Kinder Mind
Kinder Mind
Exploring Conversion Disorder: Functional Neurological System Disorders
Imagine you're handed a puzzle, and as you start piecing it together, realize some key pieces are missing. Frustrating, isn't it? That's how it feels to confront complex conditions like conversion disorder and functional neurological system disorders (FND). Thankfully, we're unraveling this intricate puzzle with our special guest, Amy Terrio, a licensed clinical mental health counselor and registered nurse. Amy brings both a professional and personal perspective as she shares her own journey with FND. Together, we'll dissect potential triggers, delve into the human body and brain, and understand the impact of our reactions to life's hurdles.
Step deeper into the labyrinth of human cognition as we explore the unsettling realm of dissociation, a potential precursor to FND. Uncover how an overstimulated brain can shift into a self-preservation mode, resulting in profound effects for those with FND. In addition, we navigate the uncharted territories of cognitive behavioral therapy and psychoeducation to address negative cognitions, which could be the lingering ghosts of past experiences.
Finally, we shine a spotlight on the profound impact of stress and trauma on our mental and physical health. Revealing the hidden ways past trauma can resurface and how perpetual panic and fear can manifest physical symptoms, we also discuss the possibility of spiraling into a mental health crisis. Amy brings her experiences in assisting clients with conversion disorder and FND to the fore, emphasizing the significance of emotional acceptance, self-healing, and the power of advocacy. Don't miss out on this enlightening exploration into these complex disorders, understanding them, and seeking the right support. Let's piece together this puzzle, one insight at a time.
Resources:
FND Hope International: https://fndhope.org/
Functional Neurological Disorder Society: https://www.fndsociety.org/
Amy Therriault, MA, LCMHCA, NCC, BSN, RN: https://www.psychologytoday.com/us/therapists/amy-g-therriault-dunn-nc/1007063
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Welcome to the Kindermind podcast, where we're devoted to opening up conversations and destigmatizing mental health. We'll bring you interviews with practitioners in the field of mental health, researchers uncovering new knowledge and best practices for treating mental health disorders, and individuals sharing their mental health journey. Thank you so much for joining us today for the Kindermind podcast. Today we are speaking with Amy Terrio, a licensed clinical mental health counselor and registered nurse. We're going to be exploring conversion disorder functional neurological system disorders. Thank you so much for joining us today, amy. Thank you, thank you for having me.
Dr. Elizabeth Barlow:So I am not going to lie. I'm going to be super transparent. I had no idea what neurological system disorders were, what conversion disorder was, so I had to do some Googling. I had to educate myself a little bit. I definitely think there is way more out there that I don't know about this disorder. So I'm very excited to be talking to you today to really unpack what this is, what it looks like and what it means. So could you start out for us by just explaining what conversion disorder is and how it differs from other mental health or neurological conditions?
Amy Therriault:To start with, conversion disorder is what is listed in our traditional DSM-5. But in the more recent DSM-5 text revision they actually reversed the way functional neurological disorders and conversion disorders are displayed. So instead of being conversion disorder parentheses functional neurological, now it is, or at least in the text revision it is referred to as the functional neurological disorder, parentheses conversion. So conversion disorder itself started out as, I guess, brain freeze haunts, it happens.
Amy Therriault:Yeah, conversion disorder is really best described as like the electrical and chemical signaling between groups of neurons, larger brain structures and regions. They're not working together for some reason and most people from the medical community look at that conversion as, oh my goodness, this person is just making random complaints or they are drug seeking, and these are the stigmas that go with, specifically, conversion but brain freeze.
Amy Therriault:So if you want to just tell us what it is and how it's different from other mental health things, so the actual term conversion was more from created, more in the belief that traumatic stresses are converted into functional neurological symptoms through psychological mechanisms that certainly there it was either all brain or all body, and now we know that the two are so interconnected that any stressor can actually propel a feeling of dysfunctional neurological disorder, pardon me, to manifest itself and become present.
Dr. Elizabeth Barlow:Okay. Does that have anything to do along the lines of the thinking of the body keeps the score? I'm not sure. Absolutely Okay. Absolutely, that makes a lot of sense. So what are some common symptoms and manifestations of conversion disorder? What are some things you would see in a client or someone who has this disorder?
