When the diagnosis of PNES is made it indicates that the seizures are of a psychological origin rather than a physiological one as in the case of epilepsy. The seizures are a symptom of an underling disorder such as dissociative or conversion disorder. This places the responsibility for treatment on those with psychological and psychiatric training. But there have been many instances of these professionals refusing to treat patients with PNES due to lack of experience and knowledge.
When a psychotherapist witnesses a seizure in their presence many will suspect that they are epileptic seizures. PNES are often indistinguishable from ES. This leads them to refer the patient back to the medical community which referred them to the psychotherapist. Frustrating, expensive and damaging to say the least. But if the diagnosis of PNES has been made then the therapist must help the patient to heal. They don’t have the right, in my opinion, to turn away the patient because they may be uncomfortable with seizures. These are normal symptoms and must be treated in an understanding and compassionate way.
This is why it is important that the one who makes the original diagnosis should be a part of helping the patient find psychiatric care. They should help the therapist understand that the seizure may look like a physiological symptom but it’s not. And most importantly they must be made to understand that the seizures are not fake or voluntary. They are real seizures, but not of physical causes.
This gets to one of the biggest problems in PNES treatment: Psychotherapists are often not accepting the diagnosis. And while patients will sometimes have great difficulty accepting the diagnosis, it’s the therapist who can help them to do so. Their training must include recognizing and working with those who have flashbacks and “psychogenic” nonepileptic seizures. Dissociation and conversion is in the domain of the psychological community and they must take responsibility and ownership of PNES and start helping patients find widely accessible treatment. I stand ready to help them in this goal and urge them to contact me at firstname.lastname@example.org for more insight into PNES.