On “Converting” Hand Pain Into Psychological Pain

Abstract

A 36-year-old woman with a history of teenage trauma presented to a pain clinic with unexplained hand pain and numbness. The patient was ultimately diagnosed with post-traumatic stress disorder with a conversion reaction. Because the trauma was taken to be significant in her symptomatology, she was referred for exposure-based therapy. Although psychological distress increased over treatment, her reported physical symptoms and an objectively measured index of symptoms both improved dramatically. Because many patients with unconventional presentations are overutilizers of medical resources, addressing the “cause” of the distress (e.g., trauma) can be advantageous for both patient and medical personnel.