Conversion Disorder and the Brain

[Sammie4258]

I have severe Conversion Disorder and am wondering where in the brain does this occur.  If it is a motor sensory problem, does that mean it is everywhere in the brain or a generalized location, like the brain stem or some thing. Obviously it is a central nervous system problem but can it be pinpointed to a certain area?  

Also, what are the best treatment for this besides counceling and such?

Tami

[JSGeare]

I'll make a stab at this. So to speak. Freud thought that unresolved emotional conflicts were suppressed (not dealt with) and then later "converted" into physical symptoms. The view fell from favor for a while, but Ziggy's ideas survive today in forms of therapy and actually it makes some sense to me. Sort of like the cat. Where's the cat? Have you seen the cat? Here kitty, kitty, kitty. Well, I'll dry the laundry and then we'll look for the ***** cat. So I start the dryer and NOW I know where the cat was! YEOWLLLLLL! Which is cat for, "let me outta here!" Who KNEW she was in the dryer?

Where in the brain? I'm making this up, but darn its good! If the source of the numbness, tingling, pains and other stuff for which no immediate and obvious reason exists IS those old experiences that are still clunking around in your attic, then it is likely that they are sort of all over the place rather than being neatly filed on some emotional to-do list right behind your left eye socket. Sort of like this forum site (or any forum site). The members are all over the world, and the computers that house the forum and handle communications among us likewise are all over the world; but everything is connected together and it all presents as though we are all here in one place together.

I'll take this a step further (I'm on a roll, here). Each of our computers has a unique "IP" address which is what the technology uses to connect everything and decide how to handle communications. I do NOT need to know the IP address of your system to communicate with it. The machines do it. If the brain works in somewhat the same way, you do not need to know, really, exactly where in the jelly jar that memory of mommy kissing Santa Claus is stored, or the playground experience with a bully when you were 8, or the libretto to "Monster Mash." In fact, it is likely that the memory itself is sort of sliced and diced and kept in various places -like stuff on a hard drive. Sort of like your keys: if you keep them in various places, you'll never lose them all at once (you will olose them all over a period of time, maybe).

My point is this: you don't need to know where in the brain a memory is to recover and examine it, anymore than you need to know where I am to communicate with me. Once a memory is uncovered and the conflict resolved, you don't need to know where all the OTHER memories are either -they will handle the communication and updating all on their own. Like the forum -I respond to ONE person, but EVERYONE gets the message. And THAT was, indeed, my therapy experience. Once one or two memories, confluct, experiences or whatever you want to call them were isolated and identified and DEALT with, the other also were adjusted in step -all by themselves. Like a see-saw: add one tiny extra bit of weight to one end -and the entire half of the see-saw goes down.

As I said, I made it all up. Run it by someone who really understands this stuff -and see what he or she has to say of it. If nothing else, this will keep the conversation going.

[Sammie4258]

Although it's obvious you have a sense of humor, I respectfully find your comments a bit offensive.  Tell me something I don't already know.  With all due respect, I think I will wait for a professional to answer my question.  Please don't insult my intellegence.  I know more about this than you think.  

sammie

[JSGeare]

Nom offense intended; I do take a risk when I deploy humor, however awkwardly, in an attempt to make my point. But something ELSE you said really does have me wondering, and I may REALLY have fallen down on the job on this one.

If what you want is a PROFESSIONAL opinion, you're in the wrong place. For that, try the "Ask a Doctor" forums. At screen top, click Forums, and you'll see them all listed on the right side of your screen. Forgive me, please, for not having understood from the get-go that such was your expectation.

If by chance, what you are really getting at is a more serious-minded and objective type answer (whether from a professional or just anyone) then don't worry -one should be coming in any time now. There are plenty of folks here who really do have some remarkable (and more respectfully expressed) views. Meanwhile, if you can squeeze out anything useful from my response -and leave the pulp behind- it might be useful.

