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Finding One’s Voice: Psychotherapy for Dissociative Motor Disorders in the Indian Context

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Abstract

Dissociation is a prevalent disorder in India, however there is a lack of evidence-based psychological interventions worldwide. The present paper includes two case studies of dissociative motor disorder with onset in the perinatal period, seeking treatment in the Indian tertiary mental health set-up. Both cases presented with disabling symptoms of paraparesis, and mutism in one. The case series discusses similarities in presentation, socio-cultural contexts, and the psychotherapeutic approach. The psychotherapy process is discussed in detail, with a focus on challenges encountered, therapist reflections and supervision. Insights from treatment are presented, including the melding of approaches, and sensitivity of interventions to the larger socio-cultural framework.

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References

  • Aybek, S., Nicholson, T. R., Zelaya, F., O’Daly, O. G., Craig, T. J., David, A. S., & Kanaan, R. A. (2014). Neural correlates of recall of life events in conversion disorder. JAMA Psychiatry, 71(1), 52–60. https://doi.org/10.1001/jamapsychiatry.2013.2842.

    Article  PubMed  Google Scholar 

  • Baker, J., Ben-Tovim, D., Butcher, A., Esterman, A., & McLaughlin, K. (2013). Psychosocial risk factors which may differentiate between women with functional voice disorder, organic voice disorder and a control group. International Journal of Speech and Language Pathology, 15, 547–563.

    Article  Google Scholar 

  • Bremner, J. D. (2010). Cognitive processes in dissociation: Comment on Giesbrecht et al. (2008). Psychological Bulletin, 136(1), 1–6. https://doi.org/10.1037/a0018021.

    Article  PubMed  PubMed Central  Google Scholar 

  • Breuer, J., & Freud, S. (1955). Studies on hysteria. The standard edition of the complete psychological works of Sigmund Freud: Vol. II. The Hogarth Press and the Institute of Psychoanalysis.

    Google Scholar 

  • Chu, J. A., Dell, P. F., Van der Hart, O., Cardeña, E., Barach, P. M., Somer, E., & Twombly, J. (2011). International society for the study of trauma and dissociation Guidelines for treating dissociative identity disorder in adults, third revision. Journal of Trauma and Dissociation, 12, 115–187.

    Article  Google Scholar 

  • Cronin, E., Brand, B., & Mattanah, J. (2014). The impact of the therapeutic alliance on treatment outcome in patients with dissociative disorders. European Journal of Psychotraumatology, 5, 22676 &db=jlh&AN=105052057&site=ehost-live.

    Article  Google Scholar 

  • Dayani, K. S., Soomar, S., & Dossa, K. S. (2019). Conversion disorders in mental health care—A basic review of literature. Mathews Journal of Psychiatry & Mental Health, 4(1), 1–3.

    Article  Google Scholar 

  • Fang, Z., Li, Y., Xie, L., Cheng, M., Ma, J., Li, T., & Jiang, L. (2021). Characteristics and outcomes of children with dissociative (conversion) disorders in western China: A retrospective study. BMC Psychiatry, 21(1), 1–9.

    Article  Google Scholar 

  • Ganslev, C., Storebø, O., Callesen, H., Ruddy, R., & Søgaard, U. (2020). Psychosocial interventions for conversion and dissociative disorders in adults (Review). Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD005331.pub3.www.cochranelibrary.com.

    Article  PubMed  PubMed Central  Google Scholar 

  • Giesbrecht, T., Lynn, S. J., Lilienfeld, S. O., & Merckelbach, H. (2008). Cognitive processes in dissociation: An analysis of core theoretical assumptions. Psychological Bulletin, 134(5), 617–647. https://doi.org/10.1037/0033-2909.134.5.617.

    Article  PubMed  Google Scholar 

  • Gururaj, G., Varghese, M., Benegal, V., Rao, G. N., Pathak, K., Singh, L. K., et al. (2016). National mental health survey: Summary of India, 2015–16 (pp. 1–62). NIMHANS Publication.

    Google Scholar 

  • Kanaan, R. A. A., & Dorota, J. (2018). Escape: A study in conversion disorder. International Journal of Psychology and Psychoanalysis, 4(1), 4–6. https://doi.org/10.23937/2572-4037.1510026.

