A patient has been diagnosed as having blindness related to conversion disorder. She displays indifference regarding the conversion symptom. The nurse states, "I can't understand why the patient doesn't seem more anxious about her symptom."

Question

Which explanation from the Clinical Nurse Specialist would enable the nurse to understand the patient's behavior? a. The patient is suppressing her true feelings. She is upset but is not showing it.
b. The blindness is actually helping the patient by reducing her anxiety.
c. Her needs are met during hospitalization, so she has no need to be anxious.
d. She is controlling her own anxiety through partial denial of the blindness.

Answer 1

B
Psychoanalytical theory suggests conversion reduces anxiety through production of a physical symptom that is symbolically linked to an underlying conflict. Conversion, not suppression, is the operative defense mechanism in this disorder. Although hospitalization may be meeting some needs, it is likely insufficient to be compensating for the original stressor or conflict that underlies the blindness. "Controlling her own anxiety through partial denial" is inherently contradictory because it implies that denial is a conscious act, when it is unconscious.