Amy Therriault:The clients that I have worked with, and then, once I've read about for research, typically it begins at the doctor's office, not in the therapy room. So you go to the doctor and you're having headaches, muscle weakness, you're having some numbness and walking becomes unsteady, or maybe navigating spares becomes more difficult. And so a lot of people head to the doctor and of course they already asked Dr Google what my diagnosis is, and so that tends to lead them down a rabbit trail of multiple sclerosis, parkinson's disease, epilepsy, naming a few, and then physicians do their thing and there is no real underlying structural cause. So then this typically leads to the referral to a mental health clinician or counselor, because in the past it's been so interlinked with emotional or psychological crises. So if someone comes in and says I haven't been walking that great lately or something of that nature, speech flow changes in tones, or that a person may speak with, some people have vision problems, but there really is no cookie cutter of functional neurological disorders.
Dr. Elizabeth Barlow:That sounds like a nightmare of a situation as a patient and really as a physician. Oh, yeah, Because I think we can probably all what's the word I'm looking for empathize, sympathize with when you've got something medically going on and you're scared. You don't know what it is, you don't know what's wrong. Oh, you know, as you have these symptoms and, like you said, Dr, Google what is wrong with me and you get that, the gambit of all the things that could be.
Amy Therriault:Which that only precipitates even more anxiety. Absolutely absolutely.
Dr. Elizabeth Barlow:And then you're taking all of these tests and they've got you going for like imaging and blood work and hopefully you have good insurance.
Amy Therriault:Absolutely, because some of these tests and diagnostics are even like in the case of multiple sclerosis or a lot of the inflammatory problem disorders require things like lumbar punctures, also known as the spinal tap. Sometimes they require tissue biopsies. And so you're not only going to your primary care physician, but now you're seeing rheumatologist, neurologist, dermatologist the whole gambit physicians and trying to nail down why you can't seem to walk straight or why you can't use both hands or write steadily on your paper anymore, and there's nothing to shut.
Dr. Elizabeth Barlow:So it sounds like the patient goes through all of this kind of what's the word I'm looking for. Medical scrutiny, right, medical scrutiny, and just like a laundry list of it's been a day. I can't think of my words either. What am I trying to say? It's when you go down that list of things and you cancel them out.
Amy Therriault:Yes, you're trying to exclude that, you're trying to pull out the things, but isn't so. Every doctor, like a neurologist, may be looking for areas of ischemia in the brain or where perhaps there's been a stroke, or looking for other blood clots. You have numbness in your hands. The doctor may look at you and say, oh, you need to go see a hand specialist, you might have carpal tunnel, and all of that's very true. You just might.
Dr. Elizabeth Barlow:Right. Cross-sectional elimination that's the word I was looking for. Yes, there we go. So then. So knowing that these different aspects of conversion disorder can really present in like a multitude of ways and diagnosing like what is actually going on can be a really big challenge. It sounds like, after the client and the doctor, or the patient and the doctor, have gone through all of these things, if things are still like inconclusive or things show that there's actually nothing medically wrong with them, is that when you would see a diagnosis of conversion disorder?
Amy Therriault:Conversion typically has been. It's more of a psychiatric, psychological diagnosis code. However, neurology has been able to step in and they too now are using some of these DSM codes for complications that some of their patients may be having. And then at that point, the discussions based on research are getting more patient sensitive from doctors' offices or from neurology departments and realizing that you're not always gonna have a neat, nice diagnosis in a box and it's gonna have a bow on it and here's what you got and go forth. And so those discussions look okay, all of your test results are negative, and then it's blank stare and the patient is on the other side going. How can my visual disturbances or my inability to speak in complete sentences without multiple pauses, how are you telling me that is something I need to see a counselor for? That's ridiculous. And so then, when they come to us, they're not only disgruntled with the medical system, but they're also just at their wits end. They just want someone to believe that it's happening with them and it is a very real disorder.
Amy Therriault:Even though maybe the seizures, the seizure activity, may not be epilepsy, it doesn't mean that there's not a disconnection somewhere in the brain, momentarily causing a person to faint or even have muscle ticks. We see a lot of times people who are on the computer for long hours tend to get the eye ticking and stuff like those nerves that run around our eyes will start twitching. And yes, it's from eye strain. But the second half of that statement, it's the strain, it's the stress that is causing that specific nerve area to twitch and act up and be bothersome. That's not a problem per se, but it is if you say drive a forklift Right, or you're right. So now we've got this huge. Now it involves work, now it involves these daily activities of living. And so how do I do this? What? How can there not be something wrong?
