Dr Stone introduces this ‘hidden world’ with this quandary: the symptoms of some functional neurological disorders (FNDs) resemble someone pretending to suffer from those symptoms. A patient might lose their tremor in one hand when they are preoccupied with a task for the other, for example – impossible for someone with MS, but symptomatic of both people with neurological disorders, and anyone consciously trembling their hand. The physical symptoms originate from the nervous symptom, thus might be alleviated when the limb is responding to reflex alone. However, this fact of the disorder presents several issues, with diagnostic practice, social stigma, and the divide between psychiatry and neurology.
Dr Stone’s presentation highlighted a range of overlapping debates around fraudulence, disability allowance, and the stigmatisation of people living with conditions that don’t outwardly present in ways recognisable to the general public. Stone raises our society’s current fixation with benefit fraud, and the danger of people with FNDs being refused treatment if they are thought to be ‘faking it’ (if not for benefits, then as ‘drug-seeking behaviour’ – an experience illustrated in Mel Moon’s autobiographical Fringe show Sick Girl). His professional diagnostic experience renders him confident in distinguishing between people with a disorder and possible frauds, but the separation is still very reliant on the discretion of clinicians. The talk also featured a guest outpatient of Dr Stone’s, who suffers from dissociative seizures. Her story prompted discussion of the importance of educating employers about managing staff with FNDs, although the plaudits given her for being in work had the potential to undermine the destigmatisation of benefits claimants.
The Cabaret of Dangerous Ideas offers an interesting format for public engagement and discussion with frontline science, and continues with a programme of expert speakers from myriad fields. (HM)
THE CABARET OF DANGEROUS IDEAS, different speakers every day until August 30th, Stand in the Square. Wheelchair Access, Level Access, Wheelchair-accessible toilets available.
Full programme here: http://codi.beltanenetwork.org/codi-2015/the-shows/
Website for Functional and Dissociative Neurological Symptoms: http://www.neurosymptoms.org
Suzanna O’Sullivan in The Guardian on functional neurological disorders and the stigma of ‘faking it’: http://www.theguardian.com/society/2015/may/16/you-think-im-mad-the-truth-about-psychosomatic-illness
Dr Jon Stone on functional neurological disorders, delivered to the North British Pain Association, 2014: https://www.youtube.com/watch?v=w4obwKD8JLU
Access All Areas,: Live Art and Diability, NYC, from the Live Art Development Agency (LADA): http://www.thisisliveart.co.uk/projects/access-all-areas-live-art-and-disability-nyc-edition/
The Eye of the Storm Symposium, culmination of artist Catherine Long’s residency with UCL’s Institute for Cognitive Neuroscience, investigating connections between the body, movement and neurology: http://expectationviolation.com
TSOTF Diagnosis of Sick Girl by Mel Moon, who was accused of drug-seeking behaviour and reflects on rare conditions: http://thesickofthefringe.com/diagnoses/2015/8/9/sick-girl-mel-moon