Talk:Conversion disorder

This disease is toxoplasmosis. Some experts know this but it is not generally known because it is being denied and help has been withdrawn. Toxoplasmosis kills in many different ways, including all the common things we are dying of; e.g., autoimmune diseases, a made-up term for "when the body turns on itself", which is obviously nonsense. Toxoplasma gondii causes cancers, blindness, deafness, alzheimers, bipolar illness, dementia, suicide and many more. Help is being denied and this must change so that many lives can be improved, prolonged and/or saved. Men, women and children contract it at a rate of 1,000 per day and the shame of dishing out diagnoses such as "hysteria", conversion disorder and "delusional parasitosis" should be abolished as the pathetically backward situation has long since been discredited but continues. It is not a mental health problem; it is a known parasitic infection for which help can be provided if diagnosis was available. A decade ago, the help ceased and the extent of the problem covered up. Clindamycin therapy, carefully timed and supervised, can help a sufferer to recover and tetrahydroquinoline can 95% cure it, but funding for trials is being withheld. Guanabenz, or Wytensin, is a 75% cure but has been withdrawn and is now not available. This shameful situation must change.

Could this be resolved, please?

Great to see the great ancient Egyptian culture credited.

Could this be resolved, please?

Calmer and more useful than my previous comment.

There have been repeated suggestions that there be a section concerning controversies. Why not just use the DSM-IV, if that is permissible within copyright, and then a section on history and competing theories. As things stand there is no reason for anyone new working on the article, to the point that I don't want to even move things around.

Comments? --Kovar (talk) 01:22, 2 December 2009 (UTC)

Enough

I was doing some casual research and came across this page. Since I sometimes work on Wikipedia I looked at the history. There has to be some better way of putting it but I am appalled, and appalled beyond belief. As a peer, as a patient, as a publisher, as a researcher, as a . . .

I did the research both inside and outside Wikipedia then went for a walk to calm down. I thought that I'd succeeded but instead had to put the draft over on my own pages. I'm keeping this brief, thus perhaps useless, because otherwise I would go on at length. Those notes might be a useful starting place if you decided to step back and see your actions from the view of someone needing an encyclopedia. --Kovar (talk) 06:07, 9 October 2009 (UTC)

Grammar!

A hyphen should never be used when an ndash or an mdash is meant. Example of a hyphen: dumb-dork. Example of an ndash: 1984 -- 2001. Example of an mdash: This could be the moment--- or maybe not.

Rory Coker

(Sorry if this is in the wrong place) Am I the only one who doesn´t understand the very first sentence in this article: "Conversion disorder is a condition where patients present with neurological symptoms such as numbness, paralysis, or fits, but where positive physical signs of hysteria can be found."

Thomas B.

It's been taken care of. --Kovar (talk) 06:07, 9 October 2009 (UTC)

"but where positive physical signs of hysteria can be found." Is it supposed to say that?

Thomas B.

Anonymous edits

Could 82.26.155.12 please register? It would make it much easier to discuss some of the edits you have made recently. I think there's some interesting stuff in there but bits of it could be interpreted as POV. I'm doing a little bit of preliminary research in this area and might be able to provide some more references. --PaulWicks 19:31, 16 February 2006 (UTC)

Anonymous edits, part the second

Here's the provocative paragraph in question:

NB:

The existence of this as a disorder is now largely discredited (see Richard Webster's "Why Freud was Wrong"). It remains as a diagnosis of convenience however with its chief proponents being Jon Stone And Michael Sharpe.

To quote Stone himself "The truth is we do not know what is causing these symptoms". In the light of this and current research showing disruptions in blood flow within the brain science is at last reaching towards the realisation first envisaged by Charcot that functional symptoms were in fact organic in origin and not caused by repressed emotions or emotional trauma. Indeed since as Stone's research shows most patients are more distressed by their symptoms than any hypothesised stressor the diagnosis appears more and more a historical anachronism.

EDITING IN PROGRESS

I've reverted this for the time being. One of the problems is that a single source is being used to "discredit" centuries of prior work. Believe it or not, there is more than Jon Stone's point of view to consider when considering the issue of conversion disorder.

Another problem is that the citations are inadequate. To cite a work, at a minimum the following must be included: author, title, publisher, and year of publication. Without this information, other editors cannot verify the citation.

This is an exciting time for those interested in the organic basis of psychiatric disease. I share the anonymous contributor's excitement and strongly desire to see the cutting-edge of research included in this article - in a well-referenced verifiable way compatible with the usual Wikipedia style guidelines. -ikkyu2 (talk)

I agree. Just last Friday I attended the British Neuropsychiatry Association annual conference where a whole afternoon was devoted to functional movement disorders which included presentations by Alan Carson, Jon Stone, Günther Deuschl, Christopher Bass, and Ned Shorter. I will take the liberty of emailing them for their input if they would like to join our endeavour. --PaulWicks 09:42, 17 February 2006 (UTC)

This should not an "exciting" time for anyone. It is regressive and reductionistic. The arguments are stale. With all the fabulous advances in technology, nothing has been added to the understanding of conversion. They still haven't even been able to demonstrate why memories are able to return to consciousness after entire brain regions have been destroyed by strokes, while other memories are erased forever as a result of trauma to parts of the body remote from the brain. They still haven't even figured out whether or not the brain activity observed during certain thought processes precedes those processes. What is truly amazing is the vanity of neuroscientists who sincerely believe they are smarter than Freud. —Preceding unsigned comment added by Snud (talk • contribs) 17:13, 30 September 2010 (UTC)

Misunderstood history

Sorry folks but conversion disorder is a condition invented by Freud. Charcot was looking for an organic cause to the symptoms he faced. Prior to this the condition, hysteria, was seen as predominantly as female illness. It was viewed by Hippocrates as having an organic basis- problems with blood flow in the brain. Recent research supports this (I'll look up the reference). There is absolutely NO emotional aetiology behind these symptoms. Stone and Sharpe live in the same diagnostic land as Freud. Their phenomenological understanding of the condition is muddled in the extreme. To say "the truth is we do not know what is causing these symptoms" (Stone) then to hypothesise a psychogenic cause based on flawed Freudian ideas is not science. Ironically the neurologist Arthur Hurst working in 1st World War had a more profound understanding of symptoms classified as "hysterical". He saw them as essentially shadows on the brain caused by disorders of attention or volition. He even hypothesises the organic basis behind this. To assert emotional causes converted into the physical is to sink back into the dark ages of cartesian dualism. Read Webster's "Why Freud Was Wrong" for a comprehensive review of the misdiagnosis of hysteria and the flawed thinking behind conversion disorder.

---

Suppose one of these days your left arm becomes numb, you feel strong palpatations, start sweating profusely, feel chest pains and faint dead away. Furthermore, you are rushed to the ER only to have the doctors tell you you are just fine. Of course, you will argue and protest and pay an arm and a leg for second opinions and tests on fabulous machines that go "piiiiiiiing" only to discover there really is nothing wrong with you. Maybe then you will finally be cured of your cheap scorn.

I would give you a URL to psychogenic heart attacks, but the only medical articles with that title on the web are hidden from public view in order to protect the lambs. However, the following might provide you with some fun edification:

http://www.medhelp.org/posts/Heart-Disease/EKG-showing-false-previous-heart-attack/show/253796

Or maybe you will discover the joys of migraine headaches and take matters into your own hands, paying an arm and a leg for eeg's and MRI's and whatnot, again only to discover there is nothing wrong with you.

Or maybe some morning you will wake up with a stiffy. Then maybe you will finally start to understand the connection between mind and body. Izeenossink (talk) 21:24, 20 July 2009 (UTC)

In reply the the anonymous edit, this is a gross misrepresentation of Charcot. He was teaching neurology, not psychology. He used the term "functional" because he didn't want to get involved in psychology. He wouldn't let his students even ask psychological questions. He wasn't stupid though. One night after demonstrating hysterical paralysis being removed by hypnotism in the lecture hall, Charcot was attending a soiree where Freud overheard him talking to a colleague saying, "Mais dans des cas pareils, c'est toujours la chose genital." (but in such cases it's always a sexual thing). When Charcot saw the look of shock on his colleague's face, he laughed and laughed, grabbed himself by the balls and jumped up and down shouting "Toujours! Toujours! Toujours!" Snud (talk) 17:30, 30 September 2010 (UTC)

Forthcoming publication

Mr. Webster is currently at work on a new book about hysteria and its misdiagnosis

Bias

This article, as written, is terrible. It is heavily biased, gives no introduction, and does not directly define what a conversion disorder is. Had I not already known the definition, I would have been completely lost. Heavy editing is needed, along with introductory material. A total re-write may not be unwarranted. March 25, 2006

This article, as has been updated, is now worse. I will ask for contributions from more writers as at present we seem to have a bit of a quagmire... --PaulWicks 11:25, 6 April 2006 (UTC)

@Alpinist Unfortunately efforts to clarify this seem to have been undone in the years since this comment as this article currently reads to me, as a layperson, as if it is still a currently accepted diagnosis. If this is not the case, then the article still needs a lot of fixing to make things clear. Catfrost (talk) 02:24, 27 June 2024 (UTC)

Yes I agree, I have clarified the meaning further that conversion disorder is an historic diagnosis. I think to suggest that any disorder is psychogenic or non-organic is essentially absurd and leads to allegations of dualism of form and function ie "the central nervous system is intact it's just not working properly" which is a tautology as Webster would agree.

