A review of the treatment of functional neurological disorder with intensive short-term dynamic psychotherapy, 2022, Russell et al

Highlights

• Research investigating underlying causes of FND reveals common clusters of associated factors which highlights potential psychological mechanisms involved in FND.
• Behavioral, psychophysiological, and neuroimaging evidence identifies that maladaptive emotional processing is associated with FND for many people with this condition.
• Intensive short-term dynamic psychotherapy is an evidence-based approach for functional symptoms which addresses maladaptive emotional processing.

Abstract
The purpose of this article was to raise awareness of an under-recognized but well-supported treatment for Functional Neurological Disorders (FND) termed Intensive Short-term Dynamic Psychotherapy (ISTDP). There has been significant interest in the role of psychological mechanisms in FND onset and maintenance with specific evidence for maladaptive emotional processing. We outline how this supports the theoretical basis for ISTDP as an option in FND treatment and undertake a literature review of the current evidence base. We describe the application of ISTDP to FND illustrated through direct therapy transcripts. We conclude with reflections on the strengths and limitations of ISTDP as well as recommendations regarding future research.

Paywall, https://www.epilepsybehavior.com/article/S1525-5050(22)00106-8/fulltext#

 

Don't the FND people keep insisting it's not a psychological disorder after all?

 

It's a review, whose purpose is to promote a particular treatment?

That doesn't sound like a review. Sounds like an ad.

It's also a lie to say that there is neuroimaging evidence supporting this has anything to do with "emotional processing". Just arguing for a preferred explanation is the opposite of a scientific process to establish evidence. Conclusion-based evidence is just that, trying to justify a pre-determined conclusion.

 

Neuroimaging suggests they have pictures that clearly and without wishful interpretation back up their point of view.

So presumably the equivalent of an MRI with a frowny/sad/smiley face clearly visible in the brain.

Clearly visible to someone who isn't a psychologist or psychiatrist wanting to make money, a point or publish a paper.

Clearly visible to someone without a vested interest.

This seems "unlikely' to me.

 

Twitter thread from one of the authors. Includes the phrase "... the impressive CODES trial of CBT for Dissociative Seizures..." - our thread, looking at how unimpressive CODES actually was, is here, Cognitive behavioural therapy for adults with dissociative seizures (CODES): a ... multicentre, randomised controlled trial (2020) Goldstein, Chalder

 

That says a lot. I remember some days ago there was some BPS ideologue ranting on Twitter about how to us patients biomedical progress amounts to "breakthroughs" while making progress from a BPS perspective is junk.

And by their own admission: results where the primary outcome failed are "impressive". Where no measurable difference can be shown, in fact where the primary benefits appear to be... to physicians, who seem impressed. Because it sure isn't the patients who are benefitting from pseudoscientific hogwash.

So, yeah, on the one hand, major breakthroughs that change millions of lives for the better, on the other hand, junk that impresses people with zero stake in the issue and even less understanding. It's hard to argue with that when there is such strong graphic design is my passion energy going around in self-perpetuated loops of failure.