Paralyzed by desire: a new type of body integrity identity disorder

Cogn Behav Neurol. 2012 Mar;25(1):34-41. doi: 10.1097/WNN.0b013e318249865a.

Abstract

Background: Body incongruity in body integrity identity disorder (BIID) manifests in the desire to have a healthy limb amputated. We describe a variant of the disorder: the desire to become paralyzed (paralysis-BIID).

Method: Sixteen otherwise healthy participants, recruited through Internet-based forums, websites, or word of mouth, completed questionnaires about details of their desire and accompanying symptoms.

Results: Onset of the desire for paralysis typically preceded puberty. All participants indicated a specific level for desired spinal cord injury. All participants simulated paralysis through mental imagery or physical pretending, and 9 (56%) reported erotic interest in paraplegia and/or disability. Our key new finding was that 37.5% of paralysis-BIID participants were women, compared with 4.4% women in a sample of 68 individuals with amputation-BIID.

Conclusions: BIID reflects a disunity between self and body, usually with a prominent sexual component. Sex-related differences are emerging: unlike men, a higher proportion of women desire paralysis than desire amputation, and, while men typically seek unilateral amputation, women typically seek bilateral amputation. We propose that these sex-related differences in BIID manifestation may relate to sex differences in cerebral lateralization, or to disruption of representation and/or processing of body-related information in right-hemisphere frontoparietal networks.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Amputation / psychology
  • Body Dysmorphic Disorders / diagnosis
  • Body Dysmorphic Disorders / psychology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Paralysis / psychology*
  • Paraphilic Disorders / psychology
  • Sex Characteristics