The FAQ about structural changes on neurosymptoms.org is very revealing. It's a newer section that's been added to try to explain away all the evidence of structural changes. It still uses the software/hardware analogy to explain things.
https://neurosymptoms.org/en/faq-2/...-changes-to-the-structure-of-their-brain-too/
Below is what seems to be the explanation for why doctors don't need to mention to patients about these structural changes in FND:
"We may at some stage need to build in an understanding of these structural changes into our models and the way we explain FND. But at the moment we simply don’t have enough data to be able to use this information in a clinically useful way.
If the structural changes have always been there, then that’s clearly important but we still don’t know if they represent an obstacle to improvement.
If the structural changes happen because of the condition, then we need to help patients understand that FND has changed their brain, but treatment can hopefully change it back again."
FND has a really difficult and stigmatised history. For a very long time it was classified as a purely psychological disorder. In the last 20 years we have been uncovering some of the ways in which FND symptoms are caused in the brain, and have made a lot of progress, but we are still a long way from a definite model.
Not dualists, though. The people talking about software/hardware and how psychological and "in the brain" have different meanings insist that they are not dualists, because they have decided that it could possibly be the case that the mind changes the brain, the software changing the hardware, which completely breaks the analogy, at least in terms of being applied to computer science. That's literally what the hard part of hardware means: unchanging, forever fixed. Wetware is neither and both at the same time. This analogy makes no sense whatsoever.
They may not have a definite model, but they sure have many definitive models that they apply as facts.
These people are truly dangerous, but not nearly as much as the health care systems and medical institutions that promote this pseudoscientific nonsense without any concern for what it means where it's wrong. Which is basically the whole of it.
Lots of weird stuff in there:
All of these common clinical features clearly show there is a problem with function which is much more obvious than a subtle problem with structure. If it was the structure then the weakness would not transiently improve, the tremor would not transiently stop, and the gait would not improve.
Which is obviously wrong with, at least, MS, since some of the damage can be repaired. And probably many more diseases. Which they obviously know, making this argument even more ethically wrong. Also we can observe something similar with Parkinson's disease, which can respond to some forms of electrical stimulation, but also quite dramatically with some drugs such as cannabis.
I was actually wondering this the other day: what is their model of drugs? Are they functional, i.e. psychological? This is their model, the structure doesn't change. And by drugs I include things like anesthetics. It changes the function of the body, including the nervous system, without changing the structure. By their model this means functional, meaning psychological. Which is obviously silly. They keep using the fact that they don't observe permanent structural change as evidence that it's not organic, even though that's clearly almost never true.
Is genetics functional, too? No structure there. The DNA is the same, just turned on or off. Poisons? The whole thing doesn't even begin to make sense, it's so full of holes.
And just so full of strawmen:
Most people with FND think, at some point, that there must be some damage to their brain to cause the symptoms they have.
Change, not necessarily damage. And some damage is so subtle that it takes extremely careful evaluation to notice it, like the myelin damage in MS. They keep putting words in the mouths of patients that many patients don't ever even think. Although it may still be damage, as they mention elsewhere above, some of it is just subtle, and then they argue that being subtle makes it less obvious, to them I guess, whether it may better be explained by some psychological process, again whatever that means in the context of "there is the mind, and there is the brain, and there is the body, and we are not dualists".
And this:
If the structural changes have always been there, then that’s clearly important but we still don’t know if they represent an obstacle to improvement.
If the structural changes happen because of the condition, then we need to help patients understand that FND has changed their brain, but treatment can hopefully change it back again.
Has all the same intelligence of your average sports commentary. "Well, Chuck, team A might win if they score more goals than team B, but then again team B may score more goals than team A and go on to win. Now let me rephrase that piss-poor excuse of an analysis for the next 4-5 minutes and we'll move on to the beer commercials." Good grief this is mediocre.
