Anger In PNES & FND

People talk a lot about FND, PNES and whether it's physical, psychological or something in between. But what they don't often talk about is anger! Anger can exist in PNES/FND either because of the hidden trauma (some people do acknowledge trauma as part of their experience), medical gaslighting or just the frustration of living with PNES or FND* So let's talk about that today. What this article Will cover : 

• Anger from hidden trauma
• Notes for medical professionals on Anger from Hidden Trauma
• Anger from Medical Gaslighting
• Notes for medical Professionals on medical Gaslighting
• Anger from living with FND/PNES
• Notes for medical professionals, families and carers on anger resulting from living with FND 

The Fire in the Machine: Navigating Anger, Trauma, and Dignity in FND and PNES

Introduction: The Silent Furnace

There is an unspoken rule handed to people with chronic illness, and it is especially rigid for those living with Functional Neurological Disorder (FND): stay agreeable. Be the good patient. Keep calm, practice your breathing exercises, don’t cause a fuss, and whatever you do, don't get angry. Anger, we are repeatedly warned, will only flare up our symptoms.

What nobody tells you is that for many of us, the anger was already there—long before the limbs stopped working, the non-epileptic seizures took hold, or the tremors began.

It wasn't an anger made of raised voices or slammed doors. It was an anger born of survival: a silent, subterranean fury that was never allowed to speak because speaking up wasn't safe. It was an anger forced underground into the physical tissues of the body, waiting decades for a voice. And when that suppressed fire finally meets a medical system that dismisses your symptoms, questions your sanity, and wraps clinical cruelty in patronising smiles, that quiet ember becomes an inferno.

Living with FND and its commodities means carrying a compounded burden: the silent somatic rage of old, unexpressed survival, alongside the fierce, entirely justified fury of being systematically disbelieved and left without support. It is time we stopped running from that anger, stopped pathologising it as a moral flaw, and began listening to what it is desperate to tell us.

Part 1: When Anger Goes Silent — Hidden Trauma and the Physical Body

When we think of anger, we tend to picture noise: raised voices, clattering dishes, or sharp words. But when it comes to hidden trauma and FND, anger often doesn’t look like anger at all.

It looks like paralysis. It looks like a tremor that won’t settle, a sudden seizure, agonising muscle rigidity, or crushing fatigue.

The anger hasn’t vanished; it has simply lodged itself directly into the physical structure of the body.

Often, this happens because at the exact moment the original trauma or chronic adversity occurred, expressing anger was impossible. Perhaps you were a child, dependent on the very people causing harm. Perhaps standing up for yourself, shouting, or fighting back would have invited further danger, abandonment, or retaliation. In that moment of survival, the nervous system made an intelligent, split-second executive decision: It is not safe to feel this, and it is certainly not safe to show this.

So, the emotion is suppressed before it even reaches conscious thought. It gets walled off. Over time, that blocked survival energy doesn't dissipate; it settles into tissues, neural pathways, and the autonomic nervous system. You may go years or decades completely disconnected from it, unable to even recognise or name what is trapped inside.

When FND develops, well-meaning advice often points straight to distraction techniques: Do a puzzle, ground yourself with 5-4-3-2-1, redirect your mind. While distraction has its place in acute symptom management, it has a serious limitation. If distraction is all we ever do, it merely reinforces the body’s oldest habit: avoiding the true emotion. It keeps the physiological lid clamped on the pressure cooker.

As modern somatic work and anger coaching remind us, we cannot heal what we refuse to feel. If anger has transformed into physical symptoms, we have to meet it at the physical level.

Crucially, this does not mean you have to excavate or relive your trauma.

You do not need to replay past horrors to release the survival energy they left behind. Instead, through gentle body-scanning and somatic awareness, the work is simply to tune in and let the body feel the physical sensations of that pent-up charge in the present moment. Where is the constriction? Where is the heat, the tight band around the ribs, the vibration in the belly?

When you sit with that physical sensation without rushing to numb or distract from it, you give the emotion something it has never had before: permission to exist safely. At the exact moment that internal state is finally acknowledged, it stops needing to broadcast itself as a neurological symptom. It stops being a rogue physical malfunction and transforms back into an active, recognisable emotion—one you can finally process, express, and let go.

"When anger is forced underground by survival, it doesn’t disappear. It lodges in tissue, locks muscles, and waits decades for a voice."