You could do no worse than ask Richard Webster (he has just been asked to lecture alongside Simon Wessely on the subject.). Richard has studied the history of conversion disorder as a Freud scholar and basically it is to quote Richard "a belief system" ie no substantial scientific evidence for the traditional and ultimately Freudian understanding ascribed to this group of symptoms. He is at work on a book on the subject as I type.

Personally I think no neurologist can really comment without reading Hurst's work on the subject, I assume you have read this? functional motor disorders have nothing to do with the conversion of unresolved, repressed crisis into physical symptoms. In my own opinion I agree with Hurst in that they are alterations of attention and volition, I also agree with Hurst that there is frequently an organic stimulus and an organic mechanism by which they are sustained. We think that Hurst had a much better understanding of functional disorders than is currently prevalent. I should also add that I did entirely accept the reality of conversion disorder but discussion with one neurologist in Newcastle and with Webster changed my mind.

Alpinist 10.49, 12 April 2006 (rainy cumbria=slippery rock)

It does now!

Definition now included. I agree it still needs editing to clarify that conversion disorders are disorders of attention and volition. Conversion disorder as put forward by Freud simply does not exist. To claim otherwise is to be ignorant of the history behind its diagnosis, in particular to be ignorant of Freud and Charcot (Le Log is also considered to have suffered from organic disease). Most neurologists freely admit they "cannot get a handle on the cause of these symptoms" (Bateman). I would assert along with Webster that the jump to an emotional aetiology is historic rather than scientific.

I therefore think the article is not biased at all and with minor edits to clarify meaning should stand. The original article was very inaccurate. An archaeology of the disorder supports this as already stated. It also has references to the unconscious, the existence of which in its modern and Freudian sense is phenomenologically doubtful (Binswanger, Heidegger also Dennett for alternative models).

From an evolutionary point of view there is also the question as to how a disorder which supposedly afflicts 40% of neurological referrals could persist at all. Neuro-paeleontology demonstrates that there are no differences between the CNS of ourselves and our neolithic ancestors. Thus faced with an acute stressor neolithic man converts this emotion into functional weakness and is too slow to run away from the tiger. Is the secondary gain the sympathy of his peers as he is eaten? Remember that with Functional weakness we are talking about real changes in tone and movement. It would perhaps be helpful to carry out a study of functional (as in of undetermined aetiology OED) symptoms in other mammals, especially chimpanzees. Humans are not uniquely conscious after all.

But how about irritable bowel syndrome, for example? (Even recognizing that it has also a neurophysiological explanation). The neolithic man would suffer from abdominal pain and other symptoms, if he has to run away from animals too frequently? I don't think we can compare; even if the CNS is the same, the environment (all facets of it) is too different..--Guruclef 09:28, 2 December 2006 (UTC)

Update and reverts

Hi guys, I've tried to integrate both Alpinists' and Boris' information. I think we should resist doing total reverts as there will always be some good information and importantly hard work that is lost each time. I would request for the time being that we let this article cool down for a bit and focus on improving the quality of the references; at the moment they suck! If you take a look at the references at Orbitofrontal cortex I would suggest they would be a good way to go. A full explanation is here: http://en.wikipedia.org/wiki/WP:CITE#Complete_citations_in_a_.22References.22_section, and the templates are here: http://en.wikipedia.org/wiki/Wikipedia:Template_messages/Sources_of_articles/Generic_citations. Alternatively just see what I did on Orbitofrontal cortex and do some copy-pasting. Enjoy!--PaulWicks 13:13, 18 April 2006 (UTC)

Much better

I think Paul has done a great job here

Simon 15:58, 18 April 2006 (UTC)Alpinist

Reversions

Whilst I agree in principle with "be bold", I think this article tends to be rather stop-start in terms of someone making a contribution and it being reverted almost immediately. This is fine in the case of vandalism, but not in the case of someone's hard work and effort which were well intentioned. In my opinion WalkerTexasRngr has made some good contributions that add to a lay person's understanding of what psychiatrists mean when they say conversion disorder. If in another editor's opinion his contributions lack clarity then the proper step must surely be to increase the clarity, not to remove them all together? --PaulWicks 21:16, 8 May 2006 (UTC)

So badly written

It is so badly written as it stands- Key Stage 3 in style, fragmented and confused. An article can become so lengthy as to be worthless. Hard work is no substitute for good work. Do psychiatrist's really know what they mean when they say "conversion disorder"?? etymologically I don't think so. Simonalpinist

Hi Simon. Whilst I agree there is not much flow between different paragraphs I think it's also important to recognise that editors may feel reluctant to contribute when it's likely to end in a revert war. --PaulWicks 08:15, 26 May 2006 (UTC)

Hi Paul, fair comment- I'm trying to improve the flow and have included more information about charcot and the general history of conversion disorder. I've also tried to highlight that as a diagnosis it is controversial. I haven't had time to work on it but have been in discussion with several patients who've had this diagnosis. Interestingly the ones who pushed and pushed eventually got a different diagnosis. Correspondence also suggests that demographically it is the educated and motivated who are able to pursue this. The incompetence and crassness of neurologists also comes across quite strongly. I still feel that there is indeed a unique disorder of attention and volition as Hurst recognised, and that this is of course organic and not a "conversion". I do feel though that misdiagnosis is probably massively under estimated and is a caused by diagnostic poverty and socio-economic factors. I would be interested to know the percentage of private neurology patients who receive this diagnosis.

Simon 19:52, 16 June 2006 (UTC)alpinist

Video

There's quite a good video of this available through a search on yahoo http://uk.wrs.yahoo.com/_ylt=A9ibyJKeKJpETxEAcVR1BQx./SIG=13fsbnusm/EXP=1151040030/**http%3a//education.hsc.wvu.edu/som/psych3/charleston-pbl/schizophrenia_and_other_psychoti.htm Supposed 05:36, 22 June 2006 (UTC)

these links don't work

Simon 17:24, 10 July 2006 (UTC)alpinist

Interesting but please quote sources

The part on Aetiology is terrible, would it be possible to add references, the bacterial hypothesis sounds interesting but how prooven is it? Also other possible causes should be stated is they exist in the litterature. In its present form this section is biased and badly referenced. Also wikipedia should not be the place to advertise forthcoming publications, please use accessible sources. By using forthcoming publications and manuscripts in preparation one can also write an article about the habits of unicorns living on the dark side of the moon...

JMB

Once upon a time there was a unicorn who lived on the dark side of the moon. Unfortunately a lunar lander decided to make its descent above the place where the unicorn was grazing. Paralysed by fear the unicorn was unable to move. Luckily the astronaut piloting the lander noticed the unicorn at the last moment and avoided a collision. However the unicorn still failed to move and indeed is there to this day turned to stone.

Moral- psychic events do not extend beyond the moment at which in heideggerian terms they are at hand. Only In fairy tales are thinfs frozen to stone by fear. In reality the longevity of so called conversion symptoms beyond the hypothesised stressor is an indicator, as slater realised of the false nature of any suggestion of relation.

Fair point on references- the neuropsychiatric nature of lyme disease is well documented. There is also of course Hughes syndrome and a myriad other disorders that mimic conversion symptoms. Hence the well documented work of B. Hyde in "The difficulties of diagnosis" in both finding organic symptoms and treating them in "conversin disorder" patients.

I'll try and find time to include the references. I think you can quote forthcoming publications- readers can use judgement and in a reasonable span time forthcoming will be a specific ISBN.

