Patrick, thank you for the compliment. I view you and the other posters on this forum an asset as well. You all certainly have been helpful to me. I'm happy to pay it back or pay it forward when I can.
MSUSpartan, that's a great question. For folks reading this thread, a conversion disorder occurs any time the brain doesn't quite know how to handle an emotional or psychological stressor and winds up producing a very real physical response or symptom(s) as a result. Please note that these are REAL, non-manufactured symptoms that the person has no actual or intentional control over. This makes a conversion disorder different from something like malingering where the person is intentionally producing physical symptoms for some sort of secondary gain (i.e. disability claim, get out of something unpleasant, etc.). Incontinence could in my mind easily be a conversion related symptom/disorder secondary to the onset of PTSD in any individual. If you think about it, we see it in healthy typically developing children all the time. When a young person encounters some sort of emotional trauma, they may "regress" (I hate that word) or lose developmental ground for a bit and have continence issues during the night and even during the day. In kids, it might take the birth of a sibling, changing schools or some other emotional trauma that the child lacks the full comprehension to deal with (which is why these things are traumatic to kids but less so for adults). In an adult, a significant emotional trauma could easily produce any number of physical symptoms (i.e. blindness, deafness, mutism, paralysis, incontinence, etc., etc.) that would be an indication that the mind is having trouble assimilating this new experience into the person's consciousness, awareness, identity and so on.
For me to think I was working with someone who had a conversion disorder, I would still want to rule out any other possible physical causes which better account for the symptom(s) that are present. In the absence of a clear physical cause, a conversion disorder diagnosis may begin to make sense and I would likely suspect some sort of traumatic incident to be the trigger for the new symptoms. If the symptom clears up in the course of our therapy, that's also a good indication that the symptom was conversion-related rather than a pure physical change or abnormality. These are touchy subjects for many people because I would never want to come close to sounding like I was accusing the person of "faking" or being a hypochondriac. My worry is that some doctors, certainly not all, may not look hard enough initially for a cause and then tell the patient "It's all in your head". If it's a conversion disorder, it's not all in your head and it doesn't mean you don't look for possible physical connections.
CJ
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