A patient with conversion disorder experiences sudden blindness after witnessing a violent event. Which is the priority therapeutic approach?

• A. Reassure her that her blindness is temporary and will resolve with time.
• B. Gently point out that she seems to be able to see well enough to function independently.
• C. Encourage expression of feelings and link emotional trauma to the blindness.
• D. Teach ways to cope with blindness, such as methodically arranging personal items.

Answer: (D)

In conversion disorder, the first goal is to help the patient regain function and cope with the symptom in a way that preserves independence and safety. Teaching practical ways to manage blindness directly supports daily living and reduces distress, giving the patient a sense of control. For example, showing how to methodically organize items, establish safe routines, and use landmarks or adaptive strategies helps the patient navigate the world despite the loss of vision. This approach validates the experience without challenging its reality and sets the stage for later psychotherapeutic work if appropriate.

Other approaches focus more on validating that the symptom is real or on probing the emotional trauma behind it. While addressing emotions and trauma is important, those steps are best built on a foundation of functional coping and safety first.