Unconscious conversion of tension or psychological conflict into physical discomfort or symptoms. The least serious form of conversion is well known: headache, intestinal disorders and fatigue as a result of tension. If a patient responds to psychological problems physically, refusing to accept a cause of mental origin, the condition is known as emotional hyperaesthesia or neurosis. The mental conflict may be so serious that it cannot be consciously acknowledged, and is replaced by physical symptoms. Patients who react in this way are certainly not pretending; they are genuinely paralysed for example, or cannot speak or see, even though there is no physiological cause. This is seen particularly in hysteria. Specific examples are paralysed arms in an aggressive patient, blindness in cases of guilt or shame (’not being able to look at it-) and a frog in the throat or complete loss of voice in cases of difficulty in self-expression. A physical approach to these problems is pointless.

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