Conversion Disorder

Why is it that people with conversion disorders are considered to have personality disorders?  If a child as myself have been abused and a victim of serious stressors, and left with debilitating consequences,  why call them personality disorders.  Am I really a product of circumstances.  

[Abhijeet Deshmukh, MD]

Hello.

Conversion disorder has it roots in the sub-conscious mind. It may be a mean to avoid certain situations, persons or events. If there is a certain situation one is afraid of, the body reacts by conversion, preventing the situation to even arise. This is the simplest model of conversion that I can explain here.

You are correct in saying that conversion disorder does not necessarily have a personality disorder associated with it. But there are certain personality types, especially in females, which are known to be associated with it.

You may have heard people call it a personality problem. But I guess they don't know the proper use of the word.

Regards

[Sammie4258]

If personality disorders are more common in females, what attributes to this?  What kind of specific personality disorders are we talking about here.  I would like to learn more.  Thanks.

[Abhijeet Deshmukh, MD]

Hello.

I would like to explain this on two platforms. These are clinical psychiatric diagnosis of a personality disorder and personality theories given by the earliest psychologists, psychiatrists and psychoanalysts.

To call a particular behavior pattern a personality disorder, there should be a significant deviation from the expected behavior. The deviant behavior should be causing a lot of distress to the person and the people around him/her. There are a number of pointers that can help psychiatrists and psychologists diagnose a person with personality disorder. Some of these are day to day problems the person is facing or creating. There are four major clusters of personality disorders.

Cluster A: the person stays aloof, does not mix up with others readily, can grow up to be schizophrenic.

Cluster B: Antisocial, Borderline, Histrionic and Narcissistic personality disorders. This group is of particular interest to us, especially the histrionic and the borderline. These are associated with emotional instability and attention seeking behaviors. These behaviors are incorporated in one's personality through all the experiences, good or bad, one has had right from the time of conception.

Cluster C: obsessive, worriers, depressives, etc.

Personality disorders are distributed as per gender. Females are more prone to borderline and histrionic personalities, whereas, males are prone to antisocial and narcissistic personalities, amongst others. These are just examples.

Talking of the personality theories, Sigmund Freud, the famous psychoanalyst from Austria has described the structure of personality based on a person's psycho-sexual development. He has described certain stages of this development.

Sigmund Freud has explained the theory of conversion disorder on the basis of emotional distress. "Conversion" is a bodily response to an emotional distress. I can explain this with an example. There are two sisters. The elder one is married to a handsome man and the younger one falls for him. She fantasizes about him and wants to marry him. But she knows this is not possible. She will be committing blasphemy. There is a lot of distress created in her subconscious mind. One fine day, she suddenly falls to the ground, paralyzed. She can't move any of her legs. Why? There is no neurological explanation. The symptom has a psychological cause. Her thoughts of possibly running away with her sister's husband created a lot of anxiety. And the body reacted with paralysis. Now, she can not even walk, forget "running away". Anxiety is settled down. The problem is solved, for the moment.

Though conversion is thought to be an attention seeking behavior, there are deeper issues involved. And these issues are unique for each individual suffering from conversion disorder.

Regards

[Sammie4258]

