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Dissociation and interoception in functional neurological disorder, 2020, Pick et al

Discussion in 'Other psychosomatic news and research' started by Andy, Jul 9, 2020.

  1. Andy

    Andy Committee Member

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    Paywall, https://www.tandfonline.com/doi/full/10.1080/13546805.2020.1791061
    Not available via Sci hub at time of posting.
     
    spinoza577 and Peter Trewhitt like this.
  2. rvallee

    rvallee Senior Member (Voting Rights)

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    Those sure are words placed in a particular order.

    Beyond that I don't know. But they do fit the requirement of being standard squiggly strokes structured in some form.
     
  3. Hutan

    Hutan Moderator Staff Member

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    Having a go at interpreting the abstract just for the fun of it - sort of an alternative to a morning cryptic crossword:

    1. the people labelled with FND scored higher on a measure of dissociation at baseline than the controls, although there's no suggestion that the level of dissociation in the FND sample reached pathological levels.
    Looking at what seemed to be the most common Dissociative Experience Scale, it's hardly surprising that people suffering from a neurological disorder, functional or not, with blurry vision, memory issues might score a bit higher than healthy controls e.g.
    • Some people sometimes feel as if they are looking at the world through a fog so that people and objects appear far away or unclear. Indicate what percentage of the time this happens to you.
    • Some people find evidence that they have done things that they do not remember doing. Indicate what percentage of the time this happens to you.
    • Some people find that they sometimes are able to ignore pain. Indicate what percentage of the time this happens to you.
    That last question is particularly relevant to a higher score for people labelled with FND. People with chronic pain are far more likely to sometimes ignore pain than healthy people.

    2. After 'dissociation-induction', the people labelled with FND scored more on a measure of dissociation than they had before the dissociation-induction. Hardly surprising - it wouldn't be a very good dissociation-induction process if they didn't.

    3. The accuracy of interoceptive processing at baseline (as measured by a heart-beat tracking task - so I assume it's about self-monitoring) didn't vary between the patients and controls, although the patients had less confidence about how well they had done. That isn't surprising given the people labelled with FND have been told that they can't trust their thoughts - and the people willing to participate in this study were probably more willing than most to believe that.

    4. After the 'dissociation-induction', the FND people did worse on the interoceptive processing. Hardly surprising, even without knowing what particular torture the 'dissociation-induction' was. I imagine the FND people may have been more dizzy or feeling sick. Even just the passage of time through the trial might explain a reduction in ability to think in the later tasks in the FND people.

    5. There was an exteroceptive task, which presumably was about monitoring something outside one-self. But the abstract says nothing more about it, so presumably the results didn't support the hypotheses.

    6. It's concluded that people with FND have meta-cognitive deficits i.e. problems with an awareness of their own thought processes. Which does not seem to be supported by the findings in the study (i.e. that the accuracy of interoceptive processing at baseline didn't differ between patients and controls).

    Of course, I could be completely wrong, because, as @rvallee pointed out, those words might be saying nearly anything, or nothing.
     
    Last edited: Jul 10, 2020
  4. Mithriel

    Mithriel Senior Member (Voting Rights)

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    Pain clinics teach you how to distract yourself from pain - it is seen as a GOOD thing not dissociation :banghead::banghead::banghead:

    I hate these questionnaires which make the symptoms of the disease give you a high score for a psychological problem which is then taken to be a cause of the disease. A lot of the things they talk about are opaque to me but asking about problems with vision in a neurological disease then taking that as proof the neurological disease is actually hysteria is clearly and obviously rubbish.
     
  5. NelliePledge

    NelliePledge Moderator Staff Member

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    Heads I win tails you loose - again
     
  6. rvallee

    rvallee Senior Member (Voting Rights)

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    Ah, well, nothing that mindfulness therapy teaching you to think very hard about constantly ignoring your symptoms can't fix. The secret is to both be mindful of them while ignoring them completely. Easy peasy.

    It's not circular logic, it's clearly an oval.
     
  7. JemPD

    JemPD Senior Member (Voting Rights)

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    But people with FND/Conversion (&MECFS because it's all basically the same thing right?) they don't ignore pain do they? Apparently they are all the time 'body watching' & 'focussing on their symptomatology'. They will make their ruddy minds up.

    All that these contradictory results from all these "studies" do, is create a framework where acceptance of, and denial of, a huge degree cognitive dissonance is a requirement, in order to believe in the theory.... which can be summarised as follows...

    if you are a patient, you're doing it wrong, you know just being, living, being you, you're doing it wrong & thats why you're suffering...

    if you push through, distract yourself, disconnect from or otherwise ignore your pain/symptoms & attempt to get on with life. If you're conscientious & like helping others & you like things done properly- well then you're doing it wrong, you've got the wrong personality - you're a people pleaser & a perfectionist (traits they laud in others mind you) but in you - well your personality & behaviour are wrong, & that's why you're suffering... its your fault. But we wont call it that, we'll say 'it's not your fault but you have a responsibility to change it" - because it's you, you as you are, are just wrong.

    But if you pay attention to your symptoms, try to find ways to alleviate them & pay attention to your body, & actually feel the distress this suffering causes instead of ignoring it or dissociating from it, if you seek medical support, don't push yourself but instead rest & pace & are gentle with yourself & stop doing things for others because you need to look after yourself. Oh well then you are 'opting out of life', 'unable to cope with the usual demands of life' & 'producing symptoms for secondary gain', along with having health anxiety, body watching & focusing too much on symptoms & seeking too much support, you are avoidant and fearful of activity, you need to distract yourself & ignore them & be more active. You also need to be 'ready to do the hard work' of pushing through, be a bit more conscientious -it's your responsibility, if you don't follow the program you cant expect to get better.

    Oh and if we decide before we even met you that you have the first set of wrong personality/thoughts/behaviour, & you have the temerity to suggest that actually that's not who you are/what you are like, or how you behave, but rather you are _ _ _ _ _ Well then no problem because you are wrong about yourself, your assessment of yourself, your thoughts behaviour/personality is wrong, you are the patient with this label therefore you cannot be trusted as a reliable witness of yourself or your experience, our beliefs are right & you are wrong. End of.

    If you suffer from symptoms we don't understand, well then You, are just wrong.
    Your personality is wrong, your thoughts are wrong, your behaviour is wrong. It doesn't matter what your personality is, or what your thoughts are, or how you behave... it's just wrong, we can come up with a way to illustrate & frame it all as wrong. That you, & your thoughts/behaviour/personality & way of being, are wrong, are the cause of your own suffering. You are doing it to yourself.

    Who you are, what you think, how you behave... are all just... wrong.
     
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  8. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    Sarcasm alert ...

    My feeling has been for some years that just seeing a doctor must be proof of mental illness (unless you have a bone sticking out or an eye hanging out of the socket and resting on your cheek or you've been hit with a machete and you're getting blood on the carpet). Patients going to a doctor for help with their health must be mad because they must know if it can't be seen it must be psychological.
     
    alktipping likes this.
  9. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

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    @JemPD

    Bravo for your post ( # 7 in this thread ) :thumbup::emoji_clap:
     
    alktipping, Hutan and JemPD like this.

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