Conversion Disorder- No, You’re Not Crazy!

Conversion disorder is an interesting beast. By definition it is the complete lack of physical cause for the resultant issues (often things like weakness and can be as severe as full paralysis), with the origins of the cause located very centrally in the brain.  Essentially, for a seemingly unknown reason (we have theories, some very solid, but nothing concrete enough to definitively say absolutely why) your brain has decided to partially or fully affect entire sections of your body, in some severe cases making a patient present to clinic as if they have just had a major spinal cord injury.

When initially looked at, this was seen as “faking it”. As the patients who were first noted to have this issue didn’t have a physical cause for these symptoms.  As it was discovered that these symptoms were very real but originating in the brain, patients with conversion disorder were almost brushed off again. The very negative connotation given was that since it was originating in the mind, it was “all in their head” and not exactly real.  The problem with this approach, of course, is not only that it stigmatizes patients with a very real problem and does not provide them any real help, but it ignores the fact that just because something originates in the mind does not mean it’s necessarily a “crazy” response.

There are very many valid reasons the brain may see it necessary to shut down the body. In life or death scenarios (motor accidents, physical trauma, severe pain), it is beneficial to our survival to go limp.  In scenarios like an injured prey or an animal who suffered a severe fall, they could actually stand a better chance of survival if their body started to shut down as this prevented them from bleeding out while their pack came to help.

Also look at car accidents, where we see that unconscious and limp persons have a much higher chance of survival in some cases than those conscious and reacting. When viewed in that light, our body having a response available like this is a good thing, and perfectly reasonable! And since most people with conversion disorder have a history of significant pain (severe migraines for example) or sudden physical or psychological trauma, having these symptoms is entirely understandable!

As we’ve learned more about these things, it has become clearer that we have simply been addressing them wrong. Admitting this is an important step for us in the healthcare field. But, making this information known to those who have been diagnosed with our old thoughts is also important. It means that we have new treatment options and care plans available!