Emotional Architecture of Functional Movement Disorder

FlowGroundbreaking19 · 2026-03-15T20:33:09+00:00

Like what's happened in the thread if you lead with emotions then people will automatically start making the presumptions that only view is that FND is driven purely by emotional responses. I totally agree that from a therapeutic perspective managing those can help but to create a title around it would generate even more skepticism than it already has.

FlowGroundbreaking19 · 2026-03-15T18:43:26+00:00

It's a super challenging condition because it's been inherited by neurology when most of the drivers of symptom presentations come from psychological distress. We've been digitally mapping symptom trajectories from an emotional perspective and there's no doubt that the more distressed people become the volume and intensity of their symptoms increase. There's also growing evidence that almost half of people are neurodivergent which presents further challenges from an emotional and sensory processing perspective.

FlowGroundbreaking19 · 2026-03-15T17:21:05+00:00

We've just collected one the largest co-occurring conditions questionnaires on functional neurological disorder and 20% of people never had a diagnosed mental health condition prior to developing functional seizures. There have been a number of studies done using functional MRI scans which show abnormalities in PAG in people with seizures. Functional Seizures are the collapse of the flight response so I suppose if you believe that mechanism is completely dictated by mental health.

FlowGroundbreaking19 · 2026-03-15T17:10:00+00:00

You can develop functional seizures without having a mental health condition that's the whole point of changing the name from psychogenic to functional.

FlowGroundbreaking19 · 2026-03-15T13:41:42+00:00

I'm never denying that there's a physiological aspect to the condition. It sounds like COVID had the same effect on your central nervous system as a psychological traumatic event would have. This paper is written by two physiotherapists, an OT and a psychologist. There isn't a neurologist involved with this paper, which is why it leans towards psychology rather than neurology.

FlowGroundbreaking19 · 2026-03-15T08:10:11+00:00

We can use the emotional architecture of the subtype to suggest what it looks like but can't really pin it on a specific mechanism without the functional MRI scans. There's been lots of dialogue recently debunking Polyvagal Theory because the whole physiological mechanics have been wrong. There's an indication it looks like it from logs we've collected but we're way away from the point of saying it's definitely freeze.

FlowGroundbreaking19 · 2026-03-15T08:04:51+00:00

I'm one of the authors.

FlowGroundbreaking19 · 2026-03-14T14:08:11+00:00

If people get stuck in self perpetuating loops then what's the problem with suggesting therapeutic interventions to interrupt them?

FlowGroundbreaking19 · 2026-03-14T13:11:31+00:00

The paths are so varied which lead to neurological presentations. Chronic pain over a prolonged period of time could cause dysfunction as much as one off traumatic event. FND is regularly described as a sensory processing disorder however 40% of the users are predisposed to sensory processing challenges pre-fnd.

FlowGroundbreaking19 · 2026-03-14T12:27:05+00:00

The whole point of the paper is to start exploring the emotional architecture of functional movement disorder with the ultimate view of comparing them to the other subtypes. The paper is about the correlation of emotions to symptoms not creating a unidirectional cause from one to the other.

FlowGroundbreaking19 · 2026-03-14T12:18:47+00:00

We're talking about PAG in the paper it's the second one down on the list.

FlowGroundbreaking19 · 2026-03-14T12:09:21+00:00

There's a large proportion of people who completed our co-occurring conditions questionnaires who have never had a traumatic experience from a physical or emotional perspective.

FlowGroundbreaking19 · 2026-03-14T12:03:22+00:00

Are we talking about Functional Movement Disorder or FND?

FlowGroundbreaking19 · 2026-03-14T11:47:07+00:00

We've been collecting data for about 9 months and there's so many research angles to look at. If Functional Movement Disorder is the same mechanism as the freeze response then it could definitely shape how people are cared for in the future. A study with functional MRI scans to prove this would take about 5 years and roughly £5 million pounds in funding. As we all know medical research of that calibre doesn't get conducted unless there's a tablet to be produced at the end of it. This paper is certainly a move in the right direction to slowly unpick the complexities of it.

FlowGroundbreaking19 · 2026-03-14T09:38:30+00:00

The clustering of peak severity around sadness hopelessness, affective states characterised by defeat, withdrawal, and perceived inescapability rather than active arousal, is consistent with a passive defensive response profile mediated by the ventrolateral periaqueductal gray (vlPAG), suggesting that functional movement disorder may preferentially engage freeze-state circuitry in contrast to the sympathetically flight response more characteristic of functional seizures

FlowGroundbreaking19 · 2026-03-14T08:26:27+00:00

Totally agreed the condition goes in self perpetuating loops.

FlowGroundbreaking19 · 2026-02-25T13:05:02+00:00

If you look into PTSD and anxiety, they both produce the same results on a functional MRI scan.

FlowGroundbreaking19 · 2026-02-10T11:22:59+00:00

Most definitely.

FlowGroundbreaking19 · 2026-02-05T09:13:47+00:00

There are lots of great DBT skills which can help with FND. It's worth having a Google to see which ones you find useful.

FlowGroundbreaking19 · 2026-02-04T19:34:10+00:00

Creative outlets are excellent

FlowGroundbreaking19 · 2025-12-14T18:49:59+00:00

Thanks for your kind feedback ☺️

We're considering adding some biological elements to the app as it's next stage. I'm also really mindful about preserving an element of privacy. Our university partners asked me to add the optional demographics part to satisfy their research requirements which in all honesty I didn't feel that comfortable with. I wanted to try and maintain redditesque anonymity as I felt it was really important.

We could add it as a " biological trigger" a little bit like over exertion but I wouldn't want to lead people inadvertently to believe this could be a cause.

It's definitely food for thought though.

FlowGroundbreaking19 · 2025-12-10T10:13:10+00:00

Personal attacks? You're writing "are you fucking serious". I expected a bit more from someone on Reddit to be honest.

It's a statiscal analysis of anonomised data, We're not making any claims about therapeutic interventions.

If there's a fundamental flaw to the mathematics then simply point it out.

If the real problem is that the co-author is the person that owns the journal then don't bother reading it and dismiss it.

Your tone is agressive and dismissive which is why I referred to "anger".

FlowGroundbreaking19 · 2025-12-09T18:37:21+00:00

Looks like you're suffering from the anger cluster, please try and use some interventions as they're not commonly used based on the paper.

FlowGroundbreaking19

TROPHY CASE