Identity or Pathology?

this is the second post relating to an article in the Atlantic Monthly about the desire to become and amputee (not for the faint of heart - not graphic, but pretty diturbing, to me at least)

One of the issues raised in the article is concerning identity. At what point does the desire to physically makeover your body stop being a quest for identity and start to be a mental illness? Tattoos, piercing, genital mutilation (surgical), rhinoplasty, liposuction, sex reassignment, amputation - is there a line? Is the otherwise “normal” person who wants two healthy legs amputated any more disfuntional and ill than the girl who wants her entire body covered in tattoos, or the guy who wants to pierce one ear? Is it an identity issue, a control issue, a pathology? How does a person decide for someone else and should they?

Wow. That is one bizarre article. I have no idea whether there is any hard and fast line that can be drawn, but my initial WAG would be to place it where normal physiological functioning becomes impaired to an appreciable degree. Tattoos? Fine. Pierce your tngue? Icky, but still fine. Cut your legs off? Umm… Get help.

Yes, I agree this is a very bizarre article; I’ve only skimmed the first part to date. Anyway, I’m guessing lots of surgeons would feel they were breaking the Hippocratic oath not to do harm if they were to amputate a person’s limb(s) for no other reason than that the patient doesn’t “feel like him or herself” with the limb(s) attached. What if such people simply looked at a trompe l’oeil photograph of themselves which made them appear to be an amputee? A lot less painful and the illusion may work for them. Also, they would save lots of money vs. an elective surgery that no insurance company will cover.

I went and looked at a couple of devotee and wannabe sites - very creepy. I’m not even going to post links.

Anyway, the one thought I had that was not brought up in the article was one of control. Your body is the one thing you absolutely own and no-one can tell you what to do with it - up to amputation of a healthy limb (okay, probably other exceptions too, but for the sake of argument…). You can paint it, pierce it, put stuff in it, shave it, change it’s weight, brand it, and surgically alter it. As more and more aspects of people’s lives are controlled and protected, are some people making these changes just because they can? Is it the only thing they feel they have power over in their lives? Is it their only way of making a mark on their world?

I suppose that since everything else is okay, amputation is likely to be the next body art fad. Someone (I can’t remember where I read it or I would give them credit) brought that up just recently in a thread. She was suggesting earlobes, finger joints, etc., but as icky as most of it seem to us old people, what are the next generation of teenagers going to think about it?

Wow, I don’t even know how to respond to that. That is a damn interesting thought.

[Superduper nitpick]

The Hippocratic Oath does not contain the primum pro nocere (first do no harm) clause. Most doctors nowadays don’t pledge to the Hippocratic Oath because it contains some bizarre and controversial type things. (Don’t treat the dying, you must treat other doctors’ sons for free, no abortion, etc.)

I feel that this phenomenon is an extreme example of “fashion” or “fad.” I also believe it is part of human nature, which is now sped up with more contact between people.

These body dysmorphic syndromes (which include bulemia and anorexia) are a good example. You can watch how the border between “individuality” and “pathology” fluctuates. Marilyn Monroe was beautiful at a size 14 just 40 years ago, and today Anna Nicole Smith is viewed as a cow.

I believe all people are suggestible, at least at some subconscious level. Everybody has certain beliefs, and they can easily become positively reinforced by suggestion. Not only does this occur both upfront (like amputee devotee websites) but also in the communal subconscious. (this thing was never described before 1977, and now it is taking off…)
And memories adapt to fit current thoughts. Suddenly, previously unknown or far marginalized behavior becomes mainstream or closer to it. (Look at piercings and scarification for instance).

This is not to pass a value judgement on marginalized behavior. Society has some bad taboos which need to be abolished. It is just that with the current age of communication, the bad and the good both get brought out into broad daylight.

Wow. Just spent some time reading the article you cite. Double-icky.

Anyway, to make a WAG at your question, I tend to fall back to a previously-prepared position: survivability. My pierced ear does not interfere with my ability to run away from predators; it’s an identity thing. The desire to modify one’s body to make it less likely to survive in extremis is indicative of a mental illness.

Just my unqualified opinion.

Okay, if we are talking survivability, any surgery requiring the use of anesthetic carries a risk of death or debilitating damage. There is also a risk of contracting diseases you wouldn’t otherwise be near just from being in the hospital, like antibiotic-resistant staph infections. Wouldn’t that drop non-essential cosmetic surgery into the mental illness category? Basically, it is someone saying they would rather risk death and brain damage than have this shape nose, or cellulite. Sure, after a successfully completed surgery they are not debilitated in any way, but why would people considered normal prefer the risks of unnecessary surgery to living with a bumpy nose or saggy eyelids?

(please note I am speaking of unnecessary surgeries only - not reconstructive theraputic ones)

I find the trend, and the desire, deeply disturbing. I think that in many cases it might well be an indicatin of a serious psychological pathology. However, I cannot justify to myself any blanket policy which would prevent an adult of sound mind (disregarding questions about this one particular desire) from choosing to self-mutilate in whatever manner they choose.

I ended up considering it as something very similar to gender reassignment surgeries: get counseling, demonstrate the firmness and constancy of the desire, show an understanding of all risks involved, and change your body as you will.

It’s really not any of my business.

I do have questions about access to social aid programs designed to assist the disabled, but that seems more of a regulatory concern than a proscriptive concern.