Sometimes the brain can provoke incredible psychological reactions, almost like a sci-fi movie. An example is conversion disorder, or as it has been renamed DSM-5, a functional neurological symptom disorder.
Conversion disorder is a perfect example of the strength of the connection between body and mind, it is a functional disorder, but it manifests itself physically, as if it were an organic disease, although there is no justification for it.
- Today.
- Somatic symptom disorders come from a set of disorders derived from the concept of hysterical neurosis.
- With Briquet being.
- In the 19th century.
- Who first ordered the classification of hysteria.
- Limiting himself to an empirical classification of symptoms.
Today, we know conversion as a symptom in which bodily functions, either completely or in zones, stop working or are severely affected, this occurs without somatic damage and is not part of a dummy disorder.
It is important not to confuse somatomorphic disorders, such as conversion, with psychosomatic diseases, in the latter we find a known base or pathological process, in which psychological factors are related to the onset or evolution of the disorder.
Charcot found that a large number of women had a number of symptoms without demonstrable organic basis, so she attributed all these symptoms to a psychological character, calling them hysterical conversion.
As we have said, conversion disorder is characterized primarily by the loss of certain bodily functions, in this sense we can find patients who suddenly go blind from one eye, affonic, with paralysis of any limb or even with severe headaches.
These pains have been called “clavus hystericus”. After a medical examination, there is absolutely nothing to explain the picture. So, what’s going on?
Like its classification partner, somatization disorder, conversion usually occurs in histrionic personalities. A histrionic personality is a personality with a marked tendency to suggestion, superficiality, emotional lability, dependence and self-centeredness; however, this type of personality remains much more defined. somatization disorder.
What is very characteristic of conversion disorder is so-called beautiful indifference, which is the patient’s lack of concern about the symptoms he is experiencing.
Imagine that one day you wake up with a paralyzed arm, chances are you’ll worry a lot, get tested, go to the doctor and be a little worried about what might happen.
That’s normal. However, this does not happen in patients with a conversion disorder, who do not mind their apparent problem, something similar to what happens in Anton’s syndrome, in which the patient goes blind, but claims to see perfectly. Sure why this beautiful indifference happens, but the truth is that it is quite impressive.
Another clear feature of conversion disorder is its relationship to psychological factors and, above all, to stress. There is a clear temporal relationship between the stressful event the patient has faced and the onset of symptoms.
Symptoms vary greatly, so they are quite heterogeneous, the most common being blindness, deafness, paralysis, aphony and total or partial loss of sensitivity, without medical evidence.
The onset of the disorder is common in adolescence and early adulthood (10 to 35 years of age), it can also occur in childhood and, especially in people under the age of 10, symptoms are limited to changes in gait and seizures.
It is more common in women. Patients of low socioeconomic status, less psychologically sophisticated or less educated, as well as women under the age of 40 who come from rural areas, have a worse prognosis. Depression is a disorder that has significant comorability, although it is often masked.
Remission usually occurs spontaneously within a few days, with or without treatment, although, of course, treatment speeds up the process, if the person re-confronts a stressor the most normal is that symptoms return, so it can be chronic. Disorder.
The DSM explains that the symptom of conversion disorder revolves around two mechanisms: primary gain, i. e. maintaining an internal conflict or need outside of consciousness, and secondary gain, avoiding harmful activity, or gaining support that you could not otherwise do.
In relation to primary gain, this disorder is often associated with traumatic experiences, excessive stress, sexual and physical abuse.
It seems that, in most cases, excessive stress is the trigger that triggers the disorder, sometimes the diseases are closely linked to the problem to which they have been exposed, for example, there are patients who feel pain in one part of their body has been injured by another person in an accident.
With regard to secondary gain, it can be said that, as in many other disorders, the patient, albeit unconsciously, can be strengthened by his problem. Attention, care, or neglect of activities such as work, for some people, can be a gain that perpetuates the problem. This is because, in other circumstances, that attention would not have been received, so this is one more way to demand affection.
As for treatment, although the problem usually goes away spontaneously, it is never more expedited to speed up the process with psychological therapy, in this way we try to solve the stressful cause that gave rise to the problem.
Indicators of good prognosis are: identifiable stressor, pre-morbid functioning, sudden onset, absence of other mental or physical disorders, lack of legal processes and short duration of symptoms.
Since cognitive behavioral therapy, training is used to reduce anxiety and manage stress, aided by techniques such as hypnosis or relaxation. Psychodynamic therapy also brings improvements in this regard and aims to resolve the underlying intrapsiquical conflicts.