Freud's (1885) concept of hysterical conversion has been widely accepted in modern psychosomatic medicine. According to Freud, in patients, the repressed into the unconscious affects are transferred to roundabout ways of their realization, but already in an altered, symbolic form in the form of a certain clinical symptom. The principle of "conversion to the organ" has acquired the meaning of the basic law of psychosomatic medicine. There is a "separation of libido" from unconscious, repressed ideas and the transformation of this libidinal energy into somatic energy. In the somatic symptom, as already noted, what was supposed to be contained in the unconscious fantasy is symbolically represented.

Hysterical conversion, according to Freud, is directed to new ways and more intense expression of affect.

The concept of the occurrence of somatic symptoms equivalent to anxiety was proposed by Z. Freud: he stated that such somatic symptoms as cardiac disorders, vasospasm, respiratory disorders, diarrhea, tremors, bouts of sweating, hunger, paresthesia, etc. accompany an anxiety attack as its equivalents or as "masked" alarm states. Often these symptoms replace the patient's feeling of anxiety as such. He was the first to describe “anxious neurosis” more than 100 years ago. Somatic manifestations of anxiety, as well as acute and chronic stress and depression, are more common in such socio-cultural communities where mental disorders are considered "unacceptable", "indecent", and somatic illness is considered "trouble", "unhappiness", which can cause sympathy, help and support from others. In addition, a number of constitutional, acquired and external factors predispose to the “somatization” of anxiety, such as the psychological makeup of the personality, the characteristics of bodily sensitivity, the duration of stress, as well as the so-called alexithymia (insufficient ability of a person to recognize and express their own feelings).

Early psychosomatic concepts within psychoanalysis. The hypothesis of psychosomatic specificity. The main issues addressed by psychosomatic medicine

The psychosomatic specificity factor determines why one patient develops a disorder, for example, of the cardiovascular system, and another - of the digestive tract, etc.

In the 40s-60s. In the works of F.M. Alexander, the role that is played in the development of psychosomatic diseases is not single experiences of a traumatic situation, but lingering, repetitive negative emotions. At the same time, negative emotions in themselves, and especially the process of their suppression, lead to the development of specific bodily disorders.

The spectrum of chronically repressed emotions is largely individual, its specificity is determined by the personal characteristics of the patient. Alexander discovered a certain psychosomatic specificity of certain emotions: the bodily disturbances caused by them manifest themselves precisely in those systems of the body to which these emotions have an “affinity”. So, for example, a suppressed feeling of anger leads to the development of cardiovascular diseases, a feeling of addiction leads to stomach ulcers, and repressed sexual desires lead to bronchial asthma. At the same time, psychosomatic patients tend to habitually repeat certain negative emotions in conflict situations. Such emotional patterns are associated with "conflict constellations" in the personality structure, reflecting, according to Alexander, conflicts from the early (preverbal!) period of the patient's life. Subsequently, in adulthood in similar life situations, these early conflicts are actualized. Thus, for each patient there are certain specific intrapsychic conflicts and a corresponding set of external conflict situations - "life constellations" that cause habitual negative emotions and, as a result of the latter, psychosomatic disorders. Hence the described model of psychosomatics was called "the theory of disease-specific psychodynamic conflicts."

Thus, spec. psychosomes. communication violations. and with psychological specificity, i.e. with an individual stereotype of a person's emotional response, and with psychophysiological specificity - the selectivity of the influence of suppressed emotions on one or another body system.

And connected with the name of Sigmund Freud. Before Freud, the cause of neuroses was seen as a disease of the nerves. Today, as at the beginning of the twentieth century, the theory of neuroses, their symptoms and treatment are most fully explored within the framework of psychoanalysis.

From the point of view of psychoanalysis neurosis is the result of a conflict between unconscious desires, often of an aggressive and sexual nature, and a mental structure that evaluates the fulfillment of these desires as potentially dangerous. This definition is an adaptation of the formulation given by Sigmund Freud regarding the difference between neurosis and psychosis, which states that: neurosis is the result of a conflict between ego and id, while psychosis is a conflict in the relationship between ego and the external world.

In other words, in neurosis, a person does not want to know anything about his inner reality - about his fantasies and desires, while in psychosis testing of external reality is violated.

