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Biology 202
2001 Third Web Report
On Serendip

Forgetting to Remember: The Source of your Symptoms?

Kristine Hoeldtke

Imagine going about your daily business when, for some reason or another, you find yourself immersed in an intense, disturbing flashback of a traumatic event that you never knew you experienced? This bizarre scenario is more commonplace than might be supposed and is opening up all sorts of legal and therapeutic controversy. Repression is one of the most haunting concepts in psychology. The rationale is that some shocking occurrence is pushed back into an inaccessible corner of the unconscious only to be retrieved later by a most confounded consciousness (1). Is the memory really real? If it is, why was it lost in the first place and what triggered its return? And how is it to be dealt with?

Perhaps a better term for repression is dissociation. "Dissociation refers to those discontinuities of the brain, the disconnections of mind that we all harbor without awareness" (2). Dissociation lets us step aside, split off from our own knowledge, behavior, emotions, and body sensations, our self-control, identity, and memory. This splitting of mind and pigeon holding of experience is a natural adaptation to the complex demands of daily life. One demonstration of this phenomenon involves a knee injury patient named Anastasia. Facing emergency surgery with a poor prognosis, she chose a spinal anesthetic with no sedative, so she could stay awake and observe the operation. She remembers the clinician administering the spinal injection, but that's all. Her next consecutive memory of the ordeal was simply "waking up" in the recovery room, disappointed that she had "fallen asleep and missed the surgery." She was further perplexed when the surgeon walked in and thanked her for "a great discussion." Anastasia eventually realized that she had carried on a technical discourse for nearly two hours, a conversation she, to this day, has absolutely no recollection of (2).

An even more dramatic illustration of dissociation (without, however, repression) is depicted in Donald Wyman's horrifying experience. In the summer of 1993, while working in a remote Pennsylvania area clearing timber, Wyman suffered a terrible accident. A huge tree fell on him, pinning his left leg. He knew he would die before anybody found him if he did not take matters into his own hands. So he made a tourniquet from a rawhide bootlace and used his chainsaw wrench to tighten it. He then went about methodically cutting off his left leg with his pocket knife. When he had severed the leg, he crawled to a bulldozer five hundred feet away, drove it about two thousand feet to his pickup truck, and then drove the truck about two miles to a farmhouse. The farmer, who called the paramedics, described Wyman as "sharp and mentally strong" (2).

For victims of sadistic and violent abuse, dissociation provides a means to sanity and survival. "Whether in bloody Bosnian back rooms, Nazi death camps, or childhood holocausts in abusive homes, victims use dissociation to escape intolerable terror and pain, to cope with terrible loss" (2). Because they are enjoined to repress their suffering and dissent, victims of sadistically abusive systems must split off these sentiments, permitting the compartmentalization of experience " (2).

So what's the problem, one might ask, with this "motivated forgetting" if it provides at least temporary protection from the stress of horrible secrets? Unfortunately, this is not a case of "what you don't know (or what your I-function doesn't know) can't hurt you." Sometimes dissociated traumatic events "leak" across dissociative barriers. Past feelings and body sensations may intrude on present-day emotions and behavior. Clinically, present day anxiety or panic disorders often stem from unexpressed effects of earlier traumatic experiences. The worst-case scenario would be dissociative identity disorder (DID, formerly MPD), with its characteristic amnesia, derealization, depersonalization, and personality-splitting. DID usually manifests in an effort to cope with prolonged traumatic childhood demands (often sadistic abuse). The demands to contain and manage the effects of massive trauma and paradoxical realities (I'm Daddy's favorite by day but by night Daddy likes to hurt me), may engender a compartmentalized, dissociative structuring of consciousness (2). Out of sight, therefore, is not necessarily out of mind, but rather in "parallel mind."

Any of this sounding familiar? Early in his career, Sigmund Freud recognized dissociation as a fundamental clinical mechanism in his hysterical patients recounting childhood abuse. Although he eventually abandoned the dissociative framework, Freud subsumed the phenomena under his new concept of repression, the central psychoanalytic tenet that people tend to inhibit (and consequently not remember) unacceptable wishes, impulses, affects, and sexual impulses (2).

Of course, not everybody is nodding along with this esoteric psychological theorizing. Robyn M. Dawes, for example, attributes the widespread belief of repressed memories to human errors in reasoning. Two important factors, she claims, are an over reliance on authorities and on social consensus. She also points to the fallibility of retrospective memory and the difficulty inherent in believing what one remembers is not true: "To ask people to question their own memory is tantamount to asking them to question their own interpretation of reality, which is at the extreme is close to asking them to consider the possibility that they are schizophrenic" (3). The mistaken beliefs that confidence is highly correlated with accuracy and that more information necessarily implies a better grasp of reality, compounded by the diminution in the scientific training of licensed therapists (training, she claims, that has essentially "gone to hell") further contributes to the "epidemic of irrational beliefs" (3).