Dr. Elizabeth Barlow:Is right, yeah, no, that makes a lot of sense. And not to go into the weeds, but self disclosure. Another reason I was so excited to learn more and talk about this topic today is my daughter. Actually, she's nine years old and ever since she had, like just turned eight, she has been having ticks. She's developed these ticks. Some have gone away, but then we've noticed that as one leaves, another one comes. And I was recalling back to when I was about eight years old. I had a tick and it lasted for about a year. It's where I would, so I got a cut in my mouth.
Dr. Elizabeth Barlow:And like when you cut the corner of your mouth with a potato chip. The cut never really healed, well cause I would continuously open my mouth overly wide, and I was so when I was researching these ticks. It seemed like the process and the behavior of doing the tick releases a lot of energy from your body and if you don't do it then you feel like you're literally going to explode like restless leg syndrome.
Amy Therriault:Yes.
Dr. Elizabeth Barlow:So I was. So what are the potential causes and triggers for these? Is it something that just some people have and they don't? Or is it something with age?
Amy Therriault:maybe In full disclosure of myself, I have been diagnosed with functional neurological disorder. In 2018, I had been a nurse for 12 years was at the top of my game professionally was I was working for the state. Great, secure job, good benefits, 401, yay, we're there and I started noticing that I was. My hair was thinning and, as a nurse, I go down my own list of what do I need to pay. So we go through all the products and we look at our shampoos and stuff like that, and then I thought, okay, let me go to my doctor and make sure my thyroid isn't out of whack, because that, too, can't cause it.
Dr. Elizabeth Barlow:Okay, so you had to start your own journey of the process of elimination.
Amy Therriault:Right, yeah, and it was just about a one year long stroke over the course of time. So I came out of nursing because it was different. Well, the brain fog was so profound it was like my body was so focused on, from the neck down, trying to coordinate muscle movement and just navigating life that six functions that I had done for years in my profession became increasingly difficult and I started just like losing blocks of time. And so I just happened to know a psychiatrist through family connections and I had. I got home one afternoon and left my car running overnight in the driveway and the next day I went in and I said I don't know what's wrong with me, but I'm losing my mind.
Amy Therriault:And from the period of my life I was in a state of depression, from the period of time that I had spoken to this person last to the time I showed up in their office, my speech had become very choppy, very slurred In fact. I remember he looked at me and he said when did you begin stuttering? And I was like, what are you talking about? But and so it. I went through the gamut MRIs they looked for multiple sclerosis, they looked for Lyme's disease, they looked for all these different things, ended up losing all of my hair and just was unable to navigate, walking up and down stairs, bilateral carpal tunnel surgery for nerve pain in my hands, all trying to get to what it was almost like an inflammatory storm in my body and I couldn't pinpoint where. Why is this happening?
Amy Therriault:And when conversion was first mentioned to me, I was honestly, I was like I was honestly, I was appalled because that's something that other people deal with. Right, I'm a healthcare provider, I know what stress is, I know what all the other stuff is and I don't have it. So rule that out, find out what's medically wrong, and went in and they did more lumbar punctures and functional PET scans and all kinds of stuff and it was like you're getting older but you don't have Alzheimer's and we don't know. Maybe we need to see a counselor and I just so that led me to pursue my master's degree in mental health counseling.
Amy Therriault:What better way to pull yourself out of the place of despair than educating yourself? I've got to learn how to deal with this. I'm gonna have to work. What can I do that I can control some of these things that seem so big, that seem to be stumping me? So Vanderkalk's book was very instrumental in not only my healing but just the greater understanding of the human body, the brain, and how they are so intertwined with trauma, and just the everyday stresses of life.
Dr. Elizabeth Barlow:Right, and as you were talking not to bring up a completely random connection story, but it really did. I was thinking about my journey with dismissing, there being anything wrong with mental stress or anything like that Cause, like you mentioned, when you went through your journey, your reaction was I'm a nurse. No, like, I know stress. I know what that looks like. It can't be that, and I think I have suffered from the same thing in my past. Of no, I am a strong person. I can control my reaction to things. I am in charge of my mind.
