Insights into Psychology

What Is… Conversion Disorder?

head with cogs inside

In this series, I dig a little deeper into the meaning of psychological terms.  This week’s term is conversion disorder.

Not to be confused with conversion therapy, conversion disorder is a psychiatric diagnosis involving neurological symptoms with a psychiatric cause.  The symptoms can involve motor or sensory functions and can include blindness or other sensory loss, paralysis, seizure-like attacks, speech disturbance, and abnormal movements.  True conversion disorder does not involve malingering (the fabrication of symptoms).

Similar conditions have been documented since ancient Egyptian times.  The term hysteria was used by ancient Greeks, and such luminaries as Plato, Aristotle, and Hippocrates thought symptoms were due to the uterus wandering around in the body.  In the 13th century, physical symptoms without an identifiable cause were thought to be due to possession by the devil.  In the Salem witch trials of 1692, the women thought to be witches were presenting with symptoms similar to conversion disorder.

Conversion disorder was studied more carefully in the 19th century by Sigmund Freud and some of his contemporaries.  The term conversion disorder stems from Freud’s belief that anxiety was being converted into physical symptoms.  In the current DSM-5, the condition is categorized as a functional neurological symptom disorder.

There is no identifiable physiological cause for the symptoms, and an extensive medical workup would be conducted to rule out any physical cause before diagnosing someone with conversion disorder.  It is possible, though, to have conversion disorder in addition to an established neurological disorder.

Conversion disorder is rare, affecting 0.01 and 0.5% of the population.  It is most commonly seen in people between the ages of 10 and 35, and is more common in females than males.  People with personality disorders or dissociative identity disorder may have an elevated risk.

Symptoms often will come on suddenly in response to a psychological stressor.  Symptoms are usually more prominent on the non-dominant (i.e. non-handed) side of the body.  The mechanism by which psychological stress is transformed into neurological symptoms is unknown.

While a variety of treatments are used, no particular treatment stands out as being clearly effective.

I’ve seen a few patients with conversion disorder over the course of my nursing career.  One patient that stands out from multiple admissions was a woman who was in her late 20s or so.  She also had a diagnosis of borderline personality disorder (BPD), and she had a significant trauma history.  While was physically capable of walking, when things were bad enough to require a hospital stay, she needed a wheelchair and was frequently incontinent.  

She had never gotten any effective treatment for her BPD, so she displayed a lot of the “difficult” behaviours that tend to be stereotypically associated with BPD, and that made treatment even more challenging. We really weren’t able to do a heck of a lot for her other than give her some time to stabilize in a supported environment.

From an intellectual perspective, this is a truly fascinating condition.  The power of the human brain really is astounding.

characteristics of conversion disorder

Source: Wikipedia: Conversion disorder 

You can find the rest of the what is… series in the Psychology Corner.

book cover: Making Sense of Psychiatric Diagnosis by Ashley L. Peterson

Making Sense of Psychiatric Diagnosis aims to cut through the misunderstanding and stigma, drawing on the DSM-5 diagnostic criteria and guest narratives to present mental illness as it really is. It’s available on Amazon.

For other books by Ashley L. Peterson, visit the Mental Health @ Home Books page.

12 thoughts on “What Is… Conversion Disorder?”

  1. My book (your book), the paperback copy will be here Tuesday!! Eek. Having it on Kindle wasn’t enough. 🙂.

    What happens to the body with this disorder? Does the body have convulsions? Like jerk and stuff? I’ve not ever heard of this.

  2. Wow! I’ve got the thrill of being back in psychology class again!! I remember studying this! Right, it’s like where you lose your vision and can’t see anything (for example) but there’s nothing wrong at all with your eyes? So it’s sort of created by your mind, but you truly believe it? It was nice of you to try so hard to help give that patient a nice, stable environment!! 🙂

    1. Yeah it’s a pretty interesting disorder. I haven’t come across anyone that can’t see because of it, although that can definitely be one way it manifests. Fascinating what the mind can do.

  3. Another under-covered area, and you’ve recapped it so clearly. I never knew the percentages though, with this affecting 0.01 and 0.5% of the pop, so this made for interesting reading.
    PS. I shared your book on my latest blog post as I thought I’d see if I could spread the love a little & let others know about it, hope that’s okay 🙂
    Caz x

  4. I’ve never heard of this disorder before but can understand the fascination with it. It is fascinated that the brain is the controller of the whole body and how it can affect your body in so many different ways. Also how trauma can influence the mind too. Theres so much we yet have to learn.

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