Chalder & Wessely - Functional(Psychogenic)Neurological disorders 6 Sep

[Cinders66]

"The 3rd International Conference on Functional (Psychogenic) Neurological Disorders will take place on September 6-8, 2017, in Edinburgh, Scotland.

They themselves put psychogenic in there? Yet most FND proponents say that it doesn't necessarily mean there's a psychological or emotional component, why should it. I agree that the nervous system can go wrong in function vs structure but not this lazy therefore let's treat it psychologically.

 

[Valentijn]

They themselves put psychogenic in there? Yet most FND proponents say that it doesn't necessarily mean there's a psychological or emotional component, why should it. I agree that the nervous system can go wrong in function vs structure but not this lazy therefore let's treat it psychologically.

It's especially hilarious that some of them spend a lot of time looking to see what's physiologically wrong with the brain - so that they can find the cause of imagining fake symptoms of course, not the cause of symptoms themselves

 

[Woolie]

I agree that the nervous system can go wrong in function vs structure but not this lazy therefore let's treat it psychologically.

The structural/functional distinction is a smokescreen too. Things like epilepsy aren't 'structural'. There's nothing structurally wrong with the brain of epileptics. Its entirely a problem with functioning. Yet you never hear people calling epilepsy a functional neurological illness.

Let's call it what it is - illnesses with widely agreed disease markers vs those without an agreed marker (which we assume to be psychological).

I hate all the bullshit in this area.

 

[Mithriel]

Woolie, you are forgetting about "pseudoepilepsy" Basically this is when you have a seizure but don't do yourself serious harm and many neurologists feel that patients often suffer from both forms. And there is the "pseudocoma" where the eyes go in the wrong direction when you examine them

Neurologists are NOT brain surgeons and they suffer from a massive chip because they aren't.

Blood diseases are easy to study. Think of blood clotting where there are about 10 steps any one of which can go wrong and a few years ago the New Scientist had a headline "Blood clotting, not as simple as we thought" then think about the most complicate organ, the brain. because they had no way to study it, medicine has made up lots of myths the way storm gods were evoked to explain weather.

And these myths are passed on with what looks to me like criminal blindness.

 

[A.B.]

Problems with diagnosing Conversion Disorder in response to variable and unusual symptoms
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4000178/

The author is a psychiatrist. Faith in psychiatry restored a little bit.

PS. the author also makes some interesting comments on adult onset mitochondrial disorders. My feeling is they're at very high risk of being misdiagnosed as some psychiatric issue because the symptoms can be quite literally random and not match any recognized medical illness.

@Woolie He also says that seizures that don't show up on EEG can be caused by dysautonomia.

 

[dreampop]

4 of the healthy controls were the investigators themselves.

Lol

 

[Woolie]

Woolie, you are forgetting about "pseudoepilepsy"

Yea, the crazy thing is, people with epilepsy were only rescued from the psychobullshit when doctors were able to demonstrate EEG signatures during their seizures. So people thought - can't be "psychological" then.

The pseudoseizures you're talking about - also sometimes called nonepileptic seizures or psychogenic seizures - don't have the accompanying EEG signature. Therefore, they are psychological.

But now it turns out that with new methods, you can measure subtle changes to brain activity during nonepileptic seizures. But now instead of these measures being used to encourage further investigation into biological bases, they are seem as an indicator of the underlying psychological process that causes the seizure.

I would just like too see some consistency. These people could at least acknowledge that by their logic, epilepsy is also 'psychological'.

I'd love to see how that went down.

 

[me/cfs 27931]

Yea, the crazy thing is, people with epilepsy were only rescued from the psychobullshit when doctors were able to demonstrate EEG signatures during their seizures. So people thought - can't be "psychological" then.

The pseudoseizures you're talking about - also sometimes called nonepileptic seizures or psychogenic seizures - don't have the accompanying EEG signature. Therefore, they are psychological.

But now it turns out that with new methods, you can measure subtle changes to brain activity during nonepileptic seizures. But now instead of these measures being used to encourage further investigation into biological bases, they are seem as an indicator of the underlying psychological process that causes the seizure.