SJO

---

Masterful polemics, but a little weak on substance. Everybody has opinions on Freud without bothering to read what he had to say. The book "Studies On Hysteria" by Breuer and Freud was primitive stuff--pre-psychoanalysis by five years; and yet this is the book that Freud's opponents read in order to attack him. Such attacks are dumb and juvenile. Anyone who wishes to argue against the etiology of conversion disorder has to read his post 1900 work. As it stands, the arguments presented here are really fatuous stuff. It's impossible to intelligently address such cranky knuckleheaded rhetoric without laughing. Snud (talk) 07:51, 30 September 2010 (UTC)

Yet there are people defending his arguments on this talk page who are literally referencing that book as their source. The article itself references “hysteria” as if it’s a real diagnosis and not long-debunked medical sexism. It seems extremely clear there is bias and poor sourcing going on in this article by supporters of Freud’s theories. Catfrost (talk) 03:35, 27 June 2024 (UTC)

-Snud —Preceding unsigned comment added by Snud (talk • contribs) 07:41, 30 September 2010 (UTC)

My opinion

As a medicine student, I can tell you that this diagnosis, as vague as it may seem, is very real. It's not an excuse for not knowing the real diagnosis, but rather, the (extreme) realization that a patient's illness is not only cells and organs malfunctioning. Nowadays, medicine is all about treating the person instead of the body; the mind, and even the environment, must be taken into account. And sometimes, what's wrong with the patient is not in the tissues but in his mind. We've all felt not only pain, but many weird sensations when under extreme stress or emotions, and in the same way, other processes can affect neurological function of the body (remember that nerves, hormones, and immune system cells, each have ways to communicate between sub-systems of the body). It's true that this is not a common diagnosis, and must be made only after exclusion of other possibilities, but most medicine students (and of course doctors) will see it more than once or twice during their lives. --Guruclef 09:23, 2 December 2006 (UTC)

The above is not really substantiated by medical evidence. We are talking severe and life long signs and symptoms here.

on autopsy 39% of patients have a serious undiagnosed condition (New Scientist)

Oh and 40% of patients seeing a neurologist in the UK receive this diagnosis. In my case a failure to spot a hereditary clotting disorder led to misdiagnosis.

Simonalpinist

Nowadays, medicine is all about treating the person instead of the body; the mind, and even the environment, must be taken into account

- The more I learn about medicine, the more I realise what a dangerous, ignorant and profoundly unscientific attitude this is

alpinist

You, sir, are and idiot. 86.139.151.109 (talk) 21:20, 25 June 2009 (UTC)

I don't quite understand who is saying what here: but I agree with gurucleft, and if someone is accusing alpinist of being an idiot, I disagree. I'd go as far as "moron," but that's it. Snud (talk) 07:53, 30 September 2010 (UTC)—Preceding unsigned comment added by Snud (talk • contribs) 07:14, 30 September 2010 (UTC)

Having a go at this article again

Dear all, in light of my very peripheral involvement with a functional movement disorder clinic I'm going to have another go at this article over the next couple of days. Regular editors please please please give me a couple of days to find sources etc before reverting. I intend to make the referencing style consistent, integrate some newer papers, and perhaps get some other editors involved.

Thanks

---

--PaulWicks 18:45, 22 February 2007 (UTC)

I really don't like this part at the end. "It should also be noted that psychoanalytic treatments, on which CBT is based, were singularly unaffective with Freud and Breuer's patients." All psychotherapy is based on Freud's psychoanalytic treatments, not just CBT. Jeff Vollmer LCPC

--

It won't help to read Breuer's and Freud's *Studies on Hysteria.* The treatment given to the patients reported in that book was not psychoanalysis. Psychoanalysis wasn't created until 1900. *Studies* was written five years before. If you want to pooh pooh Freud, you have to read his later stuff. In *Studies* he did not use the term "Conversion" in the psychoanalytic sense. He employed that term several years later differently: anxiety and conversion are two manifestions of the same thing in that they arise from internal conflicts. So far, nobody around here has demonstrated even the most elementary understanding of the subject. Snud (talk) 08:54, 30 September 2010 (UTC)

The article is a complete mess. Simon's assertions definitely hurt the article, mostly because they are poorly written, obviously biased, single-sourced, and/or poorly sourced (New Scientist? come on). In my opinion, the article needs a complete rewrite preferably by someone who has had direct experience with subjects who supposedly suffer from the disorder.

Justin N 13 June 2007

Justin- this is a completely ignorant thing to say. I do have direct experience- what makes you think I haven't???? Also I have to say not all the edits are mine and the page has gone down hill since a consensus was established sometime ago.

--- --- You yourself have admitted you know nothing about psychoanalysis. Your experience therefore is necessarily totally one-sided. There is a new field out called "neuropsychoanalysis" that you might want to look into. It's for neurologists who want to get their toes wet.

Psychoanalysis isn't something to be scorned btw. If you are a physician, you can be admitted to any psychoanalytic institute you choose, but if you only have a Ph.D.,it's a different story. Before being accepted at any psychoanalytic institute, a non-physician candidate must demonstrate he or she has made significant contributions to his or her field. After being accepted, all students must complete a curriculum lasting a minimum of five years before earning the title of psychoanalyst. There are things to be learned from such people. Snud (talk) 17:50, 30 September 2010 (UTC)

Another attempt at improving this article

Dear all,

In resposne to requests for improvements on this article to be made by someone with appropriate experience, please allow modifications on this article to be maintained over the next few days; some content will have to be cut before new stuff can be added.

Many thanks --PaulWicks (talk) 18:00, 7 December 2007 (UTC)

Just a reminder that Wikipedia is not meant to be the place to have a debate about the topic; going through this again I see a lot of NPOV material that is not helpful and we'll be endeavouring to come up with some more up-to-date references. --PaulWicks (talk) 10:32, 10 December 2007 (UTC)

Agree

Dear Paul,

Thank you for that. In order to preserve the NPOV this article could contain a section to allow those with a completely contrary view (i.e. conversion disorder does not exist) to have their (proportionate) say if they wish. Otherwise the article does need a lot of improvement to reflect the commonly described features of this condition (for example, that found at 'emedicine') and its history. I agree it will be helpful to cut it back first before adding too much - Boris69 (talk) 23:22, 12 December 2007 (UTC)

There seems to be a lot of room for improvement. The article as it is contains many weird views. Is there any evidence at all regarding the (non-)existence of this disorder? Guido den Broeder (talk) 00:30, 13 December 2007 (UTC)

It is an accepted diagnosis within neurology and psychiatry, with DSM-IV criteria. That's about as close to recognition of existence as we can get. The weird views were probably added by a user who has now left. JFW | T@lk 00:50, 13 December 2007 (UTC)

Many accepted diagnoses have no evidence to their existence, so that doesn't say much. Guido den Broeder (talk) 00:57, 13 December 2007 (UTC)

Such as? OBJECTIVE evidence is very hard to find for any psychological phenomenon. Wikipedia is not after THE TRUTH, it is after factual representation of the information available. Therefore, this article should not endeavour to demonstrate whether or not conversion disorder exists, but rather what reliable sources (in which I would include DSM) say about it. Unfortunately it is hard finding reliable sources that provide the opposing view. JFW | T@lk 01:18, 13 December 2007 (UTC)

If you have any sources, present them, so we can judge that for ourselves. Guido den Broeder (talk) 01:29, 13 December 2007 (UTC)

I'm just going to work on cleaning up the references now.--PaulWicks (talk) 22:32, 13 December 2007 (UTC)

New Mistakes

http://www.richardwebster.net/000HysteriaOpening.pdf

In short, the state of affairs which Sharpe and Stone describe, in which the rate of acknowledged or proven misdiagnosis in this area has de‐ clined significantly is exactly what one would hope for if Slater’s conclu‐ sions were a) right, and b) widely heeded by the generation of psychiatrists and neurologists who trained in the years immediately fol‐ lowing the publication of his 1965 paper. It is possible, however, that there is another factor at work. For it is also almost inevitably the case that an initial diagnosis of conversion disorder will tend significantly to reduce the number clinical tests and investigations which are performed on a patient, particularly investiga‐ tions of a non‐routine kind such as SPECT (Single Photon Emission Com‐ puted Tomography) scans. Indeed, one of the reasons psychiatrists are sometimes urged to make the diagnosis of conversion disorder or hys‐ teria is specifically in order to avoid expensive and supposedly unneces‐ sary medical investigations. There is therefore a significant danger that the label of conversion disorder can become self‐confirming as patients find themselves ‘trapped’ within a psychological diagnosis. Any non‐dogmatic treatment of the subject might at least be expected to consider these factors. It is interesting that Michael Sharpe, Jon Stone and their colleagues do not mention it. Instead they deliver themselves of the extraordinarily blunt claim that ‘Slater was wrong’.

