“Like living in a house where somebody's constantly rearranging the furniture”: Narratives of receiving a Functional Neurological Disorder diagnosis

Background: Functional Neurological Disorder (FND) is a debilitating and poorly understood condition encompassing a range of neurological and physiological symptoms. The past century has seen large shifts in FND’s conceptualisation, away from its origins of hysteria and conversion disorder, however these understandings remain prevalent within healthcare. Despite being one of the most common neurological conditions in the UK, it remains mischaracterised in clinical settings and public awareness is minimal. Against this backdrop, the patient’s experience of FND is unclear. Aims: This study aims to explore how receiving a diagnosis of FND shapes patients' meaning-making of their experiences. The study seeks to illuminate the complexities of identity, explanations, and communication in FND, with the goal of informing more effective clinical practice. Methods: Fifteen persons who have been diagnosed with FND participated in semi-structured interviews in which they shared their stories with the researcher. These stories were then transcribed and analysed using both thematic and performative narrative analysis. Results: Four narrative types are identified in the data, Stories of Biographical Disruption, Stories of Inadequate Explanation, Stories of Stigma and Validation and Stories of Embodied Reinterpretation. Discussion: These narratives reveal the impact of diagnostic ambiguity and the resultant challenges to identity. Findings underscore the for greater legitimacy for FND in clinical and social contexts. Implications for clinical practice include the importance of meaningful explanations and the ethical responsibilities of healthcare professionals in supporting FND patients.