Understanding Emotional Experiences and Partner Relationships Among Individuals with Psychogenic Non-Epileptic Seizures

Individuals with psychogenic non-epileptic seizures (PNES) show signs of emotion-related dysfunction and disrupted interpersonal relationships. Affectionate touch is an important form of non-verbal communication in relationships that may foster emotion regulation and emotional awareness. The present online survey study included 62 individuals with PNES and 80 seizure-free trauma-exposed controls high (n=40) or low (n=40) in overall symptoms of psychopathology. As hypothesized, PNES individuals reported experiencing less frequent affectionate touch and less interoceptive awareness than either control group. They also reported more somatic symptoms, more emotion regulation difficulties, and less positive emotion than the low psychopathology group. Unexpectedly, there were no group differences in emotional awareness difficulties, nor in initiation of affectionate touch. Across participants, lower interoceptive awareness was associated with lower affectionate touch frequency, indicating that if one has difficulty understanding and being aware of their own body, affectionate touch sensations may not necessarily be understood as pleasant and may be minimized or avoided. Emotional awareness difficulties surprisingly were associated with greater affectionate touch frequency among PNES (versus the expected pattern of awareness difficulties associated with less affectionate touch, as found among controls), suggesting affectionate touch may be used as an attempt to try and understand one’s own feelings, or to compensate for, or even mask a lack of understanding. Findings indicate a distinct difference in physical affection frequency and interoceptive awareness among PNES individuals even when matched to a group similar in psychiatric distress/psychopathology. These findings offer insight into the relationships between interoceptive awareness, affectionate touch, and emotion regulation more broadly.