Effects of Psychotherapy on Patients Suffering from Body Integrity Identity Disorder (BIID)

Abstract

People suffering from Body Integrity Identity Disorder (BIID) feel the intense desire for a physical disability (e.g. amputation or palsy of a limb). The suffering is caused by a divergence between their intact real body and their desired mental self-image of a disabled person. Aim of this pilot-study was to answer the question, whether psychotherapy can help to prevent the desire for amputation or palsy. Methods: A questionnaire was developed to investigate experiences with psychotherapy in BIID-patients. These people were asked about the success of different psychological and psychopharmacological types of therapy. Respondents stated whether they experienced an increase or decrease of their desire for amputation or palsy due to the specific kind of therapy and to what extent their psychological strain had been changed after therapy. Results: BIID is a very rare disturbance; still 25 people were investigated in this study. 32% had psychopharmacological treatment, 24% had cognitive behavioral therapy, 20% psychodynamic therapy, 20% had trained a relaxation technique, 8% had counseling therapy and 4% had experiences with art- and body-centered exercise therapies. In contrast to our hypothesis, all therapy-methods tended to cause an increase of the desire for obtaining a disability. A higher number of therapy sessions was positively correlated with an increased desire for an amputation, paralysis or other disability. On the other hand, the psychological strain in relation to BIID was reduced by all types of therapies; the highest reduction could be reached with psychodynamic therapy. Conclusion: Psychotherapy can reduce the psychological strain in BIID affected persons. The fact that the desire to obtain a disability increases during the therapy is explained as a result of an intense exchange about BIID with the therapist.