Functional Neurological Disorder Quotes

Having DID is, for many people, a very lonely thing. If this book reaches some people whose experiences resonate with mine and gives them a sense that they aren't alone, that there is hope, then I will have achieved one of my goals. A sad fact is that people with DID spend an average of almost seven years in the mental health system before being properly diagnosed and receiving the specific help they need. During that repeatedly misdiagnosed and incorrectly treated, simply because clinicians fail to recognize the symptoms. If this book provides practicing and future clinicians certain insight into DID, then I will have accomplished another goal. Clinicians, and all others whose lives are touched by DID, need to grasp the fundamentally illusive nature of memory, because memory, or the lack of it, is an integral component of this condition. Our minds are stock pots which are continuously fed ingredients from many cooks: parents, siblings, relatives, neighbors, teachers, schoolmates, strangers, acquaintances, radio, television, movies, and books. These are the fixings of learning and memory, which are stirred with a spoon that changes form over time as it is shaped by our experiences. In this incredibly amorphous neurological stew, it is impossible for all memories to be exact. But even as we accept the complex of impressionistic nature of memory, it is equally essential to recognize that people who experience persistent and intrusive memories that disrupt their sense of well-being and ability to function, have some real basis distress, regardless of the degree of clarity or feasibility of their recollections. We must understand that those who experience abuse as children, and particularly those who experience incest, almost invariably suffer from a profound sense of guilt and shame that is not meliorated merely by unearthing memories or focusing on the content of traumatic material. It is not enough to just remember. Nor is achieving a sense of wholeness and peace necessarily accomplished by either placing blame on others or by forgiving those we perceive as having wronged us. It is achieved through understanding, acceptance, and reinvention of the self.

Many people who struggle to find stable employment also contend with things like intergenerational poverty and/or trauma, cycles of abuse, mental illness, systemic discrimination, disability or neurological disorders. Not only are these all chronically stressful and traumatic circumstances, they have all been linked to a high incidence of impaired executive function. Welfare systems are not built to be easy for people who are anxious about using the phone, or people who mix up dates. They are not designed for people who are bad at keeping time, filling out forms, or people who can’t easily access all the relevant bank, residential and employment details from the past five years, if they thought to keep that information at all. Welfare systems don’t accommodate for transience because welfare systems are not built to be accessible, they are built to be temples of administrative doom, because, apparently, welfare is a treasure that must be protected.

We’ve clearly placed form over function when it comes to choosing dogs for the home. Maybe this is because we are such a visual species ourselves, but I think it’s a shame, and some breeds are being ruined because of this tendency to stress how they look over what they can do. Bulldogs, more commonly known as English bulldogs, are a prime example of this overemphasis on physical appearance, particularly within so-called purebred dogs. Among the laundry list of physical ailments that English bulldogs suffer from—eye and ear problems, skin infections, respiratory ailments, immune system and neurological disorders, and problems with moving, eating/digesting, copulating, and bearing puppies—many are attributable to breeding practices to produce dogs with what are considered desirable physical traits.

ME/CFS has a greater negative impact on functional status and well-being than other chronic diseases, e.g., cancer or lung diseases[8], and is associated with a drastic decrement in physical functioning[9]. In a comparison study[10] ME/CFS patients scored significantly lower than patients with hypertension, congestive heart failure, acute myocardial infarction, and multiple sclerosis (MS), on all of the eight Short Form Health Survey (SF-36)[11] subscales. As compared to patients with depression, ME/CFS patients scored significantly lower on all the scales, except for scales measuring mental health and role disability due to emotional problems, on which they scored significantly higher.

The Brits call this sort of thing Functional Neurological Symptoms, or FNS, the psychiatrists call it conversion disorder, and almost everyone else just calls it hysteria. There are three generally acknowledged, albeit uncodified, strategies for dealing with it. The Irish strategy is the most emphatic, and is epitomized by Matt O’Keefe, with whom I rounded a few years back on a stint in Ireland. “What are you going to do?” I asked him about a young woman with pseudoseizures. “What am I going to do?” he said. “I’ll tell you what I’m goin’ to do. I’m going to get her, and her family, and her husband, and the children, and even the feckin’ dog in a room, and tell ’em that they’re wasting my feckin’ time. I want ’em all to hear it so that there is enough feckin’ shame and guilt there that it’ll keep her the feck away from me. It might not cure her, but so what? As long as I get rid of them.” This approach has its adherents even on these shores. It is an approach that Elliott aspires to, as he often tells me, but can never quite marshal the umbrage, the nerve, or a sufficiently convincing accent, to pull off. The English strategy is less caustic, and can best be summarized by a popular slogan of World War II vintage currently enjoying a revival: “Keep Calm and Carry On.” It is dry, not overly explanatory, not psychological, and does not blame the patient: “Yes, you have something,” it says. “This is what it is [insert technical term here], but we will not be expending our time or a psychiatrist’s time on it. You will have to deal with it.” Predictably, the American strategy holds no one accountable, involves a brain-centered euphemistic explanation coupled with some touchy-feely stuff, and ends with a recommendation for a therapeutic program that, very often, the patient will ignore. In its abdication of responsibility, motivated by the fear of a lawsuit, it closely mirrors the beginning of the end of a doomed relationship: “It’s not you, it’s … no wait, it’s not me, either. It just is what it is.” Not surprisingly, estimates of recurrence of symptoms range from a half to two-thirds of all cases, making this one of the most common conditions that a neurologist will face, again and again.

