top of page

The Troubled History of FND

Functional Neurological Disorder (FND) is often shrouded in misunderstanding and stigma, even within the medical community. Many healthcare professionals mistakenly believe it to be a fabricated illness or solely a psychological issue, leading to misdiagnosis, inadequate treatment, and a sense of dismissal for those who suffer from it. But why does this stigma persist?​ To understand the stigma surrounding FND, we need to journey back in time and explore its troubled history.

Despite the lack of knowledge surrounding FND, you may be surprised to learn that it is actually an ancient disorder dating back to the times of Plato. Throughout history, it has been known by various names, with the more recent terms being functional neurological disorder (FND) and functional neurological symptom disorder (FNSD). If you have never heard of it, you are not alone - even many medical professionals are unfamiliar with it. Perhaps some of the other names will ring a bell - hysteria, demonic possession, conversion disorder, psychogenic, and non-organic illness. These names provide insight into the changing perspectives on the disorder over the years. Let's step into a time machine and journey back in time. 

Watch Not Defined By Me's fun, brief video on The Troubled History of FND

Jump to:

Hysteria

  • hysteria definition: behavior exhibiting overwhelming or unmanageable fear or emotional excess

    • hysteria synonyms: rampage, frenzy, uproar, fury, delirium

hysteria

As far back as 1900 BC, texts reference unexplained symptoms that, at that time, they attributed to uterine dysfunction (thought by some to be the first recorded description of FND). The word "hysteria" originated in Greek writings as 'hysterikos', describing symptoms from a "wandering uterus." Plato proposed that if a womb lies infertile for too long it would become angry, thus 'wandering' about the body causing blockages and a variety of illnesses, including FND-like symptoms. There continued to be a theme of sexual organ dysfunction. Both men and women and their respective organs of reproduction were thought to have the potential to lead individuals to behave without reason as animalistic desire overcame good sense.

Supernatural Causes

exorcism

  • supernatural definition: of or relating to an order of existence beyond the visible observable universe; attributed to an invisible agent (such as a ghost or spirit)

    • supernatural synonyms: unearthly, metaphysical, paranormal, otherworldly

In the Middle Ages, it was attributed to supernatural causes, such as gods punishing people, spirits or ghosts, demonic possession, and witchcraft.  Later in the 18th century, it was first hypothesized that FND (still termed 'hysteria at the time') was a dysfunction of the nervous system. 

Conversion Disorder 

  • conversion definition: something converted from one use to another

    • conversion synonyms: operational, running, working, operable, active​​

  • disorder definition: lack of order; an abnormal physical or mental condition

    • disorder synonyms: disarrangement, chaos, disarray, chaos, confusion​

  • psychogenic definition: originating in the mind or in mental or emotional conflict

  • psychosomatic definition: of, relating to, concerned with, or involving both mind and body; of, relating to, involving, or concerned with bodily symptoms caused by mental or emotional disturbance

  • psych definition: mind : mental processes and activities; variant of psycho

  • psycho definition: of, relating to, or being a person who is mentally or emotionally unsound or unstable especially in a way that results in dangerous or violent behavior

    • psycho synonyms: maniac, sicko, loony, psychopath, wacko, lunatic

  • pseudo definition: being apparently rather than actually as stated​

    • pseudo synonyms: bogus, fake, forced, phony, pretended

Sigmund Freud

Around the turn of the last century, largely due to Sigmond Freud's  work, the term "hysteria" underwent a transformation and became known as conversion disorder. Freud theorized that unexplained symptoms were a result of unconscious conflicts. The term "conversion" signifies the replacement of a psychological issue with a physical symptom, highlighting the role of psychological triggers in causing these symptoms. In Freud's view, this suggested that psychological distress and traumas manifest as neurological symptoms. Other terms used to describe this phenomenon include psychogenic and psychosomatic. Non-epileptic seizures often experienced by FND warriors are sometimes called psychogenic non-epileptic seizures (PNES) or pseudo-seizures.

Functional Neurological Disorder (FND)

FND Awareness

  • functional definition: of, connected with, or being a function; affecting physiological or psychological functions but not organic structure

    • functional synonyms: operational, running, working, operable, active​

  • neurological definition: variant of neurology

    • neurology definition: a branch of medicine concerned especially with the structure, function, and diseases of the nervous system​

  • disorder definition: lack of order; an abnormal physical or mental condition

    • disorder synonyms: disarrangement, chaos, disarray, chaos, confusion​

As functional imaging has emerged, and as FND has gained interest and been increasingly studied, researchers have learned more about the etiology and functions of FND. Recent studies show that only about 1/3 of FND patients have a history of trauma, and advances in imaging have provided information about the constructs that are affected in FND patients (see the Research page). This has caused the shift to the updated term of 'functional neurological disorder', which references the issue with the function of the affected constructs, rather than the actual structures. 

Concluding Thoughts

Surprisingly (and frustratingly), despite the growing body of research and evidence to the contrary, many medical professionals still cling to the outdated belief that FND is purely a psychological issue. This is particularly detrimental for patients, as timely intervention is crucial for effective treatment, as is the case in most neurological issues. As long as Functional Neurological Disorder (FND) is perceived solely as a psychological issue, the treatments will predominantly focus on psychological interventions, and FND warriors will be left without treatments or resources.

​

This is precisely why spreading knowledge and awareness is of utmost importance! Without awareness of FND-specific treatments, patients with FND will continue to be underserved and left without proper care. Not Defined By FND's goal is to create (or at least begin to create) a future where individuals can confidently seek medical help, receive a proper FND diagnosis, and access effective treatment options. Let's all work together to educate and empower one another! Each one, teach one!

bottom of page