Why do children have psychogenic seizures (PNES)? Is it because their parents are too nice to them?

boy kingIn the last couple of weeks, an article started to appear in different social media outlets in which a neurologist was quoted as saying that an important contributing factor in functional illnesses (including seizures and paralysis) in children is that their parents are showering the children with “too much love and attention.”  http://www.telegraph.co.uk/culture/hay-festival/11640715/Parents-can-be-too-nice-to-their-children-neurologist-warns.html

There seems to be a new trend in popular culture; the pendulum has shifted from seeing all problems in children as stemming from parents who are neglectful and unkind to now seeing parents’ niceness, encouragement, and support as a key problem.  Point in fact, just a few months ago, another article came out about parents who praise their children as potentially producing “little narcissists.”  http://www.csmonitor.com/The-Culture/Family/2015/0310/Are-you-too-nice-to-your-kids

It would be fantastic if life in general and functional neurological symptoms in particular had a simple explanation and a one-step recipe for success.  However, this view is not only overly simplistic; I think it can be harmful to the child and family.  From this viewpoint, parents are made to feel that their loving and caring behaviors directed at a child who is seizing are in fact creating/sustaining the problem but what would be suggested otherwise? To ignore or otherwise punish a child’s functional symptoms?

The answer is a resounding no!  Functional symptoms exist for a reason and will not go away if ignored.  Rather, they need to be the focus of careful examination and that which created them in the first place, needs to be addressed and modified.   There are always multiple layers in the development of PNES including family and patient tendencies to focus on physical symptoms rather than emotional difficulties, undetected academic and cognitive weaknesses in the child that run counter to parental expectations (and which can be addressed by school accommodations and support), children who need to learn how to read their emotions and to respond effectively to stress, undetected family stressors, etc.

So in sum, PNES in children as in adults, is a complex issue.  It is certainly not produced and maintained by excessive love.  Rather, it requires multidisciplinary professional assistance and hard work on the part of the patient and family to unravel the causes and find appropriate solutions.

 If you are really interested in reading an in-depth and accurate article on contributing factors to PNES in children, you would be advised to read this:

http://www.ncbi.nlm.nih.gov/pubmed/25244006

2 thoughts on “Why do children have psychogenic seizures (PNES)? Is it because their parents are too nice to them?”

  1. When I look back, it is between the ages of three and four years old that I find my earliest memories of needing to be perfect in order to be loved. An experience that I had in kindergarten with a pink eraser has haunted me all my life. It was my perception of life and love or otherwise around me that has had its lasting effect on me.
    It’s not only stepping inside the child’s shoes to understand what they see and feel. We must also with permission from the child, peek inside his/her mind and spirit to perceive what he/she perceives.
    Maybe then we will have a glimpse of truly understanding why the PNES in young children.

  2. Danielle McDermott

    Agree! It is very troublesome that so many fields (not only epilepsy) attempt to pidgeonhole illness states in attempt to simpify diagnostic and treatment strategies. When in fact we are doing patients – who are all unique – a huge disservice.

    Thank you.

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