Old mistakes

An anonymous editor has suggested that all interested editors familiarise themselves with this article: http://www.richardwebster.net/freudandcharcot.html --PaulWicks (talk) 23:35, 13 December 2007 (UTC)

Whilst I'm at it I think that the following prominent phrase in the introduction does address Guido's concerns proportionately to the level of evidence for his position: "The diagnosis remains controversial, however, as sufferers may disagree that their problems have a psychiatric basis." I think that the rather long quotation from Webster's book is interesting reading but it's an original synthesis rather than persuasive evidence. --PaulWicks (talk) 22:47, 13 December 2007 (UTC)

In short, the state of affairs which Sharpe and Stone describe, in which the rate of acknowledged or proven misdiagnosis in this area has de‐ clined significantly is exactly what one would hope for if Slater’s conclu‐ sions were a) right, and b) widely heeded by the generation of psychiatrists and neurologists who trained in the years immediately fol‐ lowing the publication of his 1965 paper. It is possible, however, that there is another factor at work. For it is also almost inevitably the case that an initial diagnosis of conversion disorder will tend significantly to reduce the number clinical tests and investigations which are performed on a patient, particularly investiga‐ tions of a non‐routine kind such as SPECT (Single Photon Emission Com‐ puted Tomography) scans. Indeed, one of the reasons psychiatrists are sometimes urged to make the diagnosis of conversion disorder or hys‐ teria is specifically in order to avoid expensive and supposedly unneces‐ sary medical investigations. There is therefore a significant danger that the label of conversion disorder can become self‐confirming as patients find themselves ‘trapped’ within a psychological diagnosis. Any non‐dogmatic treatment of the subject might at least be expected to consider these factors. It is interesting that Michael Sharpe, Jon Stone and their colleagues do not mention it. Instead they deliver themselves of the extraordinarily blunt claim that ‘Slater was wrong’. —Preceding unsigned comment added by 88.108.31.201 (talk) 22:53, 13 December 2007 (UTC)

I concur with PaulWicks that Webster's analysis, while probably to the point, does not provide any evidence. But if there is no positive evidence either, the article should mention that, too. That patients may disagree with the diagnosis does not seem to fully address the problem with this diagnosis. The obvious reply would be that such disagreement is expected due to the nature of their disorder, which may show that this diagnosis is an unsolvable logical puzzle and evidence for the existence or non-existence of this disorder simply cannot exist. Guido den Broeder (talk) 23:12, 13 December 2007 (UTC)

I'm confused GdB; positive evidence of what exactly? --PaulWicks (talk) 23:36, 13 December 2007 (UTC)

Evidence of the existence or non-existence of patients that actually have this disorder, instead of being erroneously diagnosed with it. Obviously, the notion' of this disorder exists, but is it real or just in the mind of Freud & co? Regards, Guido den Broeder (talk) 23:40, 13 December 2007 (UTC)

Come to my hospital =) --PaulWicks (talk) 00:02, 14 December 2007 (UTC)

Thanks for the invite. :-)

I'll come if you are willing to do the SPECT scan that I have asked for in vain for over 12 years. Guido den Broeder (talk) 01:51, 14 December 2007 (UTC)

What are you hoping to see on a SPECT? It's a fairly blunt instrument...--PaulWicks (talk) 12:22, 14 December 2007 (UTC)

Blunt- depends on the scanner-http://www.biocompresearch.org/images/spect00sm1.jpg. The RVI is about to do a big study using PET. One neurologist there might need to be told- no that's the patient's feet- their head is at the other end. He is also good at magic and can make incriminating patient notes disappear. He also is a big freud fan and another of his colleagues was involved in an exorcism. Weird ideas!!

QEEG also- see Frank Duffy Prof. of neurology Harvard University. His evidence has been used in at least one legal case I know of. I was privy to the report. Ultimately you are not going to produce a convincing argument that ideas can cause long term disability without recourse to organic mechanisms. At this point treatment will switch to treating these faulty mechanisms in patients and functional symptoms will be re-classed as organic.

Au revoir! I just didn't like to see PW try to go all POV over GdB —Preceding unsigned comment added by 88.108.31.201 (talk) 12:26, 15 December 2007 (UTC)

Heh, some pov on talk pages is permitted, I wouldn't mind. Blunt is all I need, to show hypoperfusion. PET would be better, but is too much to hope for. Guido den Broeder (talk) 20:26, 15 December 2007 (UTC)

SPECT isn't useful at all for differentiating an organic from a psychiatric cause, as patients with depression have abnormal SPECT scans. --Sciencewatcher (talk) 00:12, 16 December 2007 (UTC) This user is on my ignore list since 20071213. Guido den Broeder (talk) 00:14, 16 December 2007 (UTC)

it can be correlated with vascular spasm via transcranial doppler. Also it is erroneous and insulting to suggest that depression is not organic also? Schizophrenia now has a well documented organic basis Duffy has made enormous strides in using QEEG to identify the organic basis of ADHD. To quote Byron Hyde "there is no such thing as disease". You classifying stuff is odd. —Preceding unsigned comment added by 88.108.103.75 (talk) 16:19, 16 December 2007 (UTC)

It is pretty well established that depression is psychiatric, and that certainly isn't 'insulting'. It is also pretty well established that all psychiatric conditions have biological componenents (how does the brain work?!) But the underlying cause is still psychiatric. --Sciencewatcher (talk) 16:39, 16 December 2007 (UTC)

I've got to say, unsigned comments from anonymous IP addresses citing special evidence only they have seen is neither likely to convince me nor ultimately all that helpful. --PaulWicks (talk) 21:00, 16 December 2007 (UTC)

Potential copyvio

During the course of editing the article and chasing down references, I have found that at least some of the text now being edited somewhat has been copied from this website: http://www.psychological.com/conversion.htm

Would all editors please be aware of the guidelines on copyright violations e.g. WP:REF--PaulWicks (talk) 23:33, 13 December 2007 (UTC)

oops- edited wrong bit- they lifted it from wikipedia, not the other way round —Preceding unsigned comment added by 88.108.103.75 (talk) 16:15, 16 December 2007 (UTC)

lifted from wikipedia

I found that as well- the truth is they have lifted the article from wikipedia. Which considering their status is rather worrying. I tell my students NEVER EVER USE WIKIPEDIA. This is general policy in education and most schools are banned from editing by wikipedia anyway.

JFW said something about Weird ideas? This seems to sum up wikipedia- just as someone said a platypus was an animal designed by committee. In terms of sociolinguistics it is so naive as to be laughable no POV- absurd!!! - I'll leave that to another JFW fan though. The last version was not written by one person. I do think the article is moving in the right direction.

Speaking of weird ideas lets start with judaism and progress through a virgin for every martyr in Islam to Jesus taking off like a space rocket. (In other words I heard that JFW and I thought you didn't do personal attacks!!!) and also- the world is full of odd ideas like Freud and conversion disorder- but I will leave the social anthropology to someone else also..

Have fun JFW- this is POV and coat-hanger so I award you the barnstar of broccoli for wielding cabbage in order to further your own rhubarb

Interesting you should suddenly pop up on this page??? —Preceding unsigned comment added by 88.108.31.201 (talk) 17:48, 14 December 2007 (UTC)

the sum of all knowledge

Dear Sirs, Paul Wicks and colleagues

It was once put to me that a neurologist is a bit like a car mechanic- he lifts up the bonnet and can find nothing wrong even though he might freely admit that the engine is not working properly. It is suggested by Sharpe and others that such analogies are a good start in building a therapeutic consensus with ultimate referral to a psychiatrist. Other metaphors also abound, software error for example. The ultimate failure of this article is manifold. It may be moving in the right direction in that we have some acknowledgement of the biological basis of these symptoms, there is obviously enormous distance still to be travelled in this direction. Shorter may state that a patient's demand for organicity and a physician's willingness to meet it condemns them to perpetual disability, such a value judgement is of course spurious in the extreme.

If I take my car to a mechanic I would rapidly lose confidence in his abilities if he was unable to uncover why the brakes did not work. Similarly any IT consultant who described the brain as a "computer" would ultimately gather equal derision- the brain is not a computer. With over 50 trillion cells in the human body the diagnosis of conversion disorder can never be more than one of arrogance and ignorance. Hysteria is not a theatre of disorder because patients are play acting, rather they are desperately trying to interpret the often vague warning lights from the body and brain that some of those 50 trillion cells are not working as they should, damaged diseased etc. Once organicity is recognised patients are liberated from the worry of suffering and the social attempt to convince others that they are actually ill. Their suffering is no longer played out within a cultural milieu of desperation and recourse to thearpists like Mesmer, Carson, Sharpe or Freud but rather it is understood in the context of measurable organic anomalies. Anomalies that they themselves can work to live with or overcome.

Frans De Waal informs me that persistent and long term "conversion symptoms" do not exist in primates. Like children apes may pretend to be hurt or feel weak when faced with fear but such aspects are transitory. Extreme emotional events may cause many diseases to be manifest, heart attack and stroke to name but two. It is only in conversion disorder that neurology and psychiatry, seemingly isolated within medicine, pursue the psychosocial at the expense of the biological. Carson, Sharpe and others view illness in others as a child-like act. We as a species are still children, Rita Carter has said that the map of the human brain is more akin to medieval maps of the world. Thus faced with a lack of understanding of ourselves and by others we do indeed act oddly, even immaturely when faced with illness we do not understand. This notion is not new: "Variability is the law of life, and as no two faces are the same, so no two bodies are alike, and no two individuals react alike and behave alike under the abnormal conditions which we know as disease. Medicine is a science of uncertainty and an art of probability." William Osler, Canadian Physician. What is new is the seeming willingness to embrace a psychosocial model at the expense of the biopsychosocial.

