The dissociative conversion disorder is a group of psychosomatic disorders in which physical after a mentally traumatizing situation symptoms. Diagnosis requires the exclusion of any diseases of organic origin that could explain the symptoms. Treatment is through psychotherapy and forms of behavioral therapy.
What is dissociative conversion disorder?
Psychosomatic disorders are purely psychologically caused disorders that cause physical symptoms due to the connections between the psyche and the body. Some psychosomatic disorders are transient, i.e. they are only temporary. Dissociative conversion disorder falls into this category.
According to DigoPaul, the term is an umbrella term for different disorders that are associated with different symptoms. Although the symptoms may be more or less different from one another, they share a common characteristic. Instead of a physical illness, a stressful event is the cause of all symptoms of dissociative conversion disorder.
Like all other psychosomatic disorders, the form of conversion disorder is shaped by the connection between mental processes or feelings and physical reactions. Tangible changes in morphology occur. Exclusion of physical illness is the most relevant condition for diagnosing any dissociative conversion disorder.
In most cases, dissociative conversion disorders are based on psychological conflicts that the patient cannot cope with or can only with difficulty. The most relevant conflicts of this kind correspond to traumatic events. Such an event can be the death of a loved one, for example. In order to avoid additional stress, the person affected unconsciously filters out the accompanying stressors.
Instead of dealing with the traumatic event, it is preferable to accept an apparent illness with psychosomatic symptoms. In principle, as part of this procedure, the person affected initially experiences a primary gain in illness. According to researchers, the fact that the patient maintains the physical symptoms for months or even years is primarily due to the increased attention that the person concerned receives from other people due to the apparent illness.
Patients with dissociative conversion disorder thus experience, in addition to the primary gain from illness, a secondary gain from illness, which unconsciously encourages them to maintain their symptoms.
Symptoms, ailments & signs
The severity and manifestation of symptoms is extremely variable in the context of dissociative conversion disorder. Often there is a single symptom, such as partial amnesia. In still other cases, the patient’s motor skills are impaired, seizures occur, or sensory disorders and even paresis manifest themselves. Amnesia is one of the leading symptoms.
Above all, the patient does not remember the causally stressful event. In addition to this phenomenon, dissociative stupor can occur, which affects posture, muscle tension and the ability to react to environmental stimuli. In addition to trance and states of possession, dissociative movement disorders can be present, especially a reduced movement or a coordination disorder up to ataxia, dystonia or myoclonia.
Dissociative seizures similar to epilepsy as well as sensory or sensory disorders of the skin, sight, hearing or smell are also symptomatic. In combination with conversion disorder, dissociative disorders such as Ganser’s syndrome can be present. In addition, personality disorders or anxiety disorders often occur.
As a rule, the first step takes patients with dissociative conversion disorder to a neurologist. As part of the anamnesis or external anamnesis, the neurologist often rules out organic causes for the neurological failure symptoms. Only in the rarest of cases do the failures appear so real that imaging is ordered.
Once organic diseases have been ruled out, a dissociative conversion disorder is suspected if the symptoms are appropriate. For further diagnostics, questionnaires for self-assessment and external assessment can be used. Somatization diseases must be excluded from the differential diagnosis in order to make the diagnosis of a dissociative conversion disorder.
In addition, as part of the diagnosis, the traumatic experience that triggered the symptoms is ideally determined. The prognosis for those affected depends primarily on the time of diagnosis and the degree of chronification of the disorder.
When should you go to the doctor?
A doctor should be consulted as soon as physical and psychological irregularities develop. Medical support is required after a traumatic experience or in the event of problems in the interaction of body and mind.
If there are sensory disorders or seizures, persistent malaise or loss of zest for life, a doctor is needed. If the daily private and professional obligations can no longer be carried out as usual because the general level of performance is reduced, a doctor should be visited.
With headaches, a diffuse pain experience, lethargy, listlessness and listlessness, there is cause for concern. Digestive system problems, large changes in body weight, and general weakness need to be investigated and treated. A doctor should clarify the symptoms if they persist for several days or weeks and if they increase in intensity or volume. Concentration or attention disorders, motor problems and coordination difficulties must be examined and treated.