HISTORICAL NOTE There are no nuclear power stations in Belarus. Of the functioning stations in the territory of the former USSR, the ones closest to Belarus are of the old Soviet-designed RBMK type. To the north, the Ignalinsk station, to the east, the Smolensk station, and to the south, Chernobyl. On April 26, 1986, at 1:23:58, a series of explosions destroyed the reactor in the building that housed Energy Block #4 of the Chernobyl Nuclear Power Station. The catastrophe at Chernobyl became the largest technological disaster of the twentieth century. For tiny Belarus (population: 10 million), it was a national disaster. During the Second World War, the Nazis destroyed 619 Belarussian villages along with their inhabitants. As a result of Chernobyl, the country lost 485 villages and settlements. Of these, 70 have been forever buried underground. During the war, one out of every four Belarussians was killed; today, one out of every five Belarussians lives on contaminated land. This amounts to 2.1 million people, of whom 700,000 are children. Among the demographic factors responsible for the depopulation of Belarus, radiation is number one. In the Gomel and Mogilev regions, which suffered the most from Chernobyl, mortality rates exceed birth rates by 20%. As a result of the accident, 50 million Ci of radionuclides were released into the atmosphere. Seventy percent of these descended on Belarus; fully 23% of its territory is contaminated by cesium-137 radionuclides with a density of over 1 Ci/km2. Ukraine on the other hand has 4.8% of its territory contaminated, and Russia, 0.5%. The area of arable land with a density of more than 1 Ci/km2 is over 18 million hectares; 2.4 thousand hectares have been taken out of the agricultural economy. Belarus is a land of forests. But 26% of all forests and a large part of all marshes near the rivers Pripyat, Dniepr, and Sozh are considered part of the radioactive zone. As a result of the perpetual presence of small doses of radiation, the number of people with cancer, mental retardation, neurological disorders, and genetic mutations increases with each year. —“Chernobyl.” Belaruskaya entsiklopedia On April 29, 1986, instruments recorded high levels of radiation in Poland, Germany, Austria, and Romania. On April 30, in Switzerland and northern Italy. On May 1 and 2, in France, Belgium, the Netherlands, Great Britain, and northern Greece. On May 3, in Israel, Kuwait, and Turkey. . . . Gaseous airborne particles traveled around the globe: on May 2 they were registered in Japan, on May 5 in India, on May 5 and 6 in the U.S. and Canada. It took less than a week for Chernobyl to become a problem for the entire world. —“The Consequences of the Chernobyl Accident in Belarus.” Minsk, Sakharov International College on Radioecology The fourth reactor, now known as the Cover, still holds about twenty tons of nuclear fuel in its lead-and-metal core. No one knows what is happening with it. The sarcophagus was well made, uniquely constructed, and the design engineers from St. Petersburg should probably be proud. But it was constructed in absentia, the plates were put together with the aid of robots and helicopters, and as a result there are fissures. According to some figures, there are now over 200 square meters of spaces and cracks, and radioactive particles continue to escape through them . . . Might the sarcophagus collapse? No one can answer that question, since it’s still impossible to reach many of the connections and constructions in order to see if they’re sturdy. But everyone knows that if the Cover were to collapse, the consequences would be even more dire than they were in 1986. —Ogonyok magazine, No. 17, April 1996

fully fifty-five diseases are known to be caused by gluten (Farrell and Kelly 2002). Among these are heart disease, cancer, nearly all autoimmune diseases, osteoporosis, irritable bowel syndrome and other gastrointestinal disorders, gallbladder disease, Hashimoto’s disease (an autoimmune thyroid disorder responsible for up to 90 percent of all low-functioning thyroid issues), migraines, epilepsy, Parkinson’s disease, amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease), neuropathies (having normal EMG readings), and most other degenerative neurological disorders as well as autism, which is technically an autoimmune brain disorder.

Parkinson’s disease is a neurological disorder marked by the gradual degeneration of nerve cells in the portion of the midbrain called the basal ganglia, which controls body movements. The brains of those who have this heartbreaking disease don’t produce enough of the neurotransmitter dopamine, which the basal ganglia needs for proper functioning. Early symptoms of Parkinson’s, which is currently considered incurable, include motor issues such as muscle rigidity, tremors, and changes in gait and speech patterns that override voluntary control. In

There is no simple way to determine when and where to get help. Many factors come into play, including the child’s age, family’s financial status, insurance, knowledge of resources, religious affiliation, availability of services in community, and so on. Parents may seek outside assistance for their adopted child when other factors such as a divorce, job loss, or other stresses compound the family needs. Parents are generally in the best position to determine when to get help, but advice from relatives, family physicians, teachers, and others in a position to know the family should be carefully considered. Services for children with special needs are provided by a variety of professionals. A physician—pediatrician or the family practitioner—is usually the place to begin. Families may be referred to a neurologist for a thorough assessment and diagnosis of neurological functioning (related to cognitive or learning disabilities, seizure disorders or other central nervous system problems). For specific communication difficulties, families may consult with a speech and language therapist, while a physical therapist would develop a treatment plan to enhance motor development. A rehabilitation technologist or an occupational therapist prescribes adaptive aids or activities of daily living. Early childhood educators specializing in working with children with special needs may be called a variety of titles, including Head Start teachers, early childhood special education teacher, or early childhood specialist.

