In limbo: dealing with extreme body dysmorphia
A particularly extreme form of unhappiness with body form is the overwhelming feeling that a healthy limb or digit is an alien extension that doesn't belong to the body. This feeling is accompanied by a desperate desire to have the alien limb amputated.
A woman featured on a BBC Horizon documentary commented: “Everything about my life is ordinary, except this one aspect and it's very hard to fit that in to the rest of my life. My legs are extraneous. They shouldn't be there, they don't feel, it doesn't feel right that they extend beyond where I feel my body should end.”
The condition poses a dilemma to doctors - should they go along with a patient's wishes or refuse, on the grounds that the limb is healthy?
The condition came to the attention of the media in the late 1990s, when Robert Smith, a consultant surgeon in Scotland, amputated the healthy legs of two patients, at their request. He justified the procedures, saying there was a risk that the patients would seek backstreet amputations or intentionally injure themselves. He subsequently wrote a book on the subject with one of the patients.
By analogy with BDD, where surgery does not resolve dissatisfaction, amputation may not be the right approach (though surgery appeared to resolve the problems of Dr Smith's patients). On the other hand, the condition could be likened to transsexualism, where gender reassignment surgery is deemed acceptable.
