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Sunday, June 6, 2010

Dyslexia as Specific Psychological Disorder -Conversion Reaction Syndrome

Dyslexia as Conversion Reaction Syndrome
Some forms of Dyslexia & possibly related Learning Disabilities may be a kin to a psychological defense mechanism known as Conversion Reaction Syndrome (CRS). CRS is said to be a subconscious process by which deep emotional conflicts or fears which otherwise would give rise to considerable anxiety are disowned or put aside by converting them into an external expression of some type. This results in a feeling of detachment, which may appear as relaxed indifference – sometimes referred to as la belle indifference. This condition has been found in some dyslexics and in some persons with specific neurological damage. Denckla (1972), for example, identified a subtype of dyslexics that she called a “dyscontrol” group because they were “sweet, sloppy, and silly.” Satz & Morris (1981), and Lyon & Watson (1981) also have identified subgroups of dyslexics that have related “motivational and emotional” problems. Curiously, a similar form of indifference has been found in patients with right-hemisphere damage: they seem indifferent to the point of denial, of other severe symptoms of physical illness (Segalowitz, 1983, p. 215). There is no data to say whether these people also had any form of reading disorder.
Similarly, the CRS condition seems to arise when a deep conflict is converted to a form that symbolically represents the repressed ideas or repressing forces, whatever these might be. Examples of some typical child-centered fears and conflicts would include: fear of the parents’ learning of the child’s “intellectual; inadequacy” relative to excessive parental expectations; fears related to revelations about premature sexual interests, activity, abuse, or gender confusion; and fear that a family might break up without some crisis to hold it together. Consider now the symbolic meaning of reading. Reading generally symbolizes growing up and being responsible. The knowledge, insights, and universal truths it brings are supposed to help one face complex issues. But, sometimes a child is faced with an issue that appears bigger than life, one so insurmountable that it seems best to deny it? In order for denial- a fundamental defense mechanism of the ego - to be complete, and for life to go on, the problem must be converted or restructured into something less intrusive in the child’s life and more acceptable to public attention.
This syndrome tends to take either of two forms, one called Somatic Conversions typically result in the apparent loss of control over fundamental voluntary muscles (Laughlin, 1967). One example is the conflict experienced by the soldier who wishes to be brave and yet fears dying. Repression of the fear leads to a heightened anxiety level. Sensing that he or she might be near hysteria or likely to faint, the soldier subconsciously converts the repressed desire to run away into a psychologically saving illness or incapacitation, such as loss of control of the muscles in the legs which carry one to battle.
A similar condition can occur physiologically to involuntary muscles and functions. In these cases, so called organ (or vegetative) difficulties occur. These tend to incapacitate or delimit sensory awareness, resulting in apparent losses or distortions of vision, hearing, speech, and the like. These incapacities sound remarkably like the word reversals, semantic paralexics (word distortions), auditory discrimination problems, speech impediments, and visual problems that have been found to be associated with some reading and learning disabilities. The possible connection between these two sets of conditions is made clearer when the next two ideas are considered.

Substitution and Net Gain through Reading-Learning Dysfunction
Both somatic and physiologic conversion conditions become an alternate expression of the deeper repressed conflict or nagging problem. This substitution can serve several useful purposes for the person who is disabled. The student who is diagnosed as dyslexic, particularly the preteen whose life is largely influenced by parental rather than peer pressures, can win considerable attention from his parents while reducing his or her preoccupation with the true emotional conflict (whatever it might be), and do so at the relatively small inconvenience of simply not being able to read. This is known as an “endogain.” That is, a net gain arising from what seems, on the surface, to be a negative or liability.
In the case of dyslexia, the parents also are inconvenienced and made to feel guilty. In this way, the child’s problem is passed on to the parents, who not only bear the student’s pain but must wonder what in them may have created the disorder -- even to the point of feeling guilt about whether they have transmitted damaging genes. Further, the child not only (net) gains the attention of his parents but the outside assistance and empathy of teachers, doctors, and other specialists in resolving the symbolic problem. More importantly, hope of resolving the real problem is kept alive by those pressed into service to work on its symbolic representation. In brief, a learning disability such as dyslexia can provide several possible “endogains” for a troubled child: it can sharply reduce anxiety and pressure to resolve a difficult personal problem; it can win the assistance and empathy of many adults; and it offers the hope of resolving the real, or repressed, problem.

