Psychosomatic Illnesses: Conversion Disorder

Google Images
Google Images
Anna O. (Google Images)
Anna O. (Google Images)

The Discovery of Conversion Disorder

In 1985, a 21-year-old woman by the name of Anna O. began developing strange symptoms five months after her father became ill. During the day she began experiencing blurry vision and every once in her while she had trouble moving her right arm and her legs. Other symptoms began to develop. Suddenly, it was difficult for her to speak and she developed psychological symptoms and behavioral problems.

Anna's personality was altered, she became extremely malnourished because of her refusal to eat and drink at times, despite her hunger and thirst, and she was easily confused and at times delirious. Prior to the onset of Anna's symptoms, she was an intelligent, perfectly healthy woman.

Anna finally consulted Dr. Josef Breuer, who confronted one symptom at a time by hypnosis. Each symptom had been traced back to the death of Anna's father. Thus, the hypothesis that the stress surrounding the death of her father was the cause of her bizarre symptoms.

Sigmund Freud took Dr. Breuer's observations and used his psychoanalytic model to analyze Anna's condition. The term "conversion" simply referred to the psychological stress and anxiety that had been converted into physical symptoms.

So What Exactly is Conversion Disorder?

Conversion disorder is a psychosomatic illness classified as a somatoform disorder.

The term psychosomatic illness refers to any physical symptoms that originate from the mind and from emotions. Somataform (from the root word soma, body) clasifies these disorders that appear to be purely physical.

People with conversion disorder have physical malfunctioning without any physical or organic causes. Meaning, people with conversion disorder have physical symptoms but not physical causes. Psychological symptoms manifest in physical symptoms.

Subtypes of Conversion Disorder

  1. Conversion disorder with motor symptom or deficit
  2. Conversion disorder with sensory symptom or deficit
  3. Conversion disorder with seizures or convulsions
  4. Conversion disorder with mixed presentation.

The subtype of Conversion Disorder is diagnosed based on the symptoms exhibited. For example, conversion disorder with motor symptoms or deficit will have symptoms that mimic physical conditions such as tremors or Parkinson's Disease.

Symptoms (general)

Pseudoparalysis

  • Loss of the ability to move half of the body or a single limb
  • Weakness that doesn't make sense anatomically
  • Inconsistency with examination (never the same symptom)

Pseudosensory Syndromes

  • Numbness or lack of feeling in various parts of the body
  • Anatomical pattern doesn't make sense (is based on the patient's knowledge of their body)

Pseudoseizures (non-epileptic/psychogenic)

  • Seizures that have no physical or organic cause
  • This is the most difficult to diagnose especially because 5% and 35% of patients with pseudoseizures also have epilepsy

Pseudocoma

  • A coma not caused by physical or organic causes

Psychogenic Movement Disorders

  • Can mimic myoclonus (muscle spasams), Parkinson's, Dystonia (abnormal muscle tone), Dyskinesia (uncontrolled bodily movement) and tremor

Don't worry, you're not really seeing double. Diplopia. (Google Images)
Don't worry, you're not really seeing double. Diplopia. (Google Images)
True Ptosis (Google Images)
True Ptosis (Google Images)

Pseudoblindness

  • The affected patient believes they are blind however if a mirror is placed in front of him/her and tilted from side to side, their eyes follow the reflection. Yet, they truly believe that they cannot see.

Pseudodiplopia

  • Double vision without physical or organic causes

Pseudoptosis

  • Droopy eyelids without physical cause.
  • In real ptosis (droopy eyelids), the eyebrows are lifted. In pseudoptosis, the eyebrows are lowered

Hysterical Aphonia

  • Aphonia is the loss of the ability to produce sounds (to speak)
  • In true apnonia there is usually abnormality in the movement of the vocal cords and trouble producing any sounds. In hysterical aphonia, the patient will be able to cough and whisper normally. Their movement of the vocal cords is also normal.

