Psychologists and psychiatrists who are familiar with the area can have a lot to offer people with FND
Psychologists working in general hospitals, rehabilitation, pain clinics or in a chronic fatigue service are likely to be familiar with this area. Liaison psychiatrists or Neuropsychiatrists will definitely be familiar with it.
There are a number of reasons why patients with FND can benefit from seeing a psychologist / psychiatrist
Many patients develop FND without being stressed. The symptoms may have happened out of the blue or in relation to a physical injury, and the only thing thats stressful is having the symptoms!
And there are also many people who develop FND at times of stress. But this does not mean the stress was the only factor or even the main one.
Of course life stresses, both recent and remote, makes everything worse, and it can be a major cause of FND in some people, but in many people it is not that important.
Many people understand why other people may need to see a psychologist / psychiatrist, but have trouble thinking of themselves as being someone that ever would. If you want to ‘pull out all the stops’ of treatment, you may have to leave aside your prejudices to do so.
People also sometimes think that if they see a psychiatrist or a psychologist, the discussion and ‘treatment’ will be like old fashioned psychoanalysis. The classic, (and mistaken view) is that the psychiatrist says ‘ tell me about your childhood’, you spill the beans on every secret you’ve ever had and then the psychiatrists tells you how you’ve ended up this way.
Seeing a psychiatrists or psychologist is rarely like this. Exploring things that happened in the past can be very helpful for some people. But those explorations usually come from someone who has got to know you.
As has been explained on the ’causes’ page, it can be very difficult to pinpoint the reasons why people get FND. Sometimes its enough just to say, ‘You have a vulnerability to FND and functional disorders, lets try to work out how we can get you better’
A common, and reasonable, question is, “How can talking about it actually help my symptoms?”
These are the common ways in which “talking about it” can help:
If you put these all together then you may be surprised how helpful ‘talking about it’ can be.
Psychologists and psychiatrists vary a lot in their approach. You may need to talk to your family doctor or neurologist about who might be most helpful to see.
This section will be upgraded at some point.
If you want to see what the evidence is for psychological therapy in FND here is a useful recent review. Gutkin et al.
https://jnnp.bmj.com/content/jnnp/92/1/36.full.pdf
Also, you can see what the outcome of the largest psychological therapy trial for FND was in this video from the CODES trial
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