01/09/2026
WORDS MATTER — IT’S TIME TO CHANGE THE LANGUAGE AROUND FND
Functional Neurological Disorder is a neurological disorder of function.
Yet the language used to classify and teach FND still carries the weight of its psychiatric history.
In ICD-11, FND is primarily classified as “Dissociative neurological symptom disorder” within the chapter Mental, behavioural or neurodevelopmental disorders.
Think about what that means for the next generation of healthcare professionals.
Before many clinicians ever meet a person with FND, they have already encountered the terminology used in classifications, textbooks and medical education.
Language shapes perception.
When a condition causing seizures, paralysis, movement disorders, speech difficulties, sensory changes and other disabling neurological symptoms is framed predominantly through psychiatric terminology, it can contribute to an assumption that the symptoms are primarily psychological, less serious, or somehow less “real”.
And patients live with the consequences of those assumptions.
We are dismissed.
We are doubted.
Our symptoms can be minimised.
Physical and neurological concerns can be attributed to FND without adequate investigation.
This isn't an argument against psychiatry or people with psychiatric disorders. Mental illness is real illness too.
It is an argument for accurate language.
Our understanding of FND has changed enormously. Modern research describes abnormalities of neurological functioning involving brain networks responsible for movement, sensation, attention, prediction and agency.
Our medical language needs to evolve alongside that knowledge.
We need classifications and teaching materials that make one thing unmistakably clear:
FUNCTIONAL DOES NOT MEAN FAKE.
DISSOCIATIVE DOES NOT MEAN DELIBERATE.
AND FND SHOULD NEVER MEAN “STOP INVESTIGATING”.
Changing terminology won't solve every problem faced by people with FND.
But if we want to change how FND patients are treated, we should look carefully at the words healthcare professionals are being taught in the first place.
Change the language.
Change the understanding.
Change the care.
FND Aware NZ
www.fndaware.nz