Blake depicted Newton as a demonic figure measuring all with his compasses. I accuse neurology of the reverse, it fails to use the compasses at its disposal, it decries the technological investigation of patients, it marginalizes cutting edge technology rather than embrace it. "No neurologist in the UK uses QEEG". Yet Prof. Duffy, neurologist at Harvard is quite happy to use it to benefit and liberate HIS patients from the stigma of not finding anything wrong.

Ahh yes my engine is indeed intact- but take it for a spin and you will find the oil is not circulating properly and the wheels fall off as you forgot to check the bolts- to do so would have only convinced me that there was something wrong, when of course in your opinion everything was A ok.

Finally I applaud you all. In a consumer market where the internet, social networking, even simply money can all buy that second opinion- it is a sure way to lose patients by writing an article that does not present organicity as a fundamental part of this spectrum of symptoms, that does not even acknowledge that the DSM was born out of intense controversy, more psychiatric cook book than scientific analysis. Unless the article is radically developed towards the controversy of these symptoms then even more patients will find it irrelevant to any discussion they could have with a neurologist or psychiatrist. Emily Dickinson said "Truth is Manifold". Alas on wikipedia truth is the school boy who can shout loudest, seem the cleverest, pass all the exams by putting down what sir told him to- yet in fact have not a single original idea in their head.

Sufferer of POTS with technological evidence of peripheral neuropathy in bladder and bowel also provisional suggestion of peripheral motor neuropathy in legs (may have yet more tests, further tests on bladder as neuropathy was severe). All initially diagnosed as conversion disorder despite family history of vascular defects etc, shouted at by one neurologist, victim of spurious freudian nonsense at the hand of another etc, etc. —Preceding unsigned comment added by 88.108.109.36 (talk) 12:49, 27 December 2007 (UTC)

Could we increase the signal:noise ratio of future diatribes please? Some of us are busy. --PaulWicks (talk) 19:23, 28 December 2007 (UTC)

It is well known that the sum of all knowledge is 42. Of course, that is after conversion. Guido den Broeder (talk) 19:31, 28 December 2007 (UTC)

Interesting monologue. The problem is that QEEG/SPECT/PET/etc are pretty much useless in understanding conversion disorder or any other psychiatric illnesses. And anyway, all psychiatric illnesses are ultimately biological (unless you believe we think with a soul). QEEG and similar are nice for patients who don't want to admit they have a psychiatric illness, but denying the cause of the illness isn't ultimately very useful in curing it. This seems to be what 88.108.109.36's comments boil down to. --Sciencewatcher (talk) 01:20, 15 January 2008 (UTC)

Very tempting to use expletives to comment on the lack of intellectual insight by Messrs Wicks and Sciencewatcher but I won't. Except to say that Dr. Wicks comment is in particular unproductive, difficult to square with his role at patientslikeme and indeed difficult to square with the concept that a doctorate requires a brain behind it. Sciencewatcher's comment is just bigoted and out of touch with the concept as a historical entity and indeed the role SPECT and fMRI play in current research into "conversion" disorder. At least though he said "Interesting" which was rather more polite than Mr. Wicks. —Preceding unsigned comment added by 86.168.109.47 (talk) 19:37, 15 April 2011 (UTC)

Recent edits / reverts

Dear all, I am conscious that this article is continually going back and forth and I think we should try and pin down some of the points of contention. To be clear about my own position, I think conversion disorder is a name applied by doctors to any number of things that they don't understand. In some cases these will be undiagnosed "organic" medical conditions. However, in other cases, and I've seen a few of them in neurology clinics, some people come in with what are clearly "functional" disorders. What I mean by that is that some process is making them walk funny, or be unable to move a part of their body properly, but not in a way that is associated with any known "medical" disorder. Sometimes their reports are inconsistent, so for instance they might present with a paralysed arm, and yet objective measurement shows it's clearly not paralysed. In that case (and again, I've seen a couple and heard of several more), the only remaining explanation is psychological. I don't mean they're faking it; it's often very distressing, sometimes even more so than a known neurological disorder. What I mean is I think that the mind can do amazing things; I've seen martial artists do incredible things with their bodies via the powe of the mind, and it seems obvious to me that that same mechanism pointed in a negative direction could potentially cause weakness or even paralysis. To me, the idea that these things may be psychological is not a cause for shame or stigma, but a positive thing. Thank goodness it's not motor neurone disease, or Huntington's, where there's little we can do.

So, to the article. Let's be clear: I'm not a Freudian. We didn't cover him for more than 10 minute in my psychology degree and I'm not interested in psychodynamics. I'm interested in neuroscience. I'm not a fan of drives, ids, etc, but that doesn't mean we should throw out the baby with the bathwater. The fact that some of these problems coincide with a trauma or stressful live event does suggest there may be some relationship between the two.

What does fMRI establish? Nothing really. If CBT can change my fMRI profile then BOLD signal alterations don't really prove whether something is "organic" or not. After all, the mind is not a special case. It's composed of just the same goop as everything else in the world. If I'm traumatised, I have a physical response and an emotional response. They're both real, one is not more "organic" than the other.

My understanding is that Simon (Alpinist) was diagnosed with conversion disorder, but it later turned out to be something else. Yes it's a stigmatising diagnosis and in the absence of a great deal of knowledge about conversion, a lot of doctors were probably quite unkind/unhelpful. But now that he's got this other diagnosis, why the obsession with conversion disorder? Just because his case was an incorrect diagnosis, it doesn't mean that a.) other people don't have it, b.) it doesn't exist, or c.) everyone with "psych-" in their job title is an evil git.

Why do I revert edits made by Simon (and partner)? Because they rely upon personal knowledge that is not verifiable by others, they tend to make flippant references to things that are not explained in the article itself and are relevant only to a handful of people in the world that know the ins and outs of this debate, and they muddy the waters for anyone reading the article as it is meant to be read, as an article in an encyclopedia. He's already got conversiondisorder.com to say absolutely whatever he likes. Why persist in trying to change this article which is finally getting some attention from a psychiatrist (Snargett) whose committing several years of his life to trying to discover more about conversion and actually trying to treat it properly and get more attention for it in the NHS? If you want to do something useful with your spare time, set up a charity for people diagnosed with conversion disorder. They don't have any real guidance or support and it's a lot more productive than pointless revert wars on Wikipedia. Thanks. --PaulWicks (talk) 16:32, 15 February 2008 (UTC)

That's all plenty fair, and I'm not going to argue that conversion disorder doesn't exist -- as long as it's in the DSM IV, it "exists" at least as much as any diagnosis of exclusion can be said to "exist", and the main focus of an encyclopedic article should be on its definition, etc. But I think what you're missing here is that there are massive consequences for patients who are misdiagnosed with conversion disorder simply because their neurologist(s) don't know what's wrong with them. It means massive social stigma, it means virtually no treatment for what can be debilitating symptoms for an extended period of time, and once such diagnoses are made, it can often lead to further difficulties if new symptoms emerge requiring doctors to take another look at a physical medical cause. Given that a huge number of conversion disorder diagnoses are found to be misdiagnoses in the long run, it's bound to be a controversial subject, and it will remain so at least until some medical doctors stop allegedly misusing it as a means to explain anything with symptoms that they can't otherwise diagnose.

If you don't want to have to deal with that debate in the informational sections of the article, it might be worthwhile to have a specific section that discusses the controversies around it.

To make my own views clear, in case they aren't already, I think it is arrogant in the extreme for any doctor to assume that if they don't know what's wrong with a patient, it must be psychological. I think this diagnosis should be reworked to demand positive proof of some characteristic symptom(s), rather than vague "stressors". And I think that undiagnosable neurological symptoms that fall outside of that should probably be idiopathic something-or-other that assumes no particular base cause, psych or otherwise, when none can be found -- leaving the door open for future diagnosis and for consideration of various symptomatic treatment when available.

That said, I don't rule the universe, and I recognize that this page should be a collection of current information, not anybody's particular views -- still, I'd consider addressing some of the controversy, rather than pretending on the main page that it doesn't exist. 76.105.26.172 (talk) 21:33, 6 August 2009 (UTC)

for the record Paul

Just for the record I failed all tests for conversion disorder but was still told I had functional weakness/functional neurological deficit. Then Phil Nichols the neurologist I saw in Newcastle tried to find a psychiatrist who would agree with him that it was conversion disorder. With the intervention of Byron and Ian Gibson MP I was found to have systemic autonomic failure. At this point Phil sought legal advice before releasing my notes- I have copies of all these letters. My new neurologist Dr. Gorman suspects SPG4 a type of motor neuron disease also. My case demonstrates that faced with a determined and intelligent patient neurologists and psychiatrists better be careful. Charcot's Bad Idea presents a socio-linguistic perspective on how conversion disorder is diagnosed and treated, ultimately as Slater stated it is a diagnosis of "ignorance and error". - Simon

---

Or, "systemic autonomic failure" may explain exactly as much as Charcot's coy "functional." In reading the articles I can't help suspecting that somebody is obfuscating.

