The Physical Basis of Conversion Disorders: A Commentary on Mark Solms’s Target Paper “Function in Functional Neurological Disorders: The Common Ground of Neuroscience and Psychoanalysis”

After a definition of what the psychoanalysts used to call “hysteria,” then conversion disorder, Mark Solms shows us two central aspects that place functional neurological disorder at the center of interest for neuropsychoanalysis: (1) conversion disorder represents the inverse of the hard problem of consciousness. The hard problem of consciousness asks how the organic processes supported by neuronal structures may generate consciousness and subjective experiences in general. In conversion disorders, the question becomes: how is it possible that thoughts and feelings can translate into bodily symptoms? (2) The second development supported in Solms’ article concerns the mechanism by which the functional symptom arises and is maintained. The question thus revolves around how (on which mechanistic grounds) feelings, emotional reactions, and related thoughts, all psychic phenomena, can turn (or convert) into a somatic symptom dysfunction that sometimes lasts years in the patient’s life. Solms (taking inspiration from Freud’s views on hysteria) introduces the exciting concept of the lesion of an idea. In this interesting perspective, conversion disorder would result from a false inference, an erroneous decoding of a mental representation, or a misattribution of a sense of self-agency.