Conversion disorder in childhood and adolescence: A familial/cultural approach Part I.

Specific Biases for Identifying Facial Expression of Emotion in Children and Adolescents With Conversion Disorders

“…This study found that participants with conversion disorders differed from healthy controls in four key ways: a) they reported higher rates of cumulative negative life events, with stressors such as parental conflict, loss events (by death or separation), discrete traumatic events, bullying, physical illness, maternal anxiety/depression being very common, and abuse and neglect being surprisingly uncommon 1 ; b) linguistic analysis of the autobiographical narratives by blinded coders likewise demonstrated high rates of unresolved loss or trauma with regard to the previously described life events; c) the designation of participants into nonnormative patterns of attachmentVan inhibitory subgroup (Type A+) and a coercivepreoccupied subgroup (Type C+)Vimplied a long-standing history of relational stress and a chronic disruption of what are normally comfortable and nurturing attachments (see Figure 1); and d) more detailed analysis of attachment by subclassification showed that almost all of the participants with conversion disorders used strategies that did not include open expressions of anger. This analysis confirmed clinical observations, complemented by the observations of Seltzer (28,29) about his cohort, that in this cohort of families with conversion disorder, overt expressions of anger were not the operative, valued currency for communication. 2 Guided by these earlier findings, this study had seven aims.…”

“…In parallel, the attachment narratives of children and adolescents with conversion disorders were distinctive in that episodes of conflict with their parents were generally lacking and that the attachment strategies used by the participants with conversion disorder to elicit comfort and protection did not involve explicit expressions of anger. Interestingly, Seltzer (28,29) made similar observations about the anger-averse nature of a cohort of families with conversion disorder that he treated in a Norwegian child and adolescent psychiatry department.…”

Good Children Presenting with Conversion Disorder

“…The sick child is frequently viewed as the most robust, capable, well-adjusted, aproblematic and promising member of the family in whom the parents have invested greatly, and who is to ensure the family's success in the future (Seltzer, 1985a(Seltzer, , 1985b.…”

Theoretical Reflections on Rites of Passage in a Hungarian Therapeutic Community

“…In still another and specifically therapeutic way, being positioned between a time-space of life dependent on drugs and alcohol and one free from this dependency may also facilitate what a number of researchers have defined using various terms as the prime goal of the therapeutic process: the opening of space for telling of silent stories (Seltzer, 1985a(Seltzer, , 1985bb, 2003, and for voicing the not-yet-told (Rober, 2002), the not-yet-said (Anderson and Goolishian, 1988), and the unsaid, unsayable, and unspeakable (Rogers et al, 1999).…”