And Robyn Dawes has many confederates. One psychiatrist who has seen more than two hundred severely dissociative patients explicitly referred to such anecdotes as "empirical observations lacking in scientific underpinnings." One researcher described them as "impressionistic case studies" and claimed that they could not be counted as "anything more than unconfirmed clinical speculations" (1). In fact, many such adversaries are currently collaborating within the False Memory Syndrome Foundation that serves to temper, or at least diminish the credibility of, the steady emergence of "pseudomemories."

Dissociation, does, however, still hold its ground in psychological theory and practice and psychotherapists continue to suggest the possible reality of repressed trauma as a means to rehabilitate patients. It may be impossible to know, however, whether the therapist's interpretation is the cause of the patient's disorder or the effect of the disorder. And determining the validity of the memories becomes even more essential once other peoples' lives begin to be affected. With recent changes in legislation, people with recently unearthed memories are suing alleged perpetrators for events that took place twenty, thirty, or even forty years earlier! (1).

The most common method for assessing memory validity is the determination of symptomatology. The presence of such symptoms as low self-esteem, sexual dysfunction, and self-destructive behavior may suggest that a repressed trauma is permeating the I-function and haunting consciousness (1). More lucid symptoms involve body memories, which demonstrate the resilient capacity of the nervous system to store memories and generate associations that transcend mere recollection. Some body memories manifest in relatively harmless physical sensations while others are more extreme (voice frozen at a young age, rash on body matching inflicted injury, even hemorrhaging) (1).

"For a rape victim, a whiff of the wrong aftershave in an elevator triggers pervasive panic and dread. A WWII psychiatrist noted that bombing raid convalescents scanned the sky and became upset by the sight of a harmless sparrow" (2). While it may be impossible to pinpoint what exactly triggers the onset of memory retrieval, whether it is in the form of an image, a feeling, or a dramatic physiological response, a basic understanding of constructive memory may aid in dispelling some of the mystery. One can begin by noting that representations of new experiences can be conceptualized as patterns of features, with different features representing different facets of the experience: the outputs of perceptual modules that analyze specific physical attributes of incoming information, interpretation and evaluation of these attributes by conceptual or semantic modules, and actions undertaken in response to input. Constituent features of a memory representation are distributed widely across different parts of the entire brain, such that no single location contains a complete record of the trace of any distinct event. So, retrieval of a past experience involves a process of pattern completion in which a subset of the features comprising a particular past experience are reactivated (4). This activation spreads to the rest of the constituent features of that experience and presents the conscious awareness with a not-quite-novel motor symphony to make sense of.

Features comprising an episode must be linked together at encoding to form a bound, or coherent, representation. Because memory representations are distributed across the brain (especially in the medial temporal area, including the hippocampal formation, and the prefrontal cortex), however, it is easy to see how overlap may occur. A closely related encoding process is required to keep bound episodes separate from one another in memory. If events overlap extensively with one another, individuals may recall the general similarities common to many episodes, but fail to remember distinctive, item-specific information that distinguishes one experience from another. Retrieval cues can potentially match stored experiences other than the sought-after episode. Poor retrieval focus can result in recollection of information that does not pertain to the target episode, or may produce impaired recall of an event's details, insofar as activated information from nontarget episodes interferes with recollection of target information (4). This further complicates the determination of validity of repressed memories in that while the essence of the main event may be accurate, other dimensions of the recalled experience may be completely misguided or confounded.

So what is the bottom line? How are these memories to be dealt with? Like many questions in science, the final answer is yet to be known. The controversy has, however, demonstrated that there are areas of research that can be pursued in quest of that final resolution. Some possible probing sites include: research to provide a better understanding of the mechanism by which accurate or inaccurate recollections of events might be created; research to ascertain which clinical techniques are most likely to lead to the creation pseudomemories and which techniques are most effective in creating the conditions under which actual events of childhood abuse can be remembered with accuracy; research to ascertain how trauma and traumatic response impact the memory process; and research to determine if some people are more susceptible to others to memory suggestion and alteration and if so, why information (5). In the meantime, however, we should approach this complex issue with a complex mindset. We should maintain both a skeptical curiosity and a genuine respect for an all-too-possible phenomenon. Because even though the I-function may be notorious for its blunders, one cannot disregard the meticulous wonders of the rest of the nervous system.

WWW Sources

1)The Reality of Repressed Memories

2)Dissociation: Nature's Tincture of Numbing and Forgetting

3)Why Believe That for Which There Is No Good Evidence?

4)The cognitive neuroscience of constructive memory

5)Questions and Answers about Memories of Childhood Abuse

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