One of the questions that kept bothering me throughout class discussion and afterwards was (paraphrased): why do we not bring into question the mental health or ethical dimensions, such as psychological evaluations or physician responsibility, respectively, to the realm of extreme body modification? It would make sense to do so seeing as how, just like a surgery junkie, a person seeking to get a metal mohawk or get an abundance of facial piercings is going to great lengths to change their physical appearance. Thinking about our concept of self or consciousness of self on a spectrum where a surgery junkie would be one end and a modern primitivist would be on the other may or may not be able to clear things up.
We are conditioned to value ideals such as originality, autonomy, individual choice, agency, and free will. Anything that deviates too far away from these prompt us to become defensive in order to maintain a sense of control. It is also difficult to argue against capitalist driven normative values or ignore the socially constructed perceptions of beauty. Many would consider that surgery junkies such as those that desire to look like their favorite celebrity have fallen prey to big corporations. In this case the individual is headed towards the extreme of surgery junky, the person is trying to achieve the standards of beauty that their culture has set. This extreme is often characterized by lack of genuine individual choice—the person is considered to lack or not have a secure concept of self (the question of whether or not any of us do is a topic for another class). An abundance of literature argue that if one is working to conform to societal standards, then they are not acting on one of the features we believe to be integral to the human experience—free will. Therefore, since they are not able to exercise their free will, there must be some clinical wrong or explanation.
On the other hand we have extreme body modification in the form of primitivism. The individual who opts to indulge in this form of “body play” is not often critiqued in the same manner as the person who is obsessed with surgery (i.e. need for psych evaluation). Perhaps this is because they are not striving for this unachievable standard. They are often thought to be confident in who they are that they disregard social conventions or common practices. One can also consider them to be able to look beyond the ridiculous advertisements to truly embody their concept of self. For now this was the only way I was able to make sense of the question.