Abstract
Therapists who work with dissociative disorders frequently encounter patients who contend with unusual bodily experiences that defy organic explanation. In some cases, this presents as increased or decreased sensation, or loss of a sensory capacity. In other instances, a patient may be baffled by movement occurring outside of their conscious control. Alternately, a limb may be inexplicably unresponsive. Such symptoms may be clearly (or opaquely) linked to experienced trauma and/or the relationships between conflicted ego states. 

But variations of such phenomena are also experienced by those without dissociative personality styles. Consider having a “lump” in one’s throat or being figuratively “tongue tied.” While there are often biological processes that (partially) account for these experiences, the symbolic nature of these symptoms (often rooted in inner conflict) suggests they may be addressed through psychotherapy. This presentation provides an introduction to conceptualizing and approaching the treatment of functional neurological (FN) symptoms. 

The history of the study and treatment of FN symptoms, spanning more than 150 years, will be explored, including developments in the way the phenomena have been conceptually understood and changes in terminology (from “hysteria” to “conversion disorder” and beyond). Attendees will be introduced to relevant concepts drawn from psychodynamic and ego state theories, as well as applicable research from the hypnosis literature. Utilizing this material, a series of FN cases will be explored and analyzed in order to facilitate learners’ capacity to conceptualize the defensive processes that result in emotional distress and psychic conflict manifesting as sensory and motor symptoms. An overview of approaches for understanding the presence of somatoform dissociation in the consulting room will be provided. Specific emphasis will be placed on discerning (i) whether a symptom is new to the immediate moment, constitutes an activated historical trauma response, or both; and, when originating in the past, (ii) whether a symptom constitutes a symbolic representation or a literal somatic memory trace.