Dr. Elizabeth Barlow:And I think one of the biggest turning points for me actually was when I was in the hospital in labor with my first child, my son, and I was not in pain. I physically was feeling no pain. And my OBGYN came into the room and she said your body is not having this baby because of your pain. And I was like I'm not feeling pain, there's some mistakes you don't understand and she's no, your body has shut down from life and is not having this baby. And it was interesting cause my brain wasn't processing pain. I was feeling no discomfort, but my body was in such pain that it wasn't doing what it was supposed to do. That's when, I think, I really first took it serious that your brain and body aren't always connected. They can act independent of each other and wires do get crossed. So if that can be true, then why can't it be true that this thing that you're stressed can't negatively impact you and you maybe not be aware of it?
Amy Therriault:Absolutely, and that's a lot of what, as I traced my steps back, what through the course of my life, where I went to school, they did a wonderful job of and I would imagine that most graduate counseling programs are similar to this but not only are you learning how to help others, but you're also learning a lot about yourself, and so I started having to do research in various types of trauma and stuff like that, and when I really thought about it, being even just being a nurse in itself set my physical body up to. It was like cartwashed to whatever, and I had break.
Dr. Elizabeth Barlow:Yes, no, and that's such a great point because you're right. I remember in my graduate program that it was talked about how, if you're gonna help others, you need to get to know yourself. But really I am completely obsessed with Renee Brown, love that woman and I remember in one of her speeches she was talking about her experience as a researcher and how, before she could get into like other people's mess and sort through it, she needed to get to know her own mess.
Amy Therriault:Oh yeah.
Dr. Elizabeth Barlow:That just made so much sense to me and I feel like it's one of the hardest things that some individuals live their whole life and they never really get to know themselves. And that's why I just love and appreciate every single mental health client I ever meet or anybody that ever comes into my therapy group, because they showed up and they took that scary first step of oh God, I don't know what I'm gonna find out about me. Yes, it's scary, but I showed up and I'm gonna do it, because you don't know how you're gonna handle those things and really being honest with yourself is a hard thing to do.
Amy Therriault:It really is, and especially in the case of functional neurological disorders, you have to be willing to accept yeah, I might be in the grocery store line and actually dissociate, and that's not, that is okay. So what's leading up to that? There's a lot of noise in the store. You hear all the shopping carts, the wheels going, the kids screaming, four aisles away the loudspeakers, everybody's talking, and it's sensory overload, absolutely. And then for a moment everything's clear.
Amy Therriault:And then, when you leave, you're like what was I thinking back there? And then you realize I just was standing up by I don't know, just because I was holding the shopping cart. I wasn't present in my body, though. And so when we look at that from a functional neurological standpoint, that is, the human body and brain actually providing like self preservation, now that too can become a problem, and that's where you gotta really be careful, because dissociation is one thing if you're not thinking about it and you're like, okay, I just whatever. But if someone is so profoundly affected by an FND, then their dissociation, the brains oh wait, I get to rest if I do this and then that in itself becomes a psychological problem instead of just the rescue mode, so to speak. That reminds me of something I heard one time.
Dr. Elizabeth Barlow:I can't remember where I can't remember if it was like a leadership summit or a community meeting. I don't remember if it was like a leadership summit or where it was, but the person that was speaking was talking about burnout they were talking about being overstimulated and they basically I think the whole tenant of the conversation was multitasking can be a really bad thing, oh, my.
Dr. Elizabeth Barlow:They had us all think about times when we have been driving on our way home from work and it felt like we got home too fast. And we didn't. You don't even remember it. Yes, you don't remember when you turned, you don't remember taking that exit, you don't remember that lane change, you don't remember putting on your blinker and then all of a sudden, you're home and is that kind of what we're talking about here? Things that can happen like that?
Amy Therriault:Absolutely. And now that kind of dissociation is, that is, a muscle memory type of thing, where you know your way. It's a past. You've gone down multiple times and just by muscle memory you get there. However, where your thoughts are during that time is really interesting to go back and think about. Oftentimes we can't even remember what we were thinking about as we were driving, that we dissociated from as we're pulling out of the parking lot, and those kind of events happen regularly, especially if it's repetitive.
Amy Therriault:All the time you're doing the same thing. You can leave and come back because if somebody in front of you as you pulled out, if somebody in front of you slams on brakes, that moment when you see those brake lights and all those thousands of neurons millions of them in your backs, there behind your retina and all that stuff they begin processing the fact that the brake lights are in front of you and we step on the brake. That's that moment where you come back into yourself and you're like, okay, I need to stay present in my car, not think about who's gonna babysit Friday night. Right, snap out of that moment, right, right. And that's something that most everyone can relate to in some way or another cooking dinner, washing laundry we all dream of other things and just somehow get these menial tasks done.
