Conversion disorder not about mould

Le Roy, New York (CNN)Twelve female students from Le Roy Junior Senior High School in upstate New York are experiencing a mysterious medical condition. Their symptoms include stuttering, uncontrollable twitching movements and verbal outbursts.

Health officials say the symptoms are consistent with “conversion disorder.”

Dr. Jennifer McVige, a pediatric neurologist at the DENT Neurologic Institute who is treating many of the students affected, said, “Conversion disorder is a physical manifestation of physiological symptoms where there is traditionally some kind of stress or multiple stressors that provoke a physical reaction within the body.” McVige said the symptoms are real. “This is unconscious. It is not done purposefully.”…

Officials at the school hired an independent third party to conduct mold and air quality tests but found no environmental cause for the girls’ illnesses. A statement posted on the school’s website said, in part, “The medical and environmental investigations have not uncovered any evidence that would link the neurological symptoms to anything in the environment or of an infectious nature.”

Sanchez’s mother, Melissa Phillips said she does not agree. “I don’t think that all physical aspects of this have been exhausted; not enough testing has been done.”

The media reaction is to express “surprise” that this puzzling phenomenon can’t be traced to a contaminant in the physical environment, just like the medical community continues to be “puzzled” about the lack of clear cut medical evidence for schizophrenia. Here’s what the media should say about conversion disorder, but shies away from:

Conversion disorder: the modern hysteria
Colm Owens and Simon Dein

Conversion disorder is thought to occur primarily in societies with strict social systems that prevent individuals from directly expressing feelings and emotions towards others. Temporary somatic dysfunction is one possible mode of communication, particularly for those who are oppressed or underprivileged. The ‘psychological mindedness’ and ease of emotional expression typical of modern developed societies have led to the increasing rarity of conversion disorders in developed countries (Tseng, 2001

Conversion has been attributed to many different mechanisms. One influential theory, dating back to Ancient Greek physicians who thought the symptoms specific to women, invoked as their cause the wandering of the uterus (hustera), from which the word hysteria derives. The term conversion was first used by Freud and Breuer to refer to the substitution of a somatic symptom for a repressed idea (Freud, 1894). This behaviour exemplifies the psychological concept of ‘primary gain’, i.e. psychological anxiety is converted into somatic symptomatology, which lessens the anxiety and gives rise la belle indifference, where a patient seems surprisingly unconcerned about their physical symptoms. The ‘secondary gain’ of such a reaction is the subsequent benefit that a patient may derive from being in the sick role.

As David & Halligan (2000) point out, the concept of conversion disorder has raised great controversy between the proponents of psychological and physiological models of mental states. Conversion disorder raises the intriguing philosophical problem of how it is that psychological or mental states can effect long-term motor, sensory and cognitive changes in people claiming not to be consciously responsible for them. Theories falls into three main groups: psychoanalytic, learning theory and sociocultural formulations

Psychoanalytic theories

Psychoanalytic explanations of conversion disorder emphasise unconscious drives, including sexuality, aggression or dependency, and the internalised prohibition against their expression (Hollander, 1980). A classic paradigm of this theory is the case of Anna O., who was treated by Freud (Breuer & Freud, 1895). Physical symptoms allow for the expression of the forbidden wish or urge but also disguise it. Other psychoanalytic explanations focus on the need to suffer or identification with a lost object (Ford & Folks 1985). An analytic therapist would attempt to treat a conversion disorder by helping the patient move to more mature defence mechanisms.


It is crucial in any approach to patients with conversion disorder to establish a therapeutic alliance and to allow recovery with dignity and without loss of face. It is important that nursing and medical staff avoid labelling these individuals as manipulative, dependent or as exaggerating their difficulties.

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8 thoughts on “Conversion disorder not about mould”

  1. Who came up with this? Never confront the patient? “to allow recovery with dignity and without loss of face.”
    Everyone is lying in psychiatry. No one calls the hospital a prison, no one says the poisons-meds are just drugs.
    No one admits to hearing voices. That would be schizophrenic.
    The voice of gluttony , no one is eating too much.About one-third of U.S. adults (33.8%) are obese.
    The voice of lust, look at those sexy women/men. american idol, dancing with the stars
    The voice of sloth , the captain that did not care for his passengers. The cruise ship sinking.
    The voice of wrath, those furious with the cruise ship Captain for failing to do his job.

