Psychogenic non epileptic seizures: difficulties in reading emotions accurately

In a 2005 article in Epilepsy and Behavior Journal Bewley et. al. reported that just over 90% of PNES sufferers scored positive for “Alexithymia.”
What is alexithymia? It is a difficulty:
1) Identifying your own feelings
2) Distinguishing between emotional feelings and the bodily sensations that go along with emotion.
3) Describing feelings to other people
This does not mean you can’t feel but rather may have trouble describing what you are feeling to yourself or others. You may just find yourself using the most basic terms, like “happy” or “sad” without being able to see the nuances.
Where might this “emotional dyslexia” (as some call it) come from?
A major psychological theory “the theory of attachment” explains that babies “attach” to their caregiver (often, the mother) for security, safety, and survival. If the caretaker is sensitive and consistent, the baby/toddler develops a sense of security. However, when the caretaker is absent or inconsistent, the child gradually develops anxiety, anger, sadness, and loses a sense of security.
The caretaker has the important role of being the “translator” of events and feelings for the developing baby and child. For example, if a child is crying because a favorite toy was lost, a caretaker might understand what is happening and say: When we lose something special to us, we feel sad and it’s ok to cry about it. The caretaker is giving a name to the “sad” feeling the child is having and is soothing at the same time. In this tiny example, the child is learning to identify a feeling and is also learning to achieve calm in its presence.
Many patients with PNES have had very different childhood experiences. Caretakers have not been tuned into their experiences and have not helped them learn to name feelings and achieve calm in their presence. If these brief positive interactions have not occurred in childhood, alexithymia is a likely outgrowth.
An important role the psychotherapist plays in therapy is to assist the patient in recognizing emotions and physical sensations (i.e. neck tension, rapid heart rate) that translate into named feelings (i.e. anxiety or anger).

4 thoughts on “Psychogenic non epileptic seizures: difficulties in reading emotions accurately”

  1. Hi this item sounds very interesting. I suffer from PNES / depression / suicidal tendencys / anxiety. As a child I thought I was adopted as I was an only child. I also remember feeling un wonted and in the way. My parents have never been supportive. I am 53 and my relationship with my parents has always been tentive. When I had my first born a son. My father said that my baby was the son they never had. I had two more babys both girls and my parents don’t carless about then. My son is the golden boy and his sons are thought of the same. My daughters children have no contact with my parents she has two girls one boy. My son has six children three of each sex.

  2. Sometimes it is helpful for us to look at our parents through their own childhood and how their parents were like with them. We want to be able to understand how things came about with them and ourselves while also being able to eventually “let go” and forgive. Forgiveness is something we will talk about in a future blog.

  3. I am not sure if I am reading this right???? because this is the 2nd most ridiculous generalized over exaggeration I think I have ever seen. (1st being the new research report out where the clinician states PNES people have problematic behaviors and unstable relationships) I am surprised by the amount of opinion that makes it into articles and possibly research when it comes to PNES. I can’t help but question the creditability of these researches. I for sure agree with the need to forgive and come to peace and understanding with our childhoods. I think looking at how your parents were raised is a great place to understand why they behave the way they do. I know I hope my kids will one day cut me some slack and realize I did the best I could do given the medical situation I am in. Everything is based on perception and how we choose to see the world. I am not saying that there are not horrible parents out there and even some just not very good ones. But to make declarations across the board that 90% of PNES sufferers have Alexithymia can’t be accurate because not everyone with this disorder was contacted, I know I didn’t get anything in the mail. I will have to look up the actual report by Bewley. I do not mean this in anyway to be attacking. I personally feel that this is a long stretch. I do not think this type of information is helpful for finding better treatment options nor do I agree with the stereotypes it creates. I have wonderful parents, not perfect but wonderful. They did the best they could given how they were raised and how I behaved.

  4. Can be very misleading. Just had my daughter tell me I’m responsible for her condition because I was too distracted raising her and her brother along, working two jobs, and absent too much. So now I am the bad “guy”. Doesn’t refer to her absent father. Perception plays a big part in the whole PNES equation. A too simplistic answer doesn’t help a family trying to deal with these issues.

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