Science  Write  Now

This week on the Science Write Now podcast, we chat to neurologists Dr Alex Lehn and Dr David Palmer with sociolinguistic expert, Dr Shelley Dawson on re-writing the narrative of functional neurological disorders (FND) and why labels — and language — matter. Plus, a special bonus episode with Dr Gillian Deakin, a specialist GP and author.

Functional neurological disorders are one of the most common disorders you’ve never heard of. But an estimated 4 to 12 out of 100,000 people develop FND, and it’s the second most common presentation in neurology clinics worldwide. Tests and scans such as MRIs and EEG can’t pick up functional issues, however; leaving patients misdiagnosed, or dismissed. Many are told the symptoms are ‘all in their head’. Some are accused of ‘performing’ or fabricating symptoms. Most do not receive the diagnosis and treatment they need, nor the healthcare they deserve.

This is where the arts — the power of our stories and language — come in. 

What we do know is that FND affects the cognitive processing and communication centre of the brain, disrupting the brain signals that communicate with your body. Basically, FND is a brain “software” problem, as opposed to a “hardware” problem such as stroke or epilepsy. But does this computer/brain analogy oversimplify the workings of our most complex organ?

In this conversation, we get to the heart of our grey matter, exploring a topic that is deeply personal and yet widely felt in our communities, among patients, allied health and medical experts. An issue that is largely invisible and yet deceptively common. We uncover the historical basis, harmful discourse, and pervasive mythologies underpinning functional disorders, and what the future holds in terms of emerging research at the intersection of mind, brain and body.

One of the key issues highlighted during our conversation is the critical gap when it comes to general practitioners (GPs) and functional symptoms. This really struck a chord with me and so I went away and did some research and came across Dr Gillian Deakin, a GP based in Sydney who is particularly passionate about functional conditions, and has written a book that addresses this very fraught and frustrating problem. Below you’ll also find a special bonus episode that ties into Cognitive Conversations #9 from the perspective of a GP who is pushing for more awareness and advocacy around functional conditions in general practice.

This is Cognitive Conversations #9 Language Matters: Re-writing the narrative of Functional Neurological Disorders with a special bonus episode!

Enjoy listening, then read on to learn more about this week's guests in the Show Notes!

Meet our guests

Associate Professor Alexander Lehn attended medical school in Germany (Regensburg and Munich) and conducted his residency and basic physician training in the UK (Bristol) and Australia (Nambour and Brisbane). After a fellowship in movement disorders at the Princess Alexandra (PA) Hospital, Dr Lehn undertook a further fellowship in movement disorders in Newcastle upon Tyne (UK). Dr Lehn heads the movement disorder service at PA Hospital in Brisbane and together with Dr Sarah Olson he runs the deep brain stimulation service at the PA and Mater Hospitals in Brisbane. Dr Lehn has a keen interest in Functional Neurological Disorders (FND) and from 2015 to 2019 ran a dedicated FND clinic, the first of its kind in Australia. With his multidisciplinary team, he runs regular courses on FND in Brisbane and across Australia and has published extensively in this area.

Dr David Palmer is a movement disorders neurologist with clinical and research interest in functional neurological disorder (FND). Until his current research sabbatical, he was the neurologist for the Sunshine Coast multidisciplinary FND treatment clinic, and before moving to Australia, founded New Zealand’s first multidisciplinary FND treatment clinic. He also founded and runs FND Research Connect, an organization which aims to help people with FND more easily participate in research studies. His current research focuses on trying to better understand the mechanisms of brain processing that cause FND, and developing new and better treatments for the condition. David is joining us today from Canada.

Dr Shelley Dawson is a sociolinguist/discourse analyst in the School of Linguistics and Applied Language Studies at Te Herenga Waka Victoria University of Wellington. Her research examines how language is used to reproduce and contest social inequalities, and she uses qualitative ethnographic and discourse analytic methods to address questions of identity, marginalisation, and belonging. She investigates functional neurological disorder from a discourse perspective, with a view towards challenging the taken-for-granted ‘truths’ about the disorder and the people affected by it. Shelley is joining us today from Aotearoa.