Did you know that there has never been any physical evidence whatsoever that Bells Palsy is caused by nerve inflamation. And yet everybody somberly proclaims it's not psychological. Try to find neurological tests for Tourette's Syndrome or autism. There are none. And yet again, mainstream medicine provides truth by proclamation. All this is neurological, and don't dare contradict that or you might offend crazy people.

At least Freud never tried to make people think they had some illness without strong evidence. He always provided inferential evidence and undeniable logic within a flawless paradigm.

People like you have been flailing about attacking Freud for over a century. You think he would have really been dead by now. Izeenossink (talk) 22:05, 20 July 2009 (UTC)

But what IS IT?

In the article you don't explain what it IS, nor do you document any disease mechanism. The symptoms are vague and could be almost any disease. There is apparently no approved treatment that has any effect. There is NO scientific basis for this "disorder" whatsoever, only speculation. This is pseudoscience in a nutshell and the article ought to reflect that. T.R. 87.59.79.190 (talk) —Preceding undated comment added 00:47, 12 March 2009 (UTC).

We don't know what it is, it doesn't have a known disease mechanism, the symptoms ARE vague, and yes it could be almost any disease. There is no "approved" treatment other than psychotherapy and there is very little known about this disorder. That doesn't make it pseudoscience, that makes it an absence of science. But I've seen these patients, they exist, and nobody knows what to do with them. They're clearly suffering from something that would benefit from assistance but we don't know how to help them. They consume a lot of health resources that could be better spent doing other things. We owe them answers. There's no charity for them, they have no voice, they get very little consideration. This all regrettable, but it's true, and I don't think the Wikipedia article itself is the right place for a crusade. I wish there was more I could offer. --PaulWicks (talk) 13:08, 12 March 2009 (UTC)

It's not absence of science either. Karl Popper ended up backing off from his attacks on psychoanalysis after fellow mathemeticians kindly pointed out his errors. I got the impression he was sort of cavalier about the entire issue of "falsifiability." It was as if he was playing games; pure pedantry. Psychoanalysis is as good as any so-called soft science, and I think it's better than most, because the benefits of it are tangible every day in the universality of psychotherapy Snud (talk) 10:03, 9 December 2010 (UTC)

---

In WWII the United States was able to sink the Japanese Navy at Midway because they broke their code. This was done not through experiments or MRI's. It was done by pure inference.

We know what conversion is. Freud discovered the answer. One has to be stubborn--deliberately naive to deny it. The symptoms have psychological meaning. The existence of la belle indifference is in itself evidence enough, but the fact that blindness and paralysis can be cured by hypnosis or acupuncture or biofeedback should be the ultimate test. The reason Freud's critics never address this issue is suspicious, to say the least.

Larry —Preceding unsigned comment added by Izeenossink (talk • contribs) 18:06, 20 July 2009 (UTC)

Respectfully, this is a logically fallacious argument. The fact that one can determine the existence of something else via inference is NOT evidence that something totally unrelated must be factual. This is comparing apples to tables (as in, they’re not even in the same category) and is an extreme oversimplification of the issue.

Inference is a useful tool and key component of both logical reasoning and science/medicine but it is only as good as 1-the expertise and objectivity of the person making the inference, 2-the availability of evidence, and 3- the accurate interpretation of said evidence.

Inferences can be flawed if the person making them lacks sufficient evidence, and/or is operating from a place if bias or erroneous foundational knowledge - Which, regardless of anyone’s personal opinions on Freud’s views, must be acknowledged as a potential issue ANY time one references older psychological/medical viewpoints because medicine and psychology are constantly evolving as new discoveries are made and it’s fairly well-established that social biases can (and absolutely have) influence scientific/medical opinion.

The mere fact that even recently published papers on conversion disorder (and the above-mentioned “la belle indifference”) still seem to frequently cite papers that reference, or even themselves reference “hysteria” (a diagnosis which is unquestionably linked to sexism and not based in scientific evidence) should raise some eyebrows. While the mere association with a debunked bias-related diagnosis doesn’t automatically invalidate these other 2 diagnoses, it should result in extreme caution and scrutiny when it comes to judging the accuracy of sources, which doesn’t seem to be happening consistently. Catfrost (talk) 02:45, 27 June 2024 (UTC)

Charcot's bad idea

Just thought I'd pop by to note that sales of the book are doing very well, even used by Durham uni's anthropology department in a study on functional symptoms. So I think Mr. Wicks should eat his hat after his comments on blocking any mention of this book "vanity press" etc. It is now used by the academic establishment with one consultant neurologist commenting "many of my colleagues would be deeply interested in this book". —Preceding unsigned comment added by 88.108.125.148 (talk) 13:59, 9 December 2009 (UTC)

I would just like to point out that Anthropology is not medicine and Neurology is not psychology. If the neurologists have, in fact, found a positive test for all apparent conversion disorder symptoms, then they have a say in the renaming of a DSM IV (a manual of *mental* illness) term. Otherwise, they don't.Snud (talk) 09:49, 9 December 2010 (UTC)

Discussion of dubiousness or lack thereof

I removed the (improperly formatted) "dubious-discuss" notation at the end of the History section, as the assertion being questioned is well-documented & properly cited at the Anna O. article linked in the very sentence claimed to be dubious. At some point someone should probably replicate the actual references on this page, but for now they are at least easily found. Makingyouhungry (talk) 22:52, 8 January 2010 (UTC) =

The assertion referred to by the above editor is as follows:

"According to current research, "examination of the neurological details suggests that Anna suffered from complex partial seizures exacerbated by drug dependence."[5] In other words, her illness was not, as Freud suggested, psychological, but neurological. Many believe that Freud misdiagnosed her, and she in fact suffered from temporal lobe epilepsy, and many of her symptoms, including imagined smells, are common symptoms of types of epilepsy."

Like huh? Are they kidding? I can't believe modern neurology has been so debased by politics!

Does this so-called research explain why Anna O's paralysis was cured by Breuer through hypnosis? Does it explain how her hydrophobia went away when, under hypnosis, she remembered her disgust when her father's dog drank water from his cup? Snud (talk) 22:20, 4 October 2010 (UTC)

Merge Functional Weakness Into this Article?

There's another article on Functional weakness that seems to have a very similar definition:

"Functional weakness is weakness of an arm or leg due to the nervous system not working properly.It is not caused by damage or disease of the nervous system."

versus:

"Conversion disorder is a condition where patients present with neurological symptoms such as numbness, paralysis, or fits, but where no neurological explanation can be found."

This is a more complete, better structured article. Should the other be merged into it? EastTN (talk) 19:20, 22 January 2010 (UTC)

Neurologists prefer the term "functional" because it sounds better than saying "mentally ill." Conversion is a well known mental illness, but "functional" simply implies that some peculiarity of the nervous system in particular cases is not yet understood by neurology. Snud (talk) 00:46, 6 October 2010 (UTC)

Merge

They shouldn't be merged if the consultant neurologist with an enormous list of publications in this area thinks they are not the same and that the term "conversion disorder" is not useful. google Jon Stone and functional weakness. But hey what the hell, lets merge them anyway- lets create even more distress for patients who google "functional weakness" and get redirected to "conversion disorder" which they've just been told is a DIFFERENT diagnosis ie dissociative in the new DSM. Can't hang around to argue- too busy. —Preceding unsigned comment added by 88.105.76.167 (talk) 18:26, 29 January 2010 (UTC)

I did that. It appears that Dr. Stone prefers the term "functional weakness" to the term "conversion disorder" (and a variety of other terms) for a number of reasons. Interestingly, though, if you look at his list of publications, the titles to several of them do use the term "conversion" (e.g., "fMRI in Patients With Motor Conversion Symptoms and Controls With Simulated Weakness", "Motor Conversion Symptoms and Pseudoseizures: A Comparison of Clinical Characteristics", "Systematic review of misdiagnosis of conversion symptoms and “hysteria”"). Bottom line, I didn't see anything to suggest that he's talking about a different set of symptoms or a fundamentally different disorder, or that we should have two separate articles. If there is disagreement over the best terminology to use (and if Dr. Stone is representative of other experts in the field, it appears that there is) the article should discuss that issue. If what we really have here is a single topic and a disagreement over the best name for it, then readers will be best served by a single article that clearly explains the disagreement.EastTN (talk) 02:26, 1 February 2010 (UTC)

he used the terms "conversion disorder" to get published but doesn't agree with the accuracy of it ie more important to get published and advance the debate- mmm very generous comment from me there. As a result of his work along with Mike Sharpe and other colleagues conversion disorder will no longer feature in the next DSM. It will be replaced by dissociative disorder(s). This reflects a fundamental shift away from a "conversion" of anything into physical symptoms, a diagnosis that is essentially freudian and actually very few in this field of medicine accept (From Bass through to Spence). Personally I think seeing functional weakness as a dissociative disorder is unhelpful to patients for reasons I've enlarged on elsewhere.... However I can also see that a diagnosis of functional weakness is for many patients less distressing than "conversion disorder". If they are being told it is NOT conversion disorder then to merge the articles is unhelpful. —Preceding unsigned comment added by 88.105.116.121 (talk) 19:30, 1 February 2010 (UTC)y  ::