Notes for Medical Professionals: The Danger of Premature Attribution

• Do Not Assume Conversion Disorder: FND is a complex neuro functional condition, not an automatic synonym for classical Freudian conversion disorder. While some individuals do have symptoms tied to trauma and suppressed emotional states, many do not. It is up to the patient to discover, experience, and communicate whether psychological or emotional factors are relevant to their illness—it is never for the clinician to assert or project it as a foregone conclusion. Assuming an emotional origin invalidates those whose triggers are purely physical (injury, viral illness, structural vulnerability) and damages trust.
  
  
• Premature Psychological Framing Can Be Dam aging: Even in cases where symptoms are functioning as a somatic conversion of suppressed emotional trauma, telling a patient "this is your hidden anger" or "this is psychological" can be profoundly destabilising. The mind converts emotion into physical symptoms specifically because the conscious self and the nervous system were not ready or safe enough to experience that emotion. Forcing an emotional label onto a patient strips them of their pacing and agency.
  
  
• Assess the Environment for Real Safety: If a patient's symptoms are acting as a subconscious s    hield against intolerable emotions like rage or terror, asserting that reality when they are still living in an -, volatile, or emotionally unsafe environment can be disastrous. If they are still in the very conditions that necessitated the suppression in the first place, stripping away their defence mechanism leaves them completely exposed.
  
  
• Support Pacing and Patient Ownership: The nervous system must feel safe first—both internally and externally—before it can safely allow walled-off emotions to surface. Clinicians must allow the patient to maintain total control over when, how, and if they explore somatic or emotional connections. Provide a safe, non-judgemental container, validate their physical reality, and let the patient lead the narrative.
  
  
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Part 2: The Stolen Blueprint — Anger, Loss, and the Daily Reality of FND and PNES

Beyond the trauma of the past and the sting of medical disbelief, there is another well of fury that runs deep and constant: the sheer, grinding reality of living inside a body that has suddenly rewritten the rules.

On any given day with Functional Neurological Disorder or Psychogenic Non-Epileptic Seizures (PNES), you do not get to decide how your body shows up. You might wake up with plans, energy, and determination, only for your legs to go entirely dead as you try to stand up from bed. You might drop your morning cup of tea because a sudden tremor or functional jerking takes over your hand. You might be in the middle of a sentence, a meeting, or a quiet moment with your family, when a seizure drops you to the floor—leaving you concussed by sensory overload, unable to speak, cognitively stranded in a fog that takes hours or days to clear.

The unpredictability is its own trauma. You cannot schedule it. You cannot plan around it.

Then comes the quiet isolation.

Friends stop asking you out because cancellations become the norm. Relatives—even well-meaning ones—offer hollow advice: "Have you tried drinking more water?" "You just need to push through it," or the devastating classic, "Well, you looked fine yesterday." When family cannot grasp that a functional illness is variable by its very nature, their scepticism cuts deep. Support systems you spent a lifetime building can crumble overnight. The people who promised to stand by you often quietly drift away when they realise this is not a short-term crisis with a neat recovery arc.

To live with FND is to be thrust into an uninvited, non-linear process of profound grief. We often hear about the stages of grief in bereavement, but chronic illness brings its own bereavement—the mourning of the healthy self and the life you expected to lead:

• Denial: "This is just a temporary flare-up. If I sleep for two days, it’ll reset." You push through the warning signs, desperately trying to force the old machinery to work, pretending the blueprint hasn't torn.
  
  
• Anger: "Why me? Why now?" The white-hot fury at the sheer injustice of it all. Anger at your nervous system for betraying you, anger at friends who vanished, anger at a world that is built entirely for the able-bodied, and rage at every dream, milestone, and career plan that has been interrupted or stolen.
  
  
• Bargaining: "If I follow this strict diet, take these supplements, never complain, and stay completely calm, maybe my body will give me back my life." You try to negotiate with an unpredictable nervous system just to claw back a shred of control.
  
  
• Depression: The crushing reality sinks in. The realisation that life has fundamentally changed. The despair of facing empty calendars, lost financial independence, and the profound sadness of watching peers move forward while your life feels suspended in amber.
  
  
• Acceptance: Not a passive surrender, but an active, grounded reality check: "This is my body's current language. I must learn how to navigate life from here, rather than fighting a war against myself."
  