Amy Therriault:If you're pulling away from yourself, though, in moments where it's any sort of stressful time, if somebody has difficulty being in hospitals, a lot of people have a fear of hospitals and stuff, and when they go into them, they just blank out Right, that's whatever. And this is where it all starts circling around. Whatever it was that that person attached to being in a hospital, it could have been five minutes ago, it could have been 30 years ago, but it's causing you not to be present. What is that? And then that's where counseling. We go back and we look at okay, so why is it when you're walking through the doors at Walmart? Why is it? Do you? Does your heart start racing, do you?
Amy Therriault:When, then asking people to really tune into that, when they feel themselves beginning to dissociate because of anxiety or because of just hearing a song? Maybe that brought back a memory and it's just too much. So somehow you move on to something else. You've got to get to the root of that and discover where did I attach something painful to what is happening in my present? Because I'm not in the past anymore.
Dr. Elizabeth Barlow:Right, so it sounds like cognitive behavioral therapy is really that, like first go to for treatment.
Amy Therriault:And it is. Some of it is. It's Unfortunately there hasn't been an immense amount of studies done on what therapeutic modality works best. Cbt is incorporated a whole lot, because what do we have attached to all of these negative events or whatever? We like to carry around negative cognitions as well, and so when I take an experience that I may have had with a family member and I attach all this pain to it, then in the future, if I encounter something like that, my past tells me I'm not good enough, I'm not going to be successful at that, because that's a negative cognition you've carried, maybe since childhood, and so, okay, we got to work out that negative cognition too. So you're using a lot of CBT and a lot of psychoeducation.
Amy Therriault:I have my clients, actually, if they are able to pick up Vander Colt's book and there are a couple of great workbooks out there and I actually read the book with them and we go from one chapter to the next, and so they're getting the anatomy lesson and they're getting all this knowledge with someone that is able to say, okay, this is what that word means, because it's a very dense material, but being able to go through that and it is unbelievable, the clients that have been able to extrapolate from their child some of where a lot of this comes from, because they now understand how it got put in there anyway, along with looking at developmentally.
Amy Therriault:For instance, your daughter is eight years old, nine years old, and there may have been just something inocuous happened and at that moment perhaps she blinked her eyes really hard and so and that kind of reset, whatever that moment was for her, and then okay, so two weeks later she's still blinking her eyes really hard whenever she's got to maybe critically think or whatever the activity is. Finding a way to explain the brain, obviously to a pediatric aged client is a little different, but it's still the same system. We can draw pictures to help link the dots until, content-wise, someone's older to understand them.
Amy Therriault:But it's still being able to understand how the brain works. It enables and empowers my clients. That's the word I was looking for empowers. So as they read through this book, I may ask the question how, in what ways do you relate to whatever person you may be talking to, or a client when we meet in a session? Perhaps has been journaling and the pieces start clicking in what their body is feeling. They're able to use that mindfulness of why am I clenching my jaw so tight? Breathing Isn't a huge thing. Why am I holding my breath? That's the first thing I always when I do my checks. If I'm starting to feel stressed, the first thing I do is ask myself are you breathing? Breathe because your brain's not going to work without oxygen, so quit holding your breath. Use simple strategies. When a person knows that taking that breath will actually make a difference and the science behind it, then it means a little bit more than just a clinician going. We'll just take some deep breaths.
Dr. Elizabeth Barlow:No, that makes a lot of sense, and not to throw a curveball at you, but I know so you mentioned like CBT can be helpful. Do you know of any instances where EMDR has been used, if this disorder is related to any past trauma or anything?
Amy Therriault:Absolutely. It is the eclectic therapist's kind of ball of wax, so to speak, because there's not. Every person is different. Every person's journey to this point is different. They may not be beneficial. It may be that they are looking, you may have to incorporate or help them getting in touch with transcranial magnetic stimulation. But the T has only shown to be beneficial in those with the motor types of functional neurological disorders. T has become a big thing now with working with past stresses or working with major depressive disorder, and it too is right there, linking together our body and mind, in that it allows the person to actually be to face the fear in enough of a euphoric state that they're not fearful of it and they're able to begin processing it.
Dr. Elizabeth Barlow:Can you tell us what TMS is for any listeners who maybe have never heard that before?
