Good Children with Conversion Disorder: Breaking the Silence

Abstract

The diagnosis of conversion disorder in childhood is shrouded in uncertainty, a lack of satisfactory explanations, doctor-parent hostility, shame and family silence. Speculations as to the aetiology of conversion symptoms have resulted in hypotheses ranging from malingering, self-deceit, unconscious processes, theories of communication, intolerable predicaments and illness behaviour to hypothesized neurophysiological processes. Of note, is the absence of patient perspectives from the literature, and a tendency for families of ‘good’ children with conversion disorder to respond to inquiries about psychological factors with unease, hostility or silence. The child’s experience of conversion symptoms and illness context are valuable sources of information. This article presents two personal accounts of conversion disorder in children with exemplary premorbid functioning. It aims to demystify the circumstances in which conversion symptoms may present, reestablish dialogue about children’s predicaments and rekindle interest in the developmental trajectories of children presenting with conversion symptoms.