Thus, neurosis is a less severe psychopathological condition than psychosis. However, the degree of suffering caused by neurosis and its impact on the quality of life is impressive.

The description of mental states, which later became known as neurotic, began to appear at the end of the nineteenth century. But the ultimate recognition and exploration of neuroses came about through psychoanalysis.

Today, approaches to neuroses are different. The International Classification of Diseases of the Tenth Revision (ICD-10) includes a heading of neurotic disorders. Within the framework of domestic psychiatry, disorders of the neurotic level are considered. Whereas in the American manual for the diagnosis and statistics of mental disorders (DSM-5) there is no heading for neuroses, however, a number of disorders of a neurotic nature are provided.

2. In psychoanalysis, neuroses include:

Obsessions are aimed at preventing a certain event or the commission of a certain action. These events and actions are of an aggressive or sexual nature. In obsessive-compulsive disorder there is always a conflict of love and hate. In obsessive rituals, the realization of a love or aggressive desire and a ban on the realization of this desire are expressed. That is, the first action is canceled by the second, this is called the destruction of what has been done.

The result is that it is as if there was not a single action, when in reality there were both. Freud compared such magical thinking or animism to the rituals of primitive peoples trying to propitiate spirits. In the rituals of a person suffering from obsessive-compulsive disorder, the same tendency can be traced, when, for example, he performs a certain ritual action so that nothing happens to his relatives or to him. Such a person has an unconscious motive of hatred for a loved one and at the same time love for him. The stronger both, the stronger the obsessive symptoms.

Aggression in the symptoms of obsession is manifested in the desire to control not only oneself, but other people, forcing them to participate in the performance of their rituals.

The expectation of bad events, as well as the fear of injuring oneself, committing suicide, are associated with a sense of guilt for one's own hatred, which is not realized.

Contradictions in the mental life in obsessive-compulsive disorder are particularly pronounced. The world seems to be divided into good and evil. In compulsive rituals, there is a tendency to avoid "bad things" and deal only with "good" ones. Moreover, it can be difficult to understand the logic by which things are divided into good and bad.

People who suffer from obsessions are usually very energetic by nature, but the constant internal struggle leads them to indecision, doubt, lack of strength.

In essence, these are very conscientious people, as in all neuroses, in obsessive-compulsive disorder, guilt plays a large role. But there were events in their early history that prevented them from being in touch with their feelings, emotions, and desires. As a rule, these are psycho-traumatic events or circumstances that occurred at an age when the child did not have the mental resources to cope with them. This causes excitement in the psyche, which is transformed into aggressive and sexual desires that overwhelm a person, and obsessions arise as a defense against a breakthrough of these impulses.

Obsessive symptoms act as a barrier to forbidden impulses, which is why there is great anxiety if you try to stop the symptoms by volitional effort. A person seems to be deprived of restraining mechanisms and is left alone with his frightening desires.

Psychoanalysis makes it possible to investigate the cause and significance of the symptoms of obsessive-compulsive disorder. Reconstruction of the past and its connection with the present helps the patient understand himself, reduce the need for obsessive symptoms, and develop more adaptive mechanisms for coping with the onslaught of unbridled desires. When a person understands the meaning of his symptoms, he becomes able to find harmony with his inner world.

The meaning of the most intricate obsessive rituals can be understood if we trace how their appearance is connected in time with the patient's experiences, determine when the symptoms appeared and what events they are associated with.

Obsessive repetition

The symptoms of obsessive-compulsive disorder are very diverse and are described within the framework of various approaches, but the following manifestation of obsession has been studied mainly or even exclusively in psychoanalysis. It's about compulsive repetition. This is an inevitable hit of a person in the same circumstances. Certain life difficulties, tragic events can seem to haunt you through life. Moreover, the person himself feels such repetitions as bad luck or the disfavor of fate. One's own contribution to the formation of obsessive situations is often not recognized. However, there is always an unconscious motive to constantly experience the same situation.

An example is a series of relationships that miraculously develop and end according to the same scenario. It can be love relationships, friendships, situations with colleagues at work, and so on. It is as if the same circumstances find a person, or, more correctly, unconsciously he finds them, as if deliberately choosing exactly the path where "the same rake" lurked.

