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Wednesday, March 28, 2012

Character Clinic: Temporary Paralysis?

I'm fielding a question today from Heidi. She wanted to know if the following scenario was plausible:

I have a injured character who can walk, but when stressed, he exhibits psychosomatic-type symptoms, where he becomes temporarily partially paralyzed and is in a wheelchair. I looked up somatoform disorder, and I think that is what he has, maybe that combined with a bit of post-traumatic stress disorder. 

Heidi -

Thanks for writing in! Somatoform Disorder was a great guess, and you're definitely in the right ballpark. Somatoform Disorders is the overarching category of disorders that are characterized by physical symptoms that don't have a plausible physical reason and are believed to occur from mental reasons.

 The situation you've described fits what is called a conversion disorder. Here are the symptoms with your story world scenario in [brackets]:

A. One or more symptoms or deficits affecting voluntary motor or sensory function that suggest a neurological or other general medical condition. [temporary partial paralysis]
B. Psychological factors are judged to be associated with the symptom or deficit because the initiation or exacerbation of the symptom or deficit is preceded by conflicts or other stressors. [only happens when he's "stressed"]
C. The symptom or deficit is not intentionally produced or feigned (as in Factitious Disorder or Malingering). [he really experiences the paralysis]
D. The symptom or deficit cannot, after appropriate investigation, be fully explained by a general medical condition, or by the direct effects of a substance, or as a culturally sanctioned behavior or experience. [no known medical cause for the paralysis; i.e., your character is in good health]
E. The symptom or deficit causes clinically significant distress or impairment in social, occupational, or other important areas of functioning or warrants medical evaluation. [I assume this is the case]

The reason behind his paralysis is psychological, not medical. Somatization Disorder could be a close match, but you didn't mention that your character had more than the one physical issue, and people with Somatization Disorder (not to be confused with Somatoform Disorder, which is the category) have a whole host of physical maladies.  

So yes, in short, I believe the scenario you've described is feasible.

Hope this helps!

Let's Analyze: There are a few other disorders that fall in the Somatoform Disorder category. Can anyone think of the most well-known disorder?