Functional neurological disorders: the common ground of early development, neuroscience and psychoanalysis. Reply to Solms

This paper discusses Mark Solms' article “Function in Functional Neurological Disorders: The Common Ground of Neuroscience and Psychoanalysis,” on the phenomenon of FND. It is done from the child psychiatrist's perspective, focusing on insights from child development that can contribute to Solms' reflection. It specifically addresses three points. Starting from the notion of “lesion of ideas,” it examines the respective roles of sensation and idea within the theoretical framework Solms employs, namely predictive coding. The author proposes, as Breuer and Freud did, that FND is primarily and essentially a pathology of reminiscence rather than of ideas. This position is supported by demonstrating that there are not just one but several identified mechanisms for symptom production, three of which Freud had already described. These descriptions are supported by FND cases observed in children and adolescents. Finally, the author discusses the question of homeostasis: should it be considered from the perspective of the biological system of the individual, or from that of the developing subject within the early dyadic matrix necessary for survival? Developmental insights provide essential perspectives for understanding FNDs, rehabilitating an approach based on sensorimotor and early childhood experiences.