Why It’s Not “All in Your Head”
Functional Neurological Disorder (FND) can be a frustrating and deeply misunderstood condition. Many people with FND experience real and disabling symptoms – only to be told nothing is wrong. This dismissal can cause isolation and shame. But growing research shows conclusively that FND is not imagined or “all in your head.”
In this blog, we’ll explore what FND is, how therapy helps, what therapy sessions often involve, and real-life examples of improvement.
What Is Functional Neurological Disorder (FND)?
FND refers to neurological symptoms, such as seizures, tremors, paralysis, or dissociation, amongst other things, that are not caused by structural damage in the nervous system. Instead, the issue lies in how the brain functions or communicates with the body.
As the National Institute of Neurological Disorders and Stroke (NINDS) explains:
“Functional neurologic disorder (FND) refers to a neurological condition caused by changes in how brain networks work, rather than changes in the structure of the brain itself.” https://www.ninds.nih.gov/health-information/disorders/functional-neurologic-disorder
FND is real, diagnosable, and recognised in major medical guidelines: it’s included in the DSM‑5 and ICD‑11, and has a prevalence in neurologists’ clinics comparable to multiple sclerosis or Parkinson’s disease (Stone et al., 2020).
What Are the Symptoms of FND?
Symptoms vary widely and can include:
- Non-epileptic/dissociative seizures
- Functional limb weakness or paralysis
- Abnormal movements or tremors
- Gait (walking) difficulties
- Speech issues (e.g. whispering, stuttering)
- Visual disturbances
- Sensory changes (like numbness or tingling) (https://neurologyopen.bmj.com/content/6/1/e000659)
These are involuntary and distressing – far from being “put-on” or attention-seeking, though many patients may still feel like they’re having to fight this stigma.
Understanding the Mind-Body Connection
Functional Neurological Disorder highlights the tight dialogue between mind and body. Trauma, stress, or emotional conflict can affect not just mood, but how the brain physically sends and receives signals.
Studies using fMRI reveal that people with FND often show altered brain activity in motor control areas and emotional regulation centres (PubMedOxford Academic.) This shows clearly that FND is not just physical, nor purely psychological, but a disorder of functional brain networks.
How Can Therapy Help with FUNCATIONAL NEUROLOGICAL DISORDER?
Therapeutic support is central to recovery. FND symptoms often persist due to unrecognised emotional factors, misfiring stress systems, or learnt bodily patterns – even without brain damage. Therapy helps break those patterns. Our team consists of doctoral-level clinicians experienced in providing comprehensive care for individuals with FND. They utilise empirically validated techniques to manage both the physical symptoms – such as weakness, tremors, and non-epileptic seizures – and the emotional distress associated with the disorder. Our clinicians are well-versed in the psychological aspects of FND, offering tailored interventions that empower patients throughout their treatment journey.
Evidence-backed approaches include:
- Cognitive Behavioural Therapy (CBT)
The CODES trial—published in The Lancet Psychiatry – found that CBT tailored for dissociative seizures led to reduced seizure frequency and better quality of life. - Trauma-informed approaches
For those affected by trauma, methods like EMDR or somatic therapies can help reset stress responses. - Psychoeducation and validation
Learning about FND as a functional brain disorder has been shown to lessen symptom severity – even without other interventions. Knowledge and compassionate understanding is power! - Physiotherapy & occupational therapy
Movement retraining with FND specialists helps rebuild motor control and brain-body communication (https://www.fndsociety.org/?).
What a Therapeutic Journey Might Look Like with HMP:
- Symptom Management: Addressing both motor and sensory symptoms, including weakness, altered sensations, and coordination difficulties
- Psychological Support: Offering empirically-validated interventions to help individuals cope with emotional distress, reduce stress responses, and navigate the challenges of living with a misunderstood diagnosis
- Formulation: Helping clients consider the wider aspects of their lives that may be maintaining or contributing to ongoing FND symptoms
- Empowerment in Recovery: Encouraging active participation in treatment through education about the mind-body interaction and stress or deeper trauma, helping individuals optimise their emotional functioning
Therapy is collaborative, tailored, and paced according to each person’s journey toward health.
Real-Life Success Stories
- Dissociative seizures: A 2021 case study in Neuropsychological Rehabilitation described a young woman whose seizure frequency dropped significantly following trauma-informed therapy and emotional regulation education (Brown et al., 2021). (https://fndhope.org/fnd-research/codes-trial/?)
- Functional movement disorder: A 2016 review found that most patients showed functional improvements when psychological intervention was combined with physiotherapy.
These stories and the many more that can be found with resources like FNDhope.org reinforce that FND is treatable – and real recovery is possible.
Why This Matters
FND shows us not just the complexity of brain function – but the power of integrated, compassionate care. Therapy isn’t magic, but it’s often the missing piece where physical or biomedical treatments alone flounder.
If you or someone you love is living with FND and feeling forgotten, therapy offers validation, tools, and a path forward – toward reconnection, empowerment, and hope. If you would like to learn more about FND and how HMP can assist you, please visit https://www.healthymindpsychology.co.uk/how-we-help/functional-neurological-disorder/ and complete the online contact form, and someone will be in touch with you.
Further Reading & Resources
- NINDS: Functional Neurologic Disorder (FND)
- Cognitive behavioural therapy for adults with dissociative seizures (Goldstein et al., The Lancet Psychiatry) neurologyopen.bmj.com, https://www.ninds.nih.gov/health-information/disorders/functional-neurologic-disorder?
- Emotional stimuli and motor conversion disorder (Voon et al., Brain)
- FND Society (FND Hope) educational overview
To find out how we can help you or for further information you can read our services here or please contact us below: