Conversion Disorder: A Review Through the Prism of the Rational-Choice Theory of Neurosis

Abstract

Conversion disorder remains a mystery that has only become more complicated with the decline of the scientific status of psychoanalysis (e.g., Piper, Lillevik, & Kritzer, 2008;Rofé, 2008) and recent neurological findings suggest that this behavior is controlled by biological mechanisms (van Beilen, Vogt, & Leenders, 2010). Moreover, existing theories have difficulty explaining the efficacy of various interventions, such as psychoanalysis, behavior therapy, drug therapy and religious therapy. This article reviews research and clinical evidence pertaining to both the development and treatment of conversion disorder and shows that this seemingly incompatible evidence can be integrated within a new theory, the Rational-Choice Theory of Neurosis (RCTN; Rofé, 2010). Despite the striking differences, RCTN continues Freud's framework of thinking as it employs a new concept of repression and replaces the unconscious with self-deception. Moreover, it incorporates Freud's idea, implicitly expressed in his theory, that neurotic disorders are, in fact, rational behaviors.

Which Diagnostic Approach Is More Valid? The DSM or the Rational-Choice Theory of Neurosis

“…As noted previously, there is a unanimous agreement among researchers that a diagnostic approach guided by a theory, as suggested by RCTN, which already proved its ability to integrate research and clinical data pertaining to neurosis and psychosis (Rofé, 2000(Rofé, , 2010(Rofé, , 2016Rofé & Rofé, 2013), is preferable over atheoretical, arbitrary diagnostic approaches as proposed by the DSM.…”

“…Freud assumed the existence of an autonomous, unconscious entity that supposedly had the omnipotent ability to control the patient's daily functions. In contrast, RCTN claims that patients become unaware of their deliberate adaption and maintenance of their mad behaviors, both in neuroses and psychoses, as a result of a complex self-deceptive process (Rofé, 2000(Rofé, , 2010(Rofé, , 2016Rofé & Rofé, 2013).…”

“…Although the DSM's authors acknowledged that conversion disorder is medically unexplainable, they categorized this disorder together with non-bizarre behaviors that have clear medical causes, only because they didn't want to reinforce the psychoanalytic theory which maintains the mind-body dualism (e.g., see Carella, 1974;Rofé & Rofé, 2013). As a result of the medicalization approach of diagnosis of behavioral disorders, the DSM became "an expanding list of disease, from a few dozen disorders in the first edition to well over 200" (Grinker, 2010, p. 169), and it "now contains three times as many disorders as it did in 1952, and it is more than seven times longer than the first edition" (Warelow & Holmes, 2011, p. 385).…”

“…It seems that a new theory, termed the Rational-Choice Theory of Neurosis (RCTN), that already proved its ability to integrate research and clinical data pertaining to treatment of neurotic disorders (Rofé, 2000(Rofé, , 2010, conversion disorder (Rofé & Rofé, 2013) and panic disorder, agoraphobia and other forms of bizarre phobia (Rofé & Rofé, 2015), is the right candidate to meet this goal.…”

Fear and Phobia: A Critical Review and the Rational-Choice Theory of Neurosis

“…Likewise, while biological factors certainly increase the vulnerability to developing fear and phobia, findings have not yet confirmed that these behaviors are controlled by biological mechanisms. A new theory, the Rational-Choice Theory of Neurosis (Rofé, 2010;Y. Rofé & Rofé, 2013), which preserves the psychoanalytic claim that bizarre phobias need to be explained within a theory that accounts for neuroses by one set of theoretical concepts, was used to resolve the theoretical confusion in this field.…”