Have you ever heard the expression 'mind over matter?' Well, that pretty much describes conversion disorder. In this lesson, we'll learn about the history, symptoms, causes, and treatment of the mental illness known as conversion disorder.
Conversion Disorder and Hysteria
James can't see. His eyes work fine, and there's nothing obviously wrong with his brain, but he has lost the ability to see. It happened about a year ago when he was feeling very stressed at work. Ever since then, he has been blind. James' doctor is stumped and sends him to a psychologist for help because the doctor thinks he might have something called conversion disorder.
Conversion disorder is a psychological disorder that involves having physical or neurological symptoms of a disease without physical or neurological evidence for that disease. In the 19th century, conversion disorder was called hysteria. Early psychologists, like Sigmund Freud and Jean-Martin Charcot, noticed that many of their patients were sharing certain physical symptoms despite not actually being sick. Charcot saw many patients who seemed to suffer from seizures and paralysis but had nothing physically wrong with them.
At the time, conversion disorder was believed to only happen to women. As a result, some doctors believed that these symptoms were caused by a womb that had detached itself and wandered around the inside of the body. The term coined for the disease, 'hysteria,' came from the Greek word for the uterus.
However, as time went on, it became clear that men as well could suffer from conversion disorder. Freud, who still believed that conversion disorder was a female issue, began to call hysteria conversion disorder because he believed that it was caused by the body converting psychological issues into physical symptoms.
In the 20th century, psychological disorders were clarified in a book called the Diagnostic and Statistical Manual for Mental Disorders, or DSM for short. In this book, mental illnesses were put into categories and each disorder was given its own criteria to help psychologists diagnose it. Conversion disorder was put into the category of somatoform disorders, which are psychological illnesses that cause physical symptoms.
Remember James? For the past year, he's been unable to see, even though there's nothing physically wrong with him. Imagine that you are a psychologist and James' doctor sends him to you. You believe that he may have conversion disorder. In order to diagnose him, you pull out your DSM and look down the list of symptoms for conversion disorder.
1. Physical symptoms that suggest a neurological or medical condition.
James is blind, which is a symptom that is normally caused by either a neurological or medical condition, so he meets this criterion.
2. The symptoms began or became worse around the time of a psychological stressor.
Remember that this started for James about a year ago when he was feeling stress at work. Other possible stressors that could cause or exacerbate symptoms include losing a loved one, changing careers or even positive life events, like having a kid.
3. The person is not faking it.
That is, the patient isn't doing something to cause the symptoms and isn't pretending to have the symptoms. When James is tested, it's clear that he truly can't see.
4. The symptoms cannot be explained by a physical condition.
Both James' eyes and brain are fine, so there's no medical explanation for his blindness; therefore, he meets this criterion.
5. It causes distress or impairment.
Distress could be any type of emotional problems - if the person is upset, for example. Impairment could mean that the person is not able to have a normal relationship, or that he or she is not able to hold down a job or take care of themselves. Since James lost his sight, he has not been able to continue at his job, which constitutes occupational impairment, so yes, his condition has caused impairment.
6. There is not another mental disorder that could explain it.
There are several somatoform disorders and there are also other disorders, like sexual dysfunction disorders, that overlap with conversion disorder. If the patient has one of these, then they are not diagnosed with conversion disorder. Instead, they are diagnosed with only the one disorder. However, James does not have another mental illness that explains his symptoms.
Causes and Treatment
So James meets all the criteria for conversion disorder and you are able to diagnose him with it. But what could cause conversion disorder? And how do you treat it?
Psychologists aren't completely sure what causes conversion disorder. Freud, who believed that it was the mind converting psychic pain into physical pain, believed that the cause was the repression of sexual trauma. There is some support for Freud's theory in that a high percentage of patients with conversion disorder are survivors of childhood sexual abuse.
Some more recent studies have found that perhaps there is a neurological basis for conversion disorder. Specifically, a few brain imaging studies have shown that there appear to be blood flow issues in the brains of conversion disorder patients. However, the jury is still out on whether blood flow in the brain is a cause of the disorder.
Whatever the causes, there are several types of therapy that are used in treatment. Talk therapy is an important part of treatment for conversion disorder. Psychologists work closely with the patient to examine the stress and trauma that might be causing the disorder. They try to help the patients come to understand that there is nothing physically wrong with them.
At the same time, the physical issues associated with conversion disorder can be addressed with physiotherapy and occupational therapy, both of which focus on retraining movement patterns. This is especially important in patients that display conversion disorder with movement issues, like paralysis.
Conversion disorder is a somatoform disorder that is characterized by physical symptoms without a physical cause. Though the exact cause of conversion disorder is unknown, it is often triggered or exacerbated by a life stressor. Trauma, particularly childhood sexual trauma and blood flow issues in the brain may also be causes of the disorder. Treatment includes psychological and physical therapy.
After you have watched this lesson, you should be ready to:
- Define conversion disorder and summarize its history in psychology
- Name and describe the symptoms of conversion disorder
- Discuss possible causes and treatments for conversion disorder