To best assist a patient with a conversion disorder, which nursing intervention would be most effective?

Question

a. "Everyone has been focused on your blindness, but I would like to talk about your feelings and what emotions you were experiencing before this began.".
b. "I have looked at your test results and spoken with your doctor, and it appears that although your blindness seems real to you, it isn't.".
c. "Letting one's anger out all at once can be frightening, and that could make your blindness worse. Let's focus on some other topics instead.".
d. "Tell me more about your blindness: What exactly is it like for you, how does it affect you, and what is it like being blind all of a sudden?"

Answer 1

A
Shifting the focus from somatic symptoms to feelings and other underlying elements (e.g., stressors, unresolved conflicts) is most likely to have a positive effect on the conversion symptom. The blindness itself, although of psychogenic origin, is real; telling the patient that her experience is false destroys trust. Anger can be expressed therapeutically and when handled properly does not overwhelm the patient. Expressing and working through such feelings is more likely to be beneficial than ignoring or suppressing them. Seeking information about the blindness itself could provide secondary gains and does not help the patient to cope more adaptively.