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Outside View: Too Much Nip And Tuck

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WASHINGTON, Sep 14, 2003 (United Press International via COMTEX) -- What do liposuction, tongue splitting, body piercing, scarification, tattoos and breast implants have in common?

We seldom think of them as similar, although each is a method of aggressively altering a healthy body. But whose body is it, anyway? Isn't appearance just an issue of fashion and style, simply a matter of taste?

Perhaps I shouldn't say "just" a question of fashion. After all, fashion is the institution that successfully manages to combine our need to fit in and belong, with our wish to claim individuality. Fashion sanctions

individuality, but only when it is expressed in this season's -- commercially-driven -- culturally desirable manner. We all want to be recognized as unique, as long as we're also "in."

Our bodies express a particular consciousness. From sparkling smile to the width of our lapels, to the way we sit and move, our every gesture expresses who we are at the moment.

Human beings have always decorated and adorned their bodies. Body alteration, however, is much more than artistic expression alone. A great part of its meaning depends on the context. Back in some pagan societies, for example, grief was ritually expressed through scarification. Today, circumcision is a bodily mark of fundamental importance to Jews and Muslims. It denotes identity, group membership and commitment.

Although most of today's body alterations serve neither tribal nor religious purposes, they remain, nevertheless, social and psychic expressions. And the range of modern body alteration practices is surprisingly wide, from the innocuous single pierced ear to ... shockingly extreme, even frightening practices.

Cosmetic surgery has become conventional. For women, and, increasingly, men, cosmetic surgery is a visit to the fountain of youth. Rejecting the signs of the wear-and-tear of living, embracing the American myth of endless

self-invention, we submit our bodies to "nip and tuck" in the belief that the smoothness of youth is more desirable than the wisdom of age.

Electing surgery is not the same as just paying attention to diet and exercise, sleep and lifestyle in order to age well. Nor is it the same as using makeup and hair color to enhance the aesthetic of daily life. Cutting is transformation. When the cut is deeper, the meaning is more profound.

The subtext of surgery is the wish or belief that the patient will be better, not just look better, but also somehow be better -- more lovable, more productive, more energetic, more fun -- than they were before the cut. Cutting the body, exposing oneself to the risks of surgery, is reminiscent of invoking ancient, primitive gods who demand sacrifice in order to bestow their blessings.

Once upon a time, fashion trends began with the rich and upper classes, and were mimicked by those below. More recently, fashion trends have run in the opposite direction, starting with society's marginal groups. Excessive body

piercing and tattoos followed the latter route, migrating in from society's fringes toward the mainstream. Despite the migration, their message remains the same. These practices continue to be the simultaneous expression of vulnerability and rebellion; the more extreme they are, the closer they come to expressing self-loathing as well.

A tongue stud is a dental nightmare, but it can be removed and the hole can probably heal. Further along the continuum are tattoos. Removing them, even when possible, is painful and difficult. A split tongue, sliced down the middle from the base to result in a reptilian, evil look, is probably a permanent deformity. Many would consider it mutilation. But even that's not the limit of voluntary body design.

At the furthest extreme of body alteration one finds people who are attracted to amputation. At this stage the practice of body-design is bizarre enough to have earned a clinical label, apotemnophilia. But regardless of clinical judgment, people with that disorder seem to be able to find surgeons who will accommodate their wishes, and other people who share their taste in "fashion."

For, after all, what is voluntary amputation but a pushing of the boundaries of personal body design? An aptomenophile might even object to being labeled at all. After all, whose body is it anyway?

Whose body, indeed.

--Dr. Renee Garfinkel is a clinical psychologist in private practice in Washington, D.C., a syndicated columnist, and a member of the faculty of the Institute for Crisis, Disaster and Risk Management, George Washington University.

Copyright 2003 by United Press International.

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