Die Konversion: Psychosomatik statt Psychogenese?

The main emphasis of this paper is on a critique of the idea still current in psycho-analysis as well as in psychiatry that conversion can be seen as a purely psychogenic process. This reductionist idea is responsible for some of the difficulties clinicians encounter in their work with patients with a suspected conversion disorder; it may be a consequence of a hysterical structure of this theory. A coherent theory of the psycho-somatic phenomenon of conversion has to proceed in a non-reductionist methodology comprising psychological as well as physiological levels of description and explanation. In this paper, these hypotheses are developed in three dimensions: a) concerning clinical encounters with patients with 'pseudoneurological' symptoms; b) looking at the historical development of the Freudian concept of conversion between 1894 and 1916/17, and c) theoretically, including some concepts of cognitive neuroscience.