“La belle indifférence”

In patients, this is attitude of relative unconcern about their symptoms is another feature of Conversion Disorder. This is more often seen in adults because children are more likely to react to their strange symptoms with fear. Younger children are also more hopeless about their symptoms. In a way, adults with this mind-blowing psychiatric disorder deny their symptoms.

Google Images
Google Images

Cause and Risk Factors

The exact cause of Conversion Disorder is unknown, however there are theories that suggest the primary cause is a stressful event or situation in the patient's life. Most often, the stressful event is physical, emotional or sexual abuse. The disorder tends to be the result of an extremely delayed reaction to childhood abuse.

Risk Factors

  • A recent significant stress
  • Emotional trauma
  • Being female (statistically)
  • Being a teen or young adult (most common)
  • Having another psychological condition (e.g. dissociative disorder, personality disorders and anxiety disorders)
  • A family history (at least one member with the disorder)
  • Physical or sexual abuse in the past 
  • Financial problems

Biofeedback therapy (Google Images)
Biofeedback therapy (Google Images)

Treatment and Prognosis

  • Hospitalization (patients often go to the hospital thinking they have a physical problem)
  • Anti-anxiety and anti-depressants
  • Psychotherapy and psychodynamic therapy
  • Family and group therapy
  • Hypnosis
  • Relaxation techniques and visualization
  • Biofeedback therapy
The prognosis (future outlook) for patients with Conversion Disorder, despite the delibitating symptoms, is highly favorable. Once the triggers (and underlying cause) is discovered, the symptoms can be managed.

A True Phenomenon

Today, Conversion Disorder is still mind-boggling to medical and psychiatric professionals. I mean, think about it... blindness, paralysis, comas caused by psychological issues. Like most psychosomatic and somatoform disorders, Conversion Disorder is especially difficult to diagnose. This is because the symptoms mimic medical conditions such as:

  • Mutiple sclerosis
  • Myasthenia gravis
  • Periodic Paralysis
  • Myopathies
  • Polymyositis
  • and even Guillian-Barré Syndrome

To diagnose Conversion Disorder, several tests and examinations must be done to rule out every similar medical condition. Therefore, the psychiatric disorder is often diagnosed as one of the seemingly medical conditions mentioned above.

By now, you must be wondering "exactly how common is this disorder?" To answer that question: Conversion Disorder is a lot more common than people believe. In the West between 30 and 60% of seemingly neurological disorders are unexplained, which implies that percentage can represent cases of Conversion Disorder or other psychosomatic/somatoform disorders.

With more research about psychological problems, Conversion Disorder and other such psychosomatic/somatoform disorders can be prevented.

Opinions

What do you think of Conversion Disorder? Share your opinion below.

Comments 15 comments

marvalousnj profile image

marvalousnj 6 years ago from Central Jersey USA

You have conducted a lot of research on this topic. Interesting topic and great writing. Keep this up we all will be proud of you.


kaltopsyd profile image

kaltopsyd 6 years ago from Trinidad originally, but now in the USA Author

Yes, I have conducted a lot of research. I've always found it interesting. All psychosomatic illnesses are interesting. It makes you think twice about mis-managing stress and other underlying psychological troubles. Thank you for your faithful comments.


lorlie6 profile image

lorlie6 6 years ago from Bishop, Ca

Hello again, kaltopsyd! This disorder fascinates me since I was diagnosed with it in my 20's. I'm now 53 and the psychiatric professionals now call it PTSD. Of course you've studied that-you have a wonderful understanding of the psychological world, and I look forward to more of your hubs.


kaltopsyd profile image

kaltopsyd 6 years ago from Trinidad originally, but now in the USA Author

It IS a fascinating disorder. So you were diagnosed with conversion disorder in your 20s and now they're calling it PTSD. Interesting? Thanks for sharing. I'll love to have you read more of my Hubs. Thanks.


Mentalist acer profile image

Mentalist acer 6 years ago from A Voice in your Mind!

