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Conversion Disorder’/’Functional Neurological Disorder’ View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Middlesex University Research Repository Exploring how males who encounter phenomena they identify as ‘Conversion Disorder’/’Functional Neurological Disorder’ experience agency in their lives. Danielle Nicole Phoenix A thesis submitted in partial fulfilment of the requirements of the University of Middlesex and the New School of Psychotherapy and Counselling DCPsych This paper is an original piece of work. Ethical permissions were granted to proceed on 18th March 2015 by the chair of the ethics committee, Prof Digby Tantam October 2016 ACKNOWLEDGEMENTS This research would not have been possible without the participation of the eight men who generously agreed to be interviewed. I am sincerely grateful for their contribution. I would also like to thank my research supervisors, Dr Jacqui Farrants and Dr Edith Steffen. They have provided me with continued support and guidance that I am extremely grateful to have received. I would also like to thank my husband, children, family and friends for supporting me throughout this process. 2 Contents List of tables ..................................................................................................................................................... 6 Abbreviations .................................................................................................................................................. 6 ABSTRACT ........................................................................................................................................................ 7 1 Introduction ............................................................................................................................................. 8 1.1 Layout of the introduction and literature review ............................................................... 8 1.2 Research question ........................................................................................................................... 9 1.3 Literature search .............................................................................................................................. 9 1.4 Personal introduction and development of research ...................................................... 10 2 Medical diagnosis and classification ............................................................................................ 13 2.1 Diagnostic classification .............................................................................................................. 13 2.2 Comorbidity ..................................................................................................................................... 15 2.3 Controversy and stigma .............................................................................................................. 15 3 Agency and control ............................................................................................................................. 17 3.1 Agency and control ........................................................................................................................ 17 3.2 Self-agency versus self-ownership .......................................................................................... 18 3.3 Explicit and implicit ...................................................................................................................... 18 3.4 Agency in social psychology: ..................................................................................................... 20 4 Men as an under-represented population ................................................................................. 22 4.1 Male and female prevalence ...................................................................................................... 22 4.2 Males and trauma .......................................................................................................................... 23 4.3 Sex, gender and society ................................................................................................................ 24 4.4 The social construction of masculinity: ................................................................................. 25 5 Historical developments and theoretical explanations of CD/FND ................................. 27 5.1 Jean-Martin Charcot ...................................................................................................................... 28 5.2 Pierre Janet and Sigmund Freud .............................................................................................. 29 5.3 Psychoanalytic research involving pseudoseizures ......................................................... 31 5.4 Ludwig Binswanger and Buber ................................................................................................ 32 5.5 Learning and Sociocultural Theories ..................................................................................... 34 5.6 Neurophysiological Theories .................................................................................................... 34 6 Trauma, dissociation, and emotion .............................................................................................. 35 6.1 Trauma ............................................................................................................................................... 35 6.2 Dissociation ...................................................................................................................................... 38 6.3 Emotion .............................................................................................................................................. 39 7 Medical model context and the gap in current research ...................................................... 41 3 7.1 An explanation for the reference to the diagnostic terms ‘conversion disorder’/ ‘functional neurological disorder’ .................................................................................................... 41 7.2 Medical model and mind-body dualism ................................................................................ 43 7.3 Gap in current research ............................................................................................................... 45 8 Methodology .......................................................................................................................................... 47 8.1 Research Methodology ................................................................................................................ 47 8.1.1 A qualitative research approach ........................................................................................ 47 8.1.2 Why choose the qualitative method IPA? ....................................................................... 49 8.1.3 Interpretative Phenomenological Analysis .................................................................... 52 8.1.4 Epistemological and Ontological positions .................................................................... 55 8.2 Procedure .......................................................................................................................................... 58 8.2.1 Selection of participants ........................................................................................................ 58 8.2.2 Interview questions ................................................................................................................. 58 8.2.3 Ethical considerations: ........................................................................................................... 60 8.2.4 Recruitment of participants ................................................................................................. 61 8.2.5 Pilot study and ethical considerations: ............................................................................ 63 8.2.6 Interview approach and ethical considerations ........................................................... 66 8.2.7 Debriefing .................................................................................................................................... 67 8.2.8 Data analysis .............................................................................................................................. 68 8.3 The participants ............................................................................................................................. 69 9 Analysis ................................................................................................................................................... 72 9.1 Overview of themes: ..................................................................................................................... 72 9.2 Summary of findings:.................................................................................................................... 74 9.3 Superordinate themes .................................................................................................................. 75 9.3.1 Superordinate theme 1: Paradox of control .................................................................. 75 9.3.1.1 Subordinate theme 1: ‘Re-conceptualising control’ .............................................. 75 9.3.1.2 Subordinate theme 2: ‘Body disconnected’ .............................................................. 78 9.3.1.3 Subordinate theme 3: ‘Centrality of conscious mind’ ..........................................
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