Dissociation (amnesia) and remembering abuse anew?

How is it that someone could forget a horrific event or experience? What is happening when something new is remembered about a very old event? Is it possible to forget (lose the capacity to recall) for long periods of time but then later remember?

Continuing my series on memory, abuse, and the controversies of recovered memories [you can read my previous posts: here, here, and here], I now want to address the issue of dissociation, amnesia, and remembering abuse. In those previous posts we have looked at how memory can be degraded by intent (conscious denial or unconscious rejection), by other overwhelming stimuli, or by failure to encode. But, since I have not spent much time on the topic of dissociation and repression, I want to say just a few words about these two ideas–in part because they are frequently used but poorly defined.

What is Dissociation? Is Amnesia a better term?

People define dissociation in a variety of ways but most definitions include some disconnection from present reality–sensations of disconnection from self, others, or time–and exists on a continuum. The most mundane forms happen everyday. You are driving from point A to point B but realize you cannot remember what you saw along the way. While we could describe this as a failure to encode data into memory, we could also describe the process, a disconnecting from what is happening in the present. Some dissociation is even beneficial. If you have ever been in pain but then got a distracting phone call, your pain perceptions probably decreased. You were, in effect, dissociating from the present experience of pain.

Now, when we talk about dissociation from a counseling perspective, we are talking about a more significant disconnection from present experiences, one that often seems to happen outside the conscious control of the person (but may be a practiced habit that happens without mindful decision). Dissociative experiences include feeling unreal, disconnected from the body, unable to engage the present, unable to remember salient portions of pesonal identity, or even, rarely, the presentation of alternate personality states that appear to fight for control of the individual.

You can imagine that if you are in the position of a repeated trauma (such as child sexual abuse by a parent figure) and unable to escape it, you might develop ways of dealing with the pain by disconnecting from the present. As a result, you might find that any time you begin to feel unsafe, you naturally disappear in some minor or major way. What happens during that “disappearance” depends on the individual. For some, they are reliving some other experience (I’m no longer present but reliving a painful event in my life). For others, they report being blank–thinking and feeling absolutely nothing. The most telling sign to a therapist is that the client no longer seems to be present in the room (nonreactive or reacting clearly to something other than is going on in the present). Whatever the form of disconnection, most then experience some level of inability to remember portions of the trauma.

Interestingly, there is some evidence that those who dissociate have greater capacity to self-hypnotize. In addition, McNally describes a study (in Remembering Trauma) that followed a person with psychogenic amnesia who had altered brain function when in amnestic states.

Does dissociation lead to forgetting traumatic data?

Can a person dissociate enough to create a persistent amnesia for a traumatic event? There is evidence that those who experience frequent disconnected states have greater difficulty remembering important details of traumatic events. However, many would say that repression is a better conceptual tool to explain such forgetting. But then, repression is not well-defined either (even Freud himself interchanged repression and suppression when talking about decisional vs. unconscious forms of forgetting). Despite the frequent use of repression in common parlance (and without the Freudian baggage) I would suggest that amnesia or motivated forgetting may be better terms, a bit more descriptive and less connected to psychoanalytic theory.

Whatever you call it, some level of forgetting can happen to those experiencing relentless traumas.

• a young Jewish woman forced into an internment camp has her infant child ripped from her and killed. After the war, a relative asks the woman about the child and the woman responds, “what baby?” Only much later does she remember having a child or how this child died.
• A young male cannot remember much about his childhood. When asked about his Uncle (only 5 years older than he), he can only remember a vague uncomfortable feeling. His younger brother recounts this uncle would routinely enter their bedroom at night to sodomize both boys. Only after numerous conversations does the older brother begin to remember abuse details, even beyond those supplied to him by his younger brother.

Forgetting then Remembering anew?

In my 23 years of counseling I have never encountered someone who recovered memories of a trauma after completely blocking all memory (I believe it is theoretically possible but extremely rare). I have, however, had a number of clients recall previously long forgotten or vaguely remembered traumas. Often when they recall events with VASTLY new interpretations, so new that it feels like an entirely new memory even as they admit the memory isn’t new to them. Here’s a real example (with details changed to disguise identity),

Alice, a 52-year-old elementary school principal, enters individual therapy at her husband’s insistence to deal with her irritability at home. She admits she has developed a fantasy of leaving her husband for the new (and younger) president of the school board. She discloses that this fantasy began not long after her husband suffered a work-related accident rendering him partially disabled. During the initial intake Alice denied any history of trauma or abuse. As the therapy progressed, it became evident that Alice connected her personal identity to that of being pursued–something that her husband no longer attempted. In addition, her attempts to flirt with the school board president had been ignored. In a moment of frustration, Alice exclaimed, “I’ve always known that men found me very enticing, ever since I developed [breasts] at an early age. I’ve always had to be so careful around men, especially married men. I knew they wanted me and that made me feel dangerous but desirable. Now, who am I if no one wants me?” Alice’s therapist asked her to recount a bit of her early sexual history and without much delay Alice reported her first sexual experience at age 12 with her 35-year-old, married Sunday School teacher. She recalled her teacher hugging and fondling her breasts while telling her about his failing marriage and the need for the two of them to avoid further sexual temptation. At age 16, she reported that she and a 4o-something father of a child she babysat engaged in a 6 month sexual relationship.  Alice’s counselor indicated some surprise at how Alice described both experiences. She asked Alice how she would describe the same interactions between one of her current 6th grade students and a school teacher. Alice immediately flushed with horror. “Why, it would be child abuse!” Once Alice regained her composure, she explored how she had always remembered herself as the protagonist in both experiences. In that session and over the next several weeks, Alice reported a flood of new memories, mostly about things done or said by the two sexually abusing men and now interpreted to be predatory behavior. On several occasions she reported that it felt like she had never had these memories before even though she recounted that she never forgot the sexual encounters. The new interpretations and labels created the experience of recovering long-lost memories–ones that seemed blocked as long as she was responsible for the trysts but freed in light of her victim interpretation.

In this little vignette I want to illustrate that memories of abuse can be forgotten, whether only small portions or large, and remembered anew. Recalled or recovered memories are frequent as individuals gain the freedom to explore events from different vantage points. A therapist does not need to go on an abuse hunt or attempt to conjure up forgotten memories for this to happen. Merely exploring the narrative of a prior difficult experience can be all the priming a client needs to begin to experience “new” remembering.

But here’s where good therapy differs from unethical therapy: how the therapist responds to or pursues memories may be the determining factor when it comes to the development of false memories of past abuse. In the next post we will take up the ethics of memory work and explore therapist habits that may produce false memories of abuse.