies, those of us at peace about such.
"It's pretty invasive to medically change one's perception of oneself -- because that would be, in my opinion, actually, changing the self itself."
Yet most people think nothing of changing one's self from a person who is depresed and suicidal by taking medication that changes our perception.
Most people have a change in perception over time...even an intentionally induced one via, say education.
Or an involuntary one via an intervention or even involuntary comittment and treatment if it is seen a being necessary for the well-being of the person.
Im just wondering what is the difference...not advocating anything.
Very few of us stay the same person our whole lives.
That's an interesting idea itself. If someone were to ask, I'd say I am the same self I've always been, but I've changed. :-)
Hoo boy. On interventions. Mixed feelings on 'em. Used only to keep someone from going off a cliff, I guess, OK. But not to stop someone from driving 90 mph toward a cliff. Not to keep someone from dancing at the cliff's edge. Not to keep someone from hanging by their toes from the cliff. Trick is to catch 'em as they launch but before they get too far.
I guess the peeps in the story did say they had "tried everything" to deal with their perceived problem, that is, their problem. Maybe tinkering with their brain might make sense. But I just keep thinking of Jack Nicholson in "Cuckoo." Shudder.