Physical Problems Can Arise from the Subconscious

In part one and part two of this blog series I introduced “Nolan,” a 15-year-old who developed vocal cord dysfunction (VCD) as a reaction to having had suicidal thoughts a year before I met him. He suffered from the resultant daytime breathing problems for the subsequent year. Through my interactions with his subconscious, Nolan learned how to think differently about the events that led to his suicidal thoughts.

His breathing became normal for a few days but then he developed short-term memory loss, which may have been a substituted symptom for his breathing difficulties.

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His subconscious explained that Nolan had again started thinking about his suicidal thoughts when he returned to school and recalled a classmate who had committed suicide by hanging. Nolan confided in his parents that he had nearly hung himself the previous year, and also that he was disturbed by a YouTube video he had seen related to suicide by hanging.

At his next visit with me, I reassured him that he was on track to feeling better as he was better addressing the psychological stressors that had led to development of his symptoms. Thereafter, his breathing became normal again and he regained his memory.

Blurry Vision

Two days later, Nolan awoke in the middle of the night. His parents woke up as well and saw that he was heading to the bathroom. He told them that he could not see because his vision was dark and blurry. When he awoke in the morning he still could not see and was unable to do his schoolwork or read. He had no further breathing problems or memory loss.

In a telephone call, I explained to his parents that Nolan’s vision difficulties were likely the result of functional neurological disorder, which is also known as a conversion disorder. In Nolan’s case this likely represented another symptom substitution. Nolan told his parents that he wished his subconscious had picked another type of symptom.

Indeed, when Nolan returned to see me three days later his subconscious explained that it ensured Nolan’s vision became blurry so that he could not see phone cords or air vents that would have reminded him of his suicidal thoughts of the previous year. Nolan reiterated that he had no current suicidal thoughts.

In his usual state of awareness, Nolan was able to recollect more details about the events related to his suicidal ideation. He recalled that he felt sad and hopeless as his medical condition at that time was not explainable by anyone, and as someone told him that his breathing problems were related to epiglottitis, which can be a lethal disease.

Nolan told me he had viewed the video about hanging several times so that he would learn how to tie a knot around his neck. He said that he recorded a good-bye video on his phone. He said he had placed a noose around his neck on five different nights, but kept hearing a voice telling him not to go through with it. He said he could not understand why he felt so badly that he had contemplated suicide.

We discussed that Nolan’s subconscious may have been the part of him that told him to stay alive. I pointed out that Nolan might focus on the fact he did not go through with attempting suicide rather than thinking about how he almost did. He said he had never considered that viewpoint. His subconscious said his vision would clear the next day, and then it would decide whether Nolan needed further protection.

Deafness

Nolan’s vision cleared up with an hour of his visit with me. He told his parents that his subconscious said they should not stress him because it could cause his vision problems to recur. Two days later, Nolan got into an argument with his father because he wanted to go over to a friend’s house that evening, but his parents wanted him to stay home until he was more stable. While his father remained as calm as possible, the argument continued and then Nolan lost his hearing.

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His mother asked Nolan how he could regain his hearing and Nolan pointed to his left ear. His mother asked the subconscious to help resolve Nolan’s deafness. His father then apologized and gave Nolan a hug. A few moments later Nolan’s hearing returned. He said his subconscious had made him deaf so that he would not become too stressed and think again about his suicidal thoughts.

Paralysis

Nolan felt fine the next day, and played basketball without difficulty. However, that night he told his parents he again became scared of vents and cords. He went to take a shower and then called his parents because he found that he was unable to move his arms or hands. His father helped him get out of the shower and get dressed.

Nolan said his subconscious wanted him to explain what was going on to his parents. Nolan explained that as it was Sunday night he was again concerned about going to school the following day, and being reminded of his classmate’s suicide. He said that the reason his subconscious did not allow him to use his arms was to protect him from attempting to hang himself.

His parents reminded him that he was still learning on-line. The subconscious left it up to the parents to decide whether Nolan should be blind, deaf, unable to move his arms, or have memory loss. When they suggested that he not move his arms Nolan became uneasy, and they agreed that he could lose his memory temporarily.

When I saw Nolan two days later at his scheduled follow-up appointment, I suggested that Nolan’s subconscious stop interacting with his parents as they are not therapists. Instead, I suggested that he could e-mail me and I would discuss what might be done with his parents. Further, I suggested that Nolan can desensitize himself to the idea that he once harbored suicidal thoughts by thinking about them.

Good Health

Two days later, Nolan’s subconscious told him that it would expose him all night to the memory of his suicidal thoughts. Nolan slept restlessly that night, and awoke at 1 am. At that time, Nolan approached his father, called him by his first name (which was unusual) and told him that by morning he would be fine.