The treatment and recovery of mental illness can also be a blessing in disguise as it can leave one coming out of it with a heightened mental acuity and concious awareness that is nuanced;)


kaltopsyd profile image

kaltopsyd 6 years ago from Trinidad originally, but now in the USA Author

Very nicely put, Mentalist acer! Thank you for coming over to read my Hub and comment.


parrster profile image

parrster 6 years ago from Oz

Interesting stuff. Highlights the intimate synergy between mind, body and soul, and the care we must take in stepping gently in both our own and others lives. Great hub.


kaltopsyd profile image

kaltopsyd 6 years ago from Trinidad originally, but now in the USA Author

Thank you very much, parrster. And it IS interesting... I love psychology and psychiatry... :-)


Denise Handlon profile image

Denise Handlon 5 years ago from North Carolina

Well written hub, Kim. Great explanation and quiz following. Happy Holidays to you and your mother. :)


kaltopsyd profile image

kaltopsyd 5 years ago from Trinidad originally, but now in the USA Author

Hello, Denise.

Thank you very much. Happy Holidays to you and your family as well!


Spirit Whisperer profile image

Spirit Whisperer 5 years ago from Isle of Man

A very well researched subject and a very well written article. So impressed was I that I have tagged it in my own article "Hypnosis and Healing". Thank you


kaltopsyd profile image

kaltopsyd 5 years ago from Trinidad originally, but now in the USA Author

Oh... well thank YOU, Spirit Whisperer. I appreciate it. :)


Lea Kielinen 5 years ago

Hi, I found you on google profile while I was searching myself for conversion disorder profiles. I suffer from conversion disorder and have started a blog justmekielinen@blogspot.com as well as a Conversion Disorder FB page "Just Me - Conversion Disorder". The reason I am telling you this is because I am trying to create awareness about this disorder. It is hard trying to locate others that understand and suffer the way we do and I thought that we could be some help for each other. I have so far located two others that suffer as we do and have found that it is nice having the support system in place when no one else really understands. I hope you'll check out my blog and FB page and find some comfort or friendly words. If not, no worries, but I thought it wouldn't hurt to try. I wish you the best of luck in health. It can definitely be an uphill battle, but through connections and understanding, compassion and empathy I think bringing people together can ultimately help us all.


kaltopsyd profile image

kaltopsyd 5 years ago from Trinidad originally, but now in the USA Author

Hello, Lea. I'm not actually a sufferer. I'm currently studying psychology in hope to help, so I'll definitely love to help raise awareness. Your blog is great! (I just checked it out). You're doing a good thing. Best of luck to you :)

-K. Alto


TorriAnn 4 years ago

I guess maybe I'm biased on this issue. I have had a neurologist tell me that there is a likelihood that I have convergence disorder. I am quite angry at this as I do not believe that I do. I am however very concerned about my symptoms. Because of my neurologist is convinced that this is the disorder that he refused to do medical testing that would eliminate other medical concerns such as mini strokes. In my family there is a history of stroke, pulmonary embolism, and other blood clotting abnormalities. I too have a blood clotting abnormality but it is minor.

I do believe there is such a disorder is convergence disorder I am however concerned that because and when a doctor cannot find a medical cause that automatically the diagnosis is then convergence disorder. Just because you can't find something doesn't mean it's not there.

Of course if I would seek a new neurologist opinion and send my old records to him he would see the old neurologist felt the convergence disorder was the likely diagnosis. I believe then that will taint the new doctors outlook. Really not sure what to do. Everybody wants to seem to think that it's in my head. Well I do believe it's in my head but not psychologically.

Please don't get me wrong I do not believe that there's any shame in particular of having convergence disorder. In fact I think it's almost amazing. Think about it your body takes on the stress that your mind can't handle. In a way I think it's an awesome coping mechanism.

In my particular case however I do not believe that medically things of been looked up properly simply because the diagnosis of convergence disorder is much easier and faster for the doctors. Plus I think it allows them to save face I mean let's admit it who wants to say they don't know what's going on especially when you have a degree in this. I just want a doctor to look at me once and say I really don't know what's going on but we're going to figure it out.

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