The body comes to family therapy: Treatment of a school-aged boy with hyperventilation-induced non-epileptic seizures

Abstract

We present the case of a 10-year-old boy, Evan, where a knock to the head activated memories of past bullying, causing intense distress, activation of the body's stress-regulation systems and recurrent hospital presentations with hyperventilation-induced non-epileptic seizures. We describe the initial assessment session that enabled Evan and his family to understand the context for Evan's non-epileptic seizures, to engage with the therapeutic team and to collaborate in the implementation of a mind-body multimodal family-based intervention. Once the physical symptoms had been addressed therapeutically, we explored possible dangers within the family and school systems and we worked with Evan and his family to increase his ability to access comfort and protection from his parents. Our short hospital intervention highlighted the importance of ongoing therapeutic work with Evan and the family and laid the foundation stones for the next part of the family's therapeutic journey.

Psychogenic non-epileptic seizures in children and adolescents: Part II – explanations to families, treatment, and group outcomes

“…The structure of the Mind–Body inpatient programme has been described previously ( Kozlowska, English, Savage, & Chudleigh, 2012 ; Kozlowska, English, Savage, et al, 2013 ), and its specific application to children/adolescents with PNES is detailed in a number of published case histories ( Chandra et al, 2017 ; Chudleigh et al, 2013 ; Kozlowska, Chudleigh, Elliott, & Landini, 2016 ). All patients enrolled in the Mind–Body Programme engage in daily individual therapy to learn how to manage their PNES, attend the hospital school to commence reintegration back to school and complete a physiotherapy exercise programme to increase their body’s capacity to manage changes in body state and to increase their physical resilience.…”

Functional Neurological Disorder: Historical Trends and Urgent Directions

“…Other treatment modalities showing some evidence for children and adults with FS are education [126], biofeedback [127][128][129], family therapy [130], group therapy [120], multidisciplinary care [114,131] and inpatient treatment programs [127]. Recommendations for treating adults and children with FS specify that mood and trauma should be targeted [103,127].…”

“…Research has shown that an interdisciplinary approach providing early mental health services to families is beneficial [199,200], and that standardized FND treatment reduces hospital length of stay, subspecialist consultations, and overall health care costs [201]. Programs utilizing multidisciplinary interventions for FND have demonstrated positive results [130,[202][203][204], although such treatment is most often available only to the minority of patients capable of reaching academic healthcare settings.…”

Modelling change in self‐narratives and embodied experience: A multicase study and autoethnography

“…Kozlowska et al. (2016) described the case of a 10‐year‐old client suffering from psychogenic non‐epileptic seizures (PNES) who was observed to begin hyperventilating in session when talking about bullying that he had experienced since the second year of school. Quinn et al.…”

“…Allen and Woolfolk (2006) argued that whatever cause the client attributes to their symptoms, the therapist may demonstrate how dynamics such as stress or beliefs about symptoms can aggravate and amplify the person's experience of their somatic symptoms. Kozlowska et al (2016) described the case of a 10-year-old client suffering from psychogenic non-epileptic seizures (PNES) who was observed to begin hyperventilating in session when talking about bullying that he had experienced since the second year of school. Quinn et al (2012) presented the case of a 42-year-old man, Peter, who had recovered from his PNES during psychotherapy.…”