Beyond the medical encounter: can the free association narrative interview method extend psychosocial understandings of non-epileptic attack disorder?

Authors:
Marian PeacockEdge Hill University, UK

Search for other papers by Marian Peacock in
Current site
Google Scholar
Close
,
Jon M. DicksonUniversity of Sheffield, UK

Search for other papers by Jon M. Dickson in
Current site
Google Scholar
Close
,
Paul BissellUniversity of Chester, UK

Search for other papers by Paul Bissell in
Current site
Google Scholar
Close
,
Richard GrunewaldUniversity of Sheffield, UK

Search for other papers by Richard Grunewald in
Current site
Google Scholar
Close
, and
Markus ReuberUniversity of Sheffield, UK

Search for other papers by Markus Reuber in
Current site
Google Scholar
Close
Restricted access
Get eTOC alerts
Rights and permissions Cite this article

This exploratory interdisciplinary study was devised to explore how using the free association narrative interview (FANI) method might extend understanding of non-epileptic attack disorder (NEAD) within a psychosocial framework. NEAD is the medical definition of what can be described as embodied events that resemble epilepsy, but which are not associated with the abnormal electrical discharges in the brain found in epilepsy. They are the most frequent ‘functional’ disorder or medically unexplained symptom (MUS) seen by neurologists.

While NEAD is associated with trauma, distress and negative life events, a significant minority of patients report no trauma history. The FANI method, we argue, produced narratives which shed light on events that patients have not acknowledged as traumatic, but which might be considered as such, and we explore what aspects of the method may facilitate this process. Previous work has highlighted that a diagnosis of NEAD is often experienced as deeply troubling and contentious to both give and to receive. We thus reflect on the need for patients to feel a sense of legitimacy and how the challenges of living with a NEAD diagnosis are negotiated.

Drawing on the work of on ‘thirdness’, we suggest that the FANI method can allow the research interview to become a space that facilitates novel ways of engaging around NEAD. We conclude that the method may be a powerful tool for studying NEAD, and that further studies should be undertaken using this approach since it may have broader utility in understanding the landscape of functional neurological disorders.

  • Bauman, Z. (2013) The Individualized Society, Chichester: John Wiley & Sons.

  • Benjamin, J. (2004) Beyond doer and done to: an intersubjective view of thirdness, The Psychoanalytic Quarterly, 73(1): 546. doi: 10.1002/j.2167-4086.2004.tb00151.x

    • Search Google Scholar
    • Export Citation
  • Capri, C. and Swartz, L. (2018) ‘We are actually, after all, just children’: caring societies and South African infantilisation of adults with intellectual disability, Disability & Society, 33(2): 285308. doi: 10.1080/09687599.2017.1409102

    • Search Google Scholar
    • Export Citation
  • Carton, S., Thompson, P.J. and Duncan, J.S. (2003) Non-epileptic seizures: patients’ understanding and reaction to the diagnosis and impact on outcome, Seizure, 12: 28794. doi: 10.1016/S1059-1311(02)00290-X

    • Search Google Scholar
    • Export Citation
  • Dickinson, P. and Looper, K.J. (2012) Psychogenic nonepileptic seizures: a current overview, Epilepsia, 53(10): 167989. doi: 10.1111/j.1528-1167.2012.03606.x

    • Search Google Scholar
    • Export Citation
  • Dickinson, P., Looper, K.J. and Groleau, D. (2011) Patients diagnosed with non-epileptic seizures: their perspectives and experiences, Epilepsy & Behavior, 20(3): 45461.

    • Search Google Scholar
    • Export Citation
  • Dickson, J., Peacock, M., Grünewald, R., Howlett, S., Bissell, P. and Reuber, M. (2017) Non-epileptic attack disorder: the importance of diagnosis and treatment, BMJ Case Reports, [published online ahead of print, February 2017], doi: 10.1136/bcr-2016-218278.

    • Search Google Scholar
    • Export Citation
  • Fairclough, G., Fox, J., Mercer, G., Reuber, M. and Brown, R.J. (2014) Understanding the perceived treatment needs of patients with psychogenic nonepileptic seizures, Epilepsy & Behavior, 31: 295303.

    • Search Google Scholar
    • Export Citation
  • Fiszman, A., Alves-Leon, S.V., Nunes, R.G., D’Andrea, I. and Figueira, I. (2004) Traumatic events and posttraumatic stress disorder in patients with psychogenic non-epileptic seizures: a critical review, Epilepsy & Behavior, 5(6): 81825.

    • Search Google Scholar
    • Export Citation
  • Fox, R.C. (1980) The evolution of medical uncertainty, The Milbank Memorial Fund Quarterly. Health and Society, 149. doi: 10.2307/3349705

    • Search Google Scholar
    • Export Citation
  • Freud, S. (1924 [1896]) The Aetiology-of-Hysteria, Vol 1, pp 183221. https://icpla.edu/wp-content/uploads/2012/10/Freud-S.-Aetiology-of-Hysteria-C.P.-vol.1-1924-p.183-221.pdf

    • Search Google Scholar
    • Export Citation
  • Gadd, D. and Jefferson, T. (2007) Psychosocial Criminology, Thousand Oaks, CA: Sage Publications.

