Treatment for Functional Neurological Symptom Disorder (FNSD) in Children

Functional Neurological Symptom Disorder (FNSD), formerly known as Conversion Disorder, is a condition where children experience neurological symptoms—such as tremors, paralysis, or non-epileptic seizures—that are not due to an underlying medical condition. These symptoms are real and can be distressing, but they are not caused by any physical disease or injury. Instead, FNSD is believed to be linked to psychological factors that affect how the brain processes and responds to stress or emotional challenges.

Dr. Bastien provides specialized treatment for children with FNSD, using evidence-based therapeutic approaches to address both the neurological and psychological aspects of the disorder.

Approach to Treatment

1. Cognitive Behavioral Therapy (CBT)
   CBT is a key treatment for FNSD in children. Through CBT, your child will learn to understand the connection between stress, emotions, and physical symptoms. The therapy helps children:

   1. Identify and challenge unhelpful thoughts that may contribute to their symptoms.

   2. Develop healthier coping strategies for managing stress and emotional distress.

   3. Recognize triggers (both emotional and physical) that may worsen symptoms and learn to respond differently.

   4. Reduce avoidance behaviors and increase engagement in normal activities.

2. Exposure Therapy
   Exposure Therapy may be used to gradually help your child confront situations or emotions that trigger their symptoms, in a safe and controlled way. This process helps to reduce the distress caused by these triggers over time. For example:

   • Gradual exposure to physical activities or movements that may cause symptoms (e.g., walking, using arms) in a structured and supportive way.

   • Exposure to stressful situations that might bring on symptoms, such as social interactions or school-related activities. By gently confronting these triggers, the child learns that their symptoms are manageable and that avoiding them only reinforces the fear or anxiety.

3. Parent Training and Family Support
   We recognize that FNSD affects the entire family. Parent training and family therapy are important components of treatment, helping families understand the disorder and support their child’s progress. By working together, families can learn how to manage and reduce stressors at home, which can help alleviate symptoms. This might include:

   • Learning to reinforce positive behaviors and avoid inadvertently encouraging avoidance or maladaptive responses.

   • Helping children set realistic goals and break down tasks into manageable steps.

   • Creating a calm, supportive home environment to minimize stressors that may exacerbate symptoms.

4. Behavioral Interventions
   Behavioral interventions can help to encourage the gradual return of normal functioning, such as physical activity, school participation, or social engagement. Behavioral activation helps children increase their participation in meaningful, rewarding activities, which can combat symptoms of depression, anxiety, and avoidance behaviors that often accompany FNSD. This may involve:

   • Creating a structured daily routine that includes activities the child enjoys and feels confident doing.

   • Gradually increasing involvement in social, academic, and physical activities to reduce avoidance behaviors and improve functional abilities.

   • Rewarding progress to encourage engagement with activities and boost self-esteem.

5. Building Resilience and Coping Skills
   Throughout treatment, we focus on building your child’s resilience and helping them develop healthier coping strategies. Many children with FNSD experience physical symptoms as a response to stress or emotional overload. Teaching relaxation techniques can help children manage their anxiety and reduce physical tension. These techniques may include:

   • Deep breathing exercises to calm the body and mind.

   • Progressive muscle relaxation (PMR) to help children become aware of physical tension and learn to release it.

   • Mindfulness meditation to increase body awareness and focus on the present moment, helping children disconnect from overwhelming emotions that may lead to physical symptoms.

6. Psychoeducation

   Education is a critical part of any treatment plan. Helping your child and family understand that FNSD is a real condition, not “just in their head,” is essential for reducing stigma and anxiety. Psychoeducation helps children and families:

   • Understand the relationship between stress and physical symptoms.

   • Learn how the brain and body interact in FNSD and why the symptoms may occur.

   • Challenge misconceptions or myths about FNSD to foster greater acceptance and commitment to the treatment process.

Why Early Intervention is Important

Behavioral interventions for FNSD help children learn how to manage stress, reduce anxiety, and regain control over their physical symptoms. By addressing both the psychological and physical aspects of the disorder, these treatments aim to help children improve their quality of life and reduce symptom severity. Early intervention and a tailored treatment approach can significantly improve outcomes, empowering children to live more active, fulfilling lives despite their symptoms.

Early diagnosis and treatment are critical to helping children recover from FNSD. With the right support, many children can manage or even overcome their symptoms, improving their quality of life and overall well-being. Dr. Bastien is here to provide compassionate, specialized care that addresses both the psychological and physical aspects of FNSD.

If you are concerned that your child may have FNSD, we are here to help. Contact us today to schedule an appointment or to learn more about how we can support your child’s journey toward recovery.