“Breaking the News” of a Functional Movement Disorder

Clinicians often struggle to successfully share a diagnosis of a functional movement disorder (FMD) with the patient and their family or friends, and patients often report negative and harmful experiences. In this chapter we explore various aspects of communication with respect to FMD. We conclude that many communication barriers arise from the clinician and society, rather than the patient and are amenable to change with cognitive reframing. There is no ‘one size fits all’ approach to sharing the diagnosis, a process which should ideally be tailored to the patient’s individual assessment. We reflect that there is no reason to treat the sharing of information about functional neurological disorder (FND) any differently to other disorders in neurology or psychiatry; with a transparent approach that names the condition, explains something of mechanism and how the diagnosis has been made. Indeed, many difficulties seem to arise because clinicians break the normal rules of communication by emphasising what the patient doesn’t have or jumping too early to aetiological presumptions. We discuss the issue of prognosis and the challenges of special scenarios. We conclude that successful sharing of an FMD diagnosis is a process worthy of reflection and research, and a crucial first step in triage and/or further treatment.