I would just like too see some consistency. These people could at least acknowledge that by their logic, epilepsy is also 'psychological'.

I'd love to see how that went down.

Another crazy thing is that a person can have both psychogenic and epileptic seizures.

Here's what my HMO has to say about non-epileptic seizures:

NES are usually related to a mental health problem, like an emotional conflict or stress. But, sometimes NES are related to a problem like low blood sugar or the way the heart is working. One example of NES is psychogenic seizures, sometimes called pseudoseizures.

NES symptoms usually appear suddenly and at times of extreme emotional stress. Some doctors believe that the symptoms of NES may be an attempt to reduce anxiety by not recognizing or responding to an emotional conflict.
...

Treatment of NES varies with each person. The goals of treatment for NES are to relieve the stress or an emotional conflict that may be causing the loss of or change in physical function. Physical causes, such as low blood sugar or a heart issue, are treated as needed. Treatment may include medicines, counseling, or specific life changes, such as a job change or assistance at home.

Because NES are not caused by a problem in the brain, medicines that are used to treat epilepsy are not used to treat this condition.

 

[Snow Leopard]

"Functional disorders are the second commonest reason for a referral to a neurologist."
https://www.fnd2017.org/FND-2017.htm

I find that very hard to believe and cannot see how they could verfiy such a claim.

It means that neurologists aren't very good at their job at diagnosis - with sufficient research, these illnesses would be able to be explained in some way.

 

[Woolie]

Another crazy thing is that a person can have both psychogenic and epileptic seizures.

Yea, @Webdog, that's completely bizarre. The reasoning goes: some of your seizures are real, but at times you are only 'mimicking' your seizure behaviour to express distress, deal with conflicting emotions, avoid confrontation/responsibility, or get attention.

I wish could say I'm caricaturing their ideas, but I'm not. That's exactly the reasoning, expressed without the doublespeak.

 

[Cheshire]

But now it turns out that with new methods, you can measure subtle changes to brain activity during nonepileptic seizures. But now instead of these measures being used to encourage further investigation into biological bases, they are seem as an indicator of the underlying psychological process that causes the seizure.

Reminded me of that post by @chipmunk1 who spoke about a research on "organic" and "psychogenic" dystonia, where abnormal cerebral activity was considered a sign of organicity fo the first and of psychogenesis for the second, based on the fact that, well, hum, they are classified as psychogenic.

Once considered a rare medical phenomenon, psychogenic illnesses, believed to be triggered by psychiatric or psychological issues, are more common than thought, some specialists suggest. And research is proving that there are clear differences in the brain activity of those with psychogenic illnesses, providing evidence that people’s thoughts and emotions can have a profound effect on their physical state
What they found was that both groups of dystonia patients had abnormal activity in the motor cortex of the brain, which controls voluntary movement, and the striatum, which acts as a relay station. But there were marked differences between the two; patients with organic dystonia had overactive motor cortexes and underactive striata, while patients with psychogenic dystonia had underactive motor cortexes and overactive striata.

“Both sets of patients were very, very abnormal,

http://forums.phoenixrising.me/inde...d-as-partially-psychogenic.30992/#post-474599

 

[chipmunk1]

Another crazy thing is that a person can have both psychogenic and epileptic seizures.

Not only this but pseudo seizures are far more common in epilepsy patients.

the fact that something appears only when you are stressed does not prove it is psychological. Parkinson's symptoms or epilepsy can get worse under stress.

I think i recall there was once a case of someone losing their voice but only when stressed. No one would consider an organic cause of course.

Later it was found that there was some organic pathology that caused it but it would only have an effect in combination with muscle tension which was affected by the emotional state.

even in the most 'obvious' cases of somatisation there can always be another explanation that no one thought about sadly.

I think Dystonia was once believed to be organic then it was believed to be all in the head, then it was believed to be organic but since some cases were different from others they were labeled as psychological again. Nonsense really.

