Critical Reflection Essay
Chronic Conversion Disorder
Troy University- Montgomery, AL
Chronic Conversion Disorder
In this article the author is doing a case study on a patient known as Ms. T. The article is on Chronic Conversion Disorder Masking Depression and Anxiety: The case of Ms. T. by Dr. Robert C. Kores. A case formulation with therapeutic focus and direction, and follow-up information regarding a patient with somatic concerns is presented. A Conversion Disorder was diagnosed with underlying depression and anxiety. A lack of secure attachment and a nurturing environment were core issues. Family of origin and suppressed feelings and choices, was ridged and hypercritical, rejecting and abusive. The reason for the research was the cause and treatment of a conversion disorder. In this article the Dr. Kores goes through the patient’s life to determine the cause of this disorder.
A Conversion Disorder causes patients to suffer from neurological symptoms, such as numbness, blindness, paralysis, or fits without a definable organic cause. It is thought that symptoms arise in response to stressful situations affecting a patient’s mental health and Conversion disorder is considered a psychiatric disorder in the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5). The author came to the conclusion that Ms. T had grown up in an emotionally challenging home with excessive punishment, ridged rules and forced isolation. She felt disconnected, uninvolved and all alone. When she had married she thought that her husband would not be neglectful. However her husband was emotionally and physically abusive.
When she became unable to cope with the abuse she became psychotically depressed and ultimately was psychiatrically hospitalized. She begins to cope by somatic eye closing and head shaking symptoms and was in denial. This led to hysterical blindness in her early thirties. Dr. Kores states that the eye closing may have served as behavior designed to elicit parental support and care and attachment that she never had in early childhood. He then states it could represent “this is not where I see myself” or “I cannot see myself here again”. Ms. T. may have viewed herself as a failure as a spouse or adult taking all the blame from the abusive relationship. Ms. T was believed
to think she deserved all the “bad” that was happening to her and she had inadequate problem solving skills.
Course of Treatment
Dr. Kores states that his therapeutic efforts were directed toward altering her dysfunctional thinking and enhancing her problem solving skills. Dr. Kores used behavioral activation strategies to help her gain more positive reinforcement and increase her social interaction. Dr. Kores had to gain the trust of Ms. T. in order to help her. I believe that the reason this is important to me is because it helps me understand that stress can cause us to react in different ways. In the case of Ms. T. she began to squint her eyes and shake her head. Now if we didn’t know better it could be thought as faking to get attention. However now that I understand what Conversion Disorder is I will never think that again. I think this is important to me because I want to work with veterans someday and I want to be able to help them get through difficult situation that life has thrown at them.
Troy Library portal, and journal by Dr. Robert C. Kores
“Chronic Conversion Disorder Masking Depression and Anxiety: The Case of Ms. T.”