The treatment of neurosis with psychoanalysis helps to see the connection between the patient's past and his current life, which makes it possible to get out of the vicious circle of the same situations.

6) Emotional lability

Instability in the emotional sphere is another characteristic feature of neurosis.

The cause of emotional states and reactions often remains unclear both to those around him and to the neurotic individual himself. This is because the repressed desires and ideas, although not realized, continue to evoke feelings associated with them.

Among the feelings that are rooted in unconscious fantasies and desires, one can name: shame, guilt, anger, resentment, despondency, envy, jealousy, fear.

One of the basic feelings in a neurosis, and even forming a neurosis, is guilt. The repressed sexual and aggressive desires associated with the Oedipus complex, although not realized, continue to be condemned by their own morality. The feeling of guilt is the most difficult to endure, it torments a person, but without the ability to understand its origins and cope with it.

Dissatisfaction, despair to achieve love, internal conflicts, hatred, the causes of which remain in the unconscious, lead to aggressiveness, outbursts of indignation. If aggression is redirected to oneself, there is a depressed mood, despondency and depression.

Self-pity, low spirits, depression, and low self-esteem often accompany neurosis. A negative emotional background and underestimation of oneself lead to isolation, lack of initiative, and the loss of various opportunities. But addiction to these experiences can also arise, when the need for someone to feel sorry, sympathetic or feel guilty leads to fantasies about this or open demonstration of one's suffering. This, in turn, can form features masochism, in which pain and suffering begin to bring pleasure. As a result, a person unconsciously always seeks to turn his cheek where there is an opportunity to get hit on it.

Hot temper and irritability, becoming traits of character, can bring their owner a hidden or not so hidden pleasure, a feeling of triumph over the victims. This behavior is a manifestation sadism. But at the same time, it complicates relationships both with relatives and in professional and other areas. A person may feel like a hostage to his own explosive temperament or bad character. Behind such manifestations are unconscious motives, the understanding of which in the process of undergoing psychoanalysis helps to curb one's own temper.

Suspicion and suspiciousness can become a character trait that complicates a person's life when one's own aggressive impulses are projected outside and attributed to others. As a result, other people are perceived as bad and persecuting. This is an unconscious mechanism that allows you to keep feeling good, but violates the objective perception of other people.

The feeling of a special attitude towards oneself, condemnation from others, even if they are strangers on the street, arises under the influence of guilt.

Love heals many diseases. But in the context of the topic under discussion, questions arise: what is love and can it save from a mental disorder?

Passion, lust, addiction, habit can be mistaken for love, but the ability to experience a mature feeling is not available to everyone. Neurosis impairs a person's ability to enter into close, truly deep relationships.

According to one of the concepts of mental development, neurosis is associated with the undermining in early childhood of faith in unconditional love on the part of the closest. The capacity for deep attachment suffers from this. A person insures himself from experiencing disappointment associated with a possible break in relations, guided by the principle that he can only rely on himself. Such defense against attachments leads to loneliness, emotional closeness, lack of reciprocity and trust in relationships.

The ability to empathize and sympathize, to understand one's own emotions and the feelings of others, can be significantly limited as a result of neurosis. But the longing for close relationships remains.

Hysteria is associated with the need to attract attention to oneself by any means, hence the pretense in behavior, drama, theatricality, demonstrativeness. A person with such traits may, however, feel lonely and misunderstood, despite the increased interest in himself. This is due to the fact that the relationship remains superficial.

Experience depression is a difficult state of mind that cannot be compared with a bad mood. The psyche is trying to get out of this state, resorting to desperate attempts. There is inspiration, reaching to mania, when a person is overwhelmed with positive emotions, an indefatigable thirst for activity, he is like the sea knee-deep. But these states occur spontaneously without any reason, their character is artificial and superficial. The desire to take on everything at the same time does not allow you to productively focus on one thing. Such outbursts of irrepressible fun are abruptly replaced by low spirits, depressed mood, and a depressive phase begins.

Emotional swings can manifest themselves in different situations and relationships. For example, in the form of an unpredictable change of anger to mercy and back in relationships with loved ones, with children, in social contacts. The treacherous onslaught of feelings can negatively affect personal life and professional activities.

Mood lability, emotional instability are integral companions of neurosis, which psychoanalysis is designed to overcome. Awareness of the motives of arising feelings contributes to finding peace of mind.

