FND Hope at the annual British Neuropsychiatry Association
The following is a recap of events at the annual BNPA confrence in London. Attended by FND Hope Representative Amy Bradley.
At the end of February 2017, I had the pleasure of representing FND Hope at the annual British Neuropsychiatry Association (BNPA) conference in London. The BNPA brings together leading neurologists, psychologists, psychiatrists, neuropsychiatrists as well as researchers from a range of fields and interest. Many members and the organisation as a whole have a long-standing interest in functional symptoms and functional disorders.
Among those attending were Dr Jon Stone, Dr Timothy Nicholson, Dr Alan Carson and Professor Anthony David, along with other pioneers in Functional Neurological Disorder (FND) research, treatment and care. Over the three-day event I was privileged enough to speak to many caring and enthusiastic clinicians, with many taking FND Hope material to distribute to patients in their clinics. I promoted the existence of the Scientific Registry, the tools and patient group support facilitated by the FND Hope media platforms and discussed potential collaborations between researchers, clinicians and patient groups.
In addition to many other interesting discussions, Dr Stone gave a talk on ‘The history of hysteria, conversion and functional disorders in neurology in the 20th century’ which was positively and enthusiastically received by the audience. He took the audience on a journey through time, emphasising that functional disorders, whatever label they were/are given, have been prevalent throughout the ages. He also countered controversial claims from a couple of decades ago which suggested that functional disorders had ‘gone away’, instead arguing that functional disorders have always been present.
In particular, Dr Stone focussed on the positive ways in which a functional diagnosis can now be made, and the fact that diagnosis should now concentrate on positive signs and symptoms as well as the exclusion of disease. He stressed that positive attitudes to patients with functional symptoms should be fostered, and that clinicians and healthcare professionals must appreciate how disabling and difficult symptoms are for patients. Furthermore, he added that empathetic consultation and care is critical to the diagnostic and treatment process. Dr Stone emphasised that patient groups can be very powerful in raising awareness and addressing the historical stigma associated with functional disorders, and that they play a vital role in advocating for treatment, care and addressing other critical issues.
The whole conference was fantastic, incredibly positive, philosophical and forward-thinking. The neurologists, neuropsychologists, psychologists and psychiatrists I spoke to do not want to put us in a box. They do not want to give us a label and make us feel like it’s ‘all in the head’ or that we have some sort of control over our symptoms or experiences. They understand that there are difficulties and problems with some of the terms and explanations used, and are working to improve delivery of diagnoses, diagnostic criteria and raise awareness of the very real conditions that are collectively considered to be ‘functional’. They are constantly considering, revising and working to improve outcomes and offer care and treatment that is acceptable, accessible and fair. For example, there is currently much interest in developing and providing specialist physiotherapy care and treatment and the improvement of referral pathways and service availability.
There is much support for FND Hope and patient organisations from many clinicians and researchers. They are unanimous in their wish and belief in furthering FND treatment, research and support. Many are already using tools such as the FND Hope website to help in their work with patients, providing a human aspect, helping us to appreciate that we’re not alone. It is a long, slow process, but we do have a voice, and there are many, many hugely supportive and accommodating people working for improvement, progress and the future. Interest in and an increasing awareness of clinical need for pathways of treatment and care for functional disorders is driving provision, research and clinical care.
With people like those at the BNPA, the incredible support of Dr Stone, Dr Nicholson and many others, I believe that there is a positive and pioneering movement for furthering the treatment and care of functional disorders. It may take time, but there is a keen interest and appreciation that much progress can be made.