Unfeignable biomarkers in functional neurological disorder: drifting back to Pierre Janet, 2020, Stone

Andy

Retired committee member
My bolding.
Any scholar digging around long enough in the history of functional neurological disorder (FND) and its older name, hysteria, will eventually find the work of Pierre Janet (1859–1947), neurologist and proto-psychologist. Many who do, tend to agree that Janet, more so than Freud and Charcot, has the most to offer the modern clinician and researcher in FND. What stands out in his work are the sheer number of patients, and the depth with which he studied them. As a consequence, his books, regardless of outmoded terminology, offer clinical guidance and scientific intuitions that still have relevance today (Janet, 1907). Janet gave us the concept of dissociation, which still persists to describe a kind of cognitive or mental deficit in which different functions of the brain, including ideas, sensation and actions, become abnormally separated from each other. Janet did not view dissociation as a form of psychological defence, more as a ‘decomposition’ of the ‘psychophysiological system’. For example, he noticed that the patient with functional visual loss would typically retain central vision, but lose peripheral vision, something routinely seen still in Goldmann charts showing spiralling or small central fields (Fig. 1). Peripheral vision must at some level still be occurring in the brain, but the quality and quantity of that experience are reduced.

It also seems unlikely that this finding is specific for FND as opposed to other functional disorders. Janet wrote about a wider range of functional disorders including fatigue, sleep disturbance and pain, which were experienced by patients with FND probably to a greater degree than comorbid anxiety or depression. In a review of cognitive deficits found in fibromyalgia and chronic fatigue syndrome, there were commonalities in relation to poor selective and divided attention, slow information processing and vulnerability to distraction (Teodoro et al., 2018).
Open access, https://academic.oup.com/brain/article/143/2/393/5732976
 
In the olden days ye people fought vat parkinsons and MS and epilepsy was like demonic possession ye cos they were like really dumb and so its in the historic record that those symptoms where demonic possession cos like they didn't know how to test for fings and all the doctors where on cocaine and like envied peoples penisis ye so like we still fink that stuff now cos like its come back again and I did put it in my book of non proofs.
 
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