7) Sexual disorders

Klimt G. « Kiss ", 1907-1908. Gustav Klimt led a very unbridled sexual life. The artist had numerous novels, but he never married. Klimt is credited with up to forty illegitimate children. Psychoanalysis pays great attention to the ability to build and maintain reliable relationships.

Sexuality is one of the fundamental components of life. Surprisingly, such a fundamental instinct becomes very fragile under the influence of neurotic disorders. Sexual function, one way or another, is affected by any mental disorders.

For example, with depression, along with the general tone, sexual desire is also suppressed. Inadequate mental states hinder the development and maintenance of relationships, respectively, limit the possibility of a normal intimate life.

Mature sexuality is not limited to sexual intercourse. Mutual support, care for offspring, genuine intimacy in the broadest sense - these are the components associated with the manifestation of libido. Violations of interpersonal relationships, the inability to sincere intimacy undermine openness and trust in a couple. As a result, serious difficulties arise in intimate life and personal life in general, which not everyone succeeds in solving, as they say, amicably.

Mental conflicts, unconscious inhibitions, fantasies that are felt to be unacceptable and repressed, all underlie sexual disorders.

These include: impotence, which in most cases has a psychogenic nature; in men, premature ejaculation or difficulty reaching orgasm; among women frigidity, sexual coldness, inability to achieve orgasm, vaginismus - contraction of the muscles of the vagina before intercourse, which makes it impossible to penetrate the penis; aversion to sex; psychogenic pain and discomfort from sexual intercourse without somatic causes; neurotic experiences that impede the enjoyment of sexual life, such as: fear, anxiety, paralyzing shame, guilt, latent homosexuality that turns sexual relations of heterosexual partners into a kind of formal process.

A man who is afraid that he will not be patent enough, courageous enough, will disappoint the other half, really loses potency from these experiences, which instills even more uncertainty and forms a vicious circle.

A woman may worry about whether she is attractive to a man, how much she will be accepted by him, whether she will lose control if she gives herself to sexual pleasure. If such experiences are too intense, it prevents a woman from reaching orgasm or even enjoying sex.

It happens that the female gender identity is violated by disappointment, which was broadcast to the girl in childhood by her parents, who openly or covertly show dissatisfaction with her gender. Rudeness or coldness on the part of one or both parents, a ban on sexuality as such - all this prevents you from accepting femininity in yourself and undermines sexual sensuality in the future.

Men have the so-called division of the female image into “Madonna and prostitute”. It manifests itself in the fact that a man is able to sexually liberate himself and experience satisfaction only with a woman for whom he does not have tender feelings, while with one for whom he feels reverent love, sexual satisfaction is impossible.

In each case, their unconscious causes of sexual disorders.

Some of these disorders can be overcome as a result of the emergence of trust in the couple.

If both partners are aimed at gaining each other's trust, demonstrate acceptance, openness, sensitivity, in the end they achieve harmony in intimate life.

However, the neurotic foundations of sexual disorders are quite deep, behind them there may be: unconscious hatred, fear, undermining basic trust, envy, violated sexual identity. When we are talking about the violation of interpersonal relations in general, this is reflected in the sexual sphere.

In this case, psychoanalysis will help the patient to establish contact with his inner world and with other people. Problems in the intimate sphere will be solved as a person begins to realize their hidden causes.

8) Daydreaming

Not only thoughts can be intrusive, but also fantasies, or, as Freud called them, daydreams. When a person would like to change the external reality, but it is impossible to achieve immediate changes, he consoles himself with fantasy, where he can imagine himself as a hero, a winner, a desired object of love, a successful person, embody revenge for the wrongs inflicted in dreams, or assert himself. Such comforting daydreams are a common component of mental life, but in the case of a neurosis they seem to enslave the consciousness.

Neurosis is different in that it does not have enough mental strength to try to change the real state of affairs. Instead, satisfaction occurs in fantasies. When a person plunges into the world of dreams, he becomes divorced from the real world, which further deprives him of the opportunity to set goals and achieve them. This position is akin to masturbation, which in neurosis can completely crowd out attempts to build relationships with other people.

