Conversion: Fact or Chimera?

Abstract

For nineteenth century psychiatrists, especially in France, dissociation was viewed as the basic mechanism responsible for the formation of hysterical symptoms. To explain how dissociation occurred, Freud advanced the concept of repression and proposed that hysterical symptoms arose from the conversion of repressed psychic excitations into somatic symptoms. The notion of conversion has since become synonymous with hysteria and has been extended to include processes mediated over the autonomic as well as the sensori-motor nervous system. It is suggested that conversion is an unnecessary hypothesis involving untestable theories of energy transformation, that preoccupation with the concept has diverted scientific attention from the phenomena of dissociation, and that through renewed investigation of the latter will come further understanding of brain-behavior correlations and the genesis of psychosomatic symptoms.