Healing the disembodied mind: contemporary models of conversion disorder

The cartesian separation of body and mind has underpinned medical conceptualization of conversion symptoms over the last four centuries. Eighteenth- and nineteenth-century models explained conversion symptoms on the basis of assumed organic lesions. Subsequent psychological formulations focused on mental phenomena, which were disembodied from underlying neurobiological processes. Contemporary theories challenge this disconnection. They place conversion symptoms within an evolutionary framework, arguing that mind is embodied in physical processes and confers significant survival advantage. Current neurobiological models explain conversation symptoms as part of the human emotional response to threat, reflecting either errors in how information about body state is processes and represented, or the motor component of an automatic emotional response. Patients with conversion disorder experience their body functions in a range of distressing and disturbing ways. In order to understand these phenomena, clinicians require conceptual models that expand the conventional dualistic mind-body paradigm, integrate multiple theoretical perspectives, and take into account environmental factors that shape evolutionary and individual development.