A doctor should be consulted if there is fear, a feeling of fogging, changes in the muscles or personality. Social withdrawal, depressed mood, and persistent stress should be discussed with a doctor. If the symptoms arise after experiencing an intense and formative life event, it is advisable to consult a doctor or therapist.
Treatment & Therapy
Patients with dissociative conversion disorder are treated causally. This means that the therapist starts treating the cause of the disorder. As soon as the stress of the event is no longer perceived as stressful and the trauma has been largely overcome, the individual symptoms of the disease recede.
Symptomatic therapy would only treat the symptoms. Symptomatic therapeutic steps to alleviate the individual symptoms are available, for example, in the form of conservative drug treatments with substances such as benzodiazepines. The drug is a sedative that currently reduces the high levels of suffering of patients with dissociative conversion disorder.
In modern therapy, however, drug therapy is only used as an accompanying measure in order to make the patient’s anxiety controllable until the cause is cured and thus to improve his current quality of life. The main focus of treatment for patients with dissociative conversion disorder is behavior therapy, which enables the patient to reassess situations and their own behavior.
In psychotherapeutic conversations, attempts are also made to free the patient as early as possible from the self-inflicted isolation and to lead them back to reality. Otherwise there is a risk of the disorder becoming chronic, which requires long-term treatment and makes healing much more difficult.
Outlook & forecast
The prognosis for dissociative conversion disorder is considered unfavorable. Many patients experience several psychological disorders that reduce the prospect of a cure. If the dissociative conversion disorder is diagnosed together with an affective disorder, an addiction, eating and personality disorder, the disease can be expected to progress over several years or decades. In some cases there is no healing.
The symptoms of dissociative conversion disorder can develop suddenly after a triggering event and also regress completely in the further course. However, there is often no permanent relief. When experiencing a new life-critical event or processing repressed traumatic circumstances, the complaints reappear. These can differ in their scope and intensity from the known complaints.
Basically, a late diagnosis leads to a less favorable prognosis. In the case of patients who do not experience any healing of the symptoms, the aim of treatment is aimed at integrating the symptoms into everyday life. The decision on the therapy goal depends on the cause of the conversion disorder and the personality of the patient.
Through the integration, an overall improvement in well-being is achieved, since dealing with the disease is built up and trained in behavioral therapy. The person concerned learns how to react well to situations in life and the needs of his body.
The dissociative conversion disorder can be prevented by prophylactically dealing with psychologically stressful situations and trauma accompanied by a specialist.
Follow-up care for this disease is very difficult in most cases. The disease must first and foremost be comprehensively examined by a psychologist and also treated, although self-healing cannot occur. The earlier this conversion disorder is recognized, the better the further course will usually be.
For this reason, early diagnosis is important in the case of conversion disorder. It is also important that relatives or friends also deal with this disease and inform themselves about the symptoms and their effects. They can only help those affected if they have a thorough knowledge of the disease.
Intensive and above all loving discussions with the person affected are also very important in order to alleviate the symptoms. In many cases, patients with conversion disorder are also dependent on taking medication. It is important to ensure that the dosage is correct and that it is taken regularly. In the case of serious complaints, the relatives can persuade the person concerned to seek treatment in a closed institution. As a rule, this disease does not reduce the patient’s life expectancy.
You can do that yourself
Since dissociative conversion disorder is a psychological disorder, the possibilities for self-help for those affected are very manageable. One of the symptoms of the disease is the lack of insight into the disease. It is not possible to change one’s thoughts and actions on one’s own initiative in such a way that relief can result. Therefore, the person concerned should seek professional help.
Once the diagnosis has been made, it is a good idea to have extensive information about how the disease has progressed. Through the educational work, changes and improvements can be achieved. Since people from close social circles are often directly confronted with the patient’s complaints, these people should also inform themselves sufficiently about dissociative conversion disorder.
The knowledge of the characteristics of the mental disorder helps all those involved in the immediate environment in everyday life to avoid conflicts. The understanding of the behavior shown increases and it becomes more understandable for relatives or friends. Personal emotional injuries decrease once the disorder is learned to deal with.
Despite all adversities, a stable social environment is important for maintaining life satisfaction. For this reason, it is advisable to deal openly with the mental disorder. Withdrawal behavior is not conducive as it triggers further problems.