Functional Neurological Disorder (FND)

Conversion Disorder was officially renamed Functional Neurological Symptom Disorder (FND) in the DSM-5, which was published in May 2013.

🧠 Why the Name Changed:

🔹 1. Historical Baggage of “Conversion”

The term “conversion” originated from Freudian psychoanalysis, implying that psychological distress was being 'converted' into physical symptoms (e.g., paralysis, seizures, blindness). This model was speculative and often lacked empirical support, yet it dominated clinical thinking for a century. Many patients felt invalidated or blamed by the implication that symptoms were "all in their head" or caused purely by unconscious psychological conflict.

🔹 2. Advances in Neuroscience

Modern research (e.g., neuroimaging) has shown that FND symptoms are real and brain-based, even if they occur without structural brain damage.
Functional MRI studies show altered activity in areas responsible for volition, agency, and emotion processing. This shifted the view from “psychogenic” to “functional” — meaning the software (functioning) is disrupted even if the hardware (brain structure) is intact.

🔹 3. Clinical Utility

The new DSM-5 diagnosis allows positive diagnostic signs (e.g., Hoover’s sign, tremor entrainment test) rather than relying on exclusion of organic causes. It emphasizes observable signs that the symptom is inconsistent with known neurological diseases, rather than assuming psychological origin.

🔹 4. Improving Stigma & Patient Acceptance

The change to “Functional Neurological Symptom Disorder” or FND:
Reflects updated neuroscience understanding
Reduces stigma
Increases acceptance of the diagnosis among both patients and providers
Supports a biopsychosocial model rather than a purely psychogenic explanation

📘 Key Timeline

Year Event
Pre-DSM-5 Known as Conversion Disorder (DSM-IV) with a strong psychoanalytic framing
2013 DSM-5 renames it to Functional Neurological Symptom Disorder
Present "Functional Neurological Disorder (FND)" is used broadly in clinical and research communities

✍️ Summary

The renaming from Conversion Disorder to Functional Neurological Disorder in DSM-5 reflects a modern understanding of the condition as a brain-based functional disorder, rather than a purely psychological or “conversion” issue. The term change aims to validate patient experience, reduce stigma, and support more accurate, positive diagnosis and multidisciplinary treatment.

 OHSU (Oregon Health & Science University)

  • Dr. Jordan R. Anderson, DO: Based at OHSU, Dr. Anderson specializes in neuropsychiatry and has extensive experience in diagnosing and treating FND. This is one of the few dedicated FND practices in the region.(OHSU)
  • Neurology & Brain Institute Clinics: OHSU’s Department of Neurology and Brain Institute offer comprehensive neurological care—including evaluations and therapies—for a wide range of neurological and neuropsychiatric conditions. While FND isn't explicitly listed among their subspecialty categories, their integrated care model may support FND referrals.(OHSU)
  • ORCCAMIND (Oregon Center for Complementary & Alternative Medicine in Neurological Disorders): This center does integrative medicine and research involving neurological disorders. While not FND-specific, its programs (e.g., mindfulness, yoga, integrative interventions) may be helpful as adjunctive support if coordinated with primary care providers.(OHSU)

1. Dr. Jordan Anderson, D.O. – OHSU (Portland)

  • Specialty: Neuropsychiatry (intersection of neurology and psychiatry), with extensive experience in diagnosing and treating FND Northwest Functional Neurology+7OHSU+7Kennedy Krieger Institute+7.
  • Based at Oregon Health & Science University (OHSU), he is well-suited for outpatient management of FND, particularly where mental health intersects with neurological symptoms.

2. re+active Functional Neurological Disorders Program (Portland area)

  • An outpatient, integrated therapy program that serves adolescents (12+) and adults with FND.
  • Offers a multidisciplinary approach: physical therapy, occupational therapy, psychology, yoga therapy, and more reactive therapy.
  • Emphasizes mental health support and offers intensive outpatient formats — typically 3–5 days per week for a minimum of two weeks, making it a robust outpatient or partial hospitalization model reactive therapy.

3. ReACT FND Health – Telehealth Option (Oregon included)

  • Provides ReACT treatment via telehealth sessions with ReACT‑Certified psychologists, using a digital treatment platform.
  • Oregon is among the states where telehealth services are available reactfnd.healthOregon Clinic.
  • Ideal if outpatient in-person access is limited or if you prefer virtual care.

Providence Health & Services

  • Providence operates a broad network of hospitals and clinics across Oregon and the Pacific Northwest, offering many behavioral health and neurology services.(Wikipedia, Providence)
  • Their Behavioral Health Concierge and telehealth resources (such as Learn to Live, Talkspace) offer general mental health support and self-guided programs, but they don’t seem to include specialized FND or neuropsychiatry offerings.(Providence Health Plan)

Summary Table

Institution FND‑Specific Services General Neurology/Behavioral Health Integrative Support
OHSU Dr. Jordan Anderson (Neuropsychiatry) Yes — broad neurology & rehab ORCCAMIND
Providence No clear FND-specific service Yes — general BH and neurology Not specific to FND

 Tools & Resources

Books:

Videos:

YouTube channels like FND Hope, Neurosymptoms.org, and Physio Network often have visual content for patients

Printable Handouts:

neurosymptoms.org has patient-friendly diagrams
  • Get Self Help UK and Therapistaid for DBT/CBT visuals

🔹 Where to Find Sample Group Curricula

  • ResearchGate and PubMed: Search terms like “FND group therapy,” “conversion disorder CBT group,” or “PNES DBT group.”
  • Specialty Clinics: Look into FND programs at Mayo Clinic, Massachusetts General Hospital, and UCSF—they often run groups and may publish outlines.
  • Facebook or Google Groups for clinicians treating FND – some share treatment plans.
  • Psych forums or PESI/CE websites: Occasionally clinicians share protocols or slides from their own developed groups.

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