Psychosis and Attacks of Matthew 19:12

A recent review in the journal Psychomatics talks about people who self mutilate based upon commands in Bible verses.

Self-Mutilation and Biblical Delusions: A Review.
Schwerkoske JP, Caplan JP, Benford DM.
To review the literature for cases of deliberate self-harm that directly reference Bible verses as a motivation for action and discuss predictive factors of such behaviors and post-injury management strategies.
Sixteen cases of self-mutilation prompted by Biblical verses were found in the existing literature. The authors also describe a novel case of penile amputation prompted by a verse from the Gospel of Matthew.
Four biblical verses associated with self-mutilation were found, all from the Gospel of Matthew. All patients presented with a diagnosis of psychosis at the time of the event. Other common themes include substance abuse, guilt over sexual acts, absence of pain or regret, and destruction of the severed body part.
Patients with symptoms of psychosis may misinterpret various verses from the Gospel of Matthew as instructions to engage in self-injurious behavior. Psychiatrists should be aware of these four verses to understand their significance and potentially forestall these behaviors

World Science has more on the review, including the verses referred to in the paper.

Matthew 19:12
For there are some eu­nuchs, which were so born from their moth­er’s womb; and there are some eu­nuchs, which were made eu­nuchs of men; and there be eu­nuchs, which have made them­selves eu­nuchs for the king­dom of heav­en’s sa­ke. He that is able to re­ceive it, let him re­ceive it.

Mat­thew 18:8
Where­fore if thy hand or thy foot of­fend thee, cut them off, and cast them from thee: it is bet­ter for thee to en­ter in­to life halt or maimed, rath­er than hav­ing two hands or two feet to be cast in­to ev­er­last­ing fire.

Mat­thew 5:30
And if thy right hand of­fend thee, cut it off and cast it from thee: for it is profita­ble for thee that one of thy mem­bers should per­ish, and not that thy whole body should be cast in­to hell.

Mat­thew 5:29
But if thy right eye of­fend thee, pluck it out and cast it from thee: for it is profita­ble for thee that one of thy mem­bers should per­ish, and not that thy whole body should be cast in­to hell.

The review gives a recent of a patient “Mr P” who presented himself at a hospital in Phoenix, Arizona sans penis, which

he had flushed down the toi­let three days ago af­ter sev­er­ing it with a pock­et knife. His tes­ti­cles were al­so ab­sen­t—re­moved four years ear­li­er at Mr. P’s re­quest by a doc­tor in Mex­i­co.

It is important to note that while Mr P was somewhat incoherent at the time of admission, he had contemplated the Penectomy for several years in order to complete his transformation to the eunuch state. This was not a one-time psychotic break.

Schwerkoske et al conducted a PubMed search of the available literature and provided a list of  other patients who have presented with self-mutilations justified by these verses. The list consisted of

three par­tially or fully am­pu­tat­ed pe­nises; four pairs of cas­trat­ed tes­ti­cles; three am­pu­tat­ed hands and 11 se­verely dam­aged eye­balls. Saws, cir­cu­lar saws, screw­drivers and pen­cils were among the tools used for the hor­ri­fy­ing pro­ce­dures, al­though sev­er­al pa­tients put out their eyes with their fin­gers alone.

Again to emphasize, all of these self-mutilations were justified by the patients by quoting at least one of the verses above.

“In­di­vid­u­als who ra­t­ion­al­ize their ac­tions through bib­li­cal pas­sages ap­pear to have a se­ries of fea­tures that make them a un­ique co­hort with spe­cif­ic chal­lenges re­gard­ing prog­no­sis and treat­ment,” Ca­plan and col­leagues wrote. Many of them have no re­grets about their ac­tions; de­lib­er­ately de­stroy the body part to pre­vent its re­at­tach­ment; re­sist ef­forts to suc­cess­fully re­at­tach it when that is pos­sible; and are un­co­op­er­a­tive with oth­er as­pects of treat­ment, they added.

A 37-year-old man was quot­ed in the 1967 re­port say­ing: “Even if I do get cer­ti­fied [in­sane] and in the eyes of the world I am mad it is far bet­ter for me to have cleansed my­self.”

“Ideas of ref­er­ence (spe­cif­ic­ally, that the Bi­ble di­rectly re­fers to them) is a re­peat­ed theme in this group, un­der­scor­ing a com­mon thread of psy­chot­ic disor­ders,” Ca­plan and col­leagues wrote. “Guilt over sex­u­al acts or de­sires is anoth­er re­cur­rent the­me… Re­cent homosex­u­al ex­pe­ri­ences oc­curred in three of the cases of gen­i­tal self-mutila­t­ion.” Four of the 17 self-mutilators were fe­males; they had poked out their eyes or, in one case, am­pu­tat­ed a hand.

The authors emphasize the need for physicians faced  with requests for medically unnecessary mutilations or amputations to make immediate referrals to a psychiatrist. Outside of biblical demands for amputations, people who suffer from Body Integrity Identity Disorder (BIID) also request amputations. The psychological reasons behind BIID are little understood, but they do not appear to be based upon religious teachings and also need psychiatric rather than surgical intervention.

Back in my church-going days, I remember sermons on these verses, but the preachers I heard emphasized the allegorical nature of much of the Bible and used the sermons to encourage abstinence from earthly pleasures. For those who preach and follow a literal Bible, there is only one way to interpret these verses.

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