Hysterical Neurosis is among a group of disorders now known as Somatoform disorders, characterized by physical symptoms which however are without demonstrable organic pathology.
It can also be defined as a poly-sypmtomatic disorder characterized by recurrent multiple somatic complaints that are unexplained by organic pathology. It normally results as a reaction to situations that provokes anxiety or form repressed anxiety.
Categories of Hysterical Neurosis
It comes in two forms
1. Dissociative Reaction Disorder
This reaction is rare/uncommon and often bizarre defence reactions to stress. It involves the segregation of any group of mental or behavioural process from the rest of the person’s psychic activity and may entail the separation of an idea from accompanying emotional tone.
2. Conversional Reaction Disorder
The development of symbolic physical symptoms and distortions involving the voluntary muscles of special sense organs and not explained by any physical disorder.
In this case clients report loss of alteration of physical function that suggests a physical disorder but is in fact related to expression of psychological conflicts.
Ateiological Factors
- Personality; an hysterical personality (immature, dramatic, attention seeking, emotionally shallow, insincere, self centered, manipulative, moody, scene loving, having difficult facing/dealing with life’s problem in an appropriate way) is prone to this condition.
- childhood trauma/abuse of a physical or sexual abuse
- parental attitudes- over concern for a child’s health or excessive attention paid to a child.
- Sex- more common in females than males
- prevailing circumstances e.g severe stress, war, examination, sexual difficulties. physical illness.
Clinical Manifestation
Most symptoms are acute, but a crescendo of symptomology may occur.
It clinical manifestation takes two forms;
1. Conversion reaction
symptoms usually affect the special senses or a part of the body governed by the voluntary nervous symptoms. They may include;
- Blindness or funnel vision
- paralysis of a part , or one or more extremities.
- vomiting
- stammering or mutism
- impotence or frigidity
- symptoms of depression or anxiety
2. Dissociative Reactions
they take the dorms like;
- Dissociative Identity disorder with one uppermost consciousness determining the nature and attitude of the individuals behaviour
- Dissociative fuge – individual usually wander far from home for days, during which that time he completely forgets his past life and associations,
- Dissociative Amnesia – In this case the patient becomes of aware that he has a total loss of memory for events that occured during this period that may range from few hours to a whole life time. It may be localized, selective or continuous.
Medical Management
Patients with this condition can be managed with the following
- General Assesment – a comprehensive history and exmination of the patient’s physical and emotional/psychological problem to establish the true aetiological basis for the complaints
- Psychotherapy – a supportive interpretative individual psychology should be instituted to unravel the cause of the conflict. People in the patient’s immediate environment should be brought into the discussion. Focus should be on issues of stress and coping rather tan telling the patients that their symptoms are imaginary.
- Abreaction Technique – repressed materials accompanied with appropriate affective response can be employed in certain cases. Injection of barbiturates or inhalation of ether or Co2 can be used
- Chemetherapy
- active therapy
- change in environment may prevent recurrence
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