Respectfully submited.

-JSGeare

[Sammie4258]

I did use Ask A Doctor.  I clicked the doctor link and typed in his ID.  I was a little surprised when you responded to it.  
However, I can appreciate your sense of humor.  Obviously, you are very talented with wit and words and ordinarily I can appreciate and even enjoy that.  But,  I was looking for a very simple and straight answer from a Doctor. Please understand that I was diagnosed with a severe conversion reaction and in fact, it was in my medical report that I scored higher than anyone ever studied in clinics. Possibly concluding that it is the most severe documented case.  So, with that, I can tell you with a great deal of confidence that I understand conversion probably better than anyone else including some doctors.  I even shocked the specialist who tested me. He had not seen some of the symptoms that I displayed. I admit I have not had the time to find out where exactly in the brain this may occur.  I had already concluded myself  that because it was a motor sensory  and central nervous system condition, that it most likely was  all over in the brain.  But I assumed it all leads back to one area like the brainstem.  I just wondered if there was something I was missing.  
I do have to respectfully disagree with you in that It does matter to me where it comes from because there are professionals who can re-train the brain and certain of parts of its functions. I know this with a great deal of certainty.  I have been through the process of re-training the brain which in turn effects the other parts of our bodies.  Legs can be re-trained.  Arms and fingers.  Our eyes and ears can be re-trained.  
So to tell someone it doesnt matter to them where is comes from seems to me to take away our right to know and satisfy our interest or curiousity and limits our ability to work with the brain in a more specialized capacity.  
I would also caution you that although your approach was humourous and very intelligent, Answering a question such as mine in the way you did, is not as helpful as you might think, simply, because if you understood Conversion Disorder as well as I do, you would understand that we have cognitive deficits when it comes  in interpeting incoming stimulus.  Add ADD on top of that and with the effects of Chemo.  It is very important that Conversion reaction patients recieve simple to understand answers. With all do respect, if you understood Conversion Disorder as well as you claim, you would have known that.  I had to read your post three times before I was able to understand what you meant by all that. Four years ago, before my reaction emerged, I would have had no problem understanding you words the first time around. Our cognitive ability to understand and interpet concepts is compromised with conversion reaction.  
All this said, I still appreciate your humor and wit and don't stop being you. But please beware of individuals abilities to interpet abstract explainations.  We are not all created equal.  
With Respect,
Sammie

[LouisRawls]

"I have severe Conversion Disorder and am wondering where in the brain does this occur.  If it is a motor sensory problem, does that mean it is everywhere in the brain or a generalized location, like the brain stem or some thing. Obviously it is a central nervous system problem but can it be pinpointed to a certain area?"
________________________________________________________________________

Tami,

What part of the brain does conversion hysteria target?

Answer: Any part of it that you are able to conjure up. From a physiological standpoint, hysteria doesn't target any part of the brain. Hysteria is not organic disease. Thus, if you were to undergo an extensive work-up consisting of a brain MRI w/ contrast, an EEG, or an EMG, they would all be normal. There would be a complete lack of physical findings, as there simply are none. It's all pseudo, and stems from a far more complex source - the human psyche...

The etiology of conversion hysteria is dissociation, a process whereby specific internal mental contents (memories, ideas, feelings, perceptions) are lost to conscious awareness, and thus, become unavailable to voluntary recall.

Though unconscious, these mental contents can be recovered under special circumstances (dreams or in a hypnotic trance). They are able to affect an individual's awareness and behavior in a variety of ways through fugue or amnesia states, or through converted symptoms (paralysis of a limb, blindness, mutism, psychogenic seizures, etc).

All of the physical symptoms are psuedo, are not real, and they cannot harm you.

Conversion is actually a defensive mechanism, providing for the banishment of anxiety-provoking, painful, unpleasant mental contents from consciousness. However, the individual becomes subject to the unconscious substitution of hysterical symptoms (noted above).