With neurosis, mental pain or unbearable excitement arising from various experiences, memories or vivid impressions, like anesthesia, requires immersion in the comforting world of an alternative fantasy reality.

Addiction to the world of dreams can lead to pathological states of dependence, such as: gambling, alcohol, drug addiction, this also includes: extreme hobbies leading to injury and death, promiscuity or promiscuity, passion for everything that is associated with risk and excitement . Adventurism can become second nature to a person.

There are many manifestations of addiction, one of the leading feelings in them is the emerging excitement, detachment from reality and severe anxiety, if it is impossible to indulge in hobbies to which addiction has developed.

Psychoanalytic treatment aims to help the patient understand what is in their history that has prevented them from developing more mature ways of coping with reality. This research helps to understand the origins of social failures and learn how to adequately overcome difficulties. Gradually, a tolerance for anxiety develops, which previously could only be fought by escaping into the world of dreams.

5. Treatment of neurosis by psychoanalysis

Treatment of neurosis by psychoanalysis aims to help the patient understand the unconscious causes of his experiences and even certain life circumstances, come to terms with repressed fantasies and desires, see the impact of childhood history and relationships with loved ones on today's life, and develop more mature and adaptive ways to cope with various difficulties.

The fact is that the development of neurosis is associated with the so-called secondary benefit from the disease, which is not only responsible for the occurrence of the disorder, but also interferes with coping with it. The motives for the disease of neurosis consist in achieving a certain goal, the understanding of which is often not available to the sick person in the first place.

However, neurosis is not at all a voluntary choice of a person. Freud gives a metaphor, comparing neurosis with the instinctive impulse of an animal, replacing one difficult circumstance with another.

Imagine a traveler who rides a camel along a narrow path along a steep cliff, a lion appears from behind the turn. There is nowhere to go. But the camel finds a solution, he escapes from the lion by rushing down with the rider. The symptoms of neurosis are not the best way out, it is rather an automatic action, a lack of adaptive mechanisms from childhood. Such a choice does not allow us to cope with the situation, the solution is no better than the difficulty itself. But this is the only maneuver that the psyche of a person with a neurosis is capable of.

An ordinary conversation, no matter how confidential and warm it may be, is not able to reveal the deep unconscious motives for the emergence of a neurosis, and, consequently, to cope with it. The secondary benefit from the restrictions imposed by neurosis allows you to avoid certain circumstances, or with the help of symptoms of neurosis to influence loved ones, to achieve a certain attitude towards yourself. All this makes nervoz a valuable acquisition, to get rid of which turns out to be unprofitable for mental economy. However, this way of solving problems is not mature, along with benefits, often imaginary, neurosis brings severe mental suffering.

Difficulties arise in interpersonal relationships, adaptation to the environment is disrupted, a person loses the ability to adequately perceive his psychological needs and be in harmony with himself.

The psychoanalyst is able not only to treat with sympathy the experiences of the patient, but he also tactfully explores the questions: what do the symptoms of a neurosis mean, why and for what did the patient fall ill?

The emergence of neurosis is associated with psychological trauma received in childhood and reactivated by a similar traumatic event in adulthood. Here the expression is suitable: "Where it is thin, it breaks there." Often these topics are associated with severe mental pain, which does not allow you to directly approach them.

Everything that prevents a person from understanding his inner world and overcoming neurosis in psychoanalysis is called resistance. To demonstrate to the patient the work of resistance and to help him overcome it is one of the main tasks of the psychoanalyst. It helps to achieve it by creating trusting and reliable relationships based on unconditional acceptance, empathy and the opportunity to discuss any topic. At the same time, confidentiality and respect for the patient's personality are guaranteed.

At the dawn of psychoanalysis, when the method was just being formed, Freud achieved success in the treatment of neurosis by helping patients to remember the scenes that led them to psychological trauma and subsequently repressed from consciousness. However, it soon became clear that memories do not always eliminate the symptoms of neurosis, or the result is not stable. In addition, in some cases, patients remember sad events and even realize their connection with the current state, but this does not help to cope with mental suffering.

