CNS Spectrums

Case Report

Bypassing Shame and Conversion Disorder

Robert G. Bota c1, Walter F Ricci and Adrian Preda


We report a case of conversion disorder (partial aphonia) that was successfully treated with speech therapy. During the one year duration of this illness, the patient regained transiently (minutes) her normal speech on a few occasions, independently of concomitant pharmacological interventions. One year after recovery she developed aphonia for the second time, which responded again to speech therapy, although the response rate was slower. Several mechanisms of conversion disorder are reviewed as specifically applied to this case. The possible role of pertinent shame mechanisms in the conversion pathology is discussed.

(Received March 11 2009)

(Accepted July 17 2009)

(Online publication October 01 2010)


c1 Correspondence: Robert G. Bota, MD, Kaiser Permanente, Psychiatry Department, 2055 Kellogg Avenue, Corona, CA 92879; Tel: (951) 898-7010, Fax: (951) 898-7178; E-mail:

Dr. Bota is a staff psychiatrist at Kaiser Permanente in Corona, CA, and assistant clinical professor of psychiatry at the University of Missouri Kansas City.

Dr. Ricci is professor of psychiatry at the University of Missouri Kansas City and training and supervisor analyst at the Greater Kansas City Psychoanalytic Institute.

Dr. Preda is Health Sciences Associate Professor of Psychiatry and Human Behavior at UC Irvine.


Faculty Disolosures: The authors report no affiliations with or financial interests in any organization that may pose a conflict of interest.

Acknowledgements: To my mentor, Dr. Stuart Munro for scientific review and critical suggestions.