Maybe we could put all the right behaviours into a little book and give everyone a copy.
What colour should we make it red, or black?

Kenny,

What would you charge for the book? An arm or a leg? :)

Seriously though, if someone wants to mutilate themselves then, at least in the eyes of the majority that consist "the norm", that person is somewhat "deranged".

Cognitive Behavioural Therapy and drugs may address some of these issues, but people are free to mutilate themselves at they see fit. I once knew a guy that cut off his own finger because he didn't like it. He was also a drug addict, and perpetual criminal. At least to me this indicates a much more serious underlying mental condition

The number of people who want to "harm" themselves by extreme plastic surgery or unneccesary amputation pales into insignificance compared with the huge number who get hooked on tobacco, alcohol and gambling, all of which are promoted incessantly one way or another and can lead to all kinds of problems, frequently including eventual disease and death. And many illegal drugs are readily available, including the ones which create serious health problems.

I acknowledge of course that alcohol and gambling in moderation do not, in themselves, constitute a problem.

And a casual walk around any shopping centre will show that many people are eating themselves to death and training their children into the same deadly habits of unhealthy overeating and inactivity. I read that Kraft Foods, which is owned by Philip Morris Cigarettes, use the same marketing consultants as their tobacco associates to encourage children to overindulge on their sweet biscuits.

Of course, some people go the other way and gradually starve themselves to death.

And how about the constant enticements to borrow money, often for fatuous reasons, which many gullible people have no hope of paying back.

Whatever we think about some of these activities, we have to accept that it's basically a matter of supply and demand in a relatively free society.

We can have empathy with people with self-destructive obsessions and expect adequate education and counseling. But, apart from the financial drain on our health services, they are harming only themselves and those who love them. Which is more than can be said about the large number of people who apparently have an obsession with speed and other dangerous driving practices and who are a danger to the whole community.

As someone who lost a leg (AK) to pneumococcus and has to get around on an artificial leg, I can never understand why someone would voluntarily have a limb amputated.

This article has made me realise what I've been missing all these years.

Thank you, Virginia Tressider.

Seriously though, there are a couple of things people overlook when dealing with issues like this:

1. The definition of harm.

Amputations close off certain avenues in life, and they aren't reversible. Does this constitute harm? These two criteria applied to marriage not so very long ago...

2. The purpose of freedom

As was pointed out above, things like alcohol are legal despite having associated dangers. Personally, I enjoy a drink, and if you took away all the things in life that "might be considered harmful" there'd be nothing left to value in that extra year of lifespan your alleged "safety" bought you.

Virginia

Thank you for your extremely well written and informative article.

I have been a mental health professional since 1978. And to be sure, I have seen and heard some pretty strange stuff over the years.

I sit here recalling the many, many seriously disturbed young people who I have nursed. I would be very concerned if they had accessed the visual material that you have linked readers to on this thread (this is not a criticism of you or your article). The notion of "copy cat" stuff is of very real concern for young people who are floridly psychotic.

The last young person (18 years) our team nursed with body dysmorphic disorder cut off his testicles. We were so shocked and saddened for him. He was anhedonic and showed no emotion whatsoever.

And of course, there are those "normal" people whose sexual fetish and fantasy is to only have sex with amputees.

I was not impressed by the comments of some of the above posters who seem to find this ethical dilemna amusing.

Thank you again for your article.

Cheers
Kay

kalweb wrote:

"We were so shocked and saddened for him. He was anhedonic and showed no emotion whatsoever."

Confronting though it may be, if these people don't respond to "treatment", surely we should be supporting whatever sort of relief they can find, rather than appealing to the emotional response that *we* believe it appropriate for them to have.

"And of course, there are those 'normal' people whose sexual fetish and fantasy is to only have sex with amputees."

It's almost as though you'd prefer people to be disgusted by amputees. I really hope that's not how you feel.

"I was not impressed by the comments of some of the above posters who seem to find this ethical dilemna amusing."

To me it seems more compassionate to laugh at tangled webs like this one, than be disgusted and patronising.

Solution: straightjackets.

These are people with a disease. Not visible like a skin cancer that can be surgically removed ...which is generally an acceptable treatment option. For those with body dysmorphic disorder a hole bored in the skull or an amputated limb also seems like an acceptable treatment option ... but is not acceptable. It's all a matter of perspective.
However, if the person wanting a voluntary amputation if not assessed properly or given alternative treatment options first, there is a high risk of the "slippery slope" where one limb (for instance) is not enough.

"Should we censor Internet sites promoting radical body modifications?"

Is this a futile question? Censorship of child pornographic sites (much more harmful to the vunerable in our society!)has failed miserably....what will make censorsip of sites promoting radical body modifications any more successful? Am I being pessimistic in the extreme?

There is a possible plus for such internet sites - For those "in need" these sites can provide confirmation that they are not alone...maybe prevent a few suicides

Dewi

I have absolutely no idea how you gained the impression from my post that I am disgusted and patronising. Mental health nurses cannot be judgemental. That would fly in the face of our Code of Conduct and our philosophy.

I have always found it a privilege to care for people with serious mental health problems.

Kay

great read Virginia - and you posed some challengeing questions. My only other comment judging by your web links is that you might have a little tooo much time on your hands.

Your friend Sneekee

Censorship, in the vain belief that it will stop the 0.00000001% of the population from harming themselves?

Such “censorship” would be a little tough on the 99.9999999% of us who would not.

Ultimately, no one can stop someone else from exercising self harm, be it the individual who wants amputation or (and far more commonly) teenagers who self lacerate.

Part of the “social price” paid for “individual liberty” is that some people will do what the majority consider to be “dumb things”.

Alternatively, the “Price” we all pay for protecting some from themselves is “Who decides what to Censor” and as individuals, does that "censors" constricts conform to our individual values?

I, for one, accept that people are responsible for themselves and support their right to self expression etc, regardless of how dumb their “Expression” might be on the clear understanding that I will remain free from the dead hand of censorship.