That's what separates conversion disorder from an anxiety disorder. When the physical symptoms manifest (or when they are converted unconsciously), anxiety is relieved in the case of conversion disorder, and the person is indifferent to them (not phased by them). By comparison, physical symptoms provoke anxiety in true anxiety states, or anxiety induces physical symptoms which further fuels the anxiety. Not so in conversion hysteria.

Two more severe manifestations of conversion hysteria that were mentioned above are:

(1) Anterograde Amnesia - Complete loss of memory for all past events spanning a period of several hours (or more severely, several weeks).

(2) Fugue State - Where the individual loses all recollection of his/her past life and any awareness of who he/she is. The typical person travels far from home, begins a new occupation with a new idenity being completely unaware of any change in his/her life. Suddenly, after several days, weeks, or months, the person finally "comes to". Totally amnesic for the period of the fugue, the person recaptures his/her former identity, and greatly distressed, wonders how he/she came to be in such strange surroundings.

There is no known cure. Treatment consists of psychoanalysis or (more effectively), hypnosis (for bringing repressed ideas into consciousness). Manipulation of your enviornment (ie: changing jobs) may also be of some benefit. However, the issue with conversion hysteria is that once old symptoms abate, new ones form and take their place. That's why there is no known cure.

The symptoms are due to highly charged anxiety surrounding some incident or set of circumstances in the person's current or past life which have been completely repressed. If you are able to bring those repressed ideas into the realm of consciousness, you stand a good chance of accepting and understanding them, in tandem with a reduction or remission of your physical symptoms.

Would recommend seeking a psychologist who specializes in hypnosis and dissociative disorders specifically.

[Sammie4258]

I also have to disagree with you tht these pseudo symptoms cannot harm you.  I know  that they say you cannot die from conversion disorder but this is false. I had so many Psuedo seizures that it shoved my stomach up into my chest.  It was emergency surgery or I would have died in a matter of hours. A person can fall down stairs.  They can walk out in front of a car.  Please don't be fooled that these  symptoms are harmless.  I have done all of these with my conversion disorder.  
Sammie

[bonica]

There's no personal gain & secondary gain involved in CD.
Try being confined to a wheelchair & be racked with pain then tell me how much better you feel!
CD is not all in the mind. We have a long way to go in fully understanding how the brain works & I'm sure in time & when science is willing to fully research CD they will find an organic basis for this dreadful & soul destroying condition that reduces people's lives to abject misery.

[RCA759I]

"There's no personal gain & secondary gain involved in CD."

^quote

That is correct. Those with conversion disorder are not attention seekers or malingerers. They don't intentionally play the "sick" role, and they are not looking for sympathy - they run from it. There is no gain for the sufferer, as you've pointed out. In almost every instance, conversion disorder is induced by a traumatic event. The ideas, memories, thoughts and perceptions surrounding the event or events are greater than what the mind of the affected person can process, and ultimately, the brain looks for peripheral mechanisms to offload its burden- but there are none, as the brain is intertwined with everything. There is a non-specific disconnect between mind and central nervous system, and unexplainable physical symptoms manifest.

My own (bizarre) theory to explain the etiology surrounding conversion reactions is a selective (rather than global) over-firing (or under-firing) of Nicotinic Acetylcholine receptor sites - a selective cholinergic (or anticholinergic) crisis if you will, isolated only to specific areas of the autonomic nervous system. Receptor sites controlling motor function of the left arm, for instance, if affected, would lead to the sensation of paralysis. The diaphragm - hypoxia, the brain - seizures, the peripheral nervous system - pain or neuropathy, and so on. It's a neurological disorder from my point of view. Further research is needed in this area, albeit given the rarity of it, there is little incentive outside of private institutions to actually conduct the research.