    Article  Google Scholar 

  • Kihlstrom, J. F. (2005). Dissociative disorders. Annual Review of Clinical Psychology, 1, 227–253. https://doi.org/10.1146/annurev.clinpsy.1.102803.143925.

    Article  PubMed  Google Scholar 

  • Krüger, C. (2020). Culture, trauma and dissociation: A broadening perspective for our field. Journal of Trauma & Dissociation, 21(1), 1–13.

    Article  Google Scholar 

  • Krupnik, V., & Cherkasova, M. (2019). Strategic symptom displacement in therapy of a motor conversion disorder comorbid with PTSD: Case presentation. Journal of Contemporary Psychotherapy, 49(3), 169–176.

    Article  Google Scholar 

  • Lakhani, S., Sharma, V., & Desai, N. G. (2022). Qualitative content analysis of cultural formulations of clients suffering from conversion disorder in North India. Indian Journal of Psychiatry, 64(1), 73–79. https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_292_21.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nicholson, T. R., Aybek, S., Craig, T., Harris, T., Wojcik, W., David, A. S., & Kanaan, R. A. (2016). Life events and escape in conversion disorder. Psychological Medicine, 46(12), 2617–2626. https://doi.org/10.1017/S0033291716000714.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Srinath, S., Bharat, S., Girimaji, S., & Seshadri, S. (1993). Characteristics of a child inpatient population with Hysteria in India. Journal of the American Academy of Child & Adolescent Psychiatry, 32(4), 822–825. https://doi.org/10.1097/00004583-199307000-00017.

    Article  CAS  Google Scholar 

  • Stonnington, C. M., Barry, J. J., & Fisher, R. S. (2006). Clinical case conference conversion disorder. American Journal of Psychiatry, 163(9), 1510–1517.

    Article  Google Scholar 

  • Subramanyam, A., Somaiya, M., Shankar, S., Nasirabadi, M., Shah, H., Paul, I., & Ghildiyal, R. (2020). Psychological interventions for dissociative disorders alka. Indian Journal of Psychiatry, 62, 280. https://doi.org/10.4103/psychiatry.IndianJPsychiatry.

    Article  Google Scholar 

  • Verma, K. K., Solanki, O. P., Baniya, G. C., & Goyal, S. (2017). A study of the stressor, family environment and family burden in dissociative (conversion) disorder patients. Indian Journal of Social Psychiatry, 33(3), 196.

    Article  Google Scholar 

  • World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. World Health Organization.

    Google Scholar 

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Acknowledgements

The authors thank Dr Jyothsna Chandur for insightful comments on the initial draft of the manuscript.

Funding

There are no relevant funding sources in relation to this manuscript.

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Authors and Affiliations

  1. Department of Clinical Psychology, National Institute of Mental Health and Neurosciences, Level 3, MVG Building, Hosur Road, Bengaluru, 560029, India

    Poonam Bir Kaur Sahota & Himani Kashyap

  2. Narayana Health, Bengaluru, India

    Raina Jane D’Mello

  3. Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India

    Vandita Shanbhag, Madhuri H. Nanjundaswamy, Sundarnag Ganjekar & Prabha S. Chandra

Authors
  1. Poonam Bir Kaur Sahota
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  2. Raina Jane D’Mello
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  3. Vandita Shanbhag
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  4. Madhuri H. Nanjundaswamy
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  5. Sundarnag Ganjekar
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  6. Himani Kashyap
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  7. Prabha S. Chandra
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Contributions

All authors contributed to the study conception and design. Psychotherapeutic interventions were carried out by PS & RDM, who also wrote the first draft of the manuscript. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Himani Kashyap.

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Conflict of interest

The authors have no competing interest to declare that are relevant to the content of this article.

Ethical approval

This case series study involving human participants was in accordance with the ethical standards of the NIMHANS Institute Ethics Committee.

Consent for participation

Both participants consented to the psychotherapy treatment being performed as part of their routine care.

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Both participants provided written informed consent for publication.

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Sahota, P.B.K., D’Mello, R.J., Shanbhag, V. et al. Finding One’s Voice: Psychotherapy for Dissociative Motor Disorders in the Indian Context. J Contemp Psychother 52, 249–255 (2022). https://doi.org/10.1007/s10879-022-09538-7

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  • DOI: https://doi.org/10.1007/s10879-022-09538-7

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