  • Garfield, S., Reavey, P. and Kotecha, M. (2010) Footprints in a toxic landscape: reflexivity and validation in the free association narrative interview (FANI) method, Qualitative Research in Psychology, 7(2): 15669. doi: 10.1080/14780880802626665

    • Search Google Scholar
    • Export Citation
  • Goldstein, L.H., Robinson, E.J., Mellers, J.D., Stone, J., Carson, A. et al. (2020) Psychological and demographic characteristics of 368 patients with dissociative seizures: data from the CODES cohort, Psychological Medicine, 51(14): 243345. doi: 10.1017/S0033291720001051

    • Search Google Scholar
    • Export Citation
  • Goleva, S.B., Lake, A.M., Torstenson, E.S., Haas, K.F. and Davis, L.K. (2020) Epidemiology of functional seizures among adults treated at a university hospital, JAMA Network Open, 3(12): e2027920e2027920. doi: 10.1001/jamanetworkopen.2020.27920

    • Search Google Scholar
    • Export Citation
  • Greenhalgh, T. (2016) Cultural contexts of health: the use of narrative research in the health sector, in Health Evidence Network Synthesis Report No.49, Copenhagen: WHO Regional Office for Europe.

    • Search Google Scholar
    • Export Citation
  • Harris, P. (2019) Uneasy bedfellows? Fusing participatory and psychosocial principles in research with youth workers and young people, Journal of Psychosocial Studies, 12(3): 24557. doi: 10.1332/204378919X15674407381128

    • Search Google Scholar
    • Export Citation
  • Hoggett, P., Beedell, P., Jimenez, L., Mayo, M. and Miller, C. (2010) Working psycho-socially and dialogically in research, Psychoanalysis, Culture & Society, 15(2): 17388. doi: 10.1057/pcs.2009.36

    • Search Google Scholar
    • Export Citation
  • Hollway, W. (2001) The psycho-social subject in evidence-based practice, Journal of Social Work Practice, 15(1): 922. doi: 10.1080/02650530120041975

    • Search Google Scholar
    • Export Citation
  • Hollway, W. and Jefferson, T. (2013) Doing Qualitative Research Differently: A Psychosocial Approach, 2nd edn, London: SAGE Publications.

    • Search Google Scholar
    • Export Citation
  • Ludwig, L., Pasman, J.A., Nicholson, T., Aybek, S., David, A.S. et al. (2018) Stressful life events and maltreatment in conversion (functional neurological) disorder: systematic review and meta-analysis of case-control studies, The Lancet Psychiatry, 5(4): 30720. doi: 10.1016/S2215-0366(18)30051-8

    • Search Google Scholar
    • Export Citation
  • McKenzie, P., Oto, M., Russell, A., Pelosi, A. and Duncan, R. (2010) Early outcomes and predictors in 260 patients with psychogenic Non-epileptic attacks, Neurology, 74(1): 649. doi: 10.1212/WNL.0b013e3181c7da6a

    • Search Google Scholar
    • Export Citation
  • Monzoni, C.M., Duncan, R., Grunewald, R. and Reuber, M. (2011a) Are there interactional reasons why doctors may find it hard to tell patients that their physical symptoms may have emotional causes? A conversation analytic study in neurology outpatients, Patient Education and Counseling, 85(3). doi: 10.1016/j.pec.2011.07.014

    • Search Google Scholar
    • Export Citation
  • Monzoni, C.M., Duncan, R., Grunewald, R. and Reuber, M. (2011b) How do neurologists talk about medically unexplained symptoms? A conversation analytic study, Journal of Psychosomatic Research, 71(6): 37783. doi: 10.1016/j.jpsychores.2011.09.007

    • Search Google Scholar
    • Export Citation
  • Myers, L., Trobliger, R., Bortnik, K. and Lancman, M. (2018) Are there gender differences in those diagnosed with psychogenic nonepileptic seizures?, Epilepsy & Behavior, 78: 1615.

    • Search Google Scholar
    • Export Citation
  • Nettleton, S. (2006) ‘I just want permission to be ill’: towards a sociology of medically unexplained symptoms, Social Science & Medicine, 62(5): 116778.

    • Search Google Scholar
    • Export Citation
  • Nettleton, S., Watt, I., O’Malley, L. and Duffey, P. (2005) Understanding the narratives of people who live with medically unexplained illness, Patient Education and Counseling, 56(2): 20510. doi: 10.1016/j.pec.2004.02.010

    • Search Google Scholar
    • Export Citation
  • Novakova, B., Harris, P.R., Ponnusamy, A. and Reuber, M. (2013) The role of stress as a trigger for epileptic seizures: a narrative review of evidence from human and animal studies, Epilepsia, 54(11): 186676, doi: 10.1111/epi.12377.

