Three Reasons Why Someone May Have A Conversion Disorder

Conversion is a type of defense mechanism that converts cognitive tensions and anxiety into physical symptoms. For instance, anxiety caused by repressed feelings, perhaps stemming from childhood, can manifest itself into a cough or even a terminal illness. Many people develop psychological defense mechanisms, such as repression, displacement, and isolation, to distance themselves from unwanted feelings or thoughts, especially in uncomfortable situations. Sometimes, we perform these defenses without even being aware of them.

Learning how to recognize and ameliorate these behaviors is important for improving both your mental health and dealing with future encounters of stressful situations. The work of Anna Freud on identification and reaction formation, as well as other negative attributes related to borderline personality disorder, can help describe and provide a better response to these mechanisms. Focusing on the presence and influence of parents or significant objects in one's life may also help in understanding and managing the fear and impulse that drive the avoidance of certain feelings.

Let's take a closer look at conversion and other types of defense mechanisms commonly found in psychodynamic psychiatry research.

Top three reasons why someone might have conversion disorder

There are a variety of reasons why people develop defense mechanisms. A stressful life event or the formation of an unacceptable thought toward another person can unconsciously trigger the onset of a defense mechanism like conversion disorder or splitting.

Let’s take a closer look at three reasons why someone may have this defense mechanism.

They experienced a traumatic and distressing life event

In Professor Gordon Turnbull’s book Trauma, the doctor examines the case of his 35-year-old female patient, Ely. The young woman had suddenly lost the use of her legs and became paralyzed from the waist down. X-rays searching for a bleed in the spine came back negative. When attempting a lumbar puncture on Ely, Turnbull noticed that she didn’t even wince when he pushed the needle into her spine.

After interviewing Ely, Professor Turnbull learned she had been raped. This event had caused the perplexing physical symptoms observed by Turnbull. Ely soon found that talking about the experience helped her process and heal from it. After practicing this new therapy, Ely was able to leave the hospital.

They underwent extreme stress

People going through extreme stress, such as a divorce or a sudden death in the family, can develop a conversion disorder. This is often done to ward off unpleasant or unwanted feelings. Conversion is simply one of the many paths the brain can take when it comes to dealing with stress and trauma.

Their physical symptoms interfere with their normal day-to-day functioning

People who display physical symptoms that cause significant distress or disability after experiencing a traumatic event may have a conversion disorder. However, if the symptoms do not impede the patient’s normal way of living or if they appear normal within the context of a culture, a physician will likely not give a diagnosis for conversion disorder.

Sigmund Freud’s top 10 defense mechanisms

Sigmund Freud first proposed the idea of defense mechanisms. His idea was based on psychoanalytic theory, which views one’s personality as the interaction between the id, ego, and superego. Since his initial proposal, mental health professionals have expanded and evolved his idea of defense mechanisms. Many researchers contend that these defense mechanisms are done subconsciously. Others believe these defense mechanisms are caused by irrational beliefs rather than the subconscious mind. Most people do them without knowing what “defense strategy” they are even using.

The id, ego, and superego and their involvement in defense mechanisms

Freud’s theory on defense mechanisms is rooted in the interactions of the id, ego, and superego, which are three dueling forces in the mind. Each aspect prevails over a different need.

• Id: Primitive part of the mind that controls basic instincts and sexual urges
• Ego: Moderates the interactions between the id and superego
• Superego: The force in the mind that pushes you to make moral decisions

Ego defense mechanisms are employed to reduce conflict between the id and superego. When the needs of the id and the superego clash and create anxiety within a person, the ego defense mechanism will kick in and use self-deception to subdue the discomfort. These methods may involve blocking the unwanted thought or projecting it onto someone else.

The ten defense mechanisms

Here are the ten defense mechanisms as originally defined by Freud.

Conversion

Anything from a cough to symptoms of appendicitis can be found in patients who have a conversion disorder. One key feature of this disorder is the disconnect between a patient’s symptoms and any known medical conditions.

