A Psychodynamic Approach to Functional Movement Disorder
Location
Virtual
Event Website
https://www.medschool.lsuhsc.edu/genetics/2023_medical_student_research_poster_symposium.aspx
Presentation Date
23-10-2023 8:29 AM
Description
Functional movement disorders (FMD) involve motor disturbances without a known underlying neurological disease. Psychodynamic psychotherapy explores early experiences and relationships that impact an individual's behaviors and emotions. A key premise of psychodynamic theory is that tension between unconscious wishes, fantasies, and fears generates intrapsychic conflict that individuals express via defense mechanisms. Early in the history of psychiatry, psychodynamic therapy was considered a primary treatment for unexplained neurological symptoms. Currently, however, few psychiatrists are trained in the psychodynamic approach, and there is debate among clinicians about how FMD should be treated. Furthermore, patients experiencing FMD may see many different providers before receiving a diagnosis and treatment. Recent studies have indicated that psychodynamic therapy is an effective intervention for psychogenic nonepileptic seizures and other somatoform disorders. The current case involves a seventeen-year-old female seeking psychiatric care for diffuse uncontrollable movements that started during her junior year of high school. She was initially seen by neurology and hospital medicine with a full medical workup, and no neurological lesion or process was identified. She was treated with a trial of guanfacine that did not relieve her symptoms, and lorazepam which provided very minimal improvement. While she had previously been a good student, the patient began missing school due to her FMD symptoms. The patient had previously been involved in cognitive behavioral therapy and found applying these techniques to her movement issues ineffective. She began dyadic psychodynamic psychotherapy which included the psychiatrist making interpretations regarding her symptoms within the first two sessions. The patient’s FMD symptoms resolved fully following three sessions of psychodynamic psychotherapy treatment. She continued to participate in therapy and returned to school and social functioning. This case suggests that psychodynamic therapy may be a useful and potentially rapid treatment for FMD.
Recommended Citation
Schafer, Alison K., "A Psychodynamic Approach to Functional Movement Disorder" (2023). Medical Student Research Poster Symposium. 93.
https://digitalscholar.lsuhsc.edu/sommrd/2023MSRD/Posters/93
A Psychodynamic Approach to Functional Movement Disorder
Virtual
Functional movement disorders (FMD) involve motor disturbances without a known underlying neurological disease. Psychodynamic psychotherapy explores early experiences and relationships that impact an individual's behaviors and emotions. A key premise of psychodynamic theory is that tension between unconscious wishes, fantasies, and fears generates intrapsychic conflict that individuals express via defense mechanisms. Early in the history of psychiatry, psychodynamic therapy was considered a primary treatment for unexplained neurological symptoms. Currently, however, few psychiatrists are trained in the psychodynamic approach, and there is debate among clinicians about how FMD should be treated. Furthermore, patients experiencing FMD may see many different providers before receiving a diagnosis and treatment. Recent studies have indicated that psychodynamic therapy is an effective intervention for psychogenic nonepileptic seizures and other somatoform disorders. The current case involves a seventeen-year-old female seeking psychiatric care for diffuse uncontrollable movements that started during her junior year of high school. She was initially seen by neurology and hospital medicine with a full medical workup, and no neurological lesion or process was identified. She was treated with a trial of guanfacine that did not relieve her symptoms, and lorazepam which provided very minimal improvement. While she had previously been a good student, the patient began missing school due to her FMD symptoms. The patient had previously been involved in cognitive behavioral therapy and found applying these techniques to her movement issues ineffective. She began dyadic psychodynamic psychotherapy which included the psychiatrist making interpretations regarding her symptoms within the first two sessions. The patient’s FMD symptoms resolved fully following three sessions of psychodynamic psychotherapy treatment. She continued to participate in therapy and returned to school and social functioning. This case suggests that psychodynamic therapy may be a useful and potentially rapid treatment for FMD.
https://digitalscholar.lsuhsc.edu/sommrd/2023MSRD/Posters/93
Comments
Mentor: Dr. Cody Roi LSUHSC, Department of Psychiatry