Amy Therriault:Magnetic stimulation is the use of magnets to stimulate areas of the brain that may not, that may be under functioning and quiet down some of the others. So if you think for all of us who have seen one flu over the coopus ness electro convulsives therapy we think of that being so barbaric. But the reset on the brain is actually really helpful in getting people out of a dangerous state. The trans-magnetic stimulation it's like going into the CAT scan machine and I think that's right. The CAT scan machine and they're running these magnets uses that magnetic field to stimulate the brain into improving the electrical impulses running through the brain. So it's really bizarre.
Dr. Elizabeth Barlow:I think yeah, and it makes a lot of sense because our body has a lot of electricity in it. We know that we get a lot of energy which is created by electricity built up anytime we're reactive because we're angry or we're stressed or letting that out. So it sounds to me like drawing the correlation of this disorder when those communications get crosswired and things with your body and your brain and how you're feeling and how you're overwhelmed aren't processing correctly. It sounds like a tool that you would use to reset that process Exactly.
Amy Therriault:And that's really where collaborating with other healthcare professionals becomes really critical, my being like a clinical mental health counselor. I don't necessarily case manage in the traditional sense. I'm more the social worker role, so to speak. But you find yourself when you get really embroiled into functional neurological disorders. There's no possible way that I, singularly, can diagnose functional neurological disorders without the collaboration of other treatment and physicians that look at other things. There are certain tests that have to be done, and so it opens up the door for counselors to perhaps become a little closer to case managers at the same time.
Amy Therriault:Obviously, if people clinicians and comfortable addressing these kinds of things, then that's. I'm obviously looking at this with two lenses, one being the nursing and the other being the healthcare system that I've accessed in my previous profession that work for me now. So I ask the questions about medications and stuff like that, because I've got the pharmacological background and can be in touch with psychiatrists, physical therapists and stuff to be able to weigh out whether treatments are effective or not, because they may see the client once every three months. I may have to see them twice a week to a certain level of, just for the client to be able to see some relief and most of that at the beginning is just being present. That's it. That's all you're doing.
Dr. Elizabeth Barlow:Right, and that validation piece it sounds. I believe you. Like you said, you're not alone in thinking this is a problem that you're experiencing. I believe you.
Amy Therriault:Yes, absolutely. And now that newer research is coming out daily just about on this and the additional, the easiest or one of the ways that I've I have my clients really tune into themselves is going through your body sense, going through your five senses. What are you seeing? What are you hearing Smelling? Can you taste anything? How does your do you feel that your heart's racing? Or like when we look at someone and we say, are you okay? And they're like why, what do I look like? And you're like, look, you look a little nervous. Right now I'm not, but then when you get back, when you get him in your relaxed, you're like, wow, my shoulders are killing me. I must have been holding them up to my ears the whole day.
Amy Therriault:Right, that's just your body compensating in some way in a more critical way. Our fight or flight, that kind of that triggered moment, where is there? Am I going to be attacked? Am I at risk for something? The brain doesn't differentiate between the bully and the polar bear, for instance.
Amy Therriault:We have reason to fear both, but the chances of me running into a polar bear in North Carolina are slim than none, and so I know it can be a polar bear but it may be the bully that's causing that surge of adrenaline and cortisol and it just dumps out all throughout your body and it leaves especially in healthcare providers leaves you running in a perpetual state of fight or flight. So if you can imagine, like at one point in time when I was going through my masters and I'm thinking about all the years I spent in nursing and there was somewhat of a nursing shortage, not like during COVID, but there have been times where, my goodness, I stayed working in the emergency room. I stayed in fight or flight for 12 solid hours because we were just that busy and everything's critical. So you're always running and you're multitasking, which we know now really isn't the best thing for your body. But what do all these hormones do? As they're forcing through our bloodstream, they're depleting, they're interrupting your normal balance in your own body, and then we have GI upset, we have people now that you're going to get a cold or you're not going to sleep good or your lists of just all these random symptoms, and it's almost.
Amy Therriault:I predict this alone will create its own issues in healthcare, because so many of our healthcare providers are so burned out and they are just so tired that any kind of trauma they've experienced prior to having to run do their jobs. Law enforcement, care departments, all these they're constantly in a state of good and that can destroy parts of your body that you aren't even aware of. And I joke with a colleague if I ever decide to get my PhD, my area of interest with research is in first responders. How many of those are actually having to leave the workforce on short term disability or just leave it all together because of the stress alone causing or being linked to other parts of their bodies just breaking down, and that's going to create a problem.