Biological correlates are often used to give credence to the experience of psychosomatic disorders. An objective change on a blood test or scan allows others to believe in the suffering.

... alternating between anticipation and despondency. That has physical consequences.

Functional neurological and psychosomatic disorders are often a manifestation of a maladaptive response to the mistakes made by the human system of perception.

Studies even suggest that the social misperceptions surrounding psychological and neurological conditions can contribute to their exacerbation, perhaps even prompting a transition in severity to full-scale psychiatric disorders (Corrigan, 2007). The extent to which this impacts individuals diagnosed specifically with ADHD is highly under-investigated, but trends seem to point towards significant repercussions in their social lives. In addition to peer rejections due to perceived “weirdness,” anecdotal evidence appears to suggest that an official diagnosis of ADHD can lead to resentment from the undiagnosed. Furthermore, the effects of courtesy stigma mean that even individuals associated with the person bearing the brunt of a stigma can be negatively impacted, for no other reason than their closeness to the stigmatized person (Mueller et al., 2012).

The neurological disorder of oversensitivity to touch, which Nietzsche posited to account for Jesus' hate of reality, seems far-fetched. As a diagnosis of Jesus, these quotes are not very convincing; yet as an admission of Nietzsche's problems in intimacy, these words are suggestive. In fact, Nietzsche describes himself almost in the same way. The themes of depersonalization and derealization appear in other places too. Zarathustra said, 'To men, I am still the mean between a fool and a corpse' and as was mentioned before 'as my own father I am already dead'. Nietzsche wrote in similar terms about Jesus himself as living outside of reality, which brings up back to the dissociative phenomena in PTSD. Dissociation is the most direct defense against overwhelming traumatic experiences, consisting in symptoms of derealization (feeling as if the world is not real), and depersonalization (feeling as if one self is not real). Experiencing the world and the self from afar, enables victims of abuse, torture, and war, to escape from an unbearable and unavoidable external reality, on the one hand; and the internal distress and arousal, on the other hand. It somehow allows them to continue to live and function. In the follow comment, Nietzsche connected his disassociation, his being 'beyond life', with cryptic reference to his father: 'I regard it as a great privilege to have had such a father: it even seems to me that this exhausts all that I can claim in the matter of privileges-life, the great yea to life, excepted. What I owe to him above all is this, that I do not need any special intention, but merely patience, in order to enter involuntarily into a world of higher and finer things. There I am at home, there alone does my profoundest passion have free play. The fact that I almost paid for this privilege with my life, certainly does not make it a bad bargain. In order to understand even a little of my Zarathustra, perhaps a man must be situated much as I am myself with one foot beyond life.' Mind you, in fact, thanking his father for almost losing or ruining his life! We arrived at a secret again and have only hints that Nietzsche dropped such as 'What was silent in the father speaks in the son, and often I found in the son the unveiled secret of the father'.

The mind is a function of the brain and is created from biology.

The finding that ME and CFS group had more functional limitations and more serious symptoms than those with MS [multiple sclerosis] provides additional evidence to the seriousness of ME and CFS.

ME, a neurological disease[20,21], has been described in the medical literature since 1934 under various names[22], e.g., epidemic neuromyasthenia and atypical poliomyelitis, often on account of outbreaks[23-25]. Characteristic symptoms of ME, classified as a disease of the nervous system by the WHO since 1969[26], are: muscle weakness, neurological dysfunction, especially of cognitive, autonomic and neurosensory functions; variable involvement of the cardiac and other systems; a prolonged relapsing course; but above all general or local muscular fatigue after minimal exertion with prolonged recovery times (post-exertional “malaise”)[20].

The will, it was becoming clear, has the power to change the brain—in OCD, in stroke, in Tourette’s, and now in depression—by activating adaptive circuitry. That a mental process alters circuits involved in these disorders offers dramatic examples of how the ways someone thinks about thoughts can effect plastic changes in the brain. Jordan Grafman, chief of cognitive neuroscience at the National Institute of Neurological Disorders and Stroke, calls this top-down plasticity, because it originates in the brain’s higher-order functions. “Bottom-up” plasticity, in contrast, is induced by changes in sensory stimuli such as the loss of input after amputation. Merzenich’s and Tallal’s work shows the power of this bottom-up plasticity to resculpt the brain. The OCD work hints at the power of top-down plasticity, the power of the mind to alter brain circuitry.