    • Search Google Scholar
    • Export Citation
  • Peacock, M., Bissell, P. and Owen, J. (2014) Dependency denied: health inequalities in the neoliberal era, Social Science and Medicine, 118: 17380. doi:10.1016/j.socscimed.2014.08.006

    • Search Google Scholar
    • Export Citation
  • Plug, L., Sharrack, B. and Reuber, M. (2009) Seizure, fit or attack? The use of diagnostic labels by patients with epileptic or non-epileptic seizures, Applied Linguistics, 31(1): 94114. doi: 10.1093/applin/amp012

    • Search Google Scholar
    • Export Citation
  • Rawlings, G.H. and Reuber, M. (2016) What patients say about living with psychogenic nonepileptic seizures: a systematic synthesis of qualitative studies, Seizure, 41: 10011. doi: 10.1016/j.seizure.2016.07.014

    • Search Google Scholar
    • Export Citation
  • Rawlings, G.H., Brown, I., Stone, B. and Reuber, M. (2017) Written accounts of living with psychogenic nonepileptic seizures: A thematic analysis, Seizure, 50: 8391, doi: 10.1016/j.seizure.2017.06.006.

    • Search Google Scholar
    • Export Citation
  • Reuber, M. and Brown, R.J. (2017) Understanding psychogenic nonepileptic seizures-Phenomenology, semiology and the Integrative Cognitive Model, Seizure, 44: 199205. doi: 10.1016/j.seizure.2016.10.029

    • Search Google Scholar
    • Export Citation
  • Reuber, M., Howlett, S., Khan, A. and Grünewald, R.A. (2007) Non-epileptic seizures and other functional neurological symptoms: predisposing, precipitating, and perpetuating factors, Psychosomatics, 48(3): 23038, doi: 10.1176/appi.psy.48.3.230.

    • Search Google Scholar
    • Export Citation
  • Reuber, M., Rawlings, G.H., Schachter, S.C. eds. (2018) In Our Words: Personal Accounts of Living with Non-Epileptic Seizures (The Brainstorms Series), Oxford: Oxford University Press.

    • Search Google Scholar
    • Export Citation
  • Salmon, P. (2007) Conflict, collusion or collaboration in consultations about medically unexplained symptoms: the need for a curriculum of medical explanation, Patient Education and Counseling, 67(3): 24654. doi: 10.1016/j.pec.2007.03.008

    • Search Google Scholar
    • Export Citation
  • Scaer, R. (2014) The Body Bears the Burden: Trauma, Dissociation, and Disease, London: Routledge.

  • Silverman, D. (2011) Interpreting Qualitative Data: A Guide to the Principles of Qualitative Research, London: SAGE Publications.

  • Stenning, A. (2018) Feeling the squeeze: towards a psychosocial geography of austerity in low-to-middle income families, Geoforum, 10: 20010.

    • Search Google Scholar
    • Export Citation
  • Stone, J., Carson, A., Duncan, R., Roberts, R., Warlow, C., Hibberd, C. et al. (2010) Who is referred to neurology clinics?--the diagnoses made in 3781 new patients, Clinical Neurology and Neurosurgery, 112(9): 74751. doi: 10.1016/j.clineuro.2010.05.011

    • Search Google Scholar
    • Export Citation
  • Thompson, R., Isaac, C.L., Rowse, G., Tooth, C.L. and Reuber, M. (2009) What is it like to receive a diagnosis of nonepileptic seizures?, Epilepsy & Behavior, 14(3): 50815.

    • Search Google Scholar
    • Export Citation
  • Van Campen, J.S., Jansen, F.E., De Graan, P.N., Braun, K.P. and Joels, M. (2014) Early life stress in epilepsy: a seizure precipitant and risk factor for epileptogenesis, Epilepsy & Behavior, 38: 16071.

    • Search Google Scholar
    • Export Citation
  • Vicario, S., Peacock, M., Buykx, P., Meier, P.S. and Bissell, P. (2021) Women’s informal surveillance of alcohol consumption in intimate heterosexual relationships during the early parenting period, Social Science & Medicine, 291: 114499.

    • Search Google Scholar
    • Export Citation
  • Werner, A. and Malterud, K. (2003) It is hard work behaving as a credible patient: encounters between women with chronic pain and their doctors, Social Science & Medicine, 57(8): 140919.

    • Search Google Scholar
    • Export Citation
Marian PeacockEdge Hill University, UK

Search for other papers by Marian Peacock in
Current site
Google Scholar
Close
,
Jon M. DicksonUniversity of Sheffield, UK

Search for other papers by Jon M. Dickson in
Current site
Google Scholar
Close
,
Paul BissellUniversity of Chester, UK

Search for other papers by Paul Bissell in
Current site
Google Scholar
Close
,
Richard GrunewaldUniversity of Sheffield, UK

Search for other papers by Richard Grunewald in
Current site
Google Scholar
Close
, and
Markus ReuberUniversity of Sheffield, UK

Search for other papers by Markus Reuber in
Current site
Google Scholar
Close

Content Metrics

May 2022 onwards Past Year Past 30 Days
Abstract Views 394 353 10
Full Text Views 1360 1309 30
PDF Downloads 677 643 11

Altmetrics

Dimensions