A Glitch in the Software: Understanding Functional Neurological Disorder
Presented by Jana Staby. Written by Yvette Tan. Reviewed by Bernie and Jana, registered psychologists.
On the Couch is a series that brings expert knowledge into the room, translating the insights of health psychology professionals into accessible, thoughtful reads for anyone curious about the intersection of mind and body.
In this instalment, Jana Staby, a registered psychologist with experience in private practice and now in a hospital setting, shares her insights on Functional Neurological Disorder, drawing from a presentation she delivered to a group of health psychology professionals. What follows is an exploration of a condition that is real, often invisible, and frequently misunderstood — even by those experiencing it.
About Jana
Jana Staby is a registered psychologist with a Masters in Health Psychology. She has worked in private practice and now works in a hospital setting, where a significant portion of her patients have Functional Neurological Disorder — and it is that experience that brings her to this topic.
What is Functional Neurological Disorder?
Most neurological conditions leave a visible mark, structural changes that show up on a scan, a physical explanation for the symptoms. Functional Neurological Disorder (FND) is different. It is a condition caused by altered brain functioning rather than structural changes in the brain, meaning the brain itself appears entirely normal on standard tests.
To make sense of what that means, Jana uses a commonly used analogy, one that patients readily accept. Think of the brain and body as the hardware of a computer and the nervous system as the software. In a healthy system, the two work seamlessly together, communicating constantly to help us move, speak, sense and interact with the world around us.
“FND is like a glitch in the software.”
The hardware remains perfectly intact, but the communication between the two breaks down, and when it does, the effects are very real. A leg that stops moving. A seizure that arrives without warning. A voice that suddenly disappears. Not because of any structural changes, but because the system is not talking to itself the way it should. The glitch can occur in different ways and affect different parts of the system, which is why the symptoms that result are so highly individual, varying considerably from person to person in both type and severity, from mild and manageable to deeply debilitating.
Those differences show up across several areas of the body. In terms of movement, symptoms can include paralysis, difficulties with walking, and seizure-like episodes. When it comes to sensation, people may experience an inability to sense touch, as well as vision and hearing problems. Speech and cognitive difficulties are also commonly reported. Running across many of these areas, extreme fatigue and chronic pain including migraines are very common features of FND.
Understanding what causes FND is not straightforward either. It rarely comes down to one single thing, and is often a combination of biological, psychological and social factors that contribute to its development. Jana mentions trauma history as one example, including experiences such as domestic violence, car accidents, or head injuries. Physical illness and significant stress can also play a role. Not everyone with FND has a clear contributing factor, and each person's experience of how FND developed is unique to them.
What adds to this complexity is how closely some of FND's symptoms, particularly its seizures, can resemble those of other neurological conditions.
FND and Epilepsy: Understanding the Difference
Epileptic seizures are caused by abnormal electrical activity in the brain; whereas, functional seizures are associated with altered functioning of the nervous system rather than epileptic electrical activity. FND is understood as involving changes in how the brain and nervous system process and regulate information. A number of factors may contribute to functional seizures, including changes in attention, arousal, emotion, learning and responses to stress. Dissociation may also occur, a state where the normal connection between a person's thoughts, feelings and bodily experience becomes disrupted.
Some people with functional seizures may understandably worry that they have epilepsy, particularly because their episodes are very real, involuntary and often highly distressing. Providing accurate information about the distinction between epilepsy and functional seizures can help reduce confusion. It is also worth noting that FND and epilepsy can coexist. A person can have both conditions, and an FND diagnosis does not mean epilepsy has been ruled out, simply that the functional seizures cannot be explained by epilepsy alone.
As psychologists working with people with Functional Neurological Disorder, it is important that we recognise the limits of our role: we do not diagnose epilepsy or independently determine the neurological cause of seizure-like episodes.
From Diagnosis to Support: The Role of Psychology in FND
Understanding what FND is and how it differs from other conditions is one part of the picture. Knowing how it is confirmed and what support looks like is another.
One point Jana is particularly clear on when it comes to diagnosis is that FND is not a diagnosis of exclusion. It is not a label given when doctors have run out of other explanations. Neurologists reach an FND diagnosis through a thorough clinical process, identifying recognised signs that confirm the condition is present.
"It's not a diagnosis of exclusion. The neurologist has actually investigated it and reached that conclusion. It's a very real diagnosis."
From that point, supporting someone with FND is rarely a one-person job. A multidisciplinary team typically steps in, with neurologists managing medical care, physiotherapists working on movement, speech therapists addressing communication and swallowing, and psychologists supporting the person through the psychological dimensions of living with the condition. Each brings something different to the care of the person.
Within that team, the psychologist's role is not to treat the neurological symptoms directly. It is to help the person understand and manage the ways FND shows up in their daily life. Jana uses a range of tools tailored to the individual, and two in particular feature prominently in her presentation.
Pacing is one of them. For many people with FND, particularly those dealing with chronic pain and fatigue, a boom and bust pattern can develop, where a person pushes too hard on a good day and then crashes, making recovery harder over time. Jana explains pacing through a simple analogy: think of it like charging a phone. Rather than waiting until it goes completely flat, the idea is to top it up regularly before it runs out.
"Instead of letting your phone go flat, when you notice it's under 10%, you just plug it in and let it charge for a bit, and then you can take it out and use it again."
Alongside pacing, distraction and grounding are also central to the psychological toolkit for FND. Because symptoms tend to increase when attention is focused on the affected body part, shifting that focus can allow the brain's automatic pathways to take over and sometimes ease the symptom. Jana uses a traffic light system to help patients recognise their own warning signs, green for feeling stable, orange for building tension, and red for when a seizure is imminent, so they have a framework to draw on before things escalate. Grounding strategies then give them something concrete to focus on in those moments.
Working gently with thoughts is another part of the picture. Rather than challenging unhelpful thinking head on, the aim is to help patients develop more accurate and helpful ways of understanding what is happening in their body, grounded in what is known about FND.
Psychological support for FND is not a fixed formula. It is shaped by the individual, their symptoms, their patterns, their circumstances, and the tools Jana uses reflect that. The goal is to help the person understand what they are experiencing, build the skills to manage it, and find a way to live well alongside it.
Where to Learn More
Jana shares several resources that she recommends for anyone wanting to explore FND further.
Neurosymptoms.org is a comprehensive website covering the many different ways FND can affect individuals. FND Hope at fndhope.org includes practical guides and a list of common myths about FND that Jana finds particularly useful for addressing misconceptions. FND Australia at fndaustralia.com.au offers locally relevant information and a patient workbook that Jana draws on directly in her clinical work. Epilepsy Australia also has a fact sheet on epilepsy vs FND: https://www.epilepsy.org.au/wp-content/uploads/2026/03/Factsheet_Functional-Dissociative-Seizures_Mar2026.pdf
These resources offer a starting point for anyone wanting to learn more about FND beyond this article.
A Final Thought
FND is a real condition with real symptoms and real impact on the lives of those experiencing it. What Jana shares in her presentation (what it is, how it differs from other conditions, and what support can look like) offers something valuable for anyone encountering FND for the first time.
Jana shares that the sunflower is one of the symbols associated with FND, representing it as an invisible illness, one whose impact is not always visible from the outside. What this article hopes to do, in some small way, is make it a little more visible.
For a condition that is so often misunderstood, that clarity matters.
