People frequently ask me about the possibility of repressed memories being the origin of their problems. This is a holdover from the once dominant psychoanalytic approach to psychiatric treatment.
On television and in the movies we frequently watch psychiatrists help people recover memories of events from their childhood that may somehow explain the way they currently feel. Often, the tension builds as the patient gets closer and closer to a breakthrough and finally achieves clarity.
In reality, the techniques and results are less certain and much more controversial.
To begin with, memory does not work like a video camera accurately recording everything we experience. It is a very fragile thing that can change and decay over time.
Memory is also easy to manipulate. Many studies have shown that it is possible (and in fact quite easy) to plant memories into people’s brains.
True memories can easily be contaminated by related bits of information as time passes. For example, when recalling a memory people often make inferences about what may have happened in order to fill in gaps. Over time, it is easy to confuse the sources and meld what was inferred with the actual memory. Dreams and stories we have been told can often become part of what we think we remember.
Completely false memories are another common phenomenon. Similar to the contamination of actual memories, false memories are often made from bits of information we get in our dreams or hear in stories. Once we forget the origin of the information – where we heard it from originally – it is easy to confuse real memory with an imagined situation.
With such an unreliable, changeable tool it is not surprising that there is a lot of controversy surrounding the validity of retrieving repressed memories.
When repressed memories are discussed, it is often in reference to memories of childhood abuse or trauma.
Although memory is not a stable thing, it is true that when children and adolescents are abused there are many psychological mechanisms that help cope with the trauma. In some cases, these coping mechanisms result in a lack of conscious awareness of the abuse for varying periods of time. Memories, thoughts and feelings stemming from this abuse may emerge at a later date.
Unfortunately, many of the techniques used by therapists to help a person retrieve memories are problematic. Methods such as hypnosis are flawed because false memories may be created. Whatever is remembered needs to be validated.
While it is sometimes possible to retrieve repressed memories through these means, it is not yet known how to distinguish with complete accuracy between memories based on true events and those derived from other sources. In many cases, corroborating evidence of prior abuse can be found to back up a retrieved memory, but not in all cases.
When there is no secondary information to support a retrieved memory, patients are left with unclear memories of abuse or what is worse – memories that are clear but may not be true. In these cases, it is the psychiatrist’s role to help the patient live with the reality that he or she may never know for sure.
When working with a therapist, choose someone who is empathetic, non-judgmental and who does not try to sway you in any particular direction. Therapists with strong pre-existing convictions that a patient was abused are more likely to pressure the patient into remembering such events. Beware of anyone who says that certain behaviours can only mean abuse. This is seldom if ever the case.
Childhood abuse and trauma can lead to many psychiatric problems in adulthood, but these problems can be dealt with and treated regardless of whether the patient remembers the abuse or not. The important thing is to treat the present-life problems rather than dwelling on the past.
Dr. Latimer is president of Okanagan Clinical Trials and a Kelowna psychiatrist.
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