Conversion
Conversion has been explained with many definitions and concepts from past to present. The oldest definition made is BC. It goes back to 1900. In the sources of Egyptian Civilization, while the symptoms of conversion were mentioned as the wandering of the uterus in the human body, it was only in the seventeenth century that it was revealed that the uterus is not a disorder caused by different movements in the human body. In the years Hippocrates lived, the Greeks used this word in their writings by deriving the word hysteria from the root of the word hysteria, which is the equivalent of the word womb. In the medieval period, it was thought that hysteria would be more related to demonic features and evil spirits. These patients were believed to be people who practiced magic, they were perceived differently by the society and were excluded. Again in the same period, the "Saint-Guy Dance" in the form of ensemble hysteria was understood as the patients' selling their souls to the devil, and this led to the burning of the patients by being thrown into the fire (Alpat, 2017). It was determined that the disorder emerged due to some psychological reasons. Again, Freud, the founder of Psychoanalysis, used the word "Conversion" in the text for the first time to emphasize the bodily effects of suppressed thoughts in a sexual and aggressive nature. According to Freud, it reduces anxiety by transforming this conflict into a physical form in order to avoid the feeling of anxiety caused by the conflicts between the unconscious and motivation. He put forward the thesis that physical and mental symptoms occur. Conversion Disorders, which are included in the current modern psychiatry diagnosis system, are expressed as a specific disorder with one or more neurological symptoms that cause loss of physical functionality along with psychological friction and inhibitions. Experts in the field of psychiatry have argued that Dissociative Dissociative Similar items between the disorder share more similar causality processes depending on the overlaps with the Somatoform Disorder. According to DSM IV, Conversion Disorder is a functional disorder that is not accompanied by a neurological disorder, cannot be manifested by other medical conditions or substance abuse, is associated with psychological effects, does not occur on purpose, is not fixed by pain or sexual dysfunction, and is clearly distressed or distressed. It was also emphasized that it causes weakening of functionality in social, occupational and different areas (Uğuz, 1998). is the table. It manifests itself when a spiritual struggle or need that is not directly verbalized disrupts the physical functionality of the individual. There are those who see Conversion Disorder as a reaction that every individual encounters in a part of their life or as a symptom that can be seen in almost every psychiatric disorder, as well as those who see it as a reaction against socioeconomic reasons and close association with education (Uğuz, 1998). p>Primary and Secondary Gains of Conversion
Psychodynamic Approach Conversion symptoms are processes that help resolve unconscious pressures and conflicts. While the impulses suppressed by the superego cause the individual to be exposed to conflict, another sign of Conversion is explained by making it a symbol of this conflict. Through the manifestations of the conversion, the individual can make an analogy with the disappearing generation. As a result of conversion symptoms, the feeling of relaxation experienced by the individual with very little expression of the suppressed impulse is stated as the primary gain. As a result of the conversion symptoms, the person is perceived as sick and weak by the society and the environment, and the patient's environment strives to show interest and concern. The interest that the individual receives from his environment and this pleasure from the outside world is called secondary gain. Occurrence of symptoms occurs due to primary gain, and the continuation of the disease occurs due to secondary gain (Doğan, 2007).
In fact, the primary gain is to get rid of the anxiety caused by the psychological disorder of the individual. In other words, another situation arises because the person's brain cannot face the pain caused by the psychological problem he is experiencing. This is also about suppression. If this mechanism did not work, every individual would have to experience the effects of traumatic events as they are at every moment. While the main motive in factitious disorder is to adopt the patient role and to provide medical evaluation and treatment, there are more specific purposes in simulation such as getting monetary compensation, avoiding duty, avoiding legal proceedings or providing medication. These purposes may be similar to the secondary gain in Conversion Disorder (Öztürk,2016). In addition, it has been observed that there is a sensitivity to verbal persuasion in patients with Conversion Disorder and that this situation can be used in therapy (Moene et al. 2003). A large proportion of individuals identified with Conversion Disorder want to maintain their status soon and maintain their vague affect on ending. Here, this complaint is expected to be resolved by preventing secondary gains with operational therapies and reinforcing it in order to repeat the correct action. A conscious effort should be made to end this complaint.
Case Case
Physical teacher Hasan Bey is always in conflict with his mother-in-law and puts his thoughts on the other side. He thinks that his feet are on fire because he cannot convey it completely. In the face of this situation, Hasan Bey is seen as sick, so his mother-in-law does not argue or conflict with him.
Id: "Hasan, you can say anything that comes to mind."
Ego: "You can tell your mother-in-law what's inside within the framework of logic. .”
Superego: “You should take your mother-in-law from the ground, no matter what she says, no matter what she says.”
Because of this situation, by emphasizing the point of tendency to verbal suggestion, making an effort to treat the individual with behavioral therapy and transforming it into behavior desired standing and walking behavior� It was suggested that he could be successful and have a say in his complaints. It has been observed that verbal communication patterns and cry for help may be present in people who have difficulty in expressing or making sense of their bodily symptoms, and the course of the disease can be effective thanks to their secondary gains (Pehlivantürk 1996).
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