Understanding Non-Epileptic Seizures (PNES) and How We Can Help
If you’re experiencing seizures that aren’t explained by epilepsy, you’re not alone — and there is help available. At Dynamic Psychotherapy in Melbourne, we provide expert, evidence-based treatment for non-epileptic seizures (also known as psychogenic non-epileptic seizures or PNES). These seizures are real, distressing, and treatable with the right kind of psychological support.
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What Are Non-Epileptic Seizures?
Non-epileptic seizures are physical symptoms that look like epileptic seizures, but they’re not caused by abnormal brain activity. They often happen in response to stress, emotional pain, or unresolved trauma.
You might be:
- Having seizures with normal EEG results
- Told your seizures are “not epilepsy” but given no clear direction
- Feeling dismissed, confused, or unsure what to do next
You’re Not Imagining This — And You’re Not Alone
Non-epileptic seizures are more common than most people realise. Many people who are diagnosed with epilepsy but don’t respond to medication are later found to have PNES. This is not a sign of weakness or attention-seeking — it’s a sign of the body expressing overwhelming emotional stress.
The physical and emotional impact of PNES is real and can lead to experience of significant isolation and worry. The challenges can be difficult to explain to the people you care about, and fear of having a seizure in public can contribute to difficulties with leaving the house. As a result, those who suffer with PNES will often report increases in their sense of isolation, reduction in their physical activity levels, and worsening of mood and psychological distress.
Why Our Treatment Works
We specialise in working with people who experience non-epileptic seizures by helping uncover and resolve the emotional causes behind them. Our approach is based on deep clinical experience and the latest psychological research.
- We use Intensive Short-Term Dynamic Psychotherapy (ISTDP), a proven method for treating PNES
- Our therapists are also trained in other therapeutic approaches including CBT, and can shape therapy according to your individual presentation and goals
- Our focus is on understanding your emotional experience, not just the symptoms
- We help you regain control and reduce the frequency and intensity of seizures
What Are Non-Epileptic Seizures?
Non-epileptic seizures (also called PNES or functional seizures) are physical events that look like epileptic seizures but are not caused by electrical activity in the brain. They are real, involuntary, and often deeply distressing.
Key Facts About PNES
- PNES are not caused by epilepsy or brain damage
- They are triggered by emotional stress or psychological trauma
- The body reacts as if in danger, even when no physical threat is present
- The person is not in control of the seizures — they are not “faking it”
Common Symptoms
People with PNES may experience:
- Shaking, convulsions, or collapsing
- Loss of awareness or responsiveness
- Staring spells or unresponsiveness
- Episodes triggered by stress, conflict, or overwhelming emotion
These symptoms often lead to confusion, fear, and frustration — especially when tests like EEGs show no signs of epilepsy.
Why Diagnosis Can Be Difficult
PNES is often misunderstood. Many people go years without the right diagnosis. It’s common to be told “your seizures aren’t epileptic” without clear guidance on what that means or what to do next.
You might have:
- Seen multiple doctors without answers
- Tried epilepsy medication that didn’t help
- Felt dismissed or told “it’s all in your head”
The truth is, PNES is a real condition — and with the right therapy, it can improve.
Understanding the Cause
These seizures often stem from:
- Recent activation of past trauma, such as abuse or loss
- Long-standing emotional conflict or stress
- Unconscious anxiety that becomes overwhelming
The seizures are the body’s way of expressing something that hasn’t yet been put into words.
Why Psychological Treatment Is the Most Effective Approach
If you’ve been told you have non-epileptic seizures but haven’t found real answers, you’re not alone. Many people are left with little support after diagnosis. The most important thing to know is this: psychological therapy is the most effective treatment for non-epileptic seizures.
