- Understanding functional neurological disorder
- Historical context and terminology
- Media representation and public attitudes
- Clinical communication and patient experience
- Strategies for changing the narrative
Functional neurological disorder (FND) encompasses a range of neurological symptoms that are inconsistent with or cannot be explained by traditional structural neurological disease. These symptoms can include motor dysfunction, sensory changes, episodes resembling seizures, and difficulties with speech or movement. Although often misunderstood, FND is a genuine and disabling condition that affects an individual’s ability to function in daily life.
The nature of FND lies in the complex interplay between brain function and behaviour. Recent advances in neuroimaging and clinical studies indicate that these symptoms are not feigned or imagined, but rather result from alterations in the way the brain processes information. This understanding helps to bridge the gap between neurology and psychiatry, framing FND as a condition rooted in dysfunction rather than structural damage.
Raising awareness about FND is crucial for improving public understanding and patient care. Due to a lack of awareness, people living with FND often face stigma, disbelief, or assumptions of malingering, which can delay diagnosis and appropriate treatment. Miscommunication between health professionals and patients further compounds the issue, especially when terminology or explanations fail to convey the legitimacy of the condition.
Enhancing public understanding of FND requires clear, compassionate, and evidence-based communication. By educating health professionals, media outlets, and the general public about the nature of FND, we can build a more informed and supportive environment, in which individuals affected by the condition receive the respect and care they deserve.
Historical context and terminology
The evolution of language around functional neurological disorder (FND) reveals much about society’s shifting understanding and the complex interplay between medicine, psychology, and cultural attitudes. Historically, the symptoms now associated with FND were commonly described using terms like “hysteria” or “conversion disorder” — labels tied to outdated theories that often stigmatised patients, especially women. These terms were rooted in psychoanalytic thought, particularly the idea that psychological conflict could be “converted” into physical symptoms. While this provided an early attempt to make sense of FND, it also laid the groundwork for scepticism and misunderstanding that still affect public awareness today.
Throughout the 20th century, the medical field struggled to categorise FND, leading to a variety of terminologies that highlighted either psychiatric or neurological factors, but not both. For example, “psychogenic” implied a purely psychological origin, diminishing the neurological dimension of the disorder, while “non-organic” suggested an absence of physical pathology, often interpreted as implying that symptoms were not real. This terminological ambiguity contributed to confusion in both clinical communication and public interpretation, often reinforcing harmful stereotypes about patients exaggerating or fabricating their symptoms.
The shift towards adopting the term “functional neurological disorder” represents an effort to move beyond binary thinking and reflect contemporary understanding of the condition as a disorder of brain function rather than structural damage. Unlike earlier terms, “functional” accommodates the complex mechanisms at play, validating the seriousness of symptoms without attributing blame or intent. The use of more neutral and scientifically accurate language is an essential step in improving communication between healthcare professionals and patients, as well as promoting broader public understanding of FND.
Nevertheless, remnants of old terminology persist in some clinical settings and entrenched public attitudes. Patients often encounter confusion or scepticism when former labels are used, hindering appropriate care and contributing to feelings of invalidation. Efforts to modernise the language used in medical records, educational materials, and media reporting are crucial for reducing stigma and fostering an environment where individuals with FND can be treated with empathy and legitimacy. Language, in this context, is more than just description—it actively shapes perceptions and, by extension, the experience of those living with the condition.
Media representation and public attitudes
The media plays a significant role in shaping public understanding of medical conditions, and this is particularly true in the case of functional neurological disorder (FND). Yet, media coverage of FND remains limited, and when it does appear, the portrayal is often laden with misconceptions or stereotypes that undermine the legitimacy of the condition. Popular culture, including television dramas and news features, has at times depicted individuals with FND-like symptoms as either malingering or mentally unstable, fuelling public scepticism and impairing efforts to promote awareness and empathy.
This lack of accurate and nuanced representation contributes to a general misunderstanding of FND and can influence how patients are perceived by their families, employers, and even healthcare providers. In some cases, reports focus solely on dramatic recoveries or extreme cases, which, while compelling, fail to reflect the diverse spectrum of experiences among individuals living with FND. Sensationalist reporting may suggest that symptoms are easily reversible or purely psychological, thus marginalising those whose symptoms are persistent and disabling.
Furthermore, the media often draws on outdated terminology or imprecise descriptions, which can perpetuate confusion. Terms such as “psychosomatic” or “stress-related” are frequently used without clarification, reinforcing the idea that FND is not a legitimate medical condition. This form of communication, while perhaps unintentional, shapes public attitudes by framing the disorder in a way that questions the credibility of patients’ experiences.
In contrast, media outlets that provide balanced, evidence-based coverage of FND can play a powerful role in correcting misconceptions. Reporting that includes expert perspectives, patient voices, and current scientific understanding can help educate the public and challenge ingrained biases. Highlighting the neurological basis of FND and its complex relationship with psychological factors fosters a more informed and compassionate discourse.
Social media also presents both risks and opportunities in this regard. While misinformation can spread quickly, online platforms also offer a space for advocacy, peer support, and the sharing of lived experiences. Many patients and clinicians have taken to social media to raise awareness and advocate for improved resources, more accurate diagnosis, and respectful, informed communication. These efforts represent a grassroots movement aimed at transforming how FND is perceived and discussed in the public domain.