-Ryan

[Kadaffy]

Recent advances in technology, such as PET scans, fMRI's, and Qeeg analysis point to the temporal lobe region of the brain playing a central part in conversion. I underwent Qeeg neurotherapy to treat a movement disorder diagnosed by Psychiatry as Conversion Disorder.
After Qeeg analysis it was determined I had a high amount of Alpha activity in the temporal lobe region.Of course due to the complexity of the brain, how the symptoms manifest in each person is still unknown. I also underwent intensive psychotherapy. The movement has stopped but I now suffer from blepharospasms and dysphonia..This shows that this condition is more Neuropsychiatric and psychological in nature.
The human brain doesn't fully develop until we are around 25..
Psychological processes before this time play a large degree in how the brain is " hardwired",,Neurologically.
There is hope for us though as the brain has a high plasticity and can change, even neurologically. Just witness the recovery of stroke and brain injured patients and it is evident.. Read the treatment for Phantom limbs as an exaqmple.The trick is to find the proper techniques and support for it to manifest in positive ways.
Shawn

[nora006]

I see this is an old thread, but I read your post with great interest.

I don't suffer from conversion reactions myself, but have seen this "phenomenon" happening to a friend of mine right in the street, whilst we were talking. We had just been to the cinema and a few minutes after we had left the building my friend complained to me that she had lost strength in her legs, meaning she had suddenly lost the ability to stand on her feet. She was later examined at the ER ,with no findings. The symptoms lasted for a few days and the strength and stamina returned gradually.
I can confirm that this person is not an "attention seeker", what so ever.

The next day I told a psychoanalyst about the incidence and what had happened to my friend during this particular day, and in the light of this information he could immediately state that she had been subject to retraumatization. She said it made perfectly sense since she had indeed experienced something earlier the same day which in reality had been extremely traumatic to her even though she had not had any conscious reaction to it when it happened. The unconscious content was of such a nature that it could not be remembered or processed consciously.

I believe you're right when you say that these kinds of reactions are neuropsyciatric and psychological in nature(which your own story indeed shows us). Whether one wants to denote the phenomenon as just "neurological" is a matter of definition. Neurobiology is one way of looking at it, trying to determine which parts of the brain and what sort of neurochemistry are involved. But the psychological aspects can never be separated from the physical brain as such.
In this resepect I, in principle, agree with Sammie's argument in that the mind is "where the wild things are", thus pseudo symptoms do not need to be harmless so long as the mind obviously has the power to trigger the same physical reactions as "the real thing". In some cases that would certainly not be harmless.


Apropos/malapropos remarks:
Luckily we are not bound by the mind's beliefs, thanks to the prefrontal cortex (and associated structures) that can be used to build or strengthen synaptic pathways to control or even permanently transform the seemingly "uncontrollable". This is where psychotherapy comes into play. But being one myself that struggles with my mind's highly unreasonable, but ingrained beliefs every day, I KNOW for sure that my own mind is really the toughest opponent of all times, both due to the "hardwiring" that has taken place, but also due to the brain's extreme capacity for learning(new fears), therefore it is definetely where the wild things are. At the same time my mind (or my emotional brain) has been, and still is, vital for guiding me in creating a narrative of who I truly am, without which I could not have made sense of the different psychological manifestations I have experienced throughout life.



Yours,
Nora

[Kadaffy]

I agree Nora...That is something that makes this condition very hard to diagnose and treat....From what you explain it is a form of Post traumatic stress...While you're doing one thing the subconcious is still active on another subject. The symptoms can manifest afterwards.
I've realized this about myself while watching TV. For some reason I would have symptoms while watching a certain TV program..." Friends"...My subconcious thoughts on how things are on the show compared to how my brain percieves things should be...Compared to my values,and beliefs...It creates a conflict...From what is supposed to be normal but, I have never experienced.
Psychologicaly it is a normal process, to those who experience it.
If you don't experience it, neurologicaly it does'n't..." add up..
That is the conflct ...Even though you're "subconciously" aware of it...
Great point...
Shawn