For clients · 5 min read

Functional seizures (PNES) explained

Real seizures. Not epilepsy. Not faking. A brain-network disorder that responds to therapy.

Metaphor: A circuit breaker that trips under load — the wiring is fine, but the breaker keeps flipping.

Functional seizures are real seizures

If you've been told you have functional seizures, dissociative seizures, or PNES (psychogenic non-epileptic seizures), it means the events you're having are genuine, involuntary, and not caused by abnormal electrical activity in the brain — which is what epilepsy is. The older term 'pseudoseizures' is no longer used; it was stigmatizing and wrong. These are real episodes, and they are treatable.

What's happening in the brain

The brain hardware is working. The software — how the brain routes attention, emotion, and motor signals — has gotten dysregulated. Sometimes a circuit-breaker trips: when input becomes overwhelming (emotional, sensory, or remembered), the system shuts down or shakes in a way that looks like a seizure. For many people, there's a trauma history; for many others, there isn't. Both are valid paths to the same diagnosis.

The warning window

Most functional seizures are preceded by a feeling — a wave of dread, dizziness, a tingling, a 'here it comes' — anywhere from a few seconds to a couple of minutes before the event. That window is the most important piece of treatment. Learning to recognize it and use grounding, breath, and movement in that window can abort the seizure.

Therapy that works

The best-studied treatment is a 12-session CBT-informed protocol (sometimes called CBT-ip, developed by Dr. W. Curt LaFrance). Sessions cover seizure logs, trigger mapping, warning-sign skills, relaxation, communication, and — when relevant — trauma processing with proper pacing. Studies show seizures reduce by about half on average, alongside better mood and quality of life.

The takeaway

Functional seizures are real, treatable, and not your fault. The same nervous system that learned to flip the breaker can learn another way through.

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