Abstract
This chapter explores the complex relationship between the sense of body-ownership (SBO) and sense of agency (SA) with respect to limb ownership. It contends that in the case of a contradiction between these mechanisms, an individual is liable to develop limb-disownership .
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Notes
- 1.
Body-ownership has been linked to processing in several regions. These include the premotor cortex (PMC), intraparietal cortex (IPC), temporoparietal junction (TPJ), sensorimotor cortex, extrastriate body area (EBA), and insula (Arzy, Thut, Mohr, Michel, & Blanke, 2006; Blanke, 2012; Tsakiris, Hesse, Boy, Haggard, & Fink, 2006). The processing of interoceptive information occurs on well-defined pathways from the dorsal root of spinal nerves to the thalamus, nucleus of the solitary tract. This is then relayed to the central cortical processing regions of the anterior cingulate cortex (ACC) and insular cortex (Craig, 2003; Critchley & Harrison, 2013). Essentially, although neural processing connected to agency, ownership and interoception are subserved by distinct brain systems, they show some partial convergence in the insular and medial frontal regions.
- 2.
For an in-depth analysis of a number of cases, see Appendix 2.
- 3.
Denial and lack of awareness are not equivalent phenomena or mechanisms.
- 4.
- 5.
It may be that Coltheart’s (2010) two-factor theory suggests at least a partial (theoretical in nature) solution. According to this approach, in order for a delusional belief to emerge, two mechanisms are necessary: “(a) the presence of a neuropsychological impairment that initially prompts the delusional belief and (b) the presence of a second neuropsychological impairment that interferes with processes of belief evaluation that would otherwise cause the delusional belief to be rejected” (p. 16). Hence, we suggest that when the second mechanism ceases to function, the outcome is disownership.
- 6.
However, some have suggested that “this phenomenon, although almost certainly rare, may be more common than was originally appreciated” (First & Fisher, 2011, p. 4).
- 7.
A few decades ago scholars identified and described BIID in terms of Psychopathia Sexualis—sexual attraction to amputees or others with disabilities (Wakefield, Frank, & Meyers, 1977). However, more recent findings argue strongly against this thesis (Furth & Smith, 2000). Based on pre/postoperative evaluations, scholars have argued that individuals who undergo this elective amputation (a) do not reveal psychiatric illnesses, and (b) are not sexually attracted to amputees (Fisher & Smith, 2000). Nevertheless, according to a 2005 survey study, the underlying motivation behind these individuals’ desire for amputation is multifaceted and may include both identity and sexual elements. Indeed, two-thirds reported that sexual arousal to the image of themselves as disabled also constituted an important aspect of their desire (First, 2005). Yet the majority (77%) of subjects reported that their primary motivation for desiring amputation was “to feel whole, complete, or set right again” (i.e., correcting an identified mismatch). The question of the sexual component of BIID is fundamental and cannot be ignored. That being said, in the last few years, scholars have reached at least partial agreement that “sexual arousal is rarely the primary explanation of the desire to change one’s own anatomy” (Brugger, Lenggenhager, & Giummarra, 2013, p. 3), yet nevertheless “it is worthy of attention with respect to the ontogeny and phenomenology of the condition” (p. 3).
- 8.
We should also note that approximately two-thirds of individuals with BIID who have undergone amputation of a major limb (i.e., arms or legs) used methods that risked serious injury or death (i.e., shotgun, chainsaw, wood chipper, and dry ice) to dispose of the unwanted limb. The remaining third in this study managed to convince a surgeon to perform the surgery (First, 2005).
- 9.
Anyone who is closely familiar with cardiac patients knows how aware these patients are of what normal people are incapable of discerning the amount of air that enters their lungs. For most of us, this information is beneath the threshold of consciousness. These patients also notice every minor incline on the sidewalk, because even the smallest change in their oxygen consumption has a dramatic impact on them.
- 10.
Interestingly, when patients suffering from somatoparaphrenia saw their affected hand directly in the mirror (as a reflection), they once again felt a sense of ownership toward their hand. However, “the habitual disownership returned seconds after the mirror was removed and was repeatedly remitted every time the mirror feedback was provided.” Thus essentially, “the two opposite judgements (i.e., this arm is mine vs. this arm belongs to someone else) alternated within seconds and this did not seem to be noteworthy to either patient” (Fotopoulou, et al., 2011, p. 3591). Based on these findings it seems at least possible to suggest that there is a fundamental gap between 1pp and 3pp, that is it to say that experiencing one’s body from a first person perspective, on the one hand, and experiencing one’s body from a third person perspective, on the other, are rooted in different kinds of mechanism.
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Ataria, Y. (2018). When Ownership and Agency Collide: The Phenomenology of Limb-Disownership. In: Body Disownership in Complex Posttraumatic Stress Disorder. Palgrave Macmillan, New York. https://doi.org/10.1057/978-1-349-95366-0_4
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