Functional Neurological Disorder - Psychotherapy Service
What is Functional Neurological Disorder?
Functional Neurological Disorder (FND) is due to a problem with the functioning of the nervous system in a structurally normal brain. FND is common and accounts for up to a third of outpatient neurology appointments. FND can be diagnosed and recognised by clinical features. The reasons people develop FND are varied. It tends to happen when the brain has difficulty coping with thoughts, memories, emotions, and sensations. The brain can become overwhelmed, and therefore stop functioning normally. It can be associated with past trauma and loss, or ongoing stress, but this is not always apparent. It tends to be more common in resilient people who have a tendency to “just get on with things”. Life’s copers, they often do not communicate their difficulties to others (or themselves). Instead, in FND, it is as if the body does the ‘talking’. People with functional symptoms are not “faking it”. They cannot consciously produce, or stop, symptoms. Think of blushing - another physical manifestation of an emotion - or a churning stomach before an interview. You cannot turn that off or on at will!
What treatment can I have?
Sometimes FND symptoms resolve naturally when the diagnosis is explained. But, for most, psychotherapy is beneficial, and is the recommended treatment for FND. Your therapist will work with you on a ‘formulation’ - a shared understanding of what made you vulnerable to FND, what triggered it, and what is keeping it going - and then help you develop skills to give you more control of your symptoms.
Will psychotherapy cure my FND?
For some people, despite best efforts, there will be no measurable change. For the majority, however, there is evident improvement, including a decrease in symptoms and, for some, their complete disappearance. Just as importantly, if not more so, most people see improvement in their overall quality of life, everyday functioning, and mental health.
How long are sessions?
A maximum of 12 hour-long appointments are offered, usually on a weekly or fortnightly basis.Homework may be given between sessions. We usually suggest you attend appointments alone, although this will be discussed on an individual basis.
Is this the right time for psychotherapy?
Firstly, psychotherapy can involve exploring difficult subjects, and therefore might lead to an escalation of symptoms in the short term. Secondly, therapy is not something that is done ‘to you’, like being given medication. It requires effort on your part, and for you to be open-minded, honest, and willing. If you are unsure whether this is the right time, it might be better to wait.
What can I do to help myself get better?
It is important to come to terms with the diagnosis of FND. It is difficult for people to get better if they continue to look for a physical explanation for their symptoms. If you have doubts about your diagnosis it is better that you discuss this with your doctors before considering psychotherapy. While waiting for psychotherapy to start, visit www.neurosymptoms.org for further explanation of FND. You may also be interested in our leaflet ‘Taking control of your functional neurological symptoms’, which advises on self-help techniques.
Telephone: 0151 556 3179 / 0151 556 3183
- Last Updated:01 January 2021
- Review Date:01 January 2023
- Author:Dr H Bichard
Sometimes FND symptoms resolve naturally when the diagnosis is explained. But, for most, psychotherapy is beneficial, and is the recommended treatment for FND.