Conversion Disorder and La Belle Indifférence

· March 26, 2019
Conversion disorder is a symptomatology where bodily functions stop or can be weakened. Read on to find out more!

Conversion disorder, or la belle indifférence, is a functional disorder, but its symptoms are physical, almost as if it was an organic disease.

Somatic symptom disorders are derivatives of hysterical neurosis disorders. Conversion disorder is a symptomatology where bodily functions can be weakened and, above all, all of this happens without any physical damage nor as part of a factitious disorder.

You mustn’t confuse somatic symptom disorders, such as conversion disorder, with psychosomatic diseases, due to the fact that the former have known pathophysiological processes when psychological factors are present.

A man with conversion disorder.

Clinical characteristics of conversion disorder

Conversion disorder basically means losing any bodily function. Due to this, you can find patients that have suddenly gone blind, lost their voice, have a paralyzed limb, or even really bad headaches. However, nothing can explain these things. So, why do they happen?

Conversion disorder manifests in histrionic personalities. A histrionic personality has a tendency for suggestibility, shallowness, emotional lability, dependency, and selfishness. Most noteworthy, this type of personality is much more sensitive to somatization disorders.

A characteristic of conversion disorder is the so-called la belle indifférence, which is when patients don’t worry about the symptoms they’re experiencing.

Let’s say you wake up one day and your arm is paralyzed. Thus, you’ll worry about it, you’ll analyze your situation, you’ll go to the doctor, and you’ll feel anxious about it. That’s normal. However, this doesn’t happen in patients with conversion disorder. They seem indifferent towards their disgrace.

The symptoms of conversion disorder can vary. Common symptoms are blindness, deafness, paralysis, aphonia, and complete or partial loss of sensitivity.

The symptoms usually manifest in adolescents and young adults. They can also manifest during childhood, specifically in children under the age of 10, and it’s limited to difficulty walking and seizures.

Women are more likely to suffer from this condition. Patients with low socioeconomic status, less psychological progression, or low levels of education have a worse prognosis, just like women below the age of 40 that come from rural homes.

The symptoms tend to disappear after a few days with or without treatment. If a person has to deal with another stressful event, the symptoms will probably manifest again. That’s why it’s a chronic disorder.

Woman happy after treatment.

Explanation and treatment

In most cases, a stressful episode can unchain the disorder. Sometimes, the symptoms can be related to the problem that caused them. For example, there are patients that feel pain in the same place they see another person get hurt during an accident. It can also be a way to get affection or attention.

A good prognosis depends on identifying the stressful event, a good premorbid function, absence of other mental or physical disorders, absence of legal procedures, and a short symptomatology period.

Cognitive behavioral therapy (CBT) is used to help patients lower their anxiety levels and deal with stress. Several techniques such as hypnosis and relaxation can help. Likewise, psychodynamic therapy helps resolve underlying intrapsychic issues.

  • Belloch, A., Sandín, B. y Ramos, F (2008). Manual de psicopatología. Volúmenes I y II. McGraw-Hill.Madrid
  • American Psychiatric Association (APA) (2014): Manual de Diagnóstico y Estadísitico de los Trastornos Mentales, DSM5. Editorial Médica Panamericana. Madrid.