Ultra-brief Theraphy in Conversion Disorders

Involved in this project:

Universitat de Barcelona (UB)

Università de Roma-La Sapienza

Hospital de la Santa Creu i Sant Pau

Societat Catalana d’Hipnosi Clínica i Psicoteràpia

The concept of conversion disorder has been the subject of constant review in the scientific literature. Psychogenic movement disorders are common in neurological practice, including tremor, dystonia, changes in walking and paralysis. The diagnostic criteria emphasize clinical observations such as the inconsistency, distraction and false neurological signs. The psychological aspects of the disease go into the background, for example, these changes obviously require a psychiatric or emotional disorder, but need not be specific. By contrast, the psychiatric approach emphasizes the characteristics of the clinical interview, including psychological factors in the onset and the inferences of intent.

Both the neurological approach to psychogenic movement disorders such as psychiatric approach to conversion disorder, are problematic. Many patients move between neurological and psychiatric services, without showing a unified formulation, which contributes to an unsatisfactory outcome. Importantly, it lacks mechanisms to explain the neurological manifestation of conversion disorder, though probably psychological etiological factors are established. Thus, one of the objectives of the explanatory framework for conversion disorder is evident, collect psychological and physiological phenomena.

Nor neurology neither psychiatry, by themselves, have achieved the requisite progress in understanding the neurobiology and treatment of these disorders. This slow progress contrasts sharply with the magnitude of the problem. Medically unexplained symptoms account for approximately 30% of outpatients referred to neurology. Conversion disorder alone (specifically associated with psychological stressors in your home), representing approximately 5% of the references is a stable and accurate diagnosis.

Hypnosis and hysteria have maintained a long affair. 128 years of flirting seem to encourage the scientific establishment to lay the foundation of their relationship. There are many similarities between the symptoms of conversion hysteria and phenomena produced in hypnotic contexts.

A recurring theme is the apparent paradox between,

– First the subjective reality and involuntariness of hypnotic phenomena and conversion symptoms

– And the rules governing the sensitivity to the manipulation of motivational factors, and expectations and social influence, on the other side.

In our study we tried to replicate the initiative of Prof. Loriedo, using a form of intervention through hypnosis. This is an ultra brief therapy model based on the recognition and resolution of basic interpersonal conflicts of the individual. The aim is:

– Check the validity and effectiveness of hypnotherapy protocol ultra short compared with empathic listening.

– Observe Dr. Loriedo’s protocol and prove the possibility to use it as convention treatment of conversion disorders.

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