Conversion (psychology)

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Fig. 1. Charcot demonstrates the hysteria patient Blanche Wittman in the Salpêtrière lecture hall. Painting by André Brouillet 1887. The painting depicts the treatment of hysterical women as it was carried out during Freud's lifetime by the neurologist Jean-Martin Charcot (1825–1893) in Paris.

Conversion (from Latin conversio "conversion") describes a psychological concept of illness based on the term first coined by Sigmund Freud in 1894, according to which mental excitement is converted into the physical. The theory is based on a dualistic concept of the relationship between body and soul, cf. → mind-body problem . Freud himself spoke of “psychophysical processes”. He anticipated a concept of psychophysical correlation that is still valid today . He called his interpretation of mental symptoms as an “attempt at a neurological theory”, the title of his work, the first description of the course of the disease. Neurological above all was the application of his theory to patients who were previously treated in neurological departments for paralysis of the voluntary muscles, see Fig. 1. Freud also applied this concept to a number of other disorders, such as phobias and obsessions . To this he also counted “certain hallucinatory psychoses”. The choice of words for his description was also to be called neurological, in that he spoke in a neurophysiological way of “sums of excitation” that are converted here. Today in medicine we speak of conversion disorders (ICD-10, F44).

History of Psychiatry

The separation between neurology and psychiatry was even less pronounced during Freud's lifetime than it is today. Freud used both neurological and psychological parameters to describe his model. Freud mentions the role of the “defensive ego” among the psychological terms. This addresses the dynamic role of the "excitation sums" and their defense as well as the topical importance of the instance model . The economic aspect has also been emphasized by Peters, which consists in converting a high level of excitement with strong drive energy into a lower state of tension. This fulfills all of Freud's metapsychological criteria in terms of depth psychology . The Resomatisierung by Max Schur (1897-1969) provides a regressive represents process.

Today the neurological aspects of Freud are viewed as “pseudoneurological” symptoms of a compromise solution that can only be understood symbolically. However, psychosomatics has assessed the physical (“neurological”) symptoms as the result of an expression disease and thus as a body language . The doctor Georg Groddeck (1866–1934) greatly favored the reception of the Freudian model, even if he emphasized the symbolic character of the symptom formation too strongly. According to psychosomatic ideas, the conversion is a so-called downward effect . The model of organ neuroses and actual neuroses is also connected with the conversion .

Individual evidence

  1. ↑ Sigmund Freud : The defense neuropsychoses. Attempt of a neurological theory of acquired hysteria, many phobias and obsessions and certain hallucinatory psychoses [1894] In: Gesammelte Werke, Volume I, “Studies on Hysteria. Early writings on the theory of neuroses ”, Fischer Taschenbuch, Frankfurt / M 1999, ISBN 3-596-50300-0 ; P. 63 on tax "conversion".
  2. ↑ H. Dilling, et al., World Health Organization (Ed.): International Classification of Mental Disorders . 2nd edition, ICD-10 Chapter V (F), Hans Huber Verlag, Göttingen, 1993, ISBN 3-456-82424-6 ; P. 175 f. to tax "Conversion disorder".
  3. ↑ Uwe Henrik Peters : Dictionary of Psychiatry and Medical Psychology . 3rd edition, Urban & Schwarzenberg, Munich 1984; P. 311 to Wb.-Lemma: "Conversion".
  4. ↑ a b c Sven Olaf Hoffmann and G. Hochapfel: Theory of Neuroses, Psychotherapeutic and Psychosomatic Medicine. [1999], 6th edition, Compact Textbook, Schattauer, Stuttgart 2003, ISBN 3-7945-1960-4 ; Pp. 202–206 on the district “Conversion Concept”.
  5. ↑ Thure von Uexküll (Ed. And others): Psychosomatic Medicine . 3rd edition, Urban & Schwarzenberg, Munich 1986, ISBN 3-541-08843-5 ; Pp. 613, 732, 773, 1286, 1288 f. to control unit “downward effect”.
  6. ^ Thure von Uexküll: Basic questions of psychosomatic medicine. Rowohlt Taschenbuch, Reinbek near Hamburg 1963; P. 82 ff. On tax "Conversion and organ neurosis".