Thank you for your comments and expertise.  I understand everything you are saying but I guess I am having a problem accepting the catagorization  of clumping circumstances under the whole personality disorder theory.
For example, when I was Psychologically tested for Conversion disorder, the test asked a question of whether or not I had ever gotten angry and hung up on anyone while taking on the phone.  Being the honest person that I am, I truthfully answered, YES. It also asked me if I had ever walked off a job.  Again, I answered YES.  But here is why I walked off the job.  It was company policy that any employee who disrespected another employee, they were to be disciplined.  One day, one of the employees had the hard rock music turned up loud.  As  one of the office managers, I went out  and turned the music down.  He called me a f-------b--------!  I reported it to the owner who just blew it off.  Shame on him. I felt there was no respect for me and if that is the way it's going to be, then why should I subject myself to anymore abuse.  Grant it, I lshould have given notice and that I regret, but under the cirmcumstances, I felt at the time that I could not longer work under that stress.  Now, as for the phone call in which I hung up on.  If someone is badmouthing me over the phone and distrspecting me, why should I waste my time just to let someone hurt me.  
Now, back to the Psychological test.  Because I answered yes to these two questions,  I was labeled as having a personality disorder.  The report even went so far as to say that I was aggressive and hyper-vigilant.  This really did not set well with me because I have never attacked, hit, physically picked a fight.  How is it that I became aggressive and hyper-vigilant.  I never retaliated.  Instead, I went home and cried, got depressed  and then began sewing, which is my method of dealing with stress.  Why do I have the personality disorder?  Perhaps it was the disrespectful employee who had the problem or the other person on the other end of the phone who was bad-mouthing me. I was just the brunt of it. and we all deal with it in different ways.
I am struggling with the labeling and catagorizing of this  type of stuff as
having a personality disorder.  I don't have a problem with having a personality disorder because no one has walked in my shoes. But I do have a problem of taking the blame and being the product of someone elses weaknesses or cruelness and then being told that I have the disorder.  And more importantly, I have a sister that has place death threats on my life twice Iand as recently as  August. I was violently attacked by her and a cousin at a family reunion.  I called the police, she lied and even though there were witnesses claiming that she was the aggressive one and that I in fact hit no one, they were going to press charges against me for battery.  And because I yelled for help, they were going to press charges on me for distrubing the peace.  Eventually,  it was dropped, but if it went into court, and my psychological report was entered in. It would convict me because it concluded that I was aggressive and hyper-vigilant. What an injustice that would have been to me to go jail because of this report. I am an  honest person and will always take responsibility for my mistakes. And again, I repeat, I never hit anyone that day or any other time.  I am not a violent person. I have always been to submissive to stand up for myself.
So I guess to some things up,
Which would be worse, go home and cry and get depressed, become disfuntional, or stand up for myself and put it right back in the offenders lap. Oh, but if I did that, it would be like being aggressuve and hyper-vigilant.   So, you see my frustration?
Given all this,  I still respect the Psychological community and appreciate all they do but perhaps some re-vamping is in line.
Sammie
  

[Abhijeet Deshmukh, MD]

Hello Sammie.

I agree with you regarding the interpretation of the "Yes" answers. The questionnaire has a lot many questions which should have sub-questions to them I don't believe in diagnosing anyone with a personality disorder on the basis of a test report. It is only when a doctor or a professional talks to a person in detail and tries to find out the reasons behind the actions that they can comment upon the situation.

Your reactions are natural. They were not taken in good sprit. I must say I am not in a position to comment upon the personality issues since I have not taken a detailed history, but I do feel that you have been assertive, but just been unfortunate to be associated with people who were not quite co-operative.

As for the employee who was listening to loud music, it was his duty to comply with the office manager. But he didn't. And he said something which he should not have said. The impact was on you, not him.

I wonder if the report mentioned any particular personality disorder.

There are obvious faults in the reporting systems, and the tests should be more meaningful. Forget the report. I think you need to modify your reactions. It will help you in the long run.

Regards

[Sammie4258]

Thank you for your comments. As to the test, there may have been some sub-questions. However, when I recieved the report, I re-hashed the questions in my mind to see if any of the questions were trick questions.  I believe i was pretty consisent with my answers.  I also tried to remember if there were any other questions that may have given them the idea that I was aggressive or hyper-vigilant.  I concluded that it could have only been those two ordeals in which I answered YES too.  I believe they called it a Borderline Personality Disorder.  I will have the opportunity to go over the test in the future.  I do know that the Doctor  felt that the test was not quite accurate because it also showed that I only had an IQ of 89.  The Doctor made it very clear that that could not be right just from talking with me.  He said I was far more intellegent than what the test indicated.  So even he saw a bit of a discrepancy.  I never graduated from High School and was lousy in math and english.  However, I was able to pull A's in college and online courses.  I do agree that if the IQ test was based on math, english, science, etc, and such then, yes, I am stupid.  I'll admit that.  But I can tell you all about the current affairs of the world, people come to me to get advice on sewing and craft projects, I have learned alot about health and medical issues.  I like to think I have something going for me.  I do however, have ADD/distractive.  Maybe some of that played into the testing.  I don't know.  
Tami

[Abhijeet Deshmukh, MD]

Hello.

