Dear Yasuko KY Kishi,

hysteria is a heterogenous syndrome better described in the psychologic and psychoanalytic field; although you can find disorders that overlap with hysteria (fragmented in categorical constructs).

Here in Brazil, we are now starting studies linking models of attachment with biomarkers and advanced neuroimaging (3.0T fMRI, PET...) in some brain regions.

Well, let's share more about our work!

Best

Eduardo Nogueira

Dear Eduardo Nogueira

Thank you for your comment. That is a great reseach. Unfortunately introduction of fMRI is late in my country, Japan. It may be said that Japan is an underdeveloped country in the brain science.

In fact, I am not an engineer of the examinations of brain, and there is not the qualification of examinations instructions. However surely, sometimes physical neurological abnormal (represses symptom) and emotional hysteria symptom occurs to me. And these symptoms are still unknown.

I want to study it from psychological ( alienation of the attachment ) approach. However, MRI, fMRI, PET, the test result are very interested as reference to me. I think that brain science and psychoanalysis, the psychology should progress at the same time ethically.

Thank you so much.

Yasuko

I was the description as " Hysteria" in the previous article, but I would like to correct. In the current DSM-5, it is changed to " Conversion disorder ". This is a lack of study of me.

However, I think the outline of the symptoms are the same. The main symptoms is temporary nerve abnormality or paralysis. However, I guess that statistically of these symptoms are rare, and actually clinicians opportunity to visually symptoms will be low rate. Of course, precautions is prevention of neglect , but what is the effective method of treatment in relieving Conversion disorder and trauma ?

I think this is established theoretically, but i have idea, to give the desire to the dissociative disorder patients by a healthy treatment is effective.

( against potential frustration or unsatisfied when they were abused by someone in the past.) I think it's a very simple treatment, but are there actual clinical case?

Thanks.

Yasuko

Dear Yasuko,

there are many clinical cases, indeed. Hysteria is out of date, that is true, the classifications prefer dissociative disorder or conversion disorder, as you pointed it out. fMRI can show motor changes f.i. finger tapping, but not give the difference between dissociative symptons or signs and other motor movements, for this depens from psychological interpretation. However, I would be glad to get more information, thank you for your interesting question.

Dear Mr.Masuhr

Thanks your valuable opinion. Certainly, "Conversion disorder" is present.

However, yes, symptoms of dissociative disorders and abnormal conditions of the cranial nerves, can not be associated with as same diagnosis. I am studying the relationship, but there is a limit on study in self-learning. At result , pathogenesis condition to be result in neuro brain science. However I think the method of palliative care as a therapist also is valid.

Opinion like you, makes me cheer. Thanks so much.

Sincerely.

Your question is an interessant one, but in my view, you should understand the problem step by step. Attachment theory is come after the studies of Freud on hysteria and so the DSM IV TR ( now there is the V). I dont want to establish a hierarchy among these approaches but give you some hints for the comphrension of the problem. I suggest these step: Freud gave a superb description of the disorder. He took in account Chacot, biological explanations ( in his time ) and discovered unconscious origin of conversion physical disorder (conversion term is used by Freud on Dora case ). For the moment we can skip Janet. Attachment theory of Bowlby has been revolutionary. It established the different nature between love for parents, the need for a safe attachement and erotic love ( Freud looked for a common ground, the libido. Ferenczi did not agree ).

Biological explanation are in progress.

Today physical conversion symptoms does exists, but they are observed less frequently than in Freud time.

How to deal it? I should you a modern psychoanalysis, that take in account of many contributions, keeping in mind the Bowlby' s approach.

For example Glen Gabbard on "Psychodinamic psychiatry" and Nancy McWilliams on " Psychoanalitic diagnosis" .

@ Giovanni Portuesi, thank you, for you show perfectly the important points of International classification concerning "hysteria". I suppose, that the symptoms and signs of dissociative disorders or conversion disorders today are as frequent as 100 and 150 years ago - mostly in Neurologic clinic, seldom in Psychiatry. Why? "Hysteria" left the university and other centers of research, beeing sozialized, spreeding in the society, demonstrated by a lot of histrionic people, we cannot heal, but only admire or blame. Besides, there is a renaissance of Janet in France and Germany. But in my opinion, Freud`s description of "hysteria" and the cases Dora a.o. should never been forgotten.

@Karl F Mashur I agree with you that Freud descriptions of hysteria cases whose Dora is the most famous case, should never be forgotten for their clinical and theoretical power. Regarding the frequency of the cases of histerical origin, i.e. conversion and dissociative disorder, the question is so difficult and puzzling that should deserve a scientific work to shed some light on it, and maybe is a question impossible to answer, also because as you outline, there are a lot of emotional implications when you do such a diagnosis. Anyway, conversion disorder are sent to neurologist obviously also because you need to exclude a neurological cause ( as Freud actually did ) before of a conversion disorder. Still, it seems a diagnosis that make even more "pruderie" than in the time of Freud and Janet, often with an attitude of blaming or a "supporting " one. It seems to me that Janed regarded hysteria as a general " weakness" of the integratory functions of the coscience , while Freud looked for a specific psychic contents repressed in the unconscious. Maybe today they could be nearer than once, because we observe a lot of psychic problems concerning a " deficient" psychic function of integration ( maybe, why not, related also to the famous "mentalization" ). Thank you for your opinion from the neurologist point if view.