Helena De Preester

Body integrity identity disorder (BIID), formerly also known as apotemnophilia, is characterized by a desire for amputation of a healthy limb and is claimed to straddle or to even blur the boundary between psychiatry and neurology. The neurological line of approach, however, is a recent one, and is accompanied or preceded by psychodynamical, behavioural, philosophical, and psychiatric approaches and hypotheses. Next to its confusing history in which the disorder itself has no fixed identity and could not be classified under a specific discipline, its sexual component has been an issue of unclarity and controversy, and its assessment a criterion for distinguishing BIID from apotemnophilia, a paraphilia. Scholars referring to the lived body—a phenomenon primarily discussed in the phenomenological tradition in philosophy—seem willing to exclude the sexual component as inessential, whereas other authors notice important similarities with gender identity disorder or transsexualism, and thus precisely focus attention on the sexual component. This contribution outlines the history of BIID highlighting the vicissitudes of its sexual component, and questions the justification for distinguishing BIID from apotemnophilia and thus for omitting the sexual component as essential. Second, we explain a hardly discussed concept from Maurice Merleau-Ponty’s Phenomenology of Perception (1945a), the sexual schema, and investigate how the sexual schema could function in interaction with the body image in an interpretation of BIID which starts from the lived body while giving the sexual component its due

This article argues for a more rigorous distinction between body extensions on the one hand and incorporation of non-bodily objects into the body on the other hand. Real re-embodiment would be a matter of taking things (most often technologies) into the body, i.e. of incorporation of non-bodily items into the body. This, however, is a difficult process often limited by a number of conditions of possibility that are absent in the case of ‘mere’ body extensions. Three categories are discussed: limb extensions/prostheses, perceptual extensions/prostheses and cognitive extensions/prostheses. For each category, a distinction between extensions and incorporations is proposed, and the conditions of possibility for real incorporation are discussed. These conditions of possibility differ in each category, but in general they ask for radical or fundamental alterations not only in the motor and/or sensory or cognitive constitution of a human subject, but also in his or her subjective experience.