Using the term "disocciative" instead of "conversion" was Janet's idea. Ironically, he is the guy who went around claiming credit for Freud's discoveries. He told everyone he thought of it first. Anyway, I question the statistic that "very few in this field of medicine" still use the term conversion. It may be true about clinical psychologists, but all psychoanalysts still use it. Is that not a field of medicine? Snud (talk) 00:59, 1 October 2010 (UTC)

Do you have a source that meets Wikipedia's standards for a "reliable source" that confirms that the term will not be in the next DSM? That would be relevant, and something we should include. It still sounds like we're dealing with a single topic, though, and the question is whether it should be described as "conversion," "diassociative," or "functional." EastTN (talk) 19:29, 2 February 2010 (UTC)

. have a look at www.neurosymptoms.org —Preceding unsigned comment added by 88.105.66.14 (talk) 19:37, 10 February 2010 (UTC)

Interesting. If it's correct, we should be able to find some peer-reviewed literature that would make the same points. EastTN (talk) 21:17, 15 February 2010 (UTC)

Regarding the neurological term "functional," that was coined by Charcot to define an apparently neurological symptom which was thought to be purely psychogenic--something that Charcot forbade his students to discuss.

Snud (talk) 06:13, 6 December 2010 (UTC)

I found a way to answer any objections regarding the medical use of the word "converion" with a simple Google search.

http://k8harper.wordpress.com/category/conversion-disorder/71.107.88.57

As for your suggestion that I provide proof the DSMV will include "conversion disorder," that is necessarily idle speculation considering several branches of medicine are snarling at each other right now over this issue to the point where they have delayed the DSM V to at least 2013. The smallest branch of medicine involved in the dispute is psychoanalysis, so any final decision will not be pertinent to this particular issue I think. http://www.newscientist.com/article/mg20427381.300-psychiatrys-civil-war.html

Snud (talk) 04:05, 8 December 2010 (

Newly Diagnosed

Firstly, apologies for such a lengthy comment. I’ve recently been diagnosed with Functional Neurological Deficit, which, after doing a lot of research on the net, I have discovered appears to be the modern name for Conversion Disorder, the only difference being where the emphasis lies as to cause, whether psychological or a temporary meltdown of the Central Nervous System. This, reading through the previous comments, seems to bring with it a lot of controversy, perhaps because there is little scientific data to support the dysfunction of the CNS and not much reliable clinical data to support the psychological model. As a sufferer of childhood abuse and now having this condition, I guess I am as entitled as anyone to put in my two-penny worth. Ultimately, what I am about to hypothesis is not backed by astute medical references (I failed O Grade Biology). Also it in no way changes how I deal with this condition, or its symptoms, but may help others out there suffering the uncertainties of what it means to be diagnosed with such a controversial disorder. As a result of my childhood sexual abuse, I learned at a very young age to disassociate myself from what was happening, suppressing any negative emotions and feelings I may otherwise have been overcome by. This disassociation was, to all intents and purposes, a conscious decision by my childhood self to deal with a situation I didn’t fully understand but knew instinctively was wrong – basically, I taught myself how to survive and keep living a normal life outwith the times of abuse. I even had a really good relationship with my abuser, enjoying being together with him and he taught me a lot about not accepting things as they were, to question everything – he was my father. This never happened during the times he abused me. It was as if we were two different people playing a different role – at those times I never saw him as my father but as a monster I had to hide from and ignore. For 30 years I never suffered any further anguish from the memory of the abuse except to find it hard to build long term relationships and to trust anyone fully. I had my own, very successful business and have a very laid back, optimistic personality. I also believe that life is what you make it and not necessarily ruled by childhood experiences – I still do despite having this condition. Three years ago, I started suffering seriously disabling symptoms where at times I am unable to move from the neck down. For two years I was told there was nothing medically wrong with me because all the tests were clear, and I suffered a lot of mental anguish thinking this was something I was doing to myself. Through the help of sympathetic medical professionals over this past year though, I have learned how to retrain my brain when it forgets how to control my muscles and can recover from a ‘crash’ quite quickly, although I still remain dependant on others to help with my personal care and use a wheelchair to get around. These crashes I suffer from, do not coincide with times of emotional upheaval or overwhelming feelings of stress or panic – I have never suffered from a panic attack. If anything, they are a result of five days of uncontrollable migraines – this is the trigger to indicate a crash is on its way. I also, as well as physical symptoms, have dissociative periods as well. These periods are completely different from what I experienced as a child. They are not learned, they are not consciously initiated, indeed, while I was fully aware of what I was doing to get through the abuse as a child, the dissociation I suffer now is totally outwith my control. The wall I put up between my feelings and what I was experiencing as a child had many beneficial effects, protecting me from the worst of the fear and pain. The veil that descends occasionally on me now, is not beneficial, in that it doesn’t protect me from anything. Instead, it interferes with my relations with others. It manifests worst when someone asks me a question and I take a long time to formulate an answer. Consciously I am aware they have asked me a specific question. However, it takes me some time to process, firstly that I need to respond and secondly what my response should be. This is neither a learned strategy, nor a defensive mechanism to protect me from vulnerable situations. It is as distinctive a part of the disorder as the physical disabilities. Ultimately though, whether the childhood abuse precipitated the vulnerability to have this disorder, or if there is no connection between the two, it is not the most important issue for me. The one thing that changed my attitude to my illness and has helped me cope despite my condition worsening over the last few months, is the knowledge that, I AM NOT DOING THIS TO MYSELF. If there is stigma attached to this condition, then it is society causing it, not the individual suffering from it. If it makes it more socially acceptable and easier for sufferers to live with calling it Functional Neurological Deficit, then for heaven’s sake let’s change the name. If it makes it easier to emphasis the breakdown in communication between the Nervous System and the brain, then do so, while still acknowledging the psychological element to the disorder. Undoubtedly every disease known to man has a psychological element, hence the name dis-ease. And every disorder known to man has a physical element, again, dis-order. Personally, I believe everyone who is diagnosed with a chronic condition should see a Liaison psychiatrist. They understand better than most the relationship between the physical and the psychological – if someone is going to die from cancer because they needed to smoke 40 cigarettes a day to keep stress at bay, they need help to cope with the psychological effects of the cancer as well as dealing with the knowledge their coping mechanisms in the past have a direct correlation to the disease they are now suffering. It does not mean they willed themselves to have cancer. Just as no-one gives themselves cancer, so no-one gives themselves Conversion Disorder. The one thing that should never happen to anyone, is what happened to me for two years. During that time, the medical professionals I saw were so enamoured on their multitude of ‘tests’ and the reliability of such, that they refused to acknowledge to me they just didn’t know what was wrong and made me feel as if it was my fault I was ill. I know Functional Neurological Deficit can be used as a catchall for untestable neurological conditions – my son who has epilepsy would have been exorcised not all that long ago. However, the symptoms are real, the effects on the physical and psychological are real. My advice, if a doctor ever says to you there is nothing medically wrong, don’t take his word for it. They are not omnipotent and there are others out there who are more sympathetic and understanding. In addition, if you are told you have Conversion Disorder, or Functional Neurological Deficit, it doesn’t mean you are crazy or that it is your fault, it means you have a Neurological Disorder for which there is currently no test or magic pill. Davalay (talk) 14:30, 2 January 2011 (UTC)

I think your post is really interesting, but I'm not qualified to comment on most of it. However, it might interest you to know Freud discovered that people with hysterical personalities either have panic or conversion; not both. My daughter came down with a panic attack while she was on stage in a college play. This immediately turned into paralysis of her left hand and was accompanied by an attack of Bell's palsy which lasted until the scene was finished.

The next night, when she came to the same part in the play, she had a panic attack. It was as if she couldn't afford the paralysis because it would ruin her performance, so she suffered through the panic attack instead.

