Tics of the Saints: On Conversion Disorder, Mental Illness, and Searching for a Voice

On the gendered aspect of conversion disorder, how it might have historically manifest in nuns and mystics, and the strange comfort of being diagnosed.

Sometimes it’s real.

But I shouldn’t put it like that.

I should say: Sometimes, this overwhelming urge to move, the way my muscles ache to twitch and flail and shake—the medical term is akathisia, Greek for “can’t sit still”—sometimes it can be traced to a definite somatic cause. I recently had to adjust my psychiatric medications, and the new mood stabilizer had me buzzing like a hive of bees, full to the brim with restless but useless energy. It’s a common side effect of atypical antipsychotics. Most likely, it will fade.

At other times over the past year, the same symptoms have shown up for other reasons, reasons that don’t make so much sense: poor sleep, for instance. Adding or subtracting meds of any kind—even not having enough coffee has set me off. Usually, it can be chalked up to “stress,” that nebulous and privileged affliction; of course, stress doesn’t cause seizures. So these aren’t real seizures. This isn’t real.

But I shouldn’t put it like that.

*

At a French convent, sometime during the Middle Ages, a nun started meowing. And then another, and another—until the abbey and the whole neighborhood was treated to a daily concert of meows, lasting hours; this was attributed to demonic possession at the time, as cats were known consorts of the Devil.

In fifteenth-century Germany, at another convent, a nun began compulsively biting her companions, and this behavior spread as well; in 1749, a nunnery in Würzburg, the sisters were plagued by screaming and fits until a suspected witch’s execution.

These days, the same sort of pattern shows up in teenage girls, like the eighteen in Le Roy, New York, in 2012: One day, a cheerleader woke up from a nap with a strange seizure, one doctors were unable to attribute to an organic cause. Others followed, and though the town searched for something to blame—pollution from now-closed factories? A train accident decades before that spilled toxic chemicals into the soil? They found nothing.

It wasn’t blamed on demons, either, despite its similarities to medieval outbreaks. Instead, the girls’ symptoms were diagnosed as conversion disorder. Like the nuns before them, psychological stress was subconsciously expressed as physical illness.

*

For the first six months of last year, the twitching woke me up every single day. There was no respite, no moment of wakefulness before it began—I shook out of sleep and laid helplessly fidgeting until I managed to drag myself out of bed. It usually ebbed once I was upright, which mystified my doctors; we tried eliminating meds that might cause akathisia, we tried neurological meds like Cogentin and Baclofen, which would work for a day or two before the symptoms came roaring back. Nothing made them go away and stay gone.

It was my therapist who first mentioned conversion disorder—and, of course, I resisted the idea. This was real, this was happening, something was wrong, and I didn’t know what it was.

When I tried her suggestion of using psychological strategies to deal with the symptoms instead of continuing to look for a somatic solution . . . it worked. I couldn’t hold still if I thought about holding still. But if I concentrated with all my might on other sensations—the warm press of the covers over my body, the soft, sweet presence of my cat beside me—I was able to break the cycle, push the urge to move far enough from the forefront of my mind to bring relief.

I was so relieved, so grateful. And also afraid. If the twitching is almost always entirely psychological, does that mean my other symptoms—the pain attributed to fibromyalgia, my migraines, the recurring nausea and vomiting that two gastroenterologists couldn’t explain—are as well?

Am I faking it?

*

Not every nun suffering from conversion disorder in centuries past had her tics and compulsions condemned as demonic. For a select few, these physical renderings of emotions were considered divine messages.

When twelfth-century abbess Hildegard of Bingen hesitated to write down her visions, “through doubt and bad opinion and the diversity of human words,” she fell ill, confined to a “bed of sickness” until she began to record her experiences: “raising myself from illness by the strength I received” from her faith.

In Italy in the 1300s, Catherine of Siena suffered rashes, fever, and pain when her parents tried to force her into marriage instead of allowing her to take holy orders as she wished.

Mystic Teresa of Avila was plagued by severe pain for most of her life, which she said was the result of a seraph’s piercing her heart with an ineffable spear: “The pain was so great, that it made me moan; and yet so surpassing was the sweetness of this excessive pain, that I could not wish to be rid of it.”

These three women are among the very few to be designated Doctors of the Catholic Church; their visions, writings, and philosophies are considered vital to the development of its doctrine. So while some might be tempted to dismiss them as mentally ill, or to scoff at their illnesses as pious fakes, their influence is undeniable.

*

Conversion disorder isn’t voluntary. It isn’t malingering. It’s real. And it turns up in medieval nuns and contemporary teen girls for a reason: silence.

While the saints I’ve mentioned all chose their vocations, convents were frequent dumping grounds for unwanted daughters, widows, “promiscuous” girls. Confined under harsh discipline and unable to express themselves, their muzzled selves found a different way to be heard. The examples of Hildegard, Catherine, and Teresa show that sometimes their converted clamor was successful, rewarding. The dramatic physical symptoms they displayed gained the attention of those around them, even men, even priests and kings and popes; for them, conversion disorder may have caused lifelong distress—but it also gave them a voice.

And this makes me look at my own symptoms differently, as not simply another chronic illness, but a sign that something in me is struggling to speak—though I’m not sure yet of all it’s trying to say. I know when I fight the twitching—when I try to tamp it down with drugs, when I divert my attention on other things instead, when I just try to hold still for God’s sake—it gets worse. Only taking concrete steps to improve my health and my situation (a dental appliance to treat sleep apnea; a beta blocker to calm my heart rate and keep migraines at bay; buying a house and adopting a kitten) has eased the twitching from a daily rude awakening to an occasional annoyance, a bearable quirk of my body that lets me know I’m not listening to my own needs.

Not all of my needs are material. I’m queer, mentally ill, disabled—and though I’m privileged in other ways, these aspects of my identity often go unheard, because I’m often unable to communicate the complexity of my experience, the chaos of my emotions. And so my body shakes, poisoned by the words I swallow, the thoughts I hide.

Like Hildegard on her sickbed, I worry that my experience will be misunderstood or dismissed, and so sometimes I stay silent. But this is not a time for silence, or for fear. These three influential saints—my personal patrons—remind me of the power of my own mind. If my stifled voice is capable of such strong physical effects, how loud will it be when I finally begin to speak?