Could He Be Faking His Illness?

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I recently met a student, Matt (not his real name) who explained to me that his final examinations were in a few weeks’ time and he was having difficulty concentrating during his revision. I was about to give some usual advice as a student counsellor such as reducing screen distractions, observing sleep hygiene and using different learning and memory techniques, until I saw him cringing in pain.

He explained that whenever he has to focus, especially during revision, a shooting pain would start from the base of his spine, spreading throughout his back and end at the base of his head. He has tried various types of painkillers, prescribed and over-the-counter medications from the pharmacy, but no amount of medication could ease his pain. With the level of pain that he was having (10 out of 10 in the pain scale), it made going to classes and sitting for examination impossible.

At the first instance, my thoughts went along the lines of “he is just making this up to escape his examinations…” or perhaps, “this could be one of his attention-seeking strategies.”

I continued and asked if he had undergone any consultation with medical professionals or gone for medical tests. Apparently after going through multiple medical tests, the results came back inconclusive and he couldn’t get an official diagnosis for his condition. Some experts used the term “psychosomatic” or medically unexplained symptoms.

What Matt was experiencing could be termed as conversion disorder, also known as functional neurological disorder. This condition may happen because of a psychological conflict where the brain and the body are unable to send and receive signals properly . Studies have estimated that 20 to 25% of patients in general hospital setting have individual symptoms of conversion disorder such as blindness, paralysis, inability to speak or swallowing difficulties . But it may be difficult for us to clearly identify someone who is affected by this condition in our day-to-day setting, such as in Matt’s case. The “invisibility” of this condition makes it harder for his teachers or his school’s student support team to discover his need for medical support.

The best course of action for Matt will be to find a suitable treatment, which could range from physical therapy, counselling, effective relaxation strategies or medication .

From the conversation I had with Matt, it was revealed to me that even if medical tests do not reveal any anomalies in a person, it does not necessarily mean that irregularities aren’t there.

Our way forward is to not assume that people with unexplainable conditions are merely imagining things or making things up. Having an awareness that such disorders exist is a start.