As for why you don't get migraines, that seldom occurs in a person with hysterical personality. It's an affliction associated with obsessive/compulsive personality and represents repressed aggression.Snud (talk) 23:57, 6 April 2011 (UTC)

I can’t find an article on “hysterical personality.” Is this a currently accepted medical diagnosis, or a personal opinion about these patients? I keep seeing references to hysteria thrown around this page which is deeply concerning considering it’s well-known to NOT be a proper medical diagnosis, but a long-debunked example of medical sexism. This is absolutely not the sort of thing that should be allowed to dominate an encyclopedia article. Catfrost (talk) 03:43, 27 June 2024 (UTC)

DSM 5 Revision and Renaming of Conversion Disorder to Functional Neurological Symptoms

This is the link to the proposed revision in the upcoming DSM5. http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=8# The criteria are quite different, with psychological factors no longer a diagnostic necessity.Davalay (talk) 12:04, 2 February 2011 (UTC)

a year on

Just read through this a year on, sales of charcot's bad idea still doing well etc. I think the article fails to address how controversial this diagnosis is. It is by no means the case that even a majority of neurologists accept the diagnosis. My own neurologist believes in words stunningly similar to those of the writer Richard Webster that "modern medicine has inherited a legacy of misdiagnosis from Charcot and freud" most of her colleagues believe the same. To truly understand conversion disorder it is necessary to see it in its historical perspective- this article fails to do that and those contributors who were so keen to edit the article towards a "neo-con" view of the condition have not yet provided this framework. See "why Freud was wrong" for a more erudite discussion than my own work. —Preceding unsigned comment added by 212.183.128.78 (talk) 23:27, 14 April 2011 (UTC)

We should take a gallup poll to determine if a theory is valid or not? Presuamably it is neurotics--especially neurotics who refuse to accept their mental illness in a desperate attempt to protect their psychological defenses--who are most interested in disproving Freud and Charcot. so they would naturally believe and accept the "logic" and "evidence" presented in such books. It might interest you to know that in his *Studies on Hysteria* Freud insisted that all conversion is triggered by a real affliction or injury, and the unconscious makes use of this, exaggerates it and maintains it long after the physical effects of the affliction have disappeared.108.38.96.28 (talk) 19:56, 20 August 2011 (UTC)

This argument is not evidence-based, it is an opinion, a very obviously biased one disparaging people disagreeing with said opinion and labeling them as mentally ill. Arguing why something should be labeled an accepted theory should be done via the presentation of evidence. NOT via personal attacks/ableist generalizations.

Additionally, when citing a reference to defend this argument I’d suggest not picking one that is literally about a long-debunked diagnosis which we very clearly know WAS based in bias (sexism) rather than evidence. Catfrost (talk) 02:53, 27 June 2024 (UTC)

Dubious tag in Exclusion of Neuro Dis. Subsection

This tag has been there for nearly four years. But this claim is not dubious at all. It seems perfectly logically founded to me. However, it's possibly uncited and it does not significantly add to the article because the same claim is implied in the first (and cited) half of the sentence. Further, though it seems to be only a very small logical extension of the cited sources I believe it to be original research. If you disagree, discuss here. Johnathlon (talk) 19:49, 16 December 2011 (UTC)

Proposed merge of Conversion Syndrome into Conversion Disorder

Conversion disorder is better written, better organized, and better referenced; it is also a more widely used term than Conversion syndrome. Any thoughts? Ashleyleia (talk) 17:14, 6 April 2013 (UTC)

Support. Both articles are basically about the same thing. Lova Falk talk 12:01, 17 April 2013 (UTC)

I have completed this merge. Although the content on the merged page had poor-quality citations, I have still transposed a majority of the content, as I think it adds quality to some sections of this article. LT90001 (talk) 23:35, 11 October 2013 (UTC)

Good job! Lova Falk talk 14:15, 24 October 2013 (UTC)

Add a sentence on Psychoanalytic treatment to treatments section

Psychoanalytic treatment has been shown to help find a correlation between painful emotions/memories and Conversion disorder. Psychoanalytic treatment also attempts to express these feelings to help lighten symptoms. I believe that this would add a more up to date statement on treatment options on Conversion Disorder instead of saying that further trials are needed for all treatments. Megaman12549 (talk) 03:45, 18 April 2015 (UTC)

References

Wiki Education assignment: Wikipedia for the Medical Editor

This article was the subject of a Wiki Education Foundation-supported course assignment, between 24 October 2023 and 18 November 2023. Further details are available on the course page. Peer reviewers: Acorral101.

— Assignment last updated by Mjkim7 (talk) 18:22, 10 November 2023 (UTC)

Wiki Education assignment: Psychology Capstone

This article was the subject of a Wiki Education Foundation-supported course assignment, between 7 May 2024 and 12 August 2024. Further details are available on the course page. Student editor(s): MaddiMcg (article contribs). Peer reviewers: Allysch, Michellevp16, Sawyerbrady44, AngelOffley, Cjaneellen.

— Assignment last updated by Makylam18 (talk) 10:57, 27 August 2024 (UTC)

Article seems to be filled with inaccuracies and serious bias

I’m concerned that this article is still full of scientific inaccuracies and significant bias. I don’t currently have time to go through it all, but for example, the history section contains the following passage:

Much recent work has been done to identify the underlying causes of conversion and related disorders and to better understand why conversion disorder and hysteria appear more commonly in women.

This phrasing presents conversion disorder as an uncontroversial, accepted diagnosis, and worse, seems to refer to “hysteria” as if it’s an accepted medical diagnosis. This is a HUGE red flag that the current version of this article is presenting the topic from the perspective of a heavily biased, niche viewpoint. Note it completely contradicts the Wikipedia article on hysteria which states:

Currently, most physicians do not accept hysteria as a medical diagnosis.

Further down is the following:

The Lacanian model accepts conversion disorder as a common phenomenon inherent in specific psychical structures. The higher prevalence of it among women is based on somewhat different intrapsychic relations to the body from those of typical males, which allows the formation of conversion symptoms.

Again, the wording here gives no indication whether the ideas being presented are controversial, vs. well-accepted, established medical science. If the 2nd sentence in the above passage is intended to refer ONLY to a specific viewpoint (the aforementioned Lacanian model) then I think this needs to be reworded to make this explicitly clear. I.e. change the sentence beginning with “The higher prevalence…” to something like “This model argues that the higher prevalence…” or “According to this model, the higher prevalence…”

It’s also unclear what these gendered “different intrapsychic relations to the body” are (I can’t view the source for this statement as it’s a book a don’t own). I suggest this currently vague statement be expanded upon (or linked to a relevant article discussing this concept) to make it clear what specifically this is referring to, and whether or not this is, again, a well-accepted belief within psychology or something specific to this Lacanian model. Catfrost (talk) 03:31, 27 June 2024 (UTC)

No, these are Freudian views, from his "Three essays [...]" (1905), puberty metamorphosis (second essay), the new conferences (1918) of psychoanalysis feature another one as well, and some observations of anatomical differences between boys/girls and the Oedipal resolution (1925) with his famous sentence "anatomy is destiny". I can provide sources for the James Stratchey (1950s?) English edition and also ofc Spanish one, since here in the southern cone we host the world's psychoanalytic reservoir (López Ballesteros). To sum, Fink is a controversial figure, the public doesn't need to know the history of the psychoanalytic movement, If anything, Lacan freed up gender from sexuality, from pathology. Seminar XX, class one, at staferla.free.fr u can get original uncut versions, ELP also offers, and ofc, Spanish lacanterafreudiana.com for those speaking spanish offers the best edition, contrasting at least 7 legitimate sources. But it is inadmissible a 2nd hand source with no pages, chapters, etc, even Dylan Evan introductory psychoanalytic dictionary (albeit from the 70s iirc) would do us a better service for "science rigor/communication/clarity" Megas alejandro (talk) 11:58, 6 July 2024 (UTC)

A lot of this reply is delving into subjects I lack the expertise to discuss, but my point wasn’t re: whether or not we as individuals agree with these various sources, but whether or not the topic of this article is being presented clearly and accurately via the use of these sources, and is actually reflecting current scientific consensus.

Currently portions of it seem to be presenting very outdated and/or controversial niche views as if they are uncontested modern consensus, and that seems like a problem that needs to be remedied.

Unfortunately it’s going to have to be by someone with far more background knowledge on this subject than me. I know enough to have noticed some red flags that suggested there was a neutrality problem with the article (such as discussing “hysteria” as if it’s a currently accepted medical diagnosis) but not enough to know how best to fix it or what sources would be best to draw upon. Catfrost (talk) 09:33, 27 July 2024 (UTC)

Thanks for pointing this out. While hysteria included what we now call functional symptoms as a part of the diagnosis, it also had elements of certain personality disorders, so to call conversion disorder a rename of hysteria is not correct. Also, the quote you pointed out is obviously problematic and lacks any citation, so I will remove that. Slothwizard (talk) 07:24, 9 September 2024 (UTC)

@Slothwizard Your improvements to the article are appreciated! ScienceFlyer (talk) 19:29, 9 September 2024 (UTC)