Just remembering an event that the psyche preferred to forget means making an unhappy person out of a neurotic sufferer. That is, to return him to the moment when he acquired his neurosis. Actually, a neurosis would not have developed if a person would be able to cope with life's difficulties. Therefore, Freud came to the conclusion that in the treatment of neurosis by psychoanalysis, in addition to the memories of traumatic events, it is necessary to work out their consequences. The goal of working through is to make the patient mentally more mature, to help him overcome mental suffering, to strengthen his ability to withstand emotional stress and to use more adequate means for solving life problems than those that the neurosis forced him to resort to.

In conclusion, I would like to say about such an advantage of psychoanalysis as high standards of qualification. In psychoanalysis, a prerequisite for professional development is the passage of personal analysis. In order to be able to provide psychological assistance to patients, you need to understand yourself. The observance of the ethical principles of psychoanalytic work is supervised by professional community. Psychoanalysis is the most developed and researched method of depth psychotherapy, which has many directions. Entire institutes specialize in the study of psychoanalysis.

If you need psychological help, there are experiences that you would like to deal with, relationships do not add up, difficult life circumstances arise - contact me, I will be happy to help!

Reception lead in Moscow.

Martynov Yu.S.

Despite the fact that medicine has been studying human anatomy and psyche for many centuries, some reactions of the body are still difficult to explain. These mysterious reactions include dissociative conversion disorders.

Disease or pretense?

What is the usual attitude towards those who complain of a disease, but during the examination it turns out that they are healthy? Many will say that this person is a simulator, but they will be wrong. Physicians know that sometimes in a physically healthy person there are violations of various functions of the body. This phenomenon is called "conversion disorder".

The human psyche is very complex. In some cases, social conflicts, internal contradictions, stressful situations or psychological trauma lead to the fact that a person feels overwhelmed and sick. He experiences pain and symptoms of the disease, sometimes even paralysis occurs. Imaginary sensations and signs have long been called hysteria and treated as a pretense. Only at the end of the 19th century, Jean Martin Charcot proved that patients really experience symptoms of non-existent diseases. Since that time, official medicine has recognized that hysterical conversion disorders are a disease.

Sigmund Freud, who trained with J. M. Charcot, made his contribution to the study of the disease. The young psychologist was looking for connections between conscious and unconscious, "closed" memories. In the process of communicating with patients, Freud developed a special method called psychoanalysis, which allows you to release "closed" memories and eliminate the causes of the disease.

Why is this happening

Conversion disorder is most commonly seen in children, young adults, and the elderly. The reason is that people during this period of life are the most emotionally receptive. At the same time, girls and women are more susceptible to the disease than boys and men.

As a result of a strong psychological shock, an internal conflict occurs, and the patient cannot correctly assess the current situation. Conversion disorder can be caused by underestimation of one's own importance, an attempt to "shelter" from difficult problems, the need to make important decisions or take responsibility. All this happens against the background of stress, and the psyche "turns on" the disease.

Initially, the symptoms were reduced to fainting, hysterical seizures, paralysis and mental disorders. However, in the course of studying a complex one called "conversion disorder", the symptoms turned out to be more extensive. It was determined that the effects of the disease can be felt by any organ. A deeper analysis made it possible to divide the symptoms into four separate groups.

Motor group of symptoms

The first and most extensive group of symptoms affects or limits motor functions. The complexity of symptoms can be different: from gait disturbances to the onset of paralysis. Conversion disorder is often associated with uncontrollable seizures that suddenly appear on external stimulation. The patient may fall, raise a cry, jerk his arms or legs, arch unnaturally and roll on the floor. Such movement disorders last from several hours to several minutes, and the cause can be a sharp loud sound, the appearance of a new person, a flash of light and other stimuli.

Sensory group of symptoms of dissociative disorders

This group includes all the symptoms associated with human sensitivity. may appear in different ways:

• violation of the threshold of sensitivity, at which it may increase or decrease Numbness may occur, in which sensitivity to pain disappears altogether;
• violation of temperature perception, in which a person ceases to feel hot;
• deafness;
• taste change;
• manifestations of blindness;
• smell disorder.

All these symptoms can be more or less pronounced and felt for different periods of time.

Vegetative symptoms

Symptoms of this group cause spasms of smooth muscles and blood vessels. In this case, conversion disorder can look like any other disease. Initially, a person is put through a lot of tests and analyzes until it is suspected that this is a dissociative disorder.