  
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Anger throughout this grief is not dysfunctional. It is healthy. It is the recognition that what happened to you matters, that the life you were building was valuable, and that having that trajectory abruptly fractured by an unpredictable illness is an enormous, legitimate loss.

Notes for Medical Professionals: Moving Beyond "Triage and Abandon"

• Dismantle the Binary Mindset: Stop treating FND as if it requires a moral verdict. These patients are not malingerers looking for an easy out; nobody chooses the terrifying, isolating reality of non-epileptic seizures, limb weakness, or chronic functional disability. Dismissing them as "fakers" or "attention-seekers" is an abdication of clinical responsibility.
  
  
• Early Multi-Agency Support is Not "Enabling": There is a pervasive, harmful myth in some medical circles that providing early practical aids—wheelchairs, walking frames, adaptive equipment, or social care—will "reinforce the illness behaviour" or "fix the functional deficit in place." This is demonstrably false and actively cruel. Denying a patient mobility aids or home modifications does not cure their functional pathways; it traps them in their bedrooms, accelerates de-conditioning, destroys their mental health, and cuts them off from society. Early intervention, adaptive equipment, and occupational therapy enable living. They restore agency, reduce panic, and provide the baseline safety needed for any functional rehabilitation to actually work.
  
  
• Recognise Acute Vulnerability and Systemic Loss: When an individual is diagnosed with FND, their support network frequently implodes. Friends disappear, partners buckle under carer strain, and jobs are lost. They become acutely vulnerable adults. Clinicians must look beyond the reflex hammer and evaluate the human being sitting in the consulting room: Are they safe at home? Can they feed themselves? Can they access the bathroom? Who supports them after a seizure?
  
  
• Fulfil Your Statutory and Human Rights Obligations: Healthcare professionals have an obligation to safeguard vulnerable individuals under domestic disability frameworks and human rights law. This means proactively initiating referrals rather than leaving the patient to drown in administrative red tape:
  
  
• Occupational Therapy (OT): For functional aids, home assessments, and pacing strategies that preserve independence.
  
  
• Social Services and Local Authority: For statutory Care Act assessments, direct payments, and respite support to prevent carer breakdown.
  
  
• Housing and Benefits: Providing clear, unambiguous medical evidence for disability benefits (such as PIP) and accessible housing adaptations, without hedging or downplaying the severity of functional impairment.
  
  
• Family Education: Bringing family members into the room to explain what FND and PNES actually are, countering the damaging narrative that the patient is "putting it on" or "could do it if they tried."
  
  
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• "Early mobility aids and social support do not ‘enable’ illness behaviour. They enable living."

Part 3: The Burn of Betrayal — Medical Gas-lighting and the Fury of the Unheard

If hidden trauma is the quiet ember sitting beneath FND, medical gaslighting is the fuel poured directly onto the fire.

For countless individuals, the anger tied to FND isn't just about losing bodily control or coping with past adversity; it is a direct, justified reaction to how they were treated by the very system they turned to for help. Long before an accurate diagnosis is ever reached—and often long after—patients find themselves navigating an obstacle course of closed doors, guarded glances, and whispered clinical scepticism.

Medical gaslighting occurs when healthcare providers deny, minimise, or manipulate a patient's lived physiological reality. In FND, this gaslighting has a particularly cruel texture:

• Eroding Your Sense of Reality: When your legs give out, your speech slurs, or your limbs shake uncontrollably, and a specialist looks you in the eye and implies—or outright says—that "there is nothing physically wrong," it creates severe cognitive dissonance. It forces you to question your own senses, your sanity, and your basic perception of reality. That deliberate undermining of truth is the textbook definition of gaslighting, and the human response to having your reality dismantled is profound, visceral rage.
  
  
• Trickery and Covert Testing: Too many patients report being "tricked" during examinations. Distraction tests or Hoover’s sign checks, when performed without transparent explanation, can feel less like clinical diagnostics and more like a hostile "gotcha!" game. Being observed covertly or having a doctor smugly declare that your leg worked when you weren't looking doesn't bring relief; it feels like an accusation of fraud. It is deeply condescending and humiliating.
  
  
• Ridicule and Medical Trauma: At its worst, medical gaslighting crosses into overt mockery. Patients have been left on hospital floors, spoken about as if they are invisible, or subjected to patronising remarks by staff who cling to outdated, dis-proven dogmas about "hysteria" or malingering. This is not just poor bedside manner; it is clinical bullying. It inflicts acute medical trauma on an already devastated person.
  