Dr Gillian Deakin (bonus episode) has been studying and working in medicine for over 40 years, having graduated from Sydney University. She's worked as a doctor in Sydney and the Outback, where she cared for the cast and crew on a film set, and later, with the Royal Flying Doctors Service and the Aboriginal health services. After wintering in Antarctica as the medical officer at Davis research station, she completed her doctoral thesis, ‘Cardiovascular Risk Factors in the Antarctic’. She then undertook a master’s in public health at Sydney University, following which she directed an aid program on the remote islands of Kiribati. Returning to Sydney, she trained as a specialist GP. While keeping an up-to-date clinical knowledge of orthodox medicine, Dr Deakin has broadened her expertise through studies in nutrition and lifestyle medicine. Her first book, 101 things a GP would tell you if only there was time, was published in 2006. Her latest book is What the hell is wrong with me? How to recover from pain, fatigue, weakness and other undiagnosed symptoms.

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SHOW NOTES

A/Prof Alexander Lehn

Researcher profile: https://www.researchgate.net/profile/Alexander-Lehn

UQ Experts profile: https://about.uq.edu.au/experts/4316

Selected interviews and media:

• Functional Neurological Disorders with Dr Alex Lehn (Metagenics Institute podcast)

• Understanding Functional Movement Disorders with Dr Alex Lehn (MDS Congress)

• #103 Functional Neurological Disorders with Dr Alex Lehn (The GP Show podcast)

• Is it possible to think yourself sick? Dr Alex Lehn on SBS Insight article

Selected scholarly publications:

• Managing functional neurological disorder: treatment recommendations for health professionals in Australia (with David Palmer)

• Practical strategies for caring for patients with functional neurological disorder in the ED

• Lived experience of driving in individuals with functional neurological disorder (with David Palmer)

• How Is Functional Neurological Disorder Managed in Australian Hospitals? A Multi‐Site Study Conducted on Acute Inpatient and Inpatient Rehabilitation Wards

• Functional Neurological Disorders in the medical education: An urgent need to fill the gaps.

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Dr David Palmer

Academic Profile/s:

• https://qbi.uq.edu.au/profile/18256/david-palmer

• https://www.researchgate.net/profile/David-Palmer-43

• https://mattingley-lab.uq-qbi-cogneuro.com/home/people/david-palmer

Selected interviews and media:

• AusMed online: Introduction to Functional Neurological Disorder with Dr David Palmer

• FND Aus speaks to FND neurologists and researchers, Dr Alex Lehn and Dr David Palmer

Selected scholarly publications:

• Outcomes of an Integrated Multidisciplinary Clinic for People with Functional Neurological Disorder

• Functional neurological disorders presenting as emergencies to secondary care.

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Dr Shelley Dawson

Academic Profile/s:

• https://victoria.academia.edu/ShelleyDawson

• https://www.researchgate.net/profile/Shelley-Dawson-2

• https://www.wgtn.ac.nz/lals/study/student-profiles/shelley-dawson

Selected interviews, seminar talks and media:

Seminar Series: Linguistics and Applied Language Studies (Victoria University of Wellington)

• ‘You’re a rational guy – sort your shit out’: The mind, the body, and functional neurological disorder

• From 'hysteria' to functional neurological disorder: A sociolinguistic accounting of stigma

• FND: Language Matters Symposium 2025 (convenor and presenter)

Selected scholarly publications:

• Dawson, S. Long Covid vs. Functional Neurological Disorder: Punching down. In D. Kulick & S. Vehmas (Eds.), Clashing vulnerabilities: Disabilities in conflict (pp.102-116). Routledge. (in press)

• Expanding Participant Voice Within a Social Justice Framework: A Critical Dialogic Approach.

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Dr Gillian Deakin

• Website: https://www.whatthehellbook.com/about-the-book  

• About Dr Deakin: https://www.whatthehellbook.com/about-the-author

• Dr Deakin’s blog: https://www.whatthehellbook.com/dr-deakins-blog

Connect with Dr Deakin on Instagram.

