• motor
• sensory
• seizures or convulsions
• mixed presentations

• impaired coordination or balance
• paralysis
• difficulty speaking
• difficulty swallowing
• urinary retention

• loss of sense of touch
• inability to feel pain
• double vision
• blindness
• deafness

• seizures
• convulsions

• hysteria - hereditary disassociation of the brain
• hysterical neurosis - stems from anxiety
• la belle indifference - dismiss symptoms as minor even when incapacitating

• client seeks help continuously from several different physicians over course of years
• exaggerated physical complaints
• not faking
• rarely go a year without seeking medical attention
• do not voluntarily seek psychological treatment

• pain disorder

• not faking
• life consumed by experience of pain
• many cases, medical condition exists, but nature of pain complaint is regarded as being intricately associated with psychological issues
• on spectrum of internalizing disorders including mood, anxiety, and somatization disorder
• endless pursuit of relief and likely to become dependent on medications

• defects are imaginary or grossly exaggerated
• problems with mirrors
• thinking borders paranoia
• chronic if untreated
• related to mood and anxiety disorders

• appear to be on verge of panic
• no amount of reassurance will remove fears
• person is aware of fact their symptoms might be delusional
• anxiety and depression
• rumination about symptoms
• difficult treatment

• physical or psychological
• fabrication of problem
• inflicting physical pain
• makes med condition worse
• no ulterior motive such as economic or avoidance of responsibility
• dramatic presentation of self
• many have impressive medical knowledge

Munchausen's Syndrome

• psychosis
• depression

• factitious disorder by proxy
• munchausen's syndrome by proxy

• one or more symptoms or deficits that affect voluntary motor or sensory function suggesting a neurological or general medical condition

• psychological factors associated with condition, which began or was aggravated following a conflict or stressor

• condition is not intentionally produced

• cannot be attributed to general medical condition, substance use, or culturally sanctioned behavior

• distress and impairment

• difficult for health professional to diagnose disorder
• real physical or cognitive problem may be wrongly attributed to psychological causes and client might not receive prompt med attention
• half of those diagnosed are found later to have had physical illness not apparent when first seen for treatment
• suggest thourough neurological examination

• primary and secondary gains - what motivates people to appear sick
• elimination of positive reinforcers for being sick

• dissociative identity disorder (did)
• dissociative amnesia
• dissociative fugue
• depersonalization disorder

• two or more identities in same person
• primary identity associated with given name known as host and is passive and dependent
• have subpersonalities or alters
• transition from one alter to another is often sudden and triggered by a stimulus
• lost or distorted experiences of time

• localized - forgets all events in specific time period
• selective - fails to recall some, but not all, details of events occurring during a given time period
• generalized - person can't remember anything at all from life
• continuous - failure to recall events from a particualr date up to including present time

• unable to recall important info
• triggered by specific upsetting event
• not attributable to neurological dysfunction, brain damage, or normal forgetfulness
• abrupt onset that can last hours or years
• disappears suddenly with complete recovery

• unable to recall history or identity
• some form new identities
• often follows severely stressful event
• no recall of what took place during fugue after recovery

• detachment from one's experiences
• out of body
• often follows time of extreme stress
• change in body size and shape
• being controlled by forces outside of self
• aware that something is wrong with them increases distress

• traumatic childhood
• sociocognitive model
• psychodynamic view
• behavioral: state-dependent learning
• self-hypnosis

Traumatic Childhood

clients enact the roles that they feel (consciously and unconsciously) are demanded by the situation

social attention to condition of did along with unintentional prompting by therapists can lead to development of disorder

• lifetime of excessive repressed memories of trauma
• in a dangerous world, the child may start to escape reality by splitting from reality and creating protectors

• help client recognize the nature of disorder
• recover gaps in client's memory
• integrate subpersonalities using fusion (final merging of two plus altars)

• hypnotherapy
• cbt

• client is hypnotized while in trance state and encouraged to recall painful past experiences
• controversial because it may actually cause the emergence of other symptoms related to the disorder (iatrogenic)

• change thought process
• bolster self-efficacy through temporizing in which client controls way alters make their appearance
• change attitudes related to function of alters