DISSOCIATIVE D*

DISSOCIATIVE (CONVERSION) DISORDER

The term ‘hysteria’ this was once prevalent. Instead, these disorders are called dissociative or conversion disorders.

Freud’s greatest contribution to science is considered to be his concept of unconscious mind and of psychic determinism. The latter holds that behavior which is otherwise non – explainable can be attributed to specific psychic determinants. Freud divided the mind into unconscious, conscious and preconscious. A traumatic event or a series of them, usually of a sexual nature which had occurred in childhood are ‘repressed’ (forced down) into the unconscious, whose memories persist without producing any symptoms. However, successful, repression breaks down when there is another traumatizing event in later life and there is a return of the repressed and consequent production of symptoms of a neurotic nature. The affect (anxiety) accompanying .The trauma is converted a physical symptom, either motor or sensory. Because of this channelisation of the accompany affect the patient is free form anxiety and the anxiety reduction is called primary gain. Very often patients are unable to relinquish their symptoms – partly because by doing so they become once again aware of the mental discomfort related to the traumatic experience. Moreover the symptoms themselves bring certain advantages to the patient like attention, sympathy, etc. from the family members. This is called the secondary gain. In a dissociation reaction, some psychological functions are pathologically deflected (dissociated) from others giving rise to the primary and secondary gains to the patient.