Mental group of symptoms

In this group, there may be harmless fantasies and morbid delusions. Hallucinations may occur or imaginary memory loss, the so-called amnesia, may begin. However, the symptoms cause tension and anxiety, and in more severe cases can even cause

dissociative identity disorder

Despite the frequent mention in detective novels and action films, and the signs of which the authors use, the disease is quite rare. It can be difficult for even an experienced psychiatrist to make an accurate diagnosis without confusing it with manifestations of schizophrenia or a person's attempts to act out the disease in order to avoid responsibility or punishment for a crime.

Previously, the diagnosis used the name "multiple personality disorder". But today this diagnosis was abandoned. The official name is "dissociative identity disorder". But most often this subspecies of the disorder is called precisely "split personality". Symptoms and signs of the disease are diagnosed according to four criteria:

1. The patient has two or more personality states. Each person has his own model of behavior, a separate worldview and his own attitude to the world around him.
2. Internal personalities alternately gain control over the behavior of the patient.
3. The patient has no memories of important events in his life, does not remember important facts.
4. The patient's condition is not caused by alcohol or drugs. The patient was not exposed to toxic substances, he was not diagnosed with other mental illnesses.

When diagnosing multiple personality disorder in children, psychiatrists often encounter violent fantasies, lingering games, and fictitious friends.

How is the treatment

If a patient is diagnosed with conversion disorder, treatment should begin immediately. The first stage is the elimination of the traumatic factor. No matter how hard the doctor tries to influence the symptoms of the disease, but if the main cause is not identified, then there will be no lasting effect.

A change of scenery is beneficial for the patient. The main treatment is psychotherapy sessions. In addition, the patient must be convinced that his illness is psychological. This will help to properly tune in to treatment and speed up recovery.

A good psychoanalyst is able to identify personality conversion disorder and determine the best course of treatment. The use of drugs is often not required. Drug therapy is necessary only in the case of a depressed patient. To relieve anxiety and depression, the doctor may prescribe a course of tranquilizers or antidepressants.

The likelihood of a complete recovery is quite high. It all depends on the professionalism of the doctor and the timeliness of the provision of assistance. However, in some cases there are relapses, and sometimes conversion disorders are observed throughout a person's life.

The conversion is hysterical

Somatic resolution of the conflict of the unconscious; a process in the course of which the normal exit was closed to the affect that developed under pathogenic conditions, which is why these “pinched affects” find abnormal expression (application), or remain as sources of constant excitation, burdening mental life.

Dictionary of practical psychologist. - M.: AST, Harvest. S. Yu. Golovin. 1998 .

See what "hysterical conversion" is in other dictionaries:

Conversion- (lat. conversio - change) (Freud S., 1895). The splitting off of the affective reaction from the content of the psychic trauma and its direction along a different channel. According to A. Jakubik (1979), three options for K. are possible: 1. K. serves as a means of protection against fear, is ... ... Explanatory Dictionary of Psychiatric Terms

Clinical picture of neuroses- Neurasthenia. This neurosis is manifested by increased excitability and irritability, combined with fatigue and exhaustion. According to E. K. Krasnushkin, the causes of neurasthenia are explained by fatigue. Protective switches on... Encyclopedic Dictionary of Psychology and Pedagogy

CLASSICAL PSYCHOANALYSIS- This term denotes: 1) the direction of depth psychology, which considers the unconscious as a determinant of the development and functioning of the personality; 2) a psychotherapeutic system based on the identification of features ... ... Psychotherapeutic Encyclopedia

LANGUAGE OF THE BODY- a set of bodily manifestations (features of appearance, movements, facial expressions and gestures, internal sensations of people), reflecting the state of mind of a person, his motives and features of relationships with the outside world. You can select at least ... ... Sociology: Encyclopedia

Conversion is the process of rejecting the mental content of the subconscious, replacing it with bodily forms of manifestation of various phenomena. This is where the name of such a syndrome as conversion disorder comes from - this is a reaction of the psyche, in which, against the background of stressful situations, depressions and resentments, they are replaced at a subconscious level, leading to the development of symptoms of physiological disorders and diseases in the body.