 

[chipmunk1]

agree that the nervous system can go wrong in function vs structure but not this lazy therefore let's treat it psychologically.

well if the liver does not work you see a doctor. If the brain does not work you are to blame and should not see a doctor except a psychiatrist. Stupid really.

Neurologists are NOT brain surgeons and they suffer from a massive chip because they aren't.

I have the feeling that is not the problem. I think every neurologist sees patients on a daily basis that have clearly distressing symptoms but no cause for their problems can be found.

They need somatisation as a concept to keep their self-esteem and feel competent. If they hadn't such an inflated larger than life ego they wouldn't need it. Maybe they could benefit from seeing a psychologist instead of sending their patients to one.

 

[Cheshire]

A few tweets, that just give you the tone of the conference....

https://twitter.com/i/web/status/905362013295181824

https://twitter.com/i/web/status/905358211221479424

 

[Jo Best]

Here we go....patients with organic diseases/disorders not safe from suspicion of FND....

https://twitter.com/i/web/status/905353134356258818

 

[Jo Best]

Wessely lets slip what it's really about - 'money, money, money' - and ego I guess.

https://twitter.com/i/web/status/905362013295181824

 

[Jo Best]

Scrolling and find something else fishy about #FND2017 -
it's also the hashtag for the Fiesta Nacional del Dorado 2017!

https://twitter.com/i/web/status/899726820261732354

 

[Cheshire]

https://twitter.com/i/web/status/905538023487672321

Aims and objectives : to investigate if the use of an innovative biographical-narrative method, Free Association Narrative interviews (FANI) can give new insights into the subjective experience and aetiology of PNES and indicate whether the method is an effective tool for future research.


Trauma Denied

PNES are associated with high rates of trauma in some but not all subjects. The eliciting of unforced biographical narratives during the interviews resulted in description of some traumatic events not identified as trauma by participants.

Dear poster authors,

I can see that you managed to make un-traumatised patients believe they in fact had a traumatic past, congratulation, you’re now a level 4 skilled psychotherapist!

· But did FANI had any positive consequences for the patients? Did their health improve? Or did you just add trauma to the patient’s illness + the burden of believing that this trauma (and their inability to cope) is somewhat responsible for their health problem? But maybe your goal was just to appear as the ones who proved that the PNES trauma theory is right? (oh indeed I can read that your aim is not to get patients better but to investigate whether one can get new “insight” into PNES. Well I could see one or two ethical problems here…)

· BTW, did you prove anything? Did you test your FANI thing on healthy controls? Or on patients suffering of an equivalently disabling illness? You know, just to see if this trauma recollecting stuff is linked to PNES patients or if you just proved you’re a master manipulator.

· On the “novelty” side (“The FANI method is an innovative biographical-narrative method”), I’d be curious to know what Sigmund would think of it… I think he said one or two things about free association and the use of patients’ narrative and childhood experience to explain nearly everything in their life. Someone recently talked about old wine in new bottle, just saying… (FYI, Freudian theories have long been disproved)


(sorry, needed to vent )

 

[Woolie]

@A.B., I agree, I find this very troubling. And I worry that its quite effective too. I've seen posts on FND fora where people have blamed their illness on some person in their past that harmed them. They consider that person to have taken away their health.

Not saying that those who experienced harm in their past should just shut up about it. Be angry, take action, sure. But no-one can know whether those distant past events played any causal role in the development of the current illness. Indeed, systematic studies - that consider carefully the operation of biases like recall bias - find little evidence to support this claim.

But there's an apparently limitless number of health professionals who are happy to promote these sorts of contentious causal ideas. Very dangerous, very harmful.

And here, they appear to be looking of ways to rescue their beliefs in trauma theory by trying to show that FND sufferers that do not claim trauma are simply in denial about it!

!

 

[A.B.]

These free association narrative interviews may allow "patients to gain a therapeutic understanding of their disorder"

Or it might lead them down a path false beliefs concerning the nature and etiology of their condition, where they are effectively asked to achieve the impossible task of controlling their condition by revisiting unpleasant life experiences, and end up more confused, anxious, and hopeless than before when that brings no relief.