Conversion dynamics and metaphor

• Conversion disorder by Jon D. Boller, Ph.D., 4/18/97
  
  

Dr. Boller:

Your account of your patient and her situation seems quite comprehensible if you regard and respond to her statements as metaphors. Given her perhaps alexithymic nature and the secondary gain aspects of her symptom and situation, I would simply listen empathicly, acknowledge her "burdens," and take her foot pain serious, very serious with her--while I kept acknowledging her burdens over the years. If she moves in a direction of some insight, so much the better, but I expect some shifts may occur thru oblique, metaphorical talk as in some play therapy interventions with children. There also may be some ways to do some strategic interventions with the family if not too much change is insisted upon. At times, individuals with Somaticization Disorder can derive real benefit from this kind of under standing and probing--being careful not to "challenge" the symptom by overt or premature interpretation, which would rob them of their current organization as well as be experienced as a harsh deprivation. Good luck.

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