Dr. Elizabeth Barlow:Oh, absolutely. And as you were talking, I was thinking of a personal experience and I've never been a first responder, but I was thinking about so. I was bullied really bad in high school, and so I remember going to see a gastroenterologist one time when I was a young adult and I was very caught off guard because the gastroenterologist said oh, we typically see this in people who have a past history of trauma or are currently being abused. Do you feel safe at home? And I was just like that's the most ridiculous thing I've ever heard. I didn't say that out loud, obviously, but I saw it because I was like no, I've never been abused, like I'm not being heard at home, like why would they think that this could be a thing?
Dr. Elizabeth Barlow:And it wasn't until I became a mental health provider that I really started to think about how that affects me now. So I don't do well with conflict. The fear of the potential for conflict or being mistreated scares me so much that now, before I leave the house to travel, or I leave the house for a really important reason, I get sick at my stomach and I feel well ahead of leaving the house because I've already worked myself up into thinking what kind of conflict is going to come my way, like how are people going to perceive me and treat me? And I literally have been working on that for years and sometimes you never come back from it, like with gastrointestinal issues, like once it's there, it can be a lifelong thing. Once the trauma's gone, once you've worked through things, you still may never recover from that.
Amy Therriault:Oh yeah, you may always have motility problems or people who talk about having chronic constipation or chronic diarrhea. Or I can't eat this because it'll just work my nerves and I'll end up in the bathroom for the rest of the day. And so what you find yourself doing is you're compromising every other aspect of your life to avoid triggers, that irritable bowel. Now you're not living life anymore, right?
Dr. Elizabeth Barlow:Taking the lights, going to the airport, driving the long car rides for vacation, like the things that you have to think about and worry about because something has happened either in your life or your career that you chose. Like you mentioned first responders and they're always on go, always in the realm of trauma and now that's impacting so many other facets of your life. And that leads me to the next question On the spot question. So we recently talked in a previous podcast about clients in crisis, so clients actually experiencing a mental health crisis. Would you say that clients with this disorder are likely to experience a crisis situation where they're mentally not safe or physically unsafe because they've been going through these physical and mental challenges?
Amy Therriault:Right. So and I would say, yes, anything is possible, but most, and that's typically why, if I'm seeing somebody that has been diagnosed with a functional neurological disorder, I typically see them at least twice a week. And the reason I do that and insurance may or may not like that but the reason I do is because, having been in that position as a patient and knowing that the doctor's gonna see you for 15 minutes, bill you for 20 and not give you any answers, these specific, this population is tired. They just wanna be heard. And can you please just stand here with me at the edge of the cliff and we can back down together, because I can't drive anymore, because I have these events or episodes and they're not seizures, it's not epilepsy but I can't drive.
Amy Therriault:If you tell that to a 21 year old, that's really gonna hamper their lifestyle. In fact, it's gonna disrupt all social interaction. And so now you've got somebody still developing their pre-pharmal cortex being told you're not gonna be able to do this and they're missing out on a big block of social interaction, training, getting the mental calluses that you need for when you're 30. They're missing that because they're spending all of their time trying to figure out what's wrong with them. It is so. So when someone does call and say this particular office referred me over to you for I've been having these symptoms and they just don't care. And I do my intake with them and we go through all of this, just all of this stuff they've been told. Sometimes I do request the medical documentation from their neurologist or primary care physician so that way I can have a better understanding of how it presented to them.
Amy Therriault:But it's not always a functional neurological disorder. That's part of what we have to do is differentiate between a somatic disorder or is it a conversion, and a lot of what I look at with that is how is it affecting their activities of daily living? Is this preventing them from being the provider they wanna be? And if they call me in crisis, then and heck, yes, I'm not gonna be the one that's just gonna say don't know what. It is rather okay. So this is how I do my counseling for this disorder and I explain that to the client. And, okay, are you willing to set the time aside? That's needed so that you can heal, because this isn't in every other week visit. This isn't basic anxiety. It's somebody who can't, they're paralyzed in their lives and that in and of itself is a crisis, maybe not to the point of suicidal ideation, but to a breadwinner that can't drive to work and is missing hundreds of dollars a day, that's a crisis in itself.