Symptoms of conversion disorder include:

• Motor issues such as weakness or paralysis
• Abnormal movements including tremors and difficulty walking
• Altered vision, hearing, and touch
• Irritability and agitation
• Non-epileptic seizures where the patient experiences a loss of consciousness and limb shaking without displaying the same electrical activity as a brain energy from experiencing an actual seizure
• Troubles with speech
• Episodes similar to a coma or fainting spell
• Anxiety and nervousness

These symptoms can last for varying amounts of time — from a sudden fainting spell to a long-lasting speech problem. Conversion disorder is one of the most common defense mechanisms in women, with the condition being two times more common among them than those designated male at birth.

Projection

Projection is one of the most common defense mechanisms observed in people. To shed uncomfortable or negative feelings, a person may project these emotions onto another person. For example, someone who is cheating on their partner may project their guilt onto their partner and accuse them of cheating. Doing so preserves the guilty party’s ego and prevents them from having to accept their true feelings.

Regression

Regression occurs when the ego reverts to an earlier stage of mental development after being faced with extreme stress in the present. For instance, a young child may begin to wet the bed again or beg for a pacifier even though they have already been weaned. Regression is one of the most common defense mechanisms in children. 

Intellectualization

Intellectualization involves removing oneself emotionally from a stressful or traumatic event. Someone who was laid off from their job may repress the negative emotions associated with such an event and focus on making spreadsheets to organize job applications and leads. A patient who learns they have cancer may start asking about the survival rate and chances of success for different drugs.

Denial

Denial is also one of the most common defense mechanisms. People who are in denial of an event or piece of knowledge may block it from their awareness and refuse to accept it as reality. A functioning alcoholic, for instance, may deny that they have a drinking problem because of how well they can manage their relationships and job. 

Rationalization

People who attempt to excuse or justify their behavior may be practicing rationalization. They are unconsciously trying to avoid facing the true underlying reasons for a situation or action. While rationalization is not always considered one of the more severe defense mechanisms, it can become dangerous if the person practicing it is attempting to excuse destructive or harmful behavior.

Examples of rationalization can include someone attempting to blame their sour mood on bad traffic or a partner blaming their abused victim for being uncooperative and thereby causing their own mistreatment. People may also rationalize the choices they make if they feel as if they are incorrect or morally wrong.

If you or someone you know is or may be experiencing abuse, please call the National Domestic Violence Hotline, available 24/7, at 1.800.799.SAFE (7233) or text "START" to 88788. Live chat is also available on the National Domestic Violence Hotline website.

Sublimation

Sublimation is the act of channeling unwanted or harmful urges into acceptable ones. Some people deflect these impulses using humor or fantasy. Sublimation psychology is categorized under mature defense mechanisms due to its ability to help a person redirect negative emotions into a healthy and safe outlet.

Compartmentalization

Compartmentalization is a type of defense mechanism that blocks off certain parts of one’s life and prevents it from intermingling with others. For instance, choosing not to discuss personal issues at work could be compartmentalizing.

Altruism

People who practice altruism attempt to help others as a means of avoiding stressful situations. The person often receives joy and satisfaction from the positive responses of the people they help.

Suppression

Suppression involves the voluntary pushing of unpleasant thoughts and feelings out of one’s awareness. For instance, someone who has been unkind or rude to another person may try to avoid thinking about it. Doing so may prevent them from facing uncomfortable feelings of embarrassment or shame.

Treatment for defense mechanisms

Defense mechanisms aren’t always harmful or bad - they can sometimes help people manage painful experiences and emotions. However, defense mechanisms can also be harmful in certain situations. A refusal to face the situation causing unpleasant feelings can be unhealthy.  

In these cases, many people turn to mental health professionals to help modify or transform their defense mechanisms. Psychodynamic therapy is one tool used by therapists to help individuals better understand their unconscious processes and improve self-awareness to overcome maladaptive defense mechanisms. 

While many think of couches and therapists' offices when it comes to psychodynamic therapy, that is no longer the only option. Online therapy enables individuals to engage in talk therapy anywhere they have an internet connection. The convenience of online therapy can be beneficial for those experiencing conversion disorder, who may have serious somatic symptoms. Online therapy has also been proven just as effective as in-person therapy.