What is "apotemnophilia"

n. (context psychology English) A compulsion to become, or appear to be, an amputee.

Apotemnophilia is a neurological disorder characterized by the intense and long-standing desire for amputation of a specific limb, a need to become paralyzed, blind or deaf. another more recent term for it is body integrity identity disorder (BIID) in which otherwise sane and rational individuals express a strong and specific desire for the amputation of a healthy limb or limbs. Apotemnophilia has features in common with somatoparaphrenia. Some apotemnophiles seek surgeons to perform an amputation or purposefully injure a limb in order to force emergency medical amputation.

A separate definition of apotemnophilia is erotic interest in being or looking like an amputee. This separate definition should not be confused with acrotomophilia, which is the erotic interest in people who are amputees. Apotemnophilia was first described in a 1977 article by psychologists Gregg Furth and John Money: "Apotemnophilia: two cases of self-demand amputation as paraphilia." More recently (2008), V.S. Ramachandran, David Brang and Paul D. McGeoch have proposed that it is a neurological disorder caused by an incomplete body image map in the right parietal lobe. However, the notion of a body image map localized to one area of the brain is not supported by contemporary neuroscience.

The parietal cortex has widely distributed functional neuronal networks, and the prospect that the body image in the brain could be localized to some specific cerebral location has not stood the test of time, with our changing views of neural activity and integration. From the neuroanatomical point of view, there can be no strict localization of the perceived body.

The study carried out David Brang, Paul McGeoch and V.S. Ramachandran in 2008 was only able to work with two subjects. In 2011 Paul McGeoch et al. published the results of an experiment in which they were able to obtain MEG images of the parietal lobes for four research subjects, three of whom desired amputation. McGeoch and his co-researchers concluded that the images suggest "that inadequate activation of the right superior parietal lobe (SPL) leads to the unnatural situation in which the sufferers can feel the limb in question being touched without it actually incorporating into their body image, with a resulting desire for amputation."

Michael First, a psychiatrist at Columbia University, has pointed out that the theory advanced by Ramachandran and his colleagues fails to account for the fact that people who desire amputation of a limb sometimes change their preference as to which limb they would like to have amputated.

In 2011 a group of researchers at the University of Southern California (Brain and Creativity Institute) proposed an alternative hypothesis. These researchers proposed that "individuals with BIID may have a discrepancy between the commands from the motor cortex to the parietal lobe and from the sensory feedback to the same regions in the parietal lobe." This theory was based on the discovery that individuals who desire amputation sometimes experience phantom limbs after amputation.