Paul D. McGeoch, a visiting scholar at the Center for Brain and Cognition at the University of California, San Diego, answers:
Certain people hold a deep desire to amputate a healthy limb. They are not psychotic, and they fully realize that what they want is abnormal. Nevertheless, they have felt from childhood that the presence of a specific limb, usually a leg, somehow makes their body “overcomplete.” Ultimately, many will achieve their desired amputation through self-inflicted damage or surgery.
During the past few years my work with neuroscientists Vilayanur S. Ramachandran of U.C.S.D. and David Brang of Northwestern University, along with research by neuroscientist Peter Brugger of University Hospital Zurich in Switzerland, has transformed our understanding of this condition. Our findings suggest that a dysfunction of specific brain areas on the right side of the brain, which are involved in generating our body image, may explain the desire.
Bizarre disorders of body image have long been known to arise after a stroke or other incident inflicts damage to the right side of the brain, particularly in the parietal lobe. The right posterior parietal cortex seems to combine several incoming streams of information—touch, joint position sense, vision and balance—to form a dynamic body image that changes as we interact with the world around us.
In brain scans, we have found this exact part of the right parietal lobe to activate abnormally in individuals desiring limb removal. Because the primary sensory areas of the brain still function normally, sufferers are able to see and feel the limb in question. Yet they do not experience it as part of their body because the right posterior parietal lobe fails to adequately represent it. The mismatch between a person’s actual physical body and his or her body image seems to cause ongoing arousal in the sympathetic nervous system, which may intensify the desire to remove the limb. Given that sufferers date these feelings to childhood, the right parietal dysfunction most likely is congenital or arises in early development.
Based on our research, we have proposed the name “xenomelia” for the condition, which comes from the Greek for “foreign” and “limb.” The study of this condition has served to illuminate how the normal human brain functions and how body image emerges in us all.