Medication Doesn’t Work for PNES
- Anti-seizure medications don’t treat PNES because it’s not caused by epilepsy
- Many people with PNES have taken epilepsy medication for years without relief
- Stopping the wrong treatment, under medical supervision, can feel scary — but it may open the door to real recovery
Why Therapy Works
PNES is often a response to unresolved emotional pain, even when you’re not consciously aware of it. Therapy helps you:
- Identify and process the emotions behind your seizures
- Resolve unconscious conflicts and early trauma
- Understand how anxiety, trauma or stress may be stored in the body
- Reduce the intensity and frequency of seizures over time
Backed by Research
Multiple studies, including recent meta-analyses, show that:
- Around 82% of people experience a significant reduction in seizure frequency after psychological treatment
- Nearly half of people achieve full seizure freedom after therapy
- Psychological therapy also improves anxiety, depression, and overall quality of life
What Makes ISTDP Effective for PNES
Multiple studies, including recent meta-analyses, show that:
- Recognise emotions that may be triggering your seizures
- Understand how anxiety and defenses operate in your body
- Safely experience and process emotions rather than being overwhelmed by them
- Build greater emotional resilience and self-awareness
- Identify and resolve early trauma
This isn’t talk therapy that goes in circles. It’s focused, structured, and deeply supportive.
Clinical Evidence Supporting ISTDP for Non-Epileptic Seizures
Intensive Short-Term Dynamic Psychotherapy (ISTDP) has shown strong clinical results in treating non-epileptic seizures. At Dynamic Psychotherapy, we use ISTDP because it addresses the emotional root causes of PNES — and the research backs it up.
What the Evidence Shows
- A 2023 study found that just three sessions of ISTDP led to significant reductions in emergency healthcare use and seizure frequency over a 12-month follow-up period
- ISTDP has helped reduce symptoms even in complex cases where patients had been stuck in cycles of repeated hospital visits, unhelpful diagnoses, or ineffective treatments
- Clients reported not just fewer seizures, but better quality of life, improved emotional awareness, and reduced anxiety
Backed by Meta-Analysis
A comprehensive review of psychological treatments for PNES showed:
- 82% of people experienced a 50% or greater reduction in seizure frequency after psychological therapy
- 47% achieved full seizure freedom
- ISTDP, along with therapies like CBT and psychodynamic psychotherapy, was most effective when tailored to individual emotional needs
These numbers reflect a powerful truth: treatment works when it helps you understand and process your emotional experience.
Why Choose Dynamic Psychotherapy in Melbourne
If you’re looking for expert, effective treatment for non-epileptic seizures, you need more than general counselling — you need a therapist who understands the complexity of PNES and how to treat it properly. That’s what we offer at Dynamic Psychotherapy.
We Are Specialists in Emotional Health and Trauma
Our clinicians are trained in Intensive Short-Term Dynamic Psychotherapy (ISTDP) — a therapy model designed specifically to treat symptoms rooted in unresolved emotional stress and trauma. PNES is one of the conditions ISTDP addresses most directly and effectively.
- We have extensive experience working with clients who’ve been misdiagnosed or overlooked by the health system
- We understand the shame, confusion and fear that often come with PNES
- We create a clear, focused path forward — based on your emotional experience, not just your symptoms
FAQs About Treatment for Non-Epileptic Seizures
What causes non-epileptic seizures?
PNES is usually caused by unresolved emotional distress or trauma. The seizures are the body’s way of expressing something the mind can’t yet process.
Can non-epileptic seizures go away on their own?
Some people may experience spontaneous improvement, but for most, seizures continue — or even worsen — without proper treatment. Psychological therapy offers the best chance for lasting recovery.
Do I need a referral to see you?
You don’t need a referral to book an appointment. However, for non-epileptic seizures, it’s strongly recommended that you’ve had a full medical evaluation — ideally with a neurologist — before starting psychological treatment.
We recommend the following before beginning therapy:
Relevant documentation of diagnosis, if available
A clear diagnosis of PNES from a neurologist (preferably supported by video-EEG or similar telemetry)
Assessment to rule out epilepsy or other neurological conditions
Access to a regular GP during your course of treatment
Can I have epilepsy and PNES at the same time?
Yes. Some people have both. A neurologist can help clarify this using video EEG. If you have PNES, psychological therapy remains the most effective treatment — even if you also have epilepsy.
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