Lived Experiences of Mental Health Professionals Dealing with Functional Neurological Symptoms Disorder: A Phenomenological Perspective

Authors

  • Saheefa Noor MS Scholar, Department of Professional Psychology, Bahria University, E-8 Campus, Islamabad, Pakistan. https://orcid.org/0009-0002-4860-560X
  • Shazia Yusuf Senior Assistant Professor, Department of Professional Psychology, Bahria University, E-8 Campus, Islamabad, Pakistan. https://orcid.org/0000-0002-2365-9233

DOI:

https://doi.org/10.52053/jpap.v7i1.471

Keywords:

Epilepsy, Functional Neurological Symptom Disorder (FNSD), Pseudo-seizures, Psychiatrists, Psychologists

Abstract

The current study was conducted to explore the lived experiences of the psychologists and psychiatrists currently dealing with the clients diagnosed with Functional Neurological Symptom Disorder (FNSD) in private clinics and hospitals of Islamabad and Rawalpindi. Semi-structured interviews were conducted to collect the data.  Ten participants were interviewed. The data was analyzed with the help of Interpretative Phenomenological Approach (IPA). The main superordinate and subordinate themes were found after the data was arranged and examined several times. These themes are “Diagnostic complications (Crisscrossing symptoms, Misreporting symptoms), Therapeutic failures obstacles (Beliefs, Unsupportive caretakers and gains) and Therapeutic procedures (Psychological Therapies including Cognitive Behavior Therapy, Family therapy, and Counseling)”. The present study results are significant in the development of new therapeutic interventions and measures for treating Functional Neurological Symptoms Disorder (FNSD).

References

Alluri, P. R., Solit, J., Leveroni, C. L., Goldberg, K., Vehar, J. V., Pollak, L. E., Colvin, M. K., & Perez, D. L. (2020). Cognitive complaints in motor functional neurological (conversion) disorders: a focused review and clinical perspective. Cognitive and Behavioral Neurology, 33(2), 77-89. DOI: 10.1097/WNN.0000000000000218

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.; DSM-5-TR). Washington, DC: Author.

Aybek, S., & Perez, D. L. (2022). Diagnosis and management of functional neurological disorder. BMJ, 24, 376:o64. doi: 10.1136/bmj.o64. PMID: 35074803

Beng, K. S. (2004). The last hours and days of life: a biopsychosocial-spiritual model of care. Asia Pacific Family Medicine, 4, 1-3.

Bokharey, I. Z., & Rahman, N. K. (2013). Development of an indigenous symptom checklist for conversion disorder. Pakistan Journal of Clinical Psychology PJCP, 12(1). 17-33. https://pjcp.icpuok.edu.pk/index.php/pjcp/article/view/84/86

Boulet, C., Lopez-Castroman, J., Mouchabac, S., Olié, E., Courtet, P., Thouvenot, E., Abbar, M., & Conejero, I. (2022). Stress response in dissociation and conversion disorders: A systematic review. Neuroscience & Biobehavioral Reviews, 132, 957-967. doi: 10.1016/j.neubiorev.2021.10.049

Cascella, R., Strafella, C., Caputo, V., Errichiello, V., Zampatti, S., Milano, F., Potenza, S., Maureillo, S., Novelli, G., Ricci, F., Cusumano, A., & Giardina, E. (2018). Towards the application of precision medicine in Age-Related Macular Degeneration. Progress in Retinal and Eye Research, 63, 132-146. DOI: 10.1016/j.preteyeres.2017.11.004

Cassum, L. A., Cash, K., Qidwai, W., & Vertejee, S. (2020). Exploring the experiences of the older adults who are brought to live in shelter homes in Karachi, Pakistan: a qualitative study. BMC Geriatrics, 20, 1–12. doi: 10.1186/s12877-019-1376-8

Diez, I., Larson, A. G., Nakhate, V., Dunn, E. C., Fricchione, G. L., Nicholson, T. R., Sepulcre, J., & Perez, D. L. (2021). Early-life trauma endophenotypes and brain circuit-gene expression relationships in functional neurological (conversion) disorder. Molecular Psychiatry, 26(8), 3817-3828. doi: 10.1038/s41380-020-0665-0

Espay, A. J., Aybek, S., Carson, A., Edwards, M. J., Goldstein, L. H., Hallett, M., LaFaver, K., LaFrance, W. C., Jr, Lang, A. E., Nicholson, T., Nielsen, G., Reuber, M., Voon, V., Stone, J., & Morgante, F. (2018). Current Concepts in Diagnosis and Treatment of Functional Neurological Disorders. JAMA Neurology, 75(9), 1132–1141. https://doi.org/10.1001/jamaneurol.2018.1264

Haider, A. H. (2022). Cognitive and Dialectic Behavioural Therapies for Post-Traumatic Stress and Conversion Disorders: A Case Study. International Journal of Psychotherapy, 26(3), 63. DOI:

36075/IJP.2022.26.3.6/Haider

Hatala, A. R. (2012). The status of the “biopsychosocial” model in health psychology: Towards an integrated approach and a critique of cultural conceptions. Open Journal of Medical Psychology, 1(4), 51-62. DOI: 10.4236/ojmp.2012.14009

Hutchinson, G., & Linden, S. C. (2021). The challenge of functional neurological disorder – views of patients, doctors and medical students. JMHTEP, 16, 123–38. doi: 10.1108/JMHTEP-06-2020-0036

Ijaz, T., Nasir, A., Sarfraz, N., & Ijaz, S. (2017). Psychometric properties of conversion disorder Scale-revised (CDS) for children. Journal of Pakistan Medical Association, 67(5), 725-30.

