Now that the Atlantic Monthly has made its online archives freely accessible, I can link to the most disturbing magazine article I have ever read, about people who have an irresistible compulsion to become amputees, feeling incomplete in their completeness. Obviously this raises questions about identity, about what makes people believe they are trapped in the wrong sort of body.
Like Robert Smith, I have been struck by the way wannabes use the language of identity and selfhood in describing their desire to lose a limb. "I have always felt I should be an amputee." "I felt, this is who I was." "It is a desire to see myself, be myself, as I 'know' or 'feel' myself to be." This kind of language has persuaded many clinicians that apotemnophilia has been misnamed—that it is not a problem of sexual desire, as the -philia suggests, but a problem of body image. What true apotemnophiles share, Smith said in the BBC documentary, is the feeling "that their body is incomplete with their normal complement of four limbs." Smith has elsewhere speculated that apotemnophilia is not a psychiatric disorder but a neuropsychological one, with biological roots. Perhaps it has less to do with desire than with being stuck in the wrong body.
It strikes me too as a parable of freedom, the paradox of choice taken to a logical extreme -- if limiting options potentially liberates us, why not remove limbs and really limit our options, really put an edge on everyday activities we take for granted?
Seeing the internet as a vector for spreading the kind of identity confusion that leads to self-amputation, the article also poses the question, "Can the mere description of a condition make it contagious?" So read at your own risk.