Conversion Disorder — Mind versus Body: A Review, 2015, Ali et al

Abstract
In this article, the authors accentuate the signs and symptoms of conversion disorder and the significance of clinical judgment and expertise in order to reach the right diagnosis. The authors review the literature and provide information on the etiology, prevalence, diagnostic criteria, and the treatment methods currently employed in the management of conversion disorder. Of note, the advancements of neuropsychology and brain imaging have led to emergence of a relatively sophisticated picture of the neuroscientific psychopathology of complex mental illnesses, including conversion disorder. The available evidence suggests new methods with which to test hypotheses about the neural circuits underlying conversion symptoms. In context of this, the authors also explore the neurobiological understanding of conversion disorder.

Keywords: Conversion disorder, hysteria, unconscious conflict, repressed idea, psychoanalytic factors, psychogenic nonepileptic seizures, conversion anesthesia, therapeutic alliance, striatothalamocortical circuits

INTRODUCTION
Conversion disorder, also called functional neurological symptom disorder,1 is defined as a psychiatric illness in which symptoms and signs affecting voluntary motor or sensory function cannot be explained by a neurological or general medical condition.2 Psychological factors, such as conflicts or stress, are judged to be associated with the deficits.3 The term conversion disorder was coined by Sigmund Freud, who hypothesized that the occurrence of certain symptoms not explained by organic diseases reflect unconscious conflict.3 The word conversion refers to the substitution of a somatic symptom for a repressed idea.3,4

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4479361/

 

But doctors think patients are feigning and therefore don't really look into the patient's symptoms with any seriousness, and certainly not with any view of doing a complete diagnostic job. And nothing about conversion disorder, FND, and MUS leaves any room for dealing with doctors who are mistaken in their diagnosis and in fixing things for patients who are physically ill with a medical problem that can be fixed, but they've been wrongly diagnosed.

This is my biggest beef with all these "diagnoses" i.e. conversion disorder, hysteria, FND, MUS, Somatic Symptom Disorder, Bodily Distress Disorder, and others of that ilk. They all seem to be the same condition from my point of view, and all patients so diagnosed are all treated the same. And if the doctor got it wrong there is no recognised way for the patient to back themselves out of the cul-de-sac doctors have pushed them into, and no way for the patient to get the doctor to reconsider. And what are the chances that any doctor who diagnosed one of these conditions will agree to send a patient for a second opinion with any doctor who wasn't in the mental health field?

 

What is the etymology of the terminology "conversion disorder"? Is it related to the same medical professionals and/or disciples that used to be certain that for example "homosexuality" was a psychological disorder that could be effectively cured with "conversion therapy"?

 

No, see the quotes in post #2. But to summarise, the idea was that there was nothing actually wrong with the body - instead psychological distress/conflict is converted into bodily (somatic) symptoms.

 

I found the whole paper eye-opening. I wasn't sure how much I could include on this site, but it is definitely worth a read.

 

Thanks, but I'm not sure if that does answer the question, I think I just know too little about the subject. For homosexuality being viewed as psychological disorder and then treated with "conversion therapy" very similar beliefs were present and there is a Freud connection as well as a connection to other psychoanalysts. But I know absolutely nothing on the detailed history of these terms and how they were connected or used back then.

Aren't these very similar or the same theories to justify "conversion therapy"?

 

There's a Woody Allen movie in there somewhere.

 

I think the conversion in Gay conversion therapy refers to the active aim on the part of the person "treating" to convert the patient "back" to cis-heterosexual norms. Ie the therapy is conversion away from gay, rather than therapy for a previous conversion to gay.

You're right that some of the wacko theories included the idea that repressed psychological conflict (eg in childhood) were the cause of teh gay. Admittedly I haven't read much on this, but haven't seen the term "conversion" used in that context, but you may well be right. Others likely have better knowledge of this. Needless to say, all ghastly.

 

Hopefully the screenwriters can spell better than these authors.

 

Damn. What century is this? Hell, what millennia are these people stuck in?

 

Seems to be more of a common ancestor kind of thing, but fundamentally the ideas and their rationalizations are the exact same, just applied to a different thing. Hence why the 'treatment' is basically the exact same.

 

It really is all projection. All of it. Every single part of psychosomatization is pure projection. The illness beliefs. The being unable to accept biological explanations. The reattribution to alternative causes. The internal conflicts and frustration at being told "you're wrong". Even the accusations of bullying. About people who have zero power. Every. Single. Bit. Is. Projection.

And on the subject of gay conversion therapy sharing the same roots, you can read all over what the worse bigots are saying and it's hard to escape how they themselves are often dealing with those urges and have to keep them in check through willpower, can't imagine that other people aren't going through the same. And of course the role of abuse of power, whether religious power through shame in community, or through actual legally-enforced authority.

 

From what I can see digitalis was used formal sorts of things as far back as 1250 but mostly for dropsy, which I doubt was linked specifically to the heart until quite a bit later. Even Withering saw it as a means of treating dropsy - assuming an effect on the kidneys through diuresis. He knew it slowed the pulse but the relation between that and oedema was probably not clear until Starling.

The odd thing is that by 1980 it had been established that digitalis is only really much use for dropsy when there is rapid atrial fibrillation. The fact that it had even been identified as curing dropsy may I guess have been because alcoholic cardiac disease with AF may have been the commonest cause of dropsy around 1200-1800 when alcohol was a major source of calories in winter for a good part of the population and coronary artery disease probably had not taken hold until tobacco took over.

 

It was eye-opening because I am shocked that this is the foundation of thinking for what ME/CFS is being made out to be.

FND is mainly referred to as a 'software' issue as if it's too complex for anyone other than the researchers to understand. Yet, in this paper, it has been clearly explained as symptoms resulting from psychological conflict.

Figure 3, which serves as diagnostic guidance, asks if neurologic symptoms are inconsistent with a known disease pattern or cannot be explained by neurological or other medical conditions.

Even before the recent claims from Stone et al. that FND is now a rule in diagnosis, most pwME didn't have neurological or other medical conditions that symptoms mimic ruled out. In most cases, neurologists won't see ME patients, and GPs don't make referrals, so where is the high degree of certainty that ME/CFS symptoms are not organic coming from?