  2. Rossa,


    Can mold cause “mental illness?”

    An article about how rye contaminated with ergot (mold causing hallucinations) was likely behind the Salem witch hunts, by Lisa Nasy, M.D., Environmental Medicine –

    IMO, the term “hysteria,” “hysterical,” etc. often igrnore some of the symptoms that are unique to women – ie, candida, yeast problems, menstruation, hormonal… and also mold.

    The term “hysteria” is dismissive.

    Be well,


  3. These two comments illustrate my point. Do we as a society, lie all the time to avoid the much more painful truth? So we try to come up with a plausible cause that suits our modern scientific side that doesn’t involve going down the dark road of finding a plausible trauma? Just because an environmental contaminant like mold hasn’t been linked to these cases or previous ones, doesn’t mean that eventually one cannot be found, but there is a refusal (in this case by one of the girl’s mothers) to look at possible stress in the girl’s life-It’s too scary to confront our own lifestyles and choices, so we’ll continue to look for a physical explanation.

  4. We don’t know what is wrong with these girls and neither do the “health officials.” Period.

    My hypersensitivity to environmental toxins, and that of many of those in protracted withdrawal syndrome, is astonishing. And most people, especially those with a scientific bent (in general not always) don’t believe it’s real…leaving us at great risk of harm.

    I would never rule out an environmental toxin. We will never be able to test for everything that can be ingested or absorbed or inhaled by our bodies.

    I’m grateful I have a (normal and well-respected, mainstream!!) MD who believes me about my hypersensitivity…because it’s frankly a matter of life and death and I need him to advocate for me when I need any medical care.

    I feel horrible for these girls and I hope they are supported in all ways possible.

  5. Gianna,
    All very true, however, tests have been run and so far, there is no link. It doesn’t mean that there won’t be in the future, or there isn’t actually one now that nobody has figure out. But, my bigger point here is how much people would prefer to look for some environmental causes rather than other environmntal causes. Why not do both? With a diagnosis of schizophrenia, for example, we are told that more research is needed, and this inevitably means we will soon see another drug on the market. The mainstream isn’t looking into other causes, like trauma. When I was looking for help for Chris, I had to consider everything, not just what seemed logical, or non-threatening. Whatever is happening to these girls is real, just like people with a diagnosis of schizophrenia aren’t faking the symptoms either. But, if I were that mother, I wouldn’t be so quick to dismiss other possible causes. That’s really all I’m saying.

  6. having worked with people diagnosed with conversion disorder (one woman in particular who used to have INTENSE convulsions) I know that our mental health system is TOXIC to anyone with this diagnosis. Regardless of its cause, and frankly, I was never convinced that these seizures were psychosomatic…the message from the system to the client is that they are faking it. It’s a horrible and destructive diagnosis as communicated these days…whether or not it’s a valid idea, it’s not communicated in a way that is even remotely therapeutic.

    What I saw happen to my client is in part why I no longer work in the system as she was one of the most abused people I’ve seen in the system. Her needs were totally dismissed by most of my colleagues. I found it deeply troubling and sickening.

    we do not have a system of care that knows how to approach people in all sorts of ways…and conversion disorder as explained today to clients is about SHAMING.

  7. I suppose I should add that as holistic beings whose parts are all deeply intertwined we need always look at all aspects of our being if we are to grow…that should always be the foundation of all our health and wellbeing decisions…so I am not disagreeing with your main suggestion that we look at the whole picture…though since we live in a culture that does not do this we must compensate for that lack in all sorts of ways…pretty much all the time!

  8. Rossa,

    I’m not arguing that trauma (however subtle) might be behind some of theses symptoms. But I do think it behooves the medical community to begin to show an openness toward people who are highly sensitive individuals. These sensitivities can come from a variety of sources – family, community stressors, etc… however, they can also come from over-exposure to toxins – in foods, buildings, workplaces.

    We had some pretty lengthy discussions on these topics in Safe Harbor’s Integrative Psychiatry group, where there were some practitioners who who open to these ideas, and others who seem insistent that the root cause of sensititity was trauma. I disagree. I think that each person is unique…. percieves the world in a unique way, and responds to their environment – both emotional and physical in a way that is different from any other individual.

    At the end of the day, I believe in the ability for any individual to overcome – to heal, to get well… to move beyond, and find a sense of belonging and peace in their life.

    My two cents.


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