Diagnostic Indicators of CRS
There are six diagnostic indicators of psychologically induced dyslexia or learning disability. Three or more would provide telling evidence of this condition. 1) Considerable emotional gain from an apparent negative condition, or liability; 2) Evidence of generative learning in most areas other than reading, or whatever the specific disability might happen to be; 3) A logically inconsistent or unreliable pattern of errors on an Informal Reading Iventory, miscue analysis, or reading test battery; e.g., strong comprehension/weak vocabulary; or the inverse; 4) Reversal of sub-test scores on standardized tests, from one testing to the next (e.g., high Verbal/low Performance one time, low Performance/high Verbal another); 5) A look of relaxed, resigned indifference to the disability (''la belle indifference'' condition)
and, 6) If learning can be greatly accelerated with an essentially placebo treatment.
[[‘’’Clinical Evidence of Psychoneurotic Dyslexia & Learning Disabilities’’’]] Working from the premise that a reading dysfunction could be a symbolic representation for a deeper conflict, Manzo (1977) developed a simple test of this proposition. With 4 graduate students, they set out to try to teach two dyslexic students to read using a system which was identical to conventional reading but which they were told was recently invented for children who had special problems like theirs. They also were told that no one could really be sure that they ever would be able to read regular print, even if they learned the alternate system.
If they could be taught to read by this surrogate, but even more difficult system, it was reasoned, then it would not be logical to attribute their disability to a neurological impairment, but to some psychological explanation. They employed an alternate alphabet (Paul McKee’s funny squiggles [1948] that he used to show parents how difficult it is to learn how to read), Both youngsters had been in clinic programs for several continuous semesters and tested at primer levels. They were by all indications “severe dyslexics.”
Findings: Exceeding every expectation, the two children learned the new code more rapidly than their tutors, who had to work as a team to keep abreast of their rate of learning. In about 15 hours they were reading at about 3rd to 4th reader level in McKee’s alternate orthography. This rapid learning effect gave strong reason to believe that the children could learn to read, and rather easily, once their minds permitted them to do so.

Denckla, M. B. (1972).Clinical syndromes in learning disabilities: The case for "splitting" versus "lumping." Journal of Learning Disabilities, 5, 401-406.
Laughlin, H. P. (1967). The neuroses. Washington, D.C.: Butterworths Press.
Lyon, R., & Watson, B. (1981). Empirical derived subgroups of learning disabled readers: Diagnostic characteristics. Journal of Learning Disabilities, 14, 256-261.
Manzo, A.V. (1977) Dyslexia as specific psychoneurosis. Journal of¬ Reading Behavior, 19, 305-308]
Manzo, A.V.( 1987) Psychologically induced dyslexia and learning disabilities, The Reading Teacher, 40, 408-413.
Manzo, A.V & Manzo, U (1993) Literacy ¬Disorders: Holistic Diagnosis and Remediation. Harcourt, Brace, Jovanovich (1993).]]
Manzo, A.V & Manzo, U., & Albee, J.J. (2004) Reading/Learning Assessment for Diagnostic-Prescriptive Teaching, 2nd edition. Belmont: California, Thomson/Wadsworth Publishers
Peach, Richard (2006) Acquired dyslexia as conversion disorder: Identification and management. In Clinical Aphasiology Conference: * Clinical Aphasiology Conference (2006 : 36th : Ghent, Belgium : May 29-June 2, 2006)
Segalowitz, S. J. (1983).Two sides of the brain. Englewood Cliffs, NJ: Prentice-Hall


  1. This kind of syndrome is somewhat uncommon but indeed it happens to a lot of individuals. The problem is just people don't actually recognize the existence of the disorder.

  2. Bobby
    I think that we are in denial, CRS actually is the most common psychological disorder in the general public. Isn't it odd that none is found in schools?