For patients whose seizures are not controlled by medication alone, psychotherapeutic intervention can sometimes play a useful adjunctive role in both differential diagnosis and treatment. Diagnostic issues include the differentiation between neurogenic and hysterical seizures as well as the delineation of the possible role of psychogenic stress in triggering neurogenic seizures. Therapeutic considerations focus on the alleviation of precipitating stresses as well as the development of a sense of mastery in the patient.