Hysteria or Conversion Disorder, basics

Hysteria or Conversion Disorder, basics


  • 1 What is hysteria or conversion disorder?
  • 2 Origin of the disorder
  • 3 Common symptoms in hysteria
  • 4 Concept of gain in hysteria
  • 5 Hysteria treatment

What is hysteria or conversion disorder?

The word hysteria derives from the Greek hyaterá, which means matrix, since the ancients associated this disease with the woman's uterus and, therefore, with the female sex, neglecting the observation of hysterical phenomena in men, which also exist.

Origin of the disorder

With the name of hysteria It has been known since ancient times the appearance of important objective symptoms without injury that justifies them, for example, a paralysis without injury to the nerves or muscles, blindness without abnormalities in the eye or the components of the optical system. In all these cases of apparent organic disease it is assumed that the cause is a psychological conflict that becomes an organic symptom that symbolizes it, so it is also called conversion neurosis or somatomorphic alterations.

There is a form of hysteria in which the psychological problem is not symbolized through the imitation of a bodily illness but of a psychic illness, in these cases we talk about dissociative disorders, since the identity is dissociated, for example, a hysterical amnesia with the one that the subject forgets who he is, and in some cases he alters his own identity with that of new characters that he creates or accepts, are the cases of multiple personality.

Common symptoms in hysteria

Hysterical symptoms are an attempt at defense in a situation that does not know how to solve.

Associated symptoms of any type usually appear, but they are exaggerated and picturesque. Imitate diseases, so they can lead to confusion.

The great hysterical attack it's a storm of movements with a supreme theatricality, in which the patient screams, wallows on the floor, tears clothes, spider or strikes in an incidental way and not specifically intentional to those who try to subject him, alternates movements of generalized tonic contraction, in which he tends to move in a semicircle on the nape and heels, with other disorderly and intermittent movements and spasms that recall an epileptic attack. What characterizes the hysterical of other pathologies is that he suffers the crises after a dislike or disappointment and occurs when there are people in front of him.

Other forms of movement storm or Motor syndromes are tremors, tics, muscle spasms and athetoid or creiform movements (like the "dance of San Vito"). All tend to be of great amplitude and spectacularity and do not correspond exactly to the diseases they mimic (this supports differential diagnosis).

These patients also use a type of body immobilization reaction as a way of attracting attention. May appear hysterical paralysis of the whole body, without response to any stimulus (catalepsy), or paralysis located in the middle body (of the two legs, of the right or left part ...), of an extremity, hand, finger, etc.

Another form of hysterical manifestations is to suffer from specific sensory syndromes, such as hysterical anesthesia in which they do not feel pain, cold or heat, lack touch, etc. It can affect the whole body or a part of it. Hysterical anesthesias do not follow anatomical-neurological patterns, but are arbitrarily distributed. They can also go blind or deaf without apparent cause.

The hysterical is not a simulator. The simulator wants to look sick, pretend to be sick. The hysterically unconsciously wants to be sick, and gets it. It is the transformation of an emotional conflict into somatic or psychic symptoms.

Hysteria gain concept

The concept that these patients have of disease gain is essential. These patients get two types of gains:

  • For resolve a conflict or frustration
  • Symbolically supports the repression of said conflict to the subconscious.

Hysterical symptoms not only exist for something, but also for something. The patient has a clear disinterest in their symptoms and possible cure. If the symptoms disappear, the patient is deprived of his psychogenic defense and at the mercy of feelings of guilt. That is why the gain of the disease in the present is so important for the patient and ends up becoming an obstacle to its cure.

Hysteria treatment

The best treatment technique is psychoanalysis. The hysterical has a sickly character, which is what has caused the appearance of symptoms through its anomalous reaction mode. Therefore a total restructuring of the character and the conformation of new reaction modes are required. Although the theatrical symptoms disappear quickly during the first sessions, it should not be forgotten that the individual remains hysterical and can relapse with the same symptoms or with other symbolically equivalent if a psychotherapy with character reeducation is not performed.

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