This presentation will center on video review of an initial consultation session with a 10 year old Muslim girl presenting with symptoms of Functional Neurological Disorder, admitted for Long-Term Video-EEG Monitoring at the Comprehensive Epilepsy Center at the University of Rochester Medical Center. Seen with her mother for this initial interview, she began to experience her seizure prodrome when describing the experience of witnessing the physical abuse of her mother by the patient's father. She responded surprisingly well to an invitation to portray the feelings arising within her in an imagined unleashing of them upon her father, with resulting resolution of the seizure prodrome and significant reduction of her symptoms immediately thereafter, with complete remission achieved after several follow up sessions. Also of interest is how the therapist responds to the mixed reaction of the patient's mother to hearing her daughter's violent portrayal, which she found troubling given the family's strong religious values. Mother's response reminds us of the importance of attending to what might be called the Unconscious Therapeutic Family Alliance, without which child therapy will be impeded by loyalty conflicts. The video illustrates an approach to resolving religious obstacles to ISTDP treatment that involves conveying respect for and affirmation of the family's deeply held values an simultaneously explaining how the goals of therapy are fundamentally supportive of those values.