Conversion disorder (hysterical conversion,) is a psychological disease of a special type. Also, the phenomenon is called dissociative conversion disorders. With this syndrome, a person’s sensory or motor functions are disturbed, for this reason he begins to notice the real symptoms of various diseases in himself. In fact, there are no functional disorders in the body, despite their obvious symptoms, and the person feels sick at the same time (the subconscious mind replaces stressful situations with imitation of diseases).

At first, the French doctor, neurologist J.-M. Charcot, he gave the phenomenon the name of hysterical conversion. In the course of observing his patients suffering from the disorder, he found that patients do not feign illness, they really suffer from the symptoms of various diseases that do not really exist.

Later, information about the disorder appeared in the works of Z. Freud, who explained that the mental energy of a patient with a conversion disorder is transformed into somatic. The replacement of depressive states by the subconscious leads to fantasies of bodily illness and the development of a clinical picture of conversion.

The syndrome is manifested by a loss of consciousness control over memory and sensations, as well as over the motor function of the body. In dissociative disorders, the control process is so disturbed that it can change daily and even hourly. It is difficult to find out how much the functions of consciousness control over the body are damaged, it has been established that personality conversion disorder is characterized by a close temporal connection with traumatic events in life, conflict situations, a break in relations with a partner, and other unbearable events for the psyche.

Reasons for development

It has been established that women, as well as young people and the elderly are most susceptible to the development of the conversion syndrome, since it is in these categories of people that the emotional sphere is most vulnerable and unstable.

The main cause of conversion disorder is considered to be an internal psychological conflict, in which a person is biased towards others, makes excessive demands and ceases to realistically assess the situation around him.

In most cases, such behavior is inherent in people with a low level of self-esteem, in whom the desire to increase their own importance in the eyes of others leads to conversion - the replacement of stressful situations by the subconscious for the development of symptoms of diseases. Thus, even through various illnesses, a person tries to be in the spotlight, if he cannot achieve this in other ways.

The second reason for the body's conversion reaction to replace psychic energy with somatic energy is the desire to get away from the existing internal or external conflict. The body builds a protective reaction in the form of an imaginary illness in order to hide from stressful situations.

A person cannot consciously control both factors, he feels a firm belief that he is seriously ill, and begins to actually experience the symptoms and signs of any diseases.

A common psychological factor in personality conversion disorder is to receive some kind of unconscious benefit from this syndrome. So, a person with a dissociative disorder tries to manipulate the object of love, and keep him close at least with the help of an imaginary illness.

Symptoms

Data from studies that were conducted back in the 19th century claimed that the symptoms of personality conversion disorder are reduced to fainting, mental disorders, hysterical seizures and paralysis of varying severity. Subsequent studies have shown that the symptoms of this syndrome can spread to any system of the body, as well as to any organ. human body. The most common manifestations are a feeling of a lump in the throat, difficulty in swallowing, loss of one of the senses of sensory perception.

Conversion symptoms are divided into several groups:

Symptoms can have a fairly severe degree of manifestation, from periodic (occasionally occurring) to chronic. The regular manifestation of signs of the disorder makes it difficult for a person to function both socially and professionally, and in family life.

Treatment

Therapy for dissociative disorders includes medication and psychotherapy.

Pharmacotherapy for conversion disorders includes drugs:

• neuroleptics;
• tranquilizers;
• nootropics;
• antidepressants;
• psychostimulants;
• thymoleptics.

The most commonly used drugs in the treatment of hysterical conversion are drugs from the groups of antidepressants and tranquilizers. The effect of drug treatment is reduced to symptomatic and pathogenetic. Improving the patient's condition after taking medication can go into a state of stable remission.

Psychotherapeutic treatment is a set of measures:

Psychodynamic therapy is used to treat children and adolescents using cognitive behavioral approaches. Family therapy is indicated for couples whose conversion disorder is related to family problems. In the treatment of adolescents, group therapy is used - with the development of survival skills in a social environment.

If outpatient treatment fails, there is an indication for hospitalization of the patient. In a hospital setting, a deeper diagnosis of organic disorders is carried out and the patient's condition is improved outside of dysfunctional conditions.

Symptoms seen in loved ones, signaling the presence of such a condition as personality conversion disorder, should not go unnoticed. Only a timely appeal to a qualified psychotherapist and the elimination of provoking factors - stress, misunderstanding and conflicts in the family and at work, will become the path to successful therapy and recovery.