Psychology & Functional Neurological Disorder (FND)
By David Hennessy, Clinical Psychologist
Introduction
Functional Neurological Disorder (FND) is a complex condition that sits at the crossroads of neurology and psychology. People living with FND experience real, often debilitating neurological symptoms such as tremors, seizures, weakness, or sensory changes—yet standard neurological testing may not show a clear structural cause.
This can be deeply confusing and distressing. But the absence of a detectable lesion doesn’t mean the symptoms aren’t real. They are genuine and need understanding, compassion, and support.
What Is FND?
FND occurs when the brain has difficulty sending and receiving signals properly, leading to a disconnect between intention and action. For example, someone may want to move their leg but cannot, even though the nerves and muscles are intact.
Symptoms may include:
- Non-epileptic seizures
- Limb weakness or paralysis
- Gait disturbances
- Speech changes (e.g., stuttering or mutism)
- Sensory changes (e.g., numbness or pain)
While the symptoms mimic those of other neurological conditions like stroke or epilepsy, FND is distinct and does not show up on standard imaging like MRIs or EEGs.
A Psychological Understanding of FND
Though the symptoms are physical, FND is a disorder of function, not structure. The underlying causes often involve a complex interplay of psychological, emotional, and neurological factors.
Trauma—whether developmental, emotional, or physical—is often found in the background. So too are high levels of stress, emotional suppression, or difficult life transitions. However, FND is not “all in your head”. This outdated view has led to stigma and misdiagnosis. In truth, psychological processes like attention, expectation, and emotion can all influence brain-body communication.
The Role of the Psychologist in Treating FND
Psychological therapy plays an essential role in helping people manage FND. A clinical psychologist may assist with:
- Understanding and naming the condition
- Processing trauma or chronic stressors
- Developing emotion regulation strategies
- Reconnecting to the body with mindfulness and somatic approaches
- Managing anxiety, depression, or dissociation that often co-occur with FND
- Improving quality of life and functioning
Treatment is collaborative and respectful. The goal is never to dismiss the physical nature of symptoms but to understand how the brain’s predictive systems, stress response, and personal history may be exacerbating them.
Hopeful Realism
Recovery from FND is possible, but it often doesn’t follow a straight line. Many people benefit from a multidisciplinary approach—neurology, psychology, physiotherapy, occupational therapy, and sometimes psychiatry. Psychologists can also help clients maintain hope and self-compassion when the journey is slow or symptoms fluctuate.
It’s not about pretending everything is okay—it’s about finding ways to live well, move forward, and reclaim autonomy.
Resources and Further Support
- Hennessy Clinical Psychology | David the Psychologist.
- Hennessy Clinical Psychology | What is FND?
- Neurosymptoms.org – Developed by Prof. Jon Stone: https://www.neurosymptoms.org
- FND Hope: https://fndhope.org
- Your GP or Neurologist: Ask for a referral to a psychologist with experience in FND
If you’re living with FND or supporting someone who is, you’re not alone. There is a growing body of knowledge, treatment, and support available. And you deserve care that sees you as a whole person, not just a set of symptoms.
