Table of contents:
- What is dissociative amnesia
- Dissociative amnesia: symptoms
- Dissociative amnesia: types
- Duration of dissociative amnesia
- Risks when remembering the forgotten
- Causes of dissociative amnesia
- Dissociative amnesia: treatment
- Dissociative amnesia: clinical case
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Most of us have experienced the well-known blackouts, whereby we are not able to remember something that we normally have on the tip of our tongue every day (for example, birthday dates or names of someone we know). Sometimes we are not able to remember how we got to the room or why we entered the room and we have to go back to try to remember.
In dissociative amnesia, waiting or returning to the room where we were in order to remember something is not functional. Therefore, in this Psychology-Online article we explain what dissociative amnesia is: its symptoms, types and treatment.
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- Dissociative amnesia: symptoms
- Dissociative amnesia: types
- Duration of dissociative amnesia
- Risks when remembering the forgotten
- Causes of dissociative amnesia
- Dissociative amnesia: treatment
- Dissociative amnesia: clinical case
What is dissociative amnesia
DSM 5 (2013) defines dissociative amnesia as an inability to recall autobiographical information. This pathology goes beyond ordinary forgetfulness, since it is part of dissociative disorders and causes clinically significant discomfort and deterioration in different important areas of life such as social and work.
The characteristic of dissociative amnesia is thus the inability to recall important autobiographical information that is generally traumatic in nature (for example, sexual abuse, violence, or having been a bystander of the traumatic event).
This autobiographical information should normally be successfully stored in memory and should be easily remembered, as head injuries, infections, diseases in areas of the brain involved with memory or related to decoding of traumatic stimuli, neurodegenerative diseases and synucleinopathies have been ruled out..
Dissociative amnesia: symptoms
Here are the characteristic symptoms of dissociative amnesia:
- Inability to remember dates or years (may be related to abuse received or witnessed).
- Inability to remember addresses (including your own address).
- Inability to remember names.
- Inability to remember certain events, people or even personal information (one's name, address, age).
- Feeling of separation from oneself.
- Inability to remember some previous knowledge (for example, the semantic knowledge that causes the problem to recognize objects or remember the name of objects).
- Agnosia: the inability to process sensory information.
- Alteration of procedural knowledge (long-term memory). Procedural learning is the actions that we know how to do and that we have automated, such as speaking our language or driving.
- Associative visual agnosia (inability to match photographs or semantically related objects).
- Disorientation.
- Dissociative fugue (aimless wandering in the streets), this symptom of dissociative amnesia is usually what begins to attract attention.
- Anosognosia - People are unable to recognize their memory problems or are only partially aware.
- Chronic difficulty in the ability to form and maintain satisfactory relationships.
- Dissociative flashbacks (for example, re-experiencing traumatic events).
- Depressive symptoms and functional neurological symptoms such as depersonalization are common.
- Sometimes sexual dysfunctions are frequent.
- Feeling of lost time or not having felt the passage of time.
Dissociative amnesia: types
Following are the types of dissociative amnsesia that exist according to DSM 5 (2013):
- Localized: it is the inability to remember facts during a restricted period of time, it is the most common form of dissociative amnesia. This type of amnesia can be more extensive or extensive than single event amnesia. For example, months or years of abuse are forgotten during childhood.
- Selective: In selective amnesia, the person can remember some, but not all, of the events during a circumscribed period of time. For example , part of a traumatic event can be remembered but not other parts; External and internal stimuli such as the intensity and color of the light that existed while the sexual abuse occurred, the face or just the height of the sexual abuser can be remembered in a fragmented way. Some may state that they have both selective and localized.
- Generalized: it is the total loss of memory that covers the entire life of the person and is the least frequent. In this type of amnesia, personal identity, prior and procedural knowledge can be forgotten.
- Systematized: the person loses memory for a specific category of information. For example only memories associated with one's own family or memories with a particular person or only memories of sexual abuse.
- Continuous: in this type of amnesia the person forgets each new event that occurs from a certain event to the present.
Duration of dissociative amnesia
Dissociative amnesia usually has an acute onset (sudden or rapid). The duration of forgotten events can range from minutes to decades. Some episodes of dissociative amnesia usually resolve quickly (for example, when a person is withdrawn from the stressful situation or stimulus). Dissociative abilities may decrease with age but they do not always happen.
