![]() ![]() Most influential was the large-scale survey by First (2005), in which the term “body integrity identity disorder” (BIID) was coined. Later on, the psychiatric literature has described the desire for amputation as a paraphilia ( Money et al., 1977 Everaerd, 1983) and around the turn of the century as an identity disorder focusing on one’s body configuration (“amputee identity disorder,” Furth and Smith, 2000 Smith, 2004). Several authors cite the eighteenth century case of a man who enforced the amputation of a leg from a surgeon at gunpoint ( Johnston and Elliott, 2002 Hilti and Brugger, 2010). While the term “xenomelia” is new ( McGeoch et al., 2011), the condition is not. Xenomelia: A Disorder of Bodily Self-Consciousness We propose a social neuroscience of xenomelia that unifies neurological, psychological, and sociological approaches to bodily self-consciousness. ![]() In this article we will review work on xenomelia, one variant of the normal relationships between body and self, that is the desire of a healthy individual to have a fully functional limb amputated. ![]() It is constantly compared with others’ relationships to their bodies and evaluated against cultural norms about bodily appearance. However, an individual’s bodily self-consciousness is not fully predefined by genes and neural circuits. In times when an author can barely write about cognition without emphasizing its “embodied” aspects, it seems especially compelling to consider body-brain interactions in the field of consciousness studies or the cognitive neuroscience of “the self.” In fact, philosophers and scientists agree that knowledge about how the brain processes bodily sensations and plans executive action is key to the understanding of the experience of being a conscious self ( Blanke and Metzinger, 2009). This integrated view of xenomelia will promote the subfield of consciousness research concerned with the unity of body and self. A proper social neuroscience of xenomelia respects the functional neuroanatomy of corporeal awareness, but also acknowledges the brain’s plasticity in response to an individual’s history, which is lived against a cultural background. We propose that full insight into what should be conceived a “xenomelia spectrum disorder” will require interpretation of individual symptomatology in a social context. The present article outlays both mind-based and brain-based views highlighting their shortcomings. Formerly labeled “body integrity identity disorder” (BIID), the condition was originally considered a psychological or psychiatric disorder, but a brain-centered Zeitgeist and a rapidly growing interest in the neural underpinnings of bodily self-consciousness has shifted the focus toward dysfunctional central nervous system circuits. ![]() Xenomelia, the “foreign limb syndrome,” is characterized by the non-acceptance of one or more of one’s own extremities and the resulting desire for elective limb amputation or paralysis. 6Caulfield Pain Management & Research Centre, Caulfield Hospital, Caulfield, VIC, Australia.5School of Psychology and Psychiatry, Monash University, Clayton, VIC, Australia.4University Hospital of Child and Adolescent Psychiatry, University of Bern, Bern, Switzerland.3Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland.2Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland.1Neuropsychology Unit, Department of Neurology, University Hospital Zurich, Zurich, Switzerland.Peter Brugger 1,2,3*, Bigna Lenggenhager 1,4 and Melita J. ![]()
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