Dr. Elizabeth Barlow:Absolutely that, just oh yes, even thinking through someone going through that you can't provide for your family anymore and the stress that could come from that. What advice would you give to individuals who suspect that they may have conversion disorder but they have not yet reached out for help?
Amy Therriault:I would first say biggest piece of advice is speak up, advocate for yourself, because right now the state of healthcare is just in shambles. It is unbelievable how long it takes to get in with a mental health clinician and then to try and find someone that is, like, specialized in specific things is even more difficult. So advocate for yourself, scream it out loud to your doctor. I need you to look at me, and if you don't find anything great, that's okay. But at least I know that it's not a brain tumor. That's a beautiful thing.
Amy Therriault:But now what do I do with my speech? That's slurring. And what do I do with my brain fog? How do I deal with that? And then that's where I would come in and say, okay, I'm gonna, we're gonna work on this a couple of days a week to start, and then slowly you're. Maybe, if they're showing positive outcomes and great strides, then we can back down to once a week. But this is over an enormous amount of time, like a year. The client that I have now I've seen actually just almost a year, and they have made enormous strides in their ability to even leave the house and being able to utilize tools from CBT, the mindfulness techniques, just using them all.
Amy Therriault:And then next would be solidify your support.
Amy Therriault:If a specific person is gonna be your go-to for help in moments that you're feeling really down about the things that you are not in control of, that particular person being a part of the treatment, so that the door is open for me to communicate, maybe with the driver of this client or the aunt who's taking care of them right now, because they can't be left alone.
Amy Therriault:And don't be afraid to ask for help, especially to first responders, to people who work in healthcare, to even each other.
Amy Therriault:As mental health clinicians we hear a lot, and if you think that you're not gonna be affected in some way vicariously in learning of other people's traumas, I would I don't know, I would just about guarantee that at some point in time of your life, all of that, all of it I cry on a weekly basis and it is I have come to embrace that not as something that I'm sad about, but rather that is my physical body releasing all of the pain and the disappointment and the feelings of betrayal and disgust and panic that my clients feel that they bring in to therapy. It's gotta go somewhere and if you're empathic in any kind of way, then, even through technology, it passes right through the screens and I find myself maybe at the end of a week and I'm just so tired and saddened for the people that are having to go through the things they are that I make sure I spend time and just cry and be okay with that.
Dr. Elizabeth Barlow:It's okay to let that emotion out and you walk away a lot healthier Absolutely so it sounds like advocating for yourself, finding a really reliable support person, being okay with crying, being okay with letting out what you're feeling Because it's holding it all in.
Amy Therriault:That's what's causing all the upset to begin with. The first time a client looks at you and goes I'll just put it all back together, it'll be okay, I'm all right, I'm fine. But I'm like no, you're not. Here's a box of tissues. Do we have to play still magnolias or something for you to feel comfortable with your feelings? Is that the only no dad did this?
Amy Therriault:Oh, okay, now we're gonna dig a little in further and find out where the tears are from and when we can accept ourselves, as I think there's a healthy balance between what is considered emotional regulation and allowing yourself to feel it. I could not agree more with that statement. That is not a powerful statement.
Dr. Elizabeth Barlow:On that note, this was so educational and I know a lot of listeners out there got some really great information from this, whether they're going to be able to do it or not, and I think that's a great information from this, whether they're going through something like this or they have a loved one or friend going through this. Thank you so much again, amy, for joining us today and talking through this disorder with us. Certainly, is there anything you'd like to say, any closing words Let our listeners know, like where they can find you, or anything else you wanna share.
Amy Therriault:I am located in North Carolina. I'm from the College of Psychology to day profile that they can find me on and in finding support. There are some organizations FND Hope International or FND Hope USA, the Functional Neurological Disorder Society. Those are great places that people can link up and find support groups as well as staying on top of the absolute latest research. And being able to print that out and put it in your doctor's hand and say and go back to school is a very empowering thing for someone who doesn't feel like they've got it together.
Dr. Elizabeth Barlow:Wonderful. Thank you so much for sharing that. I will make sure that both your psychology today links and those helpful resources that you shared can get linked in the description for this podcast. You are very welcome. Thanks all of our listeners for joining us on this episode of the Kindermind podcast, where we discuss exploring conversion disorder, and stay tuned for our next episode that will be dropping in one week. The Kindermind podcast is produced by Dr Elizabeth Barlow, edited by Marco Antonio, with music by Pax Minerva. Thank you,