Risks when remembering the forgotten
As the amnesia subsides, marked and profound distress, suicidal behaviors, and characteristic symptoms of post-traumatic stress disorder (PTSD) can occur or develop. These risks, especially suicidal behavior, can arise from intolerable memories that begin to appear.
Causes of dissociative amnesia
Dissociative disorders often arise as a consequence of trauma (eg sexual abuse, war, physical abuse, child abuse, natural disasters, car accidents, homicides, and physical torture). But, although they do not fall into the category of trauma and stressor-related disorders, they do reflect a close relationship between these two types of diagnoses.
Dissociative amnesia: treatment
As Van der Kolk (2015) refers, if the thalamus is altered, the trauma is not remembered as a story, a story with a beginning, a development and an end, but as isolated sensory traces: images, sounds and physical sensations.
The treatment that is given to dissociative amnesia must be understood in these aspects where sensory experiences are integrated.
The psychological treatment that can be offered in dissociative amnesia is called EMDR. Eye Movement Desensitization and Reprocessing (EMDR) allows the reprocessing of freely associated images and memories from the past. This seems to help put the traumatic experience in a larger context or perspective. EMDR allows you to look at your experiences in a new way, without a verbal exchange with another person.
Dissociative amnesia: clinical case
The following is a clinical case of a woman with dissociative amnesia as a result of having suffered intrafamily sexual abuse:
This is a 20-year-old girl who went to the National Hospital of Guatemala, consulted about acute abdominal pain. The clinical laboratory tests performed showed only some values outside the normal parameters. What caught the attention of the clinical staff is the overweight of the patient and some unusual purple lesions on the breasts and abdomen.
The gastroenterologist orders an X-ray or endoscopy of the patient to rule out any injury and laboratory tests to be able to measure the level of cortisol and the hormone T3 and T4. Gastric ulcers were seen in the X-ray results that were probably related to the laboratory results that showed high cortisol levels.
In addition to these clinical manifestations, the patient was unable to provide some data related to her personal information. He mentioned remembering only his name but not his surname, nor could he remember his address. The patient therefore presented autopsychic and allopsychic disorientation (she is unable to identify the people around her and personal data).
The clinical staff suggests that the memory disorders are related to the physical symptoms that were the reason for consultation, but they needed to rule out that they were not brain disorders (especially the areas involved in the adrenal gland, which is the one that could be related to their high cortisol levels) or due to a psychological cause.
Pierre Janet (1986) highlighted the link between trauma and dissociation, proposing a theory of pathological dissociation resulting from people who have experienced a traumatic event. Conceptualizing dissociation as a defense against anxiety caused by traumatic experiences, which can be maintained as "subconscious fixed ideas" in the mind of the patient, damaging their mood and behavior.
Sigmund Freud was able to observe that repressed experiences do not remain in a latent state, but are re-experienced through dreams and nightmares, regressions and the overflow of feelings and sensations related to traumatic experiences.
Wilbur (1984) maintains that abuse creates in boys and girls a state of threatening and unacceptable anger. Thus, they learn that these sensations are not okay to be expressed and they should not be felt consciously, so they repress these sensations and the memories that cause them remain in the unconscious.
Dissociative amnesia is usually due to a long-term repressed memory as a result of either psychological or emotional trauma. In the present case, the probable relationship between her difficulty in remembering and her physical symptoms was reached through an interview with the patient and people close to her.
The psychologist in charge was in charge of exploring her history and the patient reported having lived all her life on the street, but the person who accompanied her explained that a few weeks ago the 20-year-old had never been seen on the streets and that she knew to her family: an alcoholic father and two uncles, as the mother had abandoned her with them from a very young age.
As Van der Kolk (2015) referred when problems are solutions; Generally, patients who have been sexually abused use their own body as a defense mechanism, they begin to eat in exorbitant quantities with the intention of gaining weight and thus not appear more attractive to the abuser. In the case of the patient, her overweight was also related to her high cortisol levels, which both caused the ulcers and were the ones that caused her acute abdominal pain.
Through the application of EMDR and psychoanalysis, the patient was able to reprocess through memory induction, regression and transfer all those memories of the abuse that had been repressed, starting