Chapter 19 - Self-Awareness Disorders in Conversion Hysteria

Abstract

Conversion hysteria refers to neurological disorders at the borderline between neurology and psychiatry, characterized by impaired awareness of bodily or cognitive function (such as paralysis, anesthesia, blindness, or amnesia) in the absence of apparent organic lesion in the nervous system. Although it is assumed that conversion hysteria may result from a transformation of psychological trauma or emotional stress into physical symptoms, which can distort self-awareness for a particular neurological function in the patient, the exact mechanisms underlying this transformation remain largely unknown, in terms of both mental processes and neurocognitive substrates. Recent studies using functional neuroimaging techniques have pointed to altered patterns of activation in brain areas involved in emotional regulation, self-monitoring, and memory, including ventral and lateral prefrontal cortex, which might in turn influence activity in sensory or motor pathways responsible for specific functional impairments (e.g., paralysis or anesthesia). However, the exact mechanisms of these disorders and the triggering causes still remain largely unresolved.