Selected interviews and media:

• Antarctica, Kiribati and outback Australia — the adventures of a GP doctor on ABC Conversations

• What the hell is wrong with you? Dr Gillian Deakin on 'functional disorders' and how to treat them on ABC Mornings

• FND Australia Talks to Dr Gillian Deakin for 2025 FND Awareness Day (YouTube)

• What are functional conditions? The mystery illnesses doctors can’t see on scans in Body+Soul’s The House of Wellness (article)

• An approach to functional disorders with Dr Gillian Deakin in AusDoc (article)

• What the doctor ordered: The opportunity of a lifetime led to a lifetime of adventure in University of Sydney News (article)

Selected publications:

• What the hell is wrong with me? How to recover from pain, fatigue, weakness and other undiagnosed symptoms by Dr Gillian Deakin

• 101 Things Your GP Would Tell You If Only There Was Time by Dr Gillian Deakin.

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FND resources:

• FND Australia: https://fndaustralia.com.au/

• FND Australia Support Services: https://fndaus.org.au/

• FND Research Connect: https://www.fnd-research.org/

• FND Hope (UK): https://fndhope.org/ (subscribe to the FND Hope newsletter)

• FND Society (UK): https://www.fndsociety.org/ (host of the annual FND Conference)

• Neurosymptoms (authoritative FND Guide): https://neurosymptoms.org/en/

Selected interviews, TEDx and media:

• FND Aus speaks to FND neurologists and researchers, Dr Alex Lehn and Dr David Palmer (video interview)

• Demystifying Functional Neurological Disorder (FND) with expert neurologist Prof Jon Stone (video interview)

• Hysterical: The condition that meant Bianca was disbelieved and made to feel hysterical – an interview with Bianca Millroy on SBS News (audio)

• Hysterical: The History of ‘hysteria’ and the travelling womb – an interview with Katerina Bryant, author of Hysteria on SBS News (audio)

• It’s All in Your Head: Challenging Dualism in Health Care with Dr. Sarah Lidstone

• Why is Functional Neurological Disorder so poorly understood? with Steph Blanco

• Tremors, seizures and paralysis: this brain disorder is more common than multiple sclerosis – but often goes undiagnosed by Benjamin Scrivener in The Conversation

• Rise in tics is caused by a known condition – and it’s not all due to TikTok by Professor Jon Stone in The Conversation.

There are hundreds of freely available authoritative articles, interviews, podcasts and talks by medical experts, health professionals and those with lived experience of FND.

Selected books and publications:

• FND Stories: Personal and Professional Experiences of Functional Neurological Disorder, edited by Gregg H. Rawlings, Markus Reuber, Jon Stone and Maxanne McCormick (includes a contribution written by SWN’s Bianca Millroy).

• Functional neurological disorder: lighting the way to a new paradigm by Dr Mark Edwards in Brain (2021)

• FND is a Feminist Issue by McLoughlin (et al) in Journal of Neurology and Neurosurgery

• Cadenza for Fractured Consciousness by FND Portal (author undisclosed)

• Hysteria: a memoir of illness, strength and women’s stories throughout history by Dr Katerina Bryant (2020)

• Overcoming Functional Neurological Symptoms: A Five Areas Approach by Christopher Williams, Alan Carson, Sharon Smith and Michael Sharpe

• It’s All in Your Head: Stories from the Frontline of Psychosomatic Illness and The Sleeping Beauties and Other Stories of Mystery Illness by Dr Suzanne O’Sullivan

• FND and Me by Mark Grimsley – a journey towards recovery, from a career in the Airforce to wildlife photography (Mark is based on the Fraser Coast and has a photography website)

Read more on Neurosymptoms.org ‘Stories’ and FND Hope ‘FND and Us’ campaign.

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This episode was recorded and produced in Meanjin, Brisbane: a place steeped in history, culture, community, and storytelling. We acknowledge the Jaegara and Turrbal People as the traditional custodians of these lands, the first scientists and storytellers. We pay our respects to Elders, past and present. Always was, always will be.

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