  
• Echoes of Past Trauma: What makes this specific anger so combustible is that medical gaslighting frequently mimics the exact dynamic of interpersonal trauma. If an individual has a history of emotional neglect, boundary violations, or being silenced by an authority figure, walking into a clinic only to be dismissed, patronised, and manipulated re-opens that original wound with surgical precision. The system repeats the abuse: You are making this up. You are dramatic. You are the problem.
  
  

The anger that stems from this experience is not a "symptom" of a psychiatric disorder. It is the natural, healthy defence mechanism of a human being whose dignity has been violated. It is the righteous outrage of someone who sought sanctuary and found contempt.

"The Hoover’s sign and entrainment tests are clinical tools to understand functional pathways—not traps to catch a liar."

Notes for Medical Professionals: Integrity, Transparency, and the Oath to Do No Harm

• "Do No Harm" Extends to Psychological Safety: The Hippocratic commitment to do no harm does not end when structural imaging comes back clear. Words, cynical body language, and deceptive clinical maneuvers cause measurable harm. Inflicting psychological distress, shame, and isolation on a vulnerable patient violates the core ethics of medicine. You can break a patient’s spirit and derail their neurological recovery with a single dismissive consultation.
  
  
• Ditch the "Gotcha" Mentality: Diagnostic signs like Hoover’s sign or entrainment tests are clinical tools to demonstrate positive signs of functional weakness and variability—they are not traps to catch a liar. When assessing a patient, speak with wholeness and total transparency. Explain what you are testing, why variability occurs in functional movement, and how the brain's attention networks interact with motor pathways. When you treat diagnostic testing as collaborative rather than covert, you build trust instead of triggering defensiveness.
  
  
• Examine Your Own Prejudices: Every clinician must honestly audit their internal biases toward functional disorders. Do you internally roll your eyes when an FND patient appears on your ward list? Do you view them as "time-wasters" or assume they are feigning illness for secondary gain? If so, you are practising from an outdated, unsupported paradigm. If you cannot approach an FND patient with the same objective compassion and respect you would give a patient with Parkinson’s or multiple sclerosis, you are actively failing that patient.
  
  
• Recognise the Risk of Re-Traumatisation: Even if you subscribe to the view that an individual's specific presentation involves conversion dynamics, consider this: an individual whose nervous system has been pushed to the point of severe physical conversion has almost certainly lived through extreme invalidation, mockery, or unsafe pracitises. If your clinical approach involves condescension, scepticism, or trickery, you are not treating them; you are reproducing the very conditions that fractured their nervous system in the first place.
  
  
• Speak with Wholeness and Honesty: Patients do not expect you to have every answer, but they require you to be honest. If you are uncertain, say so. If tests are normal, frame that as good news regarding structural integrity while fully acknowledging the reality of their functional disability. Never speak behind a patient's back in ways you would not speak to their face. Treat them as a whole, sentient human being whose physical distress deserves uncompromising dignity.
  
  

Part 4: Releasing the Pressure Valve — Somatic Practices to Discharge Anger Safely

When anger has spent years disguised as muscle spasms, paralysis, or neurological misfires, traditional anger management advice—like punching a pillow, venting aggressively, or forcing a high-intensity workout—can backfire spectacularly. For an already sensitised nervous system living with FND, high-adrenaline release can trigger severe symptom flare-ups, non-epileptic seizures, or profound exhaustion.

The goal isn't an explosion. The goal is completion. We want to signal to the autonomic nervous system that the threat has passed and that the emotion has finally been received.

Here are gentle, grounded somatic practices to help trapped anger move through the body safely:

1. The Somatic Witness: Body Scanning Without an Agenda
   
   
   Instead of scanning your body to "fix" a symptom or distract yourself from discomfort, practice scanning purely as an impartial witness. Find a fully supported position so your body feels completely held. Locate where tension, heat, or density is gathering. Drop the mental narrative or memory attached to it; simply place a gentle hand over the area if comfortable and say internally: "I feel you. You are allowed to take up space here." Acknowledging the physical sensation for even 60 to 90 seconds without rushing to suppress it allows the autonomic charge to begin de-escalating.
   
