Conversion Disorder in Children | Result of Suppressing Emotions

Two weeks ago I had a 14 years old patient with signs of right hemiplegia. For those who don't know what hemiplegia mean, it is motor dysfunction of one half of the body (right arm and right leg, or left arm and left leg). He was brought to me by his granddad saying it suddenly happened during the breakfast 3 hours ago. 

It came across my mind it could be some damage of spine, but boy was just sitting, and eating breakfast. It happened suddenly. I though it could be tumor. That was the thought I approached my young patient with. 

His right arm and leg were paralyzed. But he didn't seem worried about it. Actually he was smiling. He was accepting my little jokes. I thought: "Hmmm, this is strange."

I made simple neurological examination, and there was no neurological deficits. If someone looses ability to move arm or leg, you would expect to find no reflexes, or at least something more vivid reflexes. But, I didn't find anything. No signs of articular anomalies, either. Both arm and leg were passively movable in every direction.

I asked him to stand on one leg, while I hold him, and to try to reach his feet. And then it came to me...

Conversion disorder is neurosis presented in the way of motor paralyzis, sensor deficit, or convulsions. The father of this term was Freud. Previous name for this condition was hysteric neurosis, or hysteria. Freud defined it as anxiety in conversion to physical symptom. 

So, the main cause of this disorder is anxiety. Anxiety is free floating fear inside the person. That fear is not related to anything material, or real. It is fear of fear in basic. Difference between anxiety and fear is that in second case person is afraid of something real (frightened of death, animals, high places, something that represents real danger to one's existence). If person is anxious, that means s/he is in constant fear of something s/he can not identify. Freud gave his explanation of anxiety. He said that we constantly keep suppressing our inner conflicts, emotions, impulses... Suppressed part of us is not dead, it is very much alive. And it is constantly trying to get out from our subconsciousness. This creates tension and frustration within us. This tension, free energy, is fear of suppressed things coming out. Suppression is subconscious defense mechanism against things we run from. And that is why one can't identify object of fear in anxiety. 

This free energy, and tension inside patient, can suddenly burst, and convert to physical symptom. Aside from this cause, some acute neurological conflicts can lead to conversion disorder (something we are forced to do in affect, but our ego is not able to do that). Check what happened with my young patient: Child with Conversion Disorder.

When I asked my patient to try and reach his feet, he wasn't able. But the thing that caught my attention was him holding his "sick" arm next to his body. It wasn't falling down under the influence of gravitation, as it should be if arm was out of the function.

Then I assumed it could be CD or hysteric neurosis.

My next step was to check if there is no organic cause of the disease. And there wasn't any.

My next step was to talk to this boy and try to find out his story. Every psychiatric disorder has its story. This boy was suppressing something.

Story: Young S. was living with his mother, stepfather and 2 brothers until he was 8. When his granddad found at the time S. was victim of child abuse by child's stepfather, grandpa took the boy to live with him. But the boy loved his brothers, and the mother despite her being indifferent in this situation. After 6 years S. heard he is going to see his brothers on aunt's wedding, and S. was thrilled about it! But few days before the wedding, his grandpa used breakfast time to tell him his mother gave birth to a child, and she wasn't able to come. Young S. was so angry. He was in affect, wanting to hit his granddad for telling him bad news. But he was always good child, and his ego couldn't stand the idea of hitting loving granddad. This was the conflict that ended up in hemiplegia to stop his arm and leg to hit loving figure of father. 

Treatment: Conversion disorder is going to be spontaneously resolved within few days or weeks. It is important to establish good and stable contact with child. It is crucial child trusts you!

Child experiencing conversion disorder is subconsciously sending message to the people around him to help him. He is not aware of the fact this is just a consequence of deep inner troubles he was experiencing for long time. 

Was it child molesting? Was it love crisis of young teenage girl? Was it school bullying?

There are many situations in child's life that s/he is taking for huge and insuperable problems. In this age of confusion, and finding self in the world, finding the purpose of self in society, adolescent is under huge pressure, and s/he can easily become victim.

Suicides are quite common in the age of 14 to 18 years. Most of the reasons for this are love failures, sexual abuse, school bullying, depression...

Wizzley author Katiem2, has published an article about suicide. In this article Katie explains the most common reasons for suicides; she is writing about what happens to force someone to think about it and what are the signs suicidal person sends to us. How to discover someone is suicidal early enough to help him?

I strongly recommend to read it as addition to this article about conversion disorder: