Hypothesis A global neuronal workspace model of functional neurological disorders 2024 Naccache and Munoz-Musat

Abstract

We introduce here a general model of Functional Neurological Disorders based on the following hypothesis: a Functional Neurological Disorder could correspond to a consciously initiated voluntary top-down process causing involuntary lasting consequences that are consciously experienced and subjectively interpreted by the patient as involuntary. We develop this central hypothesis according to Global Neuronal Workspace theory of consciousness, that is particularly suited to describe interactions between conscious and non-conscious cognitive processes. We then present a list of predictions defining a research program aimed at empirically testing their validity. Finally, this general model leads us to reinterpret the long-debated links between hypnotic suggestion and functional neurological disorders. Driven by both scientific and therapeutic goals, this theoretical paper aims at bringing closer the psychiatric and neurological worlds of functional neurological disorders with the latest developments of cognitive neuroscience of consciousness.

Open access, https://www.tandfonline.com/doi/full/10.1080/19585969.2024.2340131

 

I tried to skim this and I just can't make it. It's just self-important rambling.

 

Not just self-important rambling, but global neuronal working space self-important rambling.
You need to get the full nuance!
And bad science while we're about it.

 

I've read a bit. Enough for one evening.

The inclusion of the words 'could' and 'may' pop up frequently.

Yup their clever clogs ideas could or may be useful/meaningful etc. But on the other hand, it could just be a load of unfalsifyable mumbo jumbo nonsense. The unease that clinicians can experience as evidence of somesuch made me laugh out loud

Have a pleasant evening.

 

Having seen thousands of people discussing being told they have FND over the years, a small fraction of which was definitely positive, I say, with all due respect: Horse. Shit.

They can pretend if it makes them sleep better at night but the only way to know this is to ask and they don't want to know otherwise so they almost never ask, and the few studies of this tell exactly the opposite.

So, absolutely not it's not supposed to be reassuring to patients.

 

For what it's worth, there was a recent discussion on the LC sub-reddit over someone being told by two MDs that LC was psychosomatic that it was explained to them that psychosomatic means that their central nervous system is malfunctioning, which of course is a complete bullshit explanation that obviously the clinician doesn't even believe. So things are sort of morphing into something like this.

There were several comment saying they were told something like this. The profession is trying to bridge facing mounting evidence that the whole concept is BS but simply cannot face the truth, while at the same time we are seeing a push to expand further than ever before, driven largely by neurologists, while most in the specialty don't even want to see those patients.

Honestly it's easy to see why we are so easy to dismiss. When you explain plainly and clearly all of this is all sounds so completely insane that no, well, sane person could ever accept this, continue to play along. And yet here we are. This has been a tradition for well over a century. Hundreds of millions of people, probably north of a billion to a lesser degree, have been subjected to this ideology, with real-life clinical decisions affecting, and in the case of tens of millions at least, ruining our lives.

As a scandal it rivals, and with time will outdo, what the tobacco companies did. Accounting for doing it knowingly, it probably already does. And it all feels like nothing. It's just words, for the most part. Words from people in a position of authority in a context in which failure to act is harmful.

I really fear that even with mounting overwhelming evidence, it will take a while to break this. It's too much, no one wants to take responsibility and it's all so much worse in that it's all rapidly expanding, and it's already more influential and widespread than ever before. It's by far the worst failure of expertise in human history, so much that it probably outdoes them all, combined. Like how Jupiter is 2.5x more massive than all the planets combined. It's so big that it can't be accepted.