Conversion Hysteria

by Sam Malone

Conversion hysteria, also known conversion disorder or hysterical neurosis, is characterized by the presence of physical symptoms without any underlying physical cause. It involves a change or loss in physical function of a particular part of the body, say an arm, which cannot be accounted for by any particular disorder. The symptoms manifest themselves suddenly and are often triggered by moments of anxiety or stress. For example, a soldiers arm may become paralyzed during combat. The fact that stress and anxiety are the main causes of the physical symptoms suggests that they are psychological in origin and any treatment should take this fact into account.

The incidence of conversion disorders is still disputed, with estimates of its occurrence ranging from a low of 1.1 in 10,000 to 1 in 200. This may have something to do with the subjective nature of the field of human psychology, as well as the fact that many people discontinue treatment the moment they hear that they have a psychological problem.

Conversion disorder has been linked to incidences of childhood trauma. Recent studies have found a higher incidence of childhood abuse, both physical and sexual, in cases of persons diagnosed with conversion disorder as compared to those diagnosed with mood disorders. In fact, the name itself derives from the belief that it is caused by the conversion of repressed sexual or aggressive feelings into physical symptoms.

The symptoms of conversion hysteria often mimic those of medical conditions involving voluntary motor functions such as movement or sensory functions such vision, hearing and smell. The symptoms include:
  • Paralysis of limbs or other parts of the body
  • Problems in physical coordination
  • Epilepsy
  • Blindness
  • Tunnel vision
  • Inability to speak
  • Loss of hearing
  • Loss of sense of smell
  • Loss of sensation in a limb
These symptoms do not match any medical conditions. For example, conversion epileptics will not loose bladder function during an attack unlike true epileptics and those whose vision seems to be affected can still walk around in a normal fashion. However, diagnosis of conversion disorder can be a tricky affair, with people sometimes being misdiagnosed as having an underlying problem.

To confirm a diagnosis of conversion disorder, a psychologist will need to consider the following features:
  • There should be at least one symptom that involves voluntary motor or sensory functions
  • The symptoms should be triggered or exacerbated by psychologically stressful or conflicting situations
  • The symptoms are not deliberately induced nor are they faked
  • The symptoms are severe enough to require medical attention and affect the person’s ability to function effectively, causing tremendous emotional distress
  • The symptoms need not necessarily involve pain or sexual dysfunction
  • Other mental disorders have been ruled out.
At times, patients afflicted by conversion disorder may recover on their own accord. This may happen when tests rule out any physical causes and the person begins to feel better. However, in many cases treatment will be required to help them recover from their symptoms. Treatment options may include:

  • Psychotherapy: This form of treatment can help a person learn to cope with stressful situations more effectively, resulting in the symptoms fading away. However, this form of treatment may need to be continued for a long time as many patients with conversion disorder have recurring episodes in the future.
  • Medications: In many cases anti-depressants may be prescribed to speed the recovery process. These may only be prescribed by a psychiatrist.
  • Physical or Occupational Therapy: This may be required for patients to recover the use of a limb or to relearn normal behavior.
The prognosis for conversion disorder will depend on many factors including primarily, an accurate diagnosis. People afflicted by conversion disorder will do well to continue their therapy even though progress may seem slow.

References:
  1. http://www.csun.edu/~hcpsy002/0135128978_ch07.pdf
  2. http://www.med.nyu.edu/content?ChunkIID=96743

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