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Pseudoseizures, Families, and Unspeakable Dilemmas

Received May 24, 1996; revised October 23, 1996; accepted June 6, 1997. From the Department of Psychiatry and Behavioral Sciences, The George Washington University Medical Center, Washington, DC; and the Mississippi State Hospital, Whitfield, Mississippi. Address reprint requests to Dr. Griffith, Department of Psychiatry and Behavioral Sciences AN8411, The George Washington University Medical Center, 2150 Pennsylvania Ave., N.W., Washington, DC 20037.

Fourteen videotaped family interviews of patients with diagnosed pseudoseizures were studied to determine the relationship of the symptoms to unspeakable dilemmas as forced choices imposed by family or social circumstances under conditions that also require the ensuing distress to be hidden. An unspeakable dilemma was evident in 13 of 14 interviews, with the patient the most silent family member in 13 interviews. In six cases, there was revealed a realistic threat of physical or sexual assault to a person involved in the problem, although not always the patient. These findings point to an important role for family therapy skills in the evaluation and treatment of pseudoseizures.

Key Words: Pseudoseizures • Family • Somatoform Disorders

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