When was conversion disorder discovered

She was referred to a psychiatrist who started antidepressant therapy and then sent to me because of inadequate resolution of her physical symptoms. Interestingly, the patient was able to walk if asked to stand and move in the backwards direction, but she was unable to do so if asked to walk forward. It was later discovered that immediately preceding the onset of symptoms, the patient had been assigned to a non-combat-related job in the military.

Unable to express this conflict via traditional means, the patient resorted unconsciously to a physical language to relay her guilt and shame. First outlined over years ago, CD, or functional neurological symptom disorder, continues to present a challenge to neurologists and mental health professionals. Psychoanalysis provides a lens through which to understand the physical symptoms of the disorder, and psychoanalytically informed treatment has been shown to be effective.

Perhaps most importantly, psychoanalysis teaches us that conversion symptoms are unconsciously driven, symbolic, interpretable, and amenable to psychoanalytic investigation. He is a psychoanalytic psychotherapist in private practice.

The author reports no conflicts of interest concerning the subject matter of this article. What do you think? Share comments with your colleagues by emailing PTEditor mmhgroup. Comments may be shared online pending review and editing for style. Freud S. Some points in a comparative study of organic and hysterical paralyses.

Collected Papers. London: Hogarth Press; American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders.

Feinstein A. Conversion disorder: advances in our understanding. Culture and conversion disorder: implications for DSM The prevalence of conversion symptoms in women from a general Turkish population. Psychosomatics ; Affective-cognitive behavioral therapy for somatization disorder. J Cogn Psychother.

Neurological disease, emotional disorder, and disability: they are related: a study of consecutive new referrals to a neurology outpatient department. J Neurol Neurosurg Psychiatry.

Somatization in primary care. Prevalence, health care utilization, and general practitioner recognition. Who is referred to neurology clinics? Clin Neurol Neurosurg. Ten-year prognosis of conversion disorder. Br J Psychiatry. Similar semiology of epileptic and psychogenic nonepileptic seizures recorded during stereo-EEG. Kaplan MJ. A psychodynamic perspective on treatment of patients with conversion and other somatoform disorders.

Psychodyn Psychiatry. Psychopathology and trauma in epileptic and psychogenic seizure patients. The view on women was also unchanged. Many treatises, such as The Canon of Medicine of Avicenna, written at this time described women as the cause of the disease, rather than as a patient in need of treatment. Thomas Aquinas frequently discloses his dislike for women in his work Summa Theologica.

He expresses how women should have not been created in the first place, how women are failed men , and how they are the result of sin. Aquinas also alludes to how old women are evil, look at children in a toxic way, and are witches who cooperate with demons. From this moment on, mental illnesses were seen as a connection between women and the devil. As a result, the treatment for hysteria went from spices and pleasant aromas to exorcism. Exorcism at this time was seen as a cure, and not a punishment.

Hysteria was often confused as witchcraft in the late 13 th and early 14 th centuries. This was due to physicians not being able to identify the cause of the disease, and therefore attributed it to the devil.

At this point, exorcism was a punishment and no longer a cure. Thousands of innocent women were killed as a result of this book. Thomas Willis was the first to no longer attribute hysteria to the wandering uterus, but instead relate it to the nervous system and brain.

Around the same time, Thomas Sydenham published an epistolary dissertation on hysteria. Here he recognizes that the symptoms of hysteria can be simulated across all areas of organic diseases. Sydenham also believes the uterus is not the cause of hysteria, as Willis stated beforehand, and also relates hysteria to hypochondriasis. In his dissertation, Sydenham sways between hysteria being explained psychologically or somatically. We are still not certain of this today as the ICD categorizes conversion disorder as a dissociative disorder , while the DSM-5 categorizes it as a somatic symptom disorder.

Hysteria was no longer thought to be a relationship with Satan after the Enlightenment in the 18 th century; mental illnesses began to be regarded in a scientific light. It is now that hysteria is progressively associated with the brain rather than the uterus.

Several year later, Sigmund Freud and Joseph Breuer also conducted studies on several patients with hysteria. During the late 19 th and 20 th centuries, cases of conversion disorder dropped by almost two—thirds and then continued to decline.

What might cause this dramatic decline in a once very prevalent condition? It has been suggested that syphilis mimics the same symptoms and effects as conversion disorder if gone untreated, and being able to differentiate between the two dropped cases of conversion disorder. Another suggestion is that the social circumstances for women that produced conversion disorder in the first place are no longer in effect.

Women have essentially been emancipated. Both of these theories are plausible when we take into account that conversion disorder typically occurs in populations with low socio-economic status , less educated individuals, and in strict social systems that prevent the individual from directly expressing their thoughts and feelings. The history of conversion disorder is interesting and extensive. From wandering uteruses to demons to underlying stress, several names changes, and dissociation or somatization, conversion disorder has seen it all.

Nonetheless, it is important to note that the symptoms these individuals are experiencing are very real, and are not feigned in any way.