Psychogenic Non-Epileptic Seizures (PNES): When the Body Holds What the Mind Can’t Say

Sometimes the body tells a story long before words arrive.

A person may suddenly collapse, shake, or lose awareness. It looks like epilepsy. It feels frightening and real. Yet medical tests show no seizure activity in the brain. What’s happening instead is something known as Psychogenic Non-Epileptic Seizures (PNES)—a condition in which overwhelming emotional stress or trauma is expressed through the nervous system rather than through conscious thought (Reuber & Brown, 2017).

PNES is not fake, imagined, or deliberate. It is the body’s reflexive response to distress that has nowhere else to go.

What Exactly Is PNES?

PNES is a type of functional neurological disorder (FND), a broad category of conditions affecting how the brain communicates with the body. In PNES, seizure-like episodes occur without the abnormal electrical brain activity that defines epileptic seizures. Instead, they reflect disruptions in the brain’s ability to regulate emotional, cognitive, and physical processes under stress (Perez et al., 2021).

Research has consistently shown strong links between PNES and trauma, chronic stress, dissociation, and adverse life experiences (Asadi-Pooya et al., 2019; Ludwig et al., 2018). In these cases, the nervous system may learn to respond to perceived threat through shutdown or seizure-like activity as a form of protection.

In short, when coping becomes impossible, the body takes over.

Common Signs and Symptoms

PNES can look different from person to person, but commonly reported features include:

·        Seizure-like episodes involving shaking, falling, or unresponsiveness

·        Episodes that are longer or more variable than epileptic seizures

·        Emotional or interpersonal stress triggering events

·        Closed eyes or fluctuating awareness during episodes

·        Extreme fatigue, confusion, or emotional sensitivity afterwards

·        Co-occurring anxiety, dissociation, PTSD symptoms, or chronic pain

Because symptoms closely resemble epilepsy, many individuals remain misdiagnosed for years (Pick et al., 2020).

Why PNES Is Often Misunderstood

PNES sits at the intersection of neurology and psychology—an area medicine has historically struggled to approach with nuance. When scans and tests appear “normal,” patients may feel dismissed or blamed, which can intensify shame and worsen symptoms (Stone et al., 2020).

Modern neuroscience is clear: emotional trauma reshapes nervous system functioning. The body does not distinguish between physical and emotional danger—it simply responds (Van der Kolk, 2014).

What PNES Feels Like From the Inside

Many people describe subtle warning signs before an episode, such as pressure in the chest, dizziness, tingling in the limbs, or a sense of unreality. Others experience a sudden loss of control with little awareness beforehand.

Afterwards, the body often feels depleted, heavy, and raw—like every system has been overworked. This is not a weakness. It is a nervous system stuck in survival mode.

Gentle Ways to Support Healing at Home

PNES recovery focuses on regulation rather than control.

Noticing patterns without judgment can help. Tracking emotional states, physical sensations, and triggers builds understanding and reduces fear over time (Reuber et al., 2018).

Grounding the nervous system is also explained. Slow breathing, temperature changes, textured objects, or feeling the feet against the floor can help bring the body out of threat response (Perez et al., 2021).

Establishing predictable rhythms matters. Regular meals, sleep routines, and gentle daily structure provide safety cues to the brain.

Gentle movement can restore trust in the body. Walking, stretching, or mindful movement has been shown to improve regulation in functional neurological conditions (Nielsen et al., 2023).

Rest without guilt is essential. Rest is not avoidance—it is neurological repair.

Sustainable Living as Nervous System Support

A calmer life supports a calmer body. Reducing sensory overload, limiting digital noise, spending time outdoors, and choosing intentional, eco-conscious habits can lower baseline stress and help the nervous system feel less threatened (Venhoeven et al., 2016).

In retreat and wellness settings, many people with PNES report fewer episodes when life slows down enough for the body to feel safe again.

When Professional Support Matters

Trauma-informed psychotherapy, cognitive behavioural therapy, and integrated neurological–psychological care show strong evidence for improving PNES outcomes (Goldstein et al., 2020; Myers et al., 2017). Early diagnosis paired with compassionate education significantly improves quality of life (Asadi-Pooya et al., 2019).

A Gentle Call to Action

If this resonates, pause for a moment. Feel your breath. Notice the surface beneath you.

Your body isn’t malfunctioning.It’s communicating.

Begin by offering yourself safety—through routine, rest, gentle movement, and supportive community. Healing begins not by silencing symptoms, but by listening to what they have been protecting.

Your nervous system learned survival.

References

Asadi-Pooya, A. A., et al. (2019). Psychogenic nonepileptic seizures: A concise review. Neurologic Clinics, 37(3), 597–610.Goldstein, L. H., et al. (2020). CBT for psychogenic nonepileptic seizures. Neurology, 94(20), e2132–e2142.Ludwig, L., et al. (2018). Stressful life events in functional neurological disorder. Journal of Neurology, Neurosurgery & Psychiatry, 89(10), 1117–1125.Myers, L., et al. (2017). PNES: Prevalence and management. Acta Neurologica Scandinavica, 136(1), 3–10.Nielsen, G., et al. (2023). Physiotherapy-led treatment for FND. Journal of Neurology, 270(2), 742–751.Pérez, D. L., et al. (2021). Neuroimaging in functional neurological disorder. NeuroImage: Clinical, 30, 102623.Pick, S., et al. (2020). Dissociation in dissociative seizures. Epilepsy & Behaviour, 102, 106670.Reuber, M., & Brown, R. J. (2017). Understanding PNES. Seizure, 44, 199–205.Reuber, M., et al. (2018). Clinical features of PNES. The Lancet Neurology, 17(4), 368–380.Stone, J., et al. (2020). Functional neurological disorder assessment. Practical Neurology, 20(2), 150–157.Van der Kolk, B. A. (2014). The body keeps the score.Venhoeven, L. A., et al. (2016). Why sustainable behaviour feels good. Journal of Environmental Psychology, 45, 80–89.