Functional neurological disorder: Engaging patients in treatment, 2021, O'Neal, Dworetzky and Baslet

Abstract

Patients with a functional neurological disorder can be difficult to engage in treatment. The reasons for this are complex and may be related to physician, patient and health care system issues. Providers contribute to difficulties in treatment engagement by giving confusing explanations for the patient symptoms, stigmatizing patients, and not allowing patients time to voice their questions and concerns. Patient factors include a lack of engagement after an explanation of the diagnosis, resistance to treatment, family/work dynamics and prior negative experiences with the health care system. The scarcity of providers skilled in the treatment of functional neurological disorder is yet another hurdle. This article will define these barriers and discuss good clinical practices to help improve outcomes by tackling those challenges and discuss why for many patients an integrated care team approach is needed.

Open access, https://www.sciencedirect.com/science/article/pii/S2589986421000733

 

That's because patients quickly realise that functional disorders are considered to be mental health problems and no treatment will be forthcoming (apart from anti-depressants or CBT).

 

I momentarily read 'functional' as 'fictional'. Perhaps accurate?!

 

They'll keep pretending to ask and they'll continue to pretend the patients aren't clear that the problem with this is that it's quackery and that they have no idea what they're talking about. It could go on and on for decades. It already has and nothing has changed in a full century.

That's literally them. They are describing themselves here and they are completely unaware of this. And they actually dare put blame on patients for things like not being self-aware enough, or being confused. Literally, they are blaming patients for being confused about the thoughts in their own heads. Ideas that are built entirely out of confusion. And the one thing they can't possibly think about is that it's wrong. Amazing. I'm pretty sure even medieval alchemists were not that irrational.

 

"The scarcity of providers skilled in the treatment of functional neurological disorder is yet another hurdle." i think any used car salesman could quickly get up to speed in order to talk rings around the patient and fob them of with no beneficial treatment . the patient will be so nonplussed that they will even thank said used car salesman on their way out . therefore making this approach seem successful .

 

I'd go one step further and say that the number of providers skilled in the treatment of FND is 0 and will remain at 0 no matter what is done, unless we completely redefine the definition of skills in a way that would recognize that astrologers are skilled at... something. No amount of training can make up for the fact that this is a delusional fantasy.

 

Already happening here.

 

Do they realise what they are admitting? "We literally don't know what the *%$# is wrong with about a third of the patients that come to us. Haven't got a damned clue. We just can't work it out, so we end up having to give them a placebo diagnosis".

A placebo diagnosis, I just made it up but I kind of like the term. No active ingredient, but something that appears similar.