Nolan felt well the next morning and was able to touch his phone cord and the vent in his room without difficulty. He saw me later that day, and his subconscious told me that Nolan was cured. It gave Nolan the advice to enjoy life and to live it to the fullest.

Over the next 6 weeks there was only one other incident when Nolan lost his hearing briefly. Nolan was playing basketball when he overheard older kids who were playing on the adjacent court. When he got home, he told his parents he could not hear. At their request, his subconscious explained that he heard an older kid say sarcastically, “If I don’t land this, I’m done. I’m going to kill myself.” The subconscious said he let Nolan hear this for a while and then turned off his hearing. It promised his parents never to do that again.

During the following half year of follow-up Nolan had no further issues. He was happy to reconnect with his friends, and returned to fishing, surfing, and club soccer. He told his parents that he was happy to be living a “regular boy” life.

Discussion

There are many lessons to learn from Nolan’s unusually complex case.

• Nolan became scared when he developed his allergic reactions to peanuts, which included hives and breathing difficulties. As he did not improve within a couple of weeks, he suffered and felt hopeless, which led to his suicidal ideation. Until he began therapy, he avoided dealing with the trauma of nearly committing suicide, and his fears that he could feel suicidal again. Perhaps, focusing on the physical discomfort related to his VCD, allowed Nolan to avoid dealing with his emotions.
• I suspect that if Nolan had been referred for treatment with hypnosis and counseling earlier in the year his symptoms would have resolved earlier. Thus, I believe that patients with non-exercise related VCD might be referred for psychological therapy concurrent with on-going medical evaluations.
• Nolan’s lack of response to relaxation with hypnosis alone was not surprising, since his VCD symptoms were persistent throughout the day.
• When a patient presents with a functional symptom, such as VCD, it can represent a form of “body talk.” For example, a patient who is having problems with the vocal cords might reflect a situation in which the patient does not want to say something, or to describe a trauma involving the throat, such as turned out to be the case with Nolan.
• Interactions with the subconscious allowed Nolan to tell me some of what was bothering him, at a time when he was unable to consciously consider the events that traumatized him. This is a common occurrence in patients with functional disorders. I believe hypnosis provides a unique tool to help such patients start dealing with their underlying issues.
• I used the “theater technique” with Nolan’s subconscious to help him first recall what had happened to him. Techniques that distance traumatic events by imagining them to be separate from the patients, such as viewing them on a screen, permit patients to have better control over their memories. In contrast, suggesting the patients imagine themselves to be within a traumatic event can become too emotionally intense.
• During interactions with his subconscious, my reinforcement that his subconscious can safely communicate with me outside of Nolan’s awareness may have helped him disclose more information that helped guide his therapy.
• The negotiations with Nolan’s subconscious about what might be disclosed to Nolan and his family, as well as what symptoms Nolan should maintain, permitted Nolan and his subconscious to feel more in control of his situation. Thus, these became steppingstones to his healing.
• It is important to recognize how patients can be profoundly affected when they take in medical information from their health care provider or the Internet. In Nolan’s case, he reported that he became despondent when someone suggested that his breathing problems might be related to epiglottitis, which Nolan thought could be lethal. Also, Nolan kept in mind what his father had told him about suicide and hell. Thus, his thoughts about his suicidal ideation likely worsened because of his interpretation of what he had been told.
• When Nolan addressed his father by his first name in the middle of the night, I suspect that this represented communication between Nolan’s subconscious and his father.
• It took several weeks of therapy for Nolan to be able to disclose fully to himself and his family what had occurred. A clinician dealing with complex functional symptoms should be prepared to work slowly and deliberately with the affected patients, in order to permit time for integration of the dissociated parts of the traumatic experience. Often, it is helpful to allow the patients to pace their own therapy.
• Ultimately, it turned out that Nolan was not only worried about his near suicide experiences, but also was very concerned that he could feel the same way again. His functional symptoms finally resolved only after he had learned how to sufficiently process and integrate the traumatic events.
• It is impressive and instructive that Nolan’s subconscious was able to repeatedly explain the reasoning for his various symptoms. While Nolan expressed dislike of many of his functional symptoms, I think it was of comfort for him to learn that his subconscious was protective of him. This could have given him confidence in proceeding with the therapy.
• I believe that many patients with functional neurological disorders that can cause memory loss, blindness, deafness, or paralysis as occurred with Nolan can similarly benefit greatly from accessing their subconscious.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7 dial 988 for the National Suicide Prevention Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.