Kanaan, R. A. A., & Craig, T. K. J. (2019). Conversion disorder and the trouble with trauma. Psychological Medicine, 49(10):1585-1588. doi: 10.1017/S0033291719000990

Khalil, A. A., Torbey, J., Akoury-Dirani, L., & Alameddine, R. M. (2022). Difficult diagnosis of factitious disorder. BMJ Case Reports, 4, 15(7), e244699. doi: 10.1136/bcr-2021-244699

Miller, L., Archer, R. L., & Kapoor, N. (2020). Conversion Disorder: Early Diagnosis and Personalized Therapy Plan Is the Key. Case Reports in Neurological Medicine, 10, 1967581. doi: 10.1155/2020/1967581

Morsy, S. K., Aybek, S., Carson, A., Nicholson, T. R., Stone, J., Kamal, A. M., Abdel-Fadeel, N. A., Hassan, M. A., & Kanaan, R. A. A. (2022). The relationship between types of life events and the onset of functional neurological (conversion) disorder in adults: a systematic review and meta-analysis. Psychological Medicine, 52(3), 401-418. doi: 10.1017/S0033291721004669

O'Neal, M. A., & Baslet, G. (2018). Treatment for Patients with a Functional Neurological Disorder (Conversion Disorder): An Integrated Approach. American Journal of Psychiatry, 175(4), 307-314. doi: 10.1176/appi.ajp.2017.17040450

Peeling, J. L., & Muzio, M. R. (2022). Conversion disorder. StatPearls, Treasure Island, FL. https://www.statpearls.com/point-of-care/19957

Richardson, M., Isbister, G., Nicholson, B. A. (2018). Novel Treatment Protocol (Nocebo Hypothesis Cognitive Behavioural Therapy; NH-CBT) for Functional Neurological Symptom Disorder/Conversion Disorder: A Retrospective Consecutive Case Series. Behavioral and Cognitive Psychotherapy, 46(4), 497-503. doi: 10.1017/S1352465817000832

Rosenbach, C., Renneberg, B., & Scheithauer, H. (2021). Psychometric properties of the German version of the Children’s Rejection Sensitivity Questionnaire (CRSQ). International Journal of Developmental Science, 15(1-2), 29-37. https://doi.org/10.3233/DEV-210312

Saad, M., de Medeiros, R., & Mosini, A. C. (2017). Are We Ready for a True Biopsychosocial-Spiritual Model? The Many Meanings of "Spiritual". Medicines, 4(4), 79. doi: 10.3390/medicines4040079

Stone, J., Vuilleumier, P., & Friedman, J. H. (2010). Conversion disorder: separating "how" from "why". Neurology, 74(3), 190-1. doi: 10.1212/WNL.0b013e3181cb4ea8

Szasz, A., Korner, A., & McLean, L. (2025). Qualitative systematic review on the lived experience of functional neurological disorder. BMJ Neurology Open, 7(1), e000694. doi: 10.1136/bmjno-2024-000694

Tasca, C., Rapetti, M., Carta, M. G., & Fadda, B. (2012). Women and hysteria in the history of mental health. Clinical Practice and Epidemiology in Mental Health, 8, 110–119. https://doi.org/10.2174/1745017901208010110

Tripathy, C. S., Shukla, R., Meher, A. C., & Pattojoshi, A. (2020). A study of presenting symptoms of conversion disorder in patients attending the Psychiatry OPD of a Tertiary Care Hospital in Eastern India. Journal of Advanced Medical and Dental Sciences Research, 8(11), 134-137.

Van der Feltz-Cornelis, C. M., Allen, S. F., & Van Eck van der Sluijs, J. F. (2020). Childhood sexual abuse predicts treatment outcome in conversion disorder/functional neurological disorder. An observational longitudinal study. Brain and Behavior, 10(3), e01558. doi: 10.1002/brb3.1558

Downloads

Published

2026-03-31

How to Cite

Noor, S., & Yusuf , S. . (2026). Lived Experiences of Mental Health Professionals Dealing with Functional Neurological Symptoms Disorder: A Phenomenological Perspective. Journal of Professional & Applied Psychology, 7(1), 160–173. https://doi.org/10.52053/jpap.v7i1.471

Issue

Vol. 7 No. 1 (2026): Journal of Professional & Applied Psychology

Section

Qualitative & Mixed Method Articles

Categories

License

Copyright (c) 2026 Saheefa Noor, Shazia Yusuf

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Creative Commons Attribution-Non Commercial 4.0 International (CC BY-NC 4.0) License: This article is distributed under the terms of the Creative Commons Attribution-Non Commercial 4.0 International License (https://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-Commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the Journal website at (https://iprpk.com/ojs/index.php/jpap)