FNDS Policies

The Functional Neurological Disorder Society (FNDS) is an international mission-oriented, action-based society that honors diversity, advances equity and inclusion, and fosters a sense of belonging and trust among its members. We recognize, respect, and celebrate differences in culture, background, and experience worldwide. We accept our moral and ethical responsibility to contribute to an inclusive culture and insist that members show each other respect. We disapprove of discrimination, racism, intolerance, and indifference of any kind that threatens to separate us from the overall goal of the Society’s mission and objectives. Because we strive for our values to be visibly woven into the foundation of FNDS, we focus on establishing an operational structure to support, cultivate, and promote access and belonging with an aim to advance research, education, awareness, advocacy, the meaningful exchange of ideas, and collaboration.

The FND Society has sometimes found that the term Functional Neurologic Disorder (FND) can be confused with other medical terms like “functional neurosurgery” and “functional neurology.” We prepared this brief glossary to help professionals, patients and the general public.

Functional Neurological Disorder (FND) is the diagnostic label for a condition with a variety of possible symptoms including limb weakness, movement disorder, sensory symptoms or seizures. It is diagnosed based on typical features and is the core reason for the existence of the FND Society.

Functional Neurosurgery is a type of brain surgery for conditions like Parkinson’s disease, brain tumors, and epilepsy. It involves surgical procedures like deep brain stimulation that alter the function of the brain.

Functional Neurology is an alternative or complementary health field with its own diagnostic and rehabilitation techniques. It usually is practised by chiropractors. While some ideas and methods in functional neurology overlap with more mainstream or conventional medicine and neuroscience, many do not. “Functional neurologists” are usually not board-certified neurologists and the term does not indicate that someone is specialised in FND.

Functional medicine is a broader term describing similar treatment principles applied to other medical conditions.

Functional MRI (fMRI) describes a scientific technique which can show brain activity by detecting changes in blood flow. It is used mostly in research to map the brain and work out which parts of the brain are going wrong in neurological and psychiatric conditions as well as in healthy adults. There has been a lot of interesting research using fMRI in people with FND, but it is not something that is ready to be used as a diagnostic tool yet.

Overview: The Functional Neurological Disorder Society is committed to respectful communication and exchange of ideas among professionals. Growth of professionals and ideas can only occur if all good intentioned ideas and discussions are respected, allowed, and productively engaged with in a secure and respectful professional space. This includes finding common ground, honoring shared intent, allowing divergence, respectful agreement to disagree, changing and amending endorsed concepts or ideas over time with professional growth or changing evidence.  

Communication Principle 1: Brevity & Good Intent Are Assumed

Efficient scientific and professional discussion often requires brevity. Professional exchanges are not patient communications, they may appear blunt or direct. While FNDS and its provider members are committed to improving the clinical care and scientific understanding of FND, its function is not a patient organization, nor is it intended to be a source of patient emotional support. It is intended to be an organization for professional and scientific growth, and respectful exchange and analysis of ideas among professionals in the field.

Omission of conversationally circumstantial details are often necessary to facilitate focus on the intended conversation topic.  All assumptions and additional information behind discussed concepts cannot be explicitly stated, demonstrated, caveated, or explained fully each time it is mentioned, to allow timely paced scientific dialogue. Good or helpful intent should be assumed for any aspect of a concept that is lacking in detailed or caveated explanation. Additional information or clarification can simply be respectfully requested. It should be a default assumption that ideas (and the statements used to communicate them) are not mutually exclusive with other seemingly contrary ideas or perspectives; omission does not automatically indicate disagreement with the unspoken / not-covered idea.

Communication Principle 2: Commitment to Discussion of Difficult Content  

Effective scientific research and professional practice growth requires considering all aspects relevant to working in the field of FND. This includes sensitive, and what might be considered controversial or polarized topics in professional practice. This may include topics which are difficult or uncomfortable from a patient, provider, and / or humanity perspective. FND has relevance to emotional functioning, emotional regulation, interpersonal functioning, unhelpful behavioral responses or unhelpful / inaccurate thought patterns, performance validity testing, testing effort, definitions of malingering, agency, brain-body connection, brain-mind connection, dualism, psychodynamic history, and utility of theoretical versus evidenced based hypothesis, among others. FNDS believes discussion of these topics is not in conflict with, or a threat to, evidenced based practice, up-to-date biopsychosocial, and neuroanatomically driven models of FND. FNDS believes the process of scientific discussion and discovery is robust enough to tolerate (and improve) viewpoints or ideas which generate less evidence over time or might be relevant to fewer patients. Clarity and advancement of all ideas can often only be achieved through juxtaposition.   

Concepts discussed may be emotionally uncomfortable, but scientifically or pragmatically accurate, meritorious, or historically relevant. The most accurate and helpful scientific concepts, pragmatic guidelines, and discussions regarding human experience often engender strong emotional responses and irrevocably intertwine seemingly opposing truths.

Communication Principle 3: Communication is Human & Robustness to Ideas

FNDS members are human and imperfect, as is their language. They may mis-speak, make an error, respond, or explain imperfectly, have imperfect understandings, or hold ideas which are not the newest and up to date. Language may fail to fully express, capture, or convey the intended meaning, or may hold a different meaning for the receiver than the listener. If an FNDS member (and their language) are good intentioned, and allows discussion with peers, FNDS supports all provider viewpoints and language for discussion. Again, FNDS believes the process of scientific discussion and discovery is robust enough to tolerate (and improve) viewpoints, ideas, or language which generate less evidence, applicability, or robustness over time (for professionals or patients). Given FND is a human condition, what might be considered wholly unacceptable or inapplicable idea to one patient with FND, might make perfect sense or be considered helpful to another patient with FND (even if a smaller minority). A limitation of ideas, language, or approaches may limit the availability and range of understanding, clinical treatments, and scientific discoveries available to all professionals and patients with FND.

Communication Principle 4: No Tolerance for Aggressive Speech

FNDS will not tolerate aggressive speech from its members, professional contacts, or associates. Instances of members or associates engaging in aggressive speech will be reviewed by the FNDS board, who will determine appropriate action based on severity of offense, including possible membership termination or dissolution of association.  

For example:
•    Threats of physical violence
•    Shouting
•    Name calling
•    Use of profanity in reference to another person or their ideas
•    Ad-hominin character attacks