ADD does interfere with psychometric testing. I am sure it may have interfered with the IQ testing also. Can you confirm if the IQ test had "verbal" and "performance" components? You may have had a lower score on the verbal. But 89 is still considered in the normal range for all practical purposes.

Have you been taking any help for ADD? Are there any medicines prescribed? Depression is a common accompaniment of ADD. It arises out of constant thoughts of not being able to achieve in life.

Regards

[quietsmelody]

Hi,

I am new to this site, I originally joined because of migraines, but because of a resent visit with the neurologist, I typed in what she said and ran across this section of the site. In June 09 I was rushed to the hospital because my left side went completely numb, there was tingling, my face drooped, my speech, was slurred, and I was unable to move my left side, when I was at the hospital I was told I had a mild stroke, from then on out I was in and out of the hospital, the entire summer. My last stay was in August 09 that is when after a series of MRI's CT CTA Echo Cardiograms, you name they done it... they took so much of my blood I can't count, they then said "Maybe" its conversion, they went into the whole spill as to what it was I laughed, and said ok, just send me home, mind you I was on a walker at that time, thankfully I am now on a cane.


I am now seeing a neurologist that my PCP, referred me to she sent me for a eeg, well before that she said she thought I was having Hemipleigic migraines I looked that up the symptoms fit,  she then sent me for a eeg, it was negative so I was left thinking ok HP migraines, well symptoms kept happening I was sick, this pass Dec 09 I saw her (the neurologist) on the 11th of 2010 she then said well all the test were negative there is nothing for me to treat, (basically because there is no brain bleeds or other negative things that their test can pick up nothing is wrong with me despite all the physical evidence) I asked why my face is still numb, why the sensation on my left side is not as strong as the right, why I am still on a cane (have to use it because when I over use my left leg it gets heavy and more numb), basically why is this still happening,, she said she was not a god, I remembered the conversion theory, I said oh must be conversion she respond yes, yes, (as if I gave a way out) a little bit, a little bit, she said I have sub conscious conversion? she said I am making myself sick but don't know it, so that is what brings me to you,


If by chance I am making myself sick, but don't know it, how can I fix it, of course I laughed at her because I feel since the Psychiatric community made it known that conversion was a psychological disorder doctors, Neurologist, and whom ever in the medical field that may be a bit incompetent, don't want to do the work, or stay true to the Hippocratic Oath uses Conversion as a scapegoat and that is how I feel. You are in the right field to make that call because you are licensed in that field I have had doctors that are not, So can you please tell me, how subconscious Conversion works?

I consider myself a loving mother, and I would do any and everything for my babies,  there is no way on this earth that I would want to cause them the emotional stress that I can only imagine they have felt (as I know I felt stressed while laid up in a hospital not knowing my fate) I wouldn't do that consciously or subconsciously, so for a doctor to tell me that I want to cause something as painful and scary as what I have been through this past year confuses me? I hope you can give me some clarity on this issue. Thank you


quietsmelody

[Sammie4258]

Melody, I just saw your post today.  sounds like you have has some troubles lately. Sorry to hear that.  I have a severe conversion disorder and the left side is generally the side that is most effected although not always.  You can also have migraines with conversion with saggin face.  Actually, with conversion, you can have every symptom under the sun.  The question is is there an underlying conflict that is bringnig it on and what has happened recently that was the catalyst that triggered the symptoms.  It doesn't have to take much to trigger it. THis is a complicate disorder and very hard on families if not treated effectively with in the first 6 months. You need  to see a neuropsychologist.  They really are the only ones qualified to treat this.  
Im here if you have any questions. I consider myself a pro at this.  Been dealin with it for a long time.  Sammie