Lecture Notes: Conversion Disorders, Blindsight, and Dissociative Phenomena

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Conversion Disorder and Freudian Theory

• Definition and Origin of Conversion Disorder:   * Sigmund Freud popularized the idea that individuals convert psychological distress into physical symptoms.   * Historically, Freud referred to this phenomenon as "hysteria."
• The History of "Wandering Uterus":   * This ancient Greek theory suggested that certain disorders were caused by a "wandering uterus" within the body.   * Historically, these disorders were more commonly observed in women than men, leading to the belief that female anatomy was the root cause.
• Etymology and Sexism in Terminology:   * The word "hysteria" shares the same Greek root as "hysterectomy" (the surgical removal of the uterus).   * The term "hysteric" is historically applied to women, or occasionally to men perceived as "effeminate" or overexcited.   * The speaker notes a inherent sexism in the terminology: when a woman is emotional, it is labeled "hysteria," whereas a man is described simply as "emotional."
• Glove Anesthesia Case Study:   * Definition: A numbness in the hand that stops exactly where a glove would end (at the wrist).   * Neurological Impossibility: Freud, a trained neurologist, noted that for a whole hand to go numb, two separate nerves at the wrist would have to be injured simultaneously at the same location.   * Clinical Observation: In these cases, there was no sign of physical injury, cuts, or bruising, yet the patient reported a complete lack of touch or pain sensation while maintaining the ability to move the hand.   * Freud's Interpretation: He declared this to be a conversion of "sex guilt" into physical numbness.
• Modern Medical Alternatives to Glove Anesthesia:   * Carpal Tunnel Syndrome: Caused by repetitive stress (typing, laundry, etc.) leading to inflammation in the carpal tunnels that house tendons.   * Peripheral Neuropathy: Numbness in the hands or feet, often associated with aging or nerve weakness.
• Somatic Symptom Disorder:   * This is the modern term for what Freud called conversion disorder.   * Core Feature: Characterized by unusual physical complaints that cannot be explained by medical science or physical damage (distinct from psychosomatic illnesses which involve real physical damage caused by stress).

Blindsight and Sensory Disorders

• Hysterical Blindness and Deafness:   * Situations where a person experiences sensory loss (can no longer see or hear) following a highly distressing or upsetting event.   * The person may "blot out" the sensory input to avoid remembering or processing the trauma.
• Blindsight Case Study (Neurological vs. Conversion):   * Blindsight occurs when a person is blind due to a stroke (damage to the occipital lobe/visual cortex or optic nerve), not a conversion disorder.   * The Umbrella Experiment:     * A doctor asked a blind stroke patient to grab an umbrella with a hook handle.     * The patient claimed he could not see it, but when prompted to "just try," he was able to reach out and grab the handle and point directly to the tip.
• The Two Visual Systems Theory:   * System 1 (New Brain): Connects to the cerebral cortex for conscious visual perception.   * System 2 (Old Brain): A primitive, reflexive system shared with ancestors like reptiles. It operates on reflex (e.g., a fly moving triggers a lizard's tongue).   * Conclusion: In blindsight, the conscious connection (cerebral cortex) is damaged, but the reflexive system (old brain) allows the person to interact with objects despite having no conscious awareness of seeing them.
• Hysterical Deafness Case Study (Hypnotherapy):   * A hypnotherapist treated a $12$-year-old boy who was hysterically deaf.   * The therapist used lip-reading to guide the boy into a trance.   * Under hypnosis, the therapist suggested the boy's "inner voice" was getting louder until he could hear normally.   * Upon waking, the boy's hearing was restored, demonstrating that the sensory information was being received but not consciously processed.

Schumaker’s ‘The Corruption of Reality’

• Overview of the Text:   * Title: The Corruption of Reality (written/read in $1995$).   * Cover Detail: Big purple letters on a black background, emphasizing that "reality is scary."   * Subtitle: A Unified Theory of Religion, Hypnosis, and Psychopathology.
• Theory of Religion:   * Religions evolved to help humanity cope with the threats and dangers of life (death, war, natural disasters).   * Religions provide answers to "big questions" (origins of life, what happens after death) and rituals for life transitions (birth, marriage, divorce, death).
• The Link to Hypnosis:   * Franz Mesmer: Credited with "mesmerism" in the $1700$s. He extracted techniques from Catholic exorcisms (where believers would have convulsions and enter trances).   * Mesmer mistakenly believed the power came from "animal magnetism."   * Modern View: It is the "power of suggestion" using rhythmic motions (pendulums), flashing lights, or music.
• Detachment as Coping:   * Schumaker argues that religion and hypnosis are mechanisms to "detach" from a threatening reality.   * Example: Voodoo celebrations in Haiti involve rhythmic music, dancing, and chanting that put participants into a hypnotic trance to process trauma and anxiety.

Dissociative Disorders

• Definition of Dissociation: To fall apart or break into pieces. It involves a split in personality or memory.
• Freud and Dissociation:   * Freud’s concept of the unconscious mind is a form of dissociation.   * Repression: Pushing memories and feelings into the unconscious awareness to forget them.
• Dissociative Amnesia:   * Forgetting personal information or identity due to extreme stress (marital problems, work issues), rather than a blow to the head.   * Retrograde Amnesia: Forgetting the past.   * Anterograde Amnesia: Inability to form new memories.   * Dissociative Fugue: A state where an individual loses their identity and may wander or establish a new life.   * The OJ Simpson Hypothetical: The speaker suggests OJ Simpson may have dissociated during the $1995$ murders, leading to a genuine belief in his own innocence during the trial.
• Depersonalization-Derealization Disorder (DERD):   * A disorder where the individual feels detached from themselves or feels that the world around them is not real.
• Dissociative Identity Disorder (DID):   * Formerly known as "Multiple Personality Disorder."   * Evolution of the Diagnosis: The number of cases rose from $18$ historically to thousands in the $80$s and $90$s, partly due to media exposure and daytime talk shows.   * Fragmented vs. Fully Formed: The name was changed to DID because the "personalities" are often just fragments or pieces of a broken core identity, not fully developed people.   * Case Study - The Strawberry Girl: A woman in her $40$s had a personality fragment called the "Strawberry Girl" who was in her $30$s and only ate strawberries.   * Case Study - The Retrace Lady: A fragment that refused to travel back home using the same road she took to get to town, due to a fear of repeating past mistakes.   * Causation: Usually attributed to severe childhood trauma, such as physical or sexual abuse, or natural disasters, occurring while the personality is still forming.

Questions & Discussion

• Question regarding Fugue States: A student asked if the state of forgetting identity is called a "fugue state."
• Response: The speaker confirmed that it is called a "dissociative fugue" and clarified that you can have dissociative amnesia with or without the fugue component.