Cases of conversion disorder abound at Lady Reading, a colonial-era hospital built mostly of red bricks in the shade of the Bala Hissar Fort. Both are now on the front lines of the region’s battle with terrorism, one deploying troops and one treating victims. I came to the hospital’s psychiatric ward to learn how the conflict has affected people, but found that the sort of conflict that has the biggest impact on people’s lives doesn’t as often make headlines.

The drab, gray walls of the hospital’s psych ward are adorned with homemade posters. They’re bordered with bright-pink flowers and cartoon characters, but depict serious subjects: One is labeled “psychotherapeutic measures” and another “dissociative disorders.”

Dissociative disorders, the group of psychosomatic psychiatric illnesses that includes conversion disorder, according to the World Health Organization (WHO) classification handbook ICD-10, was the second most common diagnosis (after depression) made among female patients admitted to Lady Reading’s psych ward between January and November of last year. The ward diagnosed 23 dissociative cases last January, compared to only four cases of schizophrenia, two patients with mood disorders, and none with anxiety.

The 16-bed female ward is almost always full. There is only one psychiatrist for every 100,000 people in Pakistan, according to the WHO. Mental health facilities are particularly rare in the restive and conservative tribal areas in the country’s northwest, and some traverse mountain roads for hours to receive medical treatment in Peshawar. One possible explanation for the prevalence of conversion disorder at Lady Reading could be that the severity of conversion symptoms is enough to spur patients to travel to the hospital, but some local doctors believe that that conversion is a common psychiatric disorder among women here.

“We have a lot of conversion patients because women are suppressed,” Karamat says. “The culture is very strict and it’s a male-dominated society, so women’s rights are violated. Other than that, it’s because we don’t have many spaces for women to get out and enjoy their lives: That trend is nonexistent here. We don’t have any social parks and women can’t really even go out to eat. So because of that, women are bound to the house. That causes them to bury their emotions and develop frustrations. Then they come up with physical symptoms. Sometimes they come with pain, or body aches, and most common is fits, [which are called] conversion fits or non-epileptic seizures.”

The notion that repressed trauma or latent desires might be “converted” into physical ailments has been at the core of how mental-health professionals have dealt with the disorder for at least the last hundred years. This theory was popularized, perhaps unsurprisingly, by Sigmund Freud, who thought that repressed memories or the impossibility of fulfilling a sexual drive would manifest itself physiologically as fainting spells or the inability to speak.