It is common for healthy people to experience episodes of somatization occasionally throughout their lives. Somatization is the unconscious ability to transform psychic afflictions or conflicts into physical, organic, and functional symptoms.
However, in health sciences, when this somatization becomes pathological, we can speak of conversion disorder. There is also a broad categorization of different types of conversion disorder according to the accepted physical or psychological functions.
What is conversion disorder?
Conversion disorder, or dissociative disorder, was once known as conversion hysteria and it was with the well-known psychiatrist Sigmund Freud that it gained popularity; who claims that unresolved internal conflicts become physical symptoms.
This disorder is distinguished by the presence of a series of neurological symptoms that impair sensory and motor functions. However, most characteristic of all is that there really is no underlying disease that causes or justifies them.
As the name suggests, the person suffers from conversion disorder he unconsciously turns their psychological concerns or conflicts into symptoms, Physical difficulties or deficits; such as blindness, paralysis of a limb, numbness, etc.
Usually, patients with this disorder tend to deny any such conflicts or issues that are obvious to others.
Types of conversion disorder
According to the CIE-10 manual, it different types of conversion disorders according to the functions or capacities affected.
1. Dissociative amnesia
In this subtype of disorder, the person suffers from memory loss in which ** forgets all recent events **. This loss has no organic origin or cause and is too pronounced to be due to stressors or fatigue.
This memory loss primarily affects traumatic events or a very intense emotional load, and tends to be partial and selective.
this amnesia it is usually accompanied by various affective states, Such as anxiety and bewilderment, but on many occasions the person accepts this disorder very kindly.
The keys to diagnosis are:
- Onset of partial or complete amnesia of recent events traumatic or stressful in nature.
- Lack of organic brain condition, possible intoxication or extreme fatigue.
2. Dissociative escape
In this case, the disorder meets all the requirements for dissociative amnesia, but also includes an intentional removal from where the patient is usually located, this displacement tends to be in places already known to the subject.
It is even possible to make a change of identity by the patient, which can last from a few days to long periods, and with an extreme level of authenticity. Dissociative theft can be given to a seemingly ordinary person for anyone who doesn’t know it.
In this case, the diagnostic rules are:
- To present the properties of dissociative amnesia.
- Intentionally leaving the everyday context.
- Retention of basic caring skills and interaction with others.
3. Dissociative stupor
For this phenomenon, the patient presents all the symptoms of stupor but without an organic basis to justify it. In addition, after a clinical interview, the existence of a traumatic or stressful biographical event, or even relevant social or interpersonal conflicts, is revealed.
Stupid states are characterized by a decrease or paralysis of voluntary motor skills and a lack of response to external stimuli. The patient remains motionless, but with muscle tone present, for a very long time. Likewise, the ability to speak or communicate is also practically absent.
The diagnostic model is as follows:
- Presence of stupor.
- Absence of psychiatric or somatic condition that justifies the stupor.
- Emergence of stressful events or recent conflicts.
4. Trance and possession disorders
In the disorder of trance and possession, a forgetting of one’s own personal identity and environmental awareness arises. During the crisis the patient behaves as if he is possessed by another person, by a spirit or by a higher force.
In terms of movement, these patients usually exhibit a very expressive ensemble or a combination of movements and displays.
This category only includes involuntary trance states that occur outside of culturally accepted ceremonies or rites.
5. Dissociative disorders of voluntary motility and sensitivity
In this alteration, the patient suffers from a somatic disease, the origin of which cannot be found. Usually the symptoms are a representation of what the patient believes to be the diseaseBut they don’t have to adapt to the actual symptoms of it.
In addition, like other conversion disorders, after a psychological evaluation, a traumatic event, or a series of them, is revealed. Likewise, in most cases secondary motivations are discovered, As a need for care or dependence, avoidance of responsibilities or unpleasant conflicts for the patient.
In this case, the keys to the diagnosis are:
- They find no evidence of the existence of a somatic disease.
- Precise knowledge of the environment and the psychological characteristics of the patient which lead to the suspicion that there are reasons for the appearance of the disorder.
6. Dissociative motility disorders
In these cases, the patient manifests a series of mobility difficulties, in some cases suffering from a total loss of mobility or paralysis of certain members of the body.
These complications can also manifest in the form of ataxia or coordination difficulties; in addition to tremors and small tremors that can affect any part of the body.
7. Dissociative crises
In dissociative seizures, symptoms can mimic those of a seizure. However, in this disorder no loss of consciousness occurs, But rather a little state of stuffiness or trance.
8. Anesthesia and dissociative sensory loss
In dissociative sensory deficits, problems of lack of skin sensitivity or alterations in one of the senses they cannot be explained or justified by a somatic or organic condition. In addition, this sensory deficit can be accompanied by paresthesias or skin sensations without apparent cause.
9. Mixed dissociative disorder
This category includes patients who have a combination of some of the above disorders.
10. Other dissociative disorders
There are a number of dissociative disorders that cannot be classified under the previous classifications:
Multiple personality disorder
- Transient conversion disorder in childhood and adolescence
- Other specified conversion disorders
Finally, there is another category called Unspecified Conversion Disorder, Which includes people with dissociative symptoms but who do not meet the requirements of the above classifications.