GANSER syndrome: What is it, symptoms, causes and treatment

Spiegel (1991) defines dissociation as the structured separation of mental processes, such as thoughts, memory, or identity, that are normally integrated. It is defined in a similar way by the American Psychologist Association (APA) a few years later (1995), specifically, such as the alteration of the integrative functions of identity, memory or awareness.

So, if we talk about Ganser syndrome, can we say that it is a dissociative disorder or is it another type of disorder? The answer will depend on the manual that we are consulting. As is common in the sciences, knowledge is updated periodically and it is common to observe changes and modifications over time.

If you want to know more about this syndrome and its evolution, keep reading! In this Psychology-Online article, we will talk about the Ganser syndrome: what is it, symptoms, causes and treatment. In addition, we will show you an illustrative example so you can get an idea of ​​what exactly it is.

Index

1. What is Ganser syndrome
2. Symptoms of Ganser syndrome
3. Causes of Ganser syndrome
4. Treatment of Ganser syndrome
5. Example of Ganser syndrome

Ganser syndrome is a dissociative disorder present in the classification of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-R)^[1]. According to this provision, it is within dissociative disorders not otherwise specified, since its symptoms are also common in a wide range of psychotic disorderslike schizophrenia.

It should be noted that Ganser syndrome also manifests symptoms common with other organic brain disorders, but no longer appears in the fifth edition of it (DSM-5)^[2], since in these cases it should be classified as the primary pathology.

Origin of Ganser syndrome

Ganser syndrome was described by Sigbert J.M. Ganser in 1898. The German psychiatrist thus diagnosed three prisoners awaiting trial by his answers to some questions, in which they showed traits of Vorbeireden, that is, giving approximate answers, so that, being wrong answers, they are so close to the correct answer that the questioner suspects that the subject knows the correct answer.

This led to Ganser syndrome also being described as the Approximate answer syndrome. Although Ganser was the promoter of this method, he himself recognized that it is infrequent and that, surely, it is more likely in those awaiting trial sentences than in those already sentenced.

How does Ganser syndrome manifest? The symptoms initially described by the German psychiatrist were the following:

• Wrong answers to questions, but close to the correct answer. Specifically, he said, "in choosing responses, the patient seems to deliberately go from the indicated correct answer to select a false one, which even a child could recognize as such" (quoted in Sims, 1988).
• Consciousness disorders: Obtundation with disorientation.
• hysterical stigmata.
• Amnesia for the period in which the symptoms manifested.
• Recent history of brain damage.
• emotional stress severe.
• Auditory and visual hallucinations: which rather take the form of pseudohallucinations.

As always, the causes of Ganser syndrome that lead to mental disorders are a genetic and biological combination with environmental factors. None of them is decisive, but it is necessary for the manifestation of said disorder.

In the case of dissociative disorders, we find some theories that could explain the causes of their appearance:

• Neo-dissociative theory (Hilgard, 1977): a divided consciousness is produced by the intervention, in certain circumstances, of executive control. In this way, the integration and hierarchical organization of the lower control structures is interrupted. The connection is broken and there is a decrease in voluntary control.
• Theory of memory disorders (Kihlstrom, 1990): a process becomes conscious only if a connection is established between the mental representation of the event and the agent of the event itself.

On the one hand, the Ganser syndrome patient could benefit from a pharmacological treatment accompanied by psychotherapy focused on a reorientation to reality. Being a dissociative disorder, previously known as hysteria, some psychoanalysts recommend hypnotherapy to treat this mental disorder.

On the other hand, if the trigger for Ganser syndrome is a trauma, the treatment that is applied depends on its characteristics. Let's see the two most frequent cases:

• Psychological trauma: In this case, the treatment will consist of analyzing the mental processes involved in the traumatic event and working on accepting it. In this article you will find more information about what is psychological trauma and how to deal with it.
• neurological trauma: there is brain damage, so initially the treatment of Ganser syndrome should focus on controlling and improving the physical damage caused. Subsequently, the symptomology must be treated on a psychological level.

As we have seen, this mental disorder can be difficult to understand. Therefore, below, we will show you an example of the Ganser syndrome, reported by Sims (1998), in which symptoms of hysteria as well as organic symptoms are manifested.

The 20-year-old suffered a head injury and concussion while she was in Italy. Her premorbid personality was markedly histrionic and theatrical, and when she was 13 years old she developed a hysterical ability to walk that lasted several weeks. When she was transferred from the hospital in England, she responded as follows:

• +What is the capital of Italy?
• -Naples
• +How many legs does a centipede have?
• - 7

In addition to these responses, he also stated emotional lability, flirting behavior, interference in other people's treatment and funny mannerisms.

At 12 days, the brain damage was found to be gone and an intelligence test (WAIS) was started. To be able to distinguish it, we recommend you read this article on types of intelligence tests. In the test, a greater deterioration was observed, which was manifested above all in the verbal items, despite the fact that more than a month had passed. The young woman's intellectual functioning did not return to a higher level until after 9 months.

This article is merely informative, in Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

If you want to read more articles similar to Ganser syndrome: what it is, symptoms, causes and treatment, we recommend that you enter our category of Clinical psychology.

1. American psychiatric association, (2002). Diagnostic and Statistical Manual of Mental Disorders DSM-4. Madrid Spain. Pan American Medical Publishing.
2. American psychiatric association, (2014). Diagnostic and Statistical Manual of Mental Disorders DSM – 5. Madrid Spain. Pan American Medical Publishing.

• Belloch, A., Sandin, B., Ramos, F., (2009). Manual of psychopathology, volume II. Madrid. McGraw Hill / Interamericana de España, S.A.U.