Ultimately, improving media representation of FND is essential for building public understanding and reducing stigma. Collaboration between journalists, healthcare professionals, and patient groups can lead to the development of content that is both informative and sensitive, ensuring that the stories told in the media reflect the realities faced by those living with FND. In doing so, the media can shift the narrative from one of doubt and dismissal to one of knowledge, empathy, and validation.
Clinical communication and patient experience
In clinical settings, the language used by healthcare professionals when discussing functional neurological disorder (FND) has a direct impact on patient experience, treatment engagement, and overall outcomes. Clear, empathetic communication is essential to validating the patient’s symptoms and promoting trust, yet many individuals with FND report feeling dismissed or misunderstood during medical encounters. The terminology employed—whether intentionally or not—can frame their condition either as legitimate and treatable or as vague and suspect. This has profound implications, not only for how patients interpret their symptoms but also for how they interact with the healthcare system as a whole.
Patients frequently face situations in which healthcare providers express uncertainty or use outdated language, such as “psychosomatic” or “hysterical,” which can carry connotations of blame or disbelief. Even phrases like “nothing wrong on the scan” or “it’s all in your head” can lead patients to feel that their suffering is minimised or invalidated. Such interactions may inadvertently reinforce the notion that their condition is not genuine, leaving patients feeling isolated and anxious, and potentially leading them to withdraw from care or seek unnecessary investigations. Conversely, when clinicians take the time to explain FND using current, evidence-based models that emphasise brain function and neurobiological mechanisms, patients are more likely to feel understood and empowered.
Developing communication strategies that are both scientifically accurate and sensitive to patient experience is crucial. This includes framing FND not as a diagnosis of exclusion but as a positive diagnosis based on identifiable clinical signs and symptoms. Emphasising the legitimacy of the disorder, while also acknowledging the complexity of its presentation, helps bridge the gap between the medical explanation and the patient’s lived experience. Ongoing training for clinicians in the language of FND, including how to address uncertainty and communicate hope, can greatly improve therapeutic relationships and treatment compliance.
Another key aspect of the patient experience is the role of interdisciplinary collaboration. Neurologists, psychiatrists, physiotherapists, psychologists and occupational therapists each contribute to a multifaceted understanding of FND. However, inconsistencies in communication between team members can lead to mixed messages, leaving patients confused about their diagnosis and the rationale for treatment. Structured care pathways and coordinated messaging across services enhance clarity and public understanding, ensuring that patients receive cohesive and consistent explanations throughout their treatment journey.
Patients with FND often become strong advocates for themselves, seeking out information and support networks to make sense of their condition in the face of clinical ambiguity. Increasing awareness about FND among clinicians, along with fostering strong communication skills, is essential for ensuring patients are not left to navigate this complex disorder alone. When clinical conversations are framed with empathy and accuracy, the medical encounter becomes not just a diagnostic process but also an opportunity to validate the patient’s reality, offer hope, and lay the foundation for recovery.
Strategies for changing the narrative
Changing the narrative around functional neurological disorder (FND) requires concerted efforts across multiple domains of society, particularly in healthcare, education, and media. One of the most immediate strategies involves improving communication and language used by health professionals. Training programmes that focus on person-centred communication can equip clinicians with the tools to explain FND in a way that validates the patient’s experience while providing clear, evidence-based information. Emphasising the role of functional brain processes, rather than attributing symptoms solely to psychological causes, can help dispel misconceptions and establish a strong foundation of trust between clinicians and patients.
Educational initiatives aimed at increasing awareness of FND in medical and allied health curricula are also essential. Including FND in training for neurologists, general practitioners, mental health professionals, physiotherapists and emergency department staff ensures that those on the front line of patient care are equipped to recognise and manage the condition with confidence and sensitivity. By embedding up-to-date understanding of FND into routine education, stigma can be addressed from the outset, contributing to a generation of practitioners who are both knowledgeable and empathetic.
Public understanding can also be significantly enhanced by updating informational materials in both clinical settings and the public sphere. Leaflets, websites, and patient support resources that describe FND using current clinical models and patient-centred language help to normalise the condition and reduce fear. These resources can serve as valuable tools not just for patients, but also for their families, employers, and educators, fostering a more inclusive environment in which people with FND are better supported to manage their symptoms and participate fully in society.
Collaboration with media creators offers another powerful avenue for change. Advising scriptwriters, journalists and content producers on the realities of FND ensures more accurate and responsible representations in television, documentaries, and news stories. Partnering with patient-led organisations in these efforts reinforces authenticity and introduces personal narratives that challenge stereotypes, making the condition relatable and human. Encouraging the media to highlight stories of ongoing treatment, meaningful recovery, and adaptive living rather than extremes or drama can help reset public expectations and promote a more nuanced understanding.
Social media campaigns, webinars, and awareness days are also effective platforms for reshaping discourse around FND. These platforms provide space for lived experience to be shared directly and for experts to engage in dialogue with broader audiences. Hashtag campaigns, educational videos and patient testimonials can shift perceptions by showing the realities of navigating life with FND—complex, varied, but very much real. When amplified through trusted voices, such content cultivates empathy and clears the path toward reducing stigma.
Policy and advocacy work must not be overlooked. Incorporating FND into broader mental health and neurological strategies within healthcare systems highlights its importance and ensures that funding, research, and service provision reflect the needs of those affected. By supporting policies that promote integrated care and parity of esteem between neurological and psychological conditions, stakeholders can institutionalise compassion and accuracy in how FND is perceived and addressed. These systemic changes, driven by informed communication and growing public awareness, are key to fostering a healthcare and societal landscape where people with FND no longer feel invisible, misunderstood or dismissed.
