When Seizures Aren’t Epilepsy: Understanding PNES and the Nervous System

If you or someone you love has experienced episodes that look like seizures, but were told they are not epilepsy, you may have come across the term Psychogenic Non-Epileptic Seizures (PNES).

If you’ve received this diagnosis and are feeling unsure what it means or where to go from here, you’re not alone, and there is a path forward.

What Are Psychogenic Non-Epileptic Seizures (PNES)?

Psychogenic Non-Epileptic Seizures (PNES), sometimes referred to as Functional Seizures, are real, involuntary episodes that can closely resemble epileptic seizures, but they are not caused by abnormal electrical activity in the brain.

Instead, they arise from the nervous system’s response to overwhelming emotional stress, trauma, or internal conflict.

This is not “faking,” and certainly not “all in your head.”

This is your nervous system doing its best to protect you when something inside feels too much to hold.

How is PNES Diagnosed?

Most people first seek medical care believing they are having epileptic seizures, which makes complete sense given how physical and intense these episodes can feel; or, because it feels like something is terribly wrong, like their body is betraying them or acting in ways they can’t control.

Diagnosis typically involves working with a neurologist and undergoing a video EEG, which records brain activity during an episode. When no epileptic activity is found, and the events are still occurring, PNES is identified.

For many, this moment brings a mix of relief and confusion. If it’s not epilepsy, then what is happening?

That question deserves a thoughtful, compassionate answer.

What Do PNES Episodes Feel Like?

PNES doesn’t look just one way. For some people, episodes involve full-body shaking or collapsing. For others, it may look like going still, staring, or feeling suddenly disconnected from the present moment.

Sometimes it’s less visible but just as intense, such as an overwhelming wave of dread, a sense that something inside is shutting down, or the feeling of being “there but not there.”

Many people describe it as their body taking over in a way they can’t control. And that loss of control can feel scary, confusing, deeply frustrating, and incredibly energy-taxing (physically, mentally, and emotionally).

A Nervous System Perspective: The Dam and the Circuit Breaker

One way to understand PNES is to think about emotional stress like water building up behind a dam.

Day after day, stress accumulates. Emotions get pushed aside. Needs go unmet. The system keeps holding, adapting, managing… until the pressure becomes too much.

Eventually, the dam can’t contain it anymore. Something has to give. A PNES episode can be that release.

Another way to understand it is through the image of a circuit breaker. When there’s too much electrical load, the breaker trips; not because something is broken, but because the system is trying to prevent damage.

In this way, a PNES episodeis not a failure of your body.

It’s a protective response from a nervous system that has reached its limit.

Why Does PNES Happen?

PNES often develops in nervous systems that have been under prolonged stress or have experienced trauma; sometimes recent, sometimes long ago. For many people, PNES develops in nervous systems that have been under stress for a long time, especially when those experiences haven’t been fully processed or integrated, even when support was present.

When unprocessed emotional experiences linger in the body, the stored nervous system activation can build and build until the system finds a way to release it.

Seen this way, PNES isn’t a sign of weakness. It’s often the nervous system alarming that something here needs care.

Treatment for PNES: Healing the Nervous System (Not Just Managing Symptoms)

The hopeful part of this story is that PNES is treatable.

Because these episodes live in the nervous system (not just in thoughts), healing involves more than insight or willpower. It requires gently helping the body process what it has been holding.

At HeARTS for Hope Therapy, in Greenville, SC, we use integrative, trauma-informed approaches that work with both the mind and the body. Each modality offers a different doorway into healing, and together they support the nervous system in releasing stored stress in a way that feels safe and paced.

EMDR (Eye Movement Desensitization and Reprocessing)helps the brain reprocess experiences that may feel “stuck.” Rather than reliving the past, clients are supported in metabolizing it, so the memory no longer carries the same emotional or physiological charge. As this happens, the nervous system doesn’t have to work as hard to keep that material contained.

Somatic therapy focuses on what’s happening in the body in real time. This can include noticing sensations, tracking shifts in tension or breath, and incorporating gentle, intentional movements that help the body release what it’s been holding. Over time, clients begin to learn a new language…one rooted in the body rather than in overthinking or analysis. Instead of getting stuck in mental loops, the work becomes about listening to what the body is communicating and responding to it with curiosity and care. This helps the nervous system build the capacity to feel and process experiences without needing to shut down or escalate into an episode.

Art Therapy offers a non-verbal way to process what may feel too complex or overwhelming to say out loud. Through art-making, metaphor, and creative exploration, internal experiences can take form outside the body—making them easier to understand, relate to, and transform.

Brainspotting works by identifying specific eye positions—“brainspots”—that correlate with where trauma or distress is stored in the brain and body. By staying with these points in a focused, supported way, the brain can process deeply held material beneath conscious awareness. Many clients find this approach especially helpful when words are hard to find.

Accelerated Resolution Therapy (ART) combines elements of eye movements with imagery rescripting. This means clients can actively shift how distressing memories are stored—often replacing painful images with ones that feel more neutral or empowering. The process is structured and tends to move efficiently, while still honoring the nervous system’s pace.

Across all of these approaches, the goal isn’t to “stop” PNES episodes through force. Instead, we focus on reducing the internal pressure that leads to them.

As the nervous system begins to feel safer, more supported, and less overwhelmed, it no longer needs to rely on extreme protective responses like shutting down or discharging through episodes.

Healing happens gradually, with respect for your system’s timing.

And at every step, the work we offer at HeARTS for Hope Therapy in Greenville, SC is collaborative. You are not being “fixed” because you are not “broken!” You’ll be supported in reconnecting with your body’s innate capacity to heal.