Incarnation and animation: physical versus representational deficits of body integrity

Abstract

Hilti, L; Brugger, P (2010). Incarnation and animation: physical versus representational deficits of body integrity. Experimental Brain Research, 204(3) AbstractTwo apparently disparate phenomena of defective body integrity are reviewed. The first concerns dysmelia, characterized by the congenital absence or deformation of limbs, and the focus of the review is on phantom sensations of people with this kind of physical integrity disorder. The second phenomenon consists of non-psychotic individuals' desire to have a healthy limb amputated, which is interpreted as a mismatch between the physical integrity of a particular limb and its representation in multimodal cortical areas of the brain. We outlined commonalities and differences between the two conditions and note the absence, in both areas of research, of a unified theory that would account for the reported phenomenology. Phantom limbs in dysmelia and the desire for limb amputation most likely are the consequence of very early developmental dissociations between physical and phenomenal body shapes. They are mirror images of one another in that the former constitutes an "animation without incarnation" and, the latter, an "incarnation without animation". Keywords-body integrity identity disorder (BIID) -paraphilias -parietal lobes -body image, body schema -borderlands of psychiatry and neurology 2 This paper examines two apparently disparate phenomena of corporeal awareness. In both, the completeness or integrity of one's own body is hampered. The first is the occurrence of phantom limbs in individuals born with an "incomplete" body, in which the physical body is incomplete, but the missing limb seems to be represented in the subject's brain, at least as can be inferred from its phenomenal presence. The second phenomenon is the strong desire, by non-psychotic and otherwise well-adjusted healthy individuals, to have a fully functional limb removed. In this condition, it can be argued that despite the physical presence of a limb, the lack of acceptance is due to some underrepresentation in the subject's brain. We review the literature on both conditions and propose that phantom sensations of physically absent limbs and the request for removal of normally developed extremities may be mirror images of one another on the conceptual level: an animation without incarnation and an incarnation without animation, respectively.

Impaired Spatial-Temporal Integration of Touch in Xenomelia (Body Integrity Identity Disorder)

“…We thus propose that the prioritization in our experiment of an undesired part of the body is due to a hyperattention directed towards that part. 1 We agree with Brang et al (2008) andMcGeoch et al (2011) to envisage the right superior parietal lobule and its connections with the insula as possible candidates for a seemingly bizarre disorder of corporeal awareness that may have innate components (Hilti and Brugger, 2010).…”

When less is more – Implicit preference for incomplete bodies in xenomelia

“…Thus, even more insight into the cognitive patterns of xenomelia could be gained from a comparison with individuals with congenital absence of a limb as it might sketch out developmental aspects of xenomelia (Hilti and Brugger, 2010). Such a comparison may elucidate some basic questions of both physical and representational integrity.…”

Body Integrity Identity Disorder: Deranged Body Processing, Right Fronto-Parietal Dysfunction, and Phenomenological Experience of Body Incongruity

“…Visual body-part processing is comparable to intact people compared with amputees with no phantom sensations (Funk and Brugger 2008;Funk, et al 2005) The affected limb is essentially a "negative phantom", in which affected part(s), though physically normal, are experienced with a lack of animation, or "incarnation without animation" (Hilti and Brugger 2010;Vitacco, et al 2009). (Brang, et al 2008;Muller 2009;Ramachandran and McGeoch 2007) Id Identity disordered; DSO Disturbed sense of limb ownership; Sx paraphilia/sexual deviation; lFn the limb function is abnormal or disordered (e.g., with sensory or motor disturbance); rBM Reorganisation of body maps; nE negative emotional appraisal of the limb; Ob Obsessivity/hyper-attention; Pr pretending or confabulation involved; In Insight to the abnormal/unusual character of the condition a not previously linked with BIID; +++ symptom always present; ++ symptom usually present; + symptom sometimes present; -symptom not present;~symptom likely present, but as yet no empirical data available purely from misrepresentation of body parts (as suggested by Brang et al 2008;McGeoch et al 2011), but is likely also a consequence of some breakdown in multisensory integration, self-attribution, agency, and holistic embodiment.…”

“…In BIID, the affected limb may be characterised as a "negative phantom", in which affected part(s), though physically normal, are experienced as if they are "overpresent" as they are ultimately experienced without animation (Hilti and Brugger 2010;Vitacco et al 2009). The recognition that one's limb is "over-present" or "over-able" typically emerges during early childhood or puberty (First 2005).…”