   
2. Isometric Pushing: Mobilising Survival Energy Safely
   
   
   Anger is fundamentally a "fight" or boundary-setting impulse that was arrested mid-action. You can allow the muscles to complete that protective movement without raising your heart rate or risking physical strain. Sit firmly against a wall or place your palms flat against a sturdy table or door-frame. On an exhale, press firmly into the surface at about 40–50% of your maximum effort. Notice the boundary of your body pushing back against a solid surface. Hold for 5–10 seconds, then slowly release with a long, unhurried exhale. This allows the motor pathways to enact the protective impulse of "pushing away" an intrusion without overwhelming the system.
   
   
3. Low-Frequency Vocal Toning: Releasing the Clenched Throat
   
   
   Suppressed anger very often constricts the throat, jaw, and diaphragm—the exact places where words, shouts, or cries were held back to stay safe. High-pitched screams can be dys-regulating, but low-frequency sound stimulates the vagus nerve and soothes the nervous system. Inhale gently into the belly and lower ribs. On the exhale, make a deep, low humming sound, an extended "voo" sound, or a low growl from the base of the throat. Focus your attention entirely on the physical vibration buzzing in your lips, jaw, and chest cavity. That vibration physically breaks up muscular holding patterns in the airway and signals safety to the brain-stem.
   
   
4. The Micro-Tear and Scribble: Externalising the Charge
   
   
   If you feel an internal agitation or restless frustration that you cannot put into words, give your hands a safe, tangible task. Take a piece of scrap paper or an old magazine page. Rather than writing neatly, use a pencil or crayon to press down firmly and scribble out the physical intensity of the feeling, focusing on the friction of the paper. Alternatively, slowly and deliberately tear the paper into tiny, precise strips. It is a controlled physical output for tension without raising adrenaline.
   
   
5. Rationing: Stopping Before the Crash
   
   
   The golden rule of somatic release with FND is rationing—taking things in tiny, manageable sips rather than trying to clear decades of emotional backlog in one sitting. If you feel your neurological symptoms starting to amplify—such as tremors quickening, vision blurring, or dizziness creeping in—pause immediately. Return your attention to neutral physical anchors: the feeling of your feet on the carpet, the temperature of the air on your hands, or a cool sip of water. Remind yourself: We are not in a race. Allowing your body to feel 5% of its anger today without crashing is a massive neurological victory.
   
   

• "Distraction has its place, but if that’s all we ever do, it just keeps the physiological lid clamped on the pressure cooker. We cannot heal what we refuse to feel."

Conclusion: Reclaiming Anger as an Ally

Healing the relationship between anger and FND is not about learning how to suppress it more effectively. Suppression is the exact mechanism that brought our nervous systems to their knees in the first place.

If anger has taken up residence in your body, it is because it once had nowhere else to go. Honouring that truth does not require you to rip open old wounds or relive the traumas that silenced you. It simply asks that you meet your body where it is right now—giving the tight jaw, the racing pulse, and the clenched ribs permission to exist without being shoved back into the dark with endless distractions. When anger is acknowledged as a physical reality rather than feared as a monster, it stops needing to commandeer your motor pathways just to be felt. It ceases to be an erratic symptom and transforms back into what it was always meant to be: a clean, protective emotion.

For the medical community, the mandate is straightforward and urgent. True healing cannot occur in an environment of suspicion, mockery, and covert testing. The oath to "do no harm" must encompass psychological dignity. When clinicians stop playing gatekeeper to a patient's reality and instead offer transparent, wholehearted integrity and practical multi-agency support, they remove the very invalidation that fuels this fire.

Your anger does not make you broken. It does not make you difficult, and it does not make your neurological symptoms imaginary. Often, it is the healthiest part of you—the part that knows you deserved safety then, and the part that demands dignity now. When we finally stop fighting our anger, we can let it put down its weapons, step out of the shadows of the nervous system, and help guide us back home to ourselves.

"Your anger does not make you broken, and it does not make your neurological symptoms imaginary. Often, it is the healthiest part of you—the part that knows you deserved safety then, and demands dignity now."

Lorraine Kashdan is the author of the book: Building Your FND Survival Toolkit Edition 2: A Holistic Approach available on Amazon and other reliable bookstores: https://amzn.eu/d/0gpXXein
She is also the author of the book Living Well with NEAD/PNES: A Wobbly Workbook Available on Amazon Here
And FND Hero: Dynamic Ideas For Children and Young People With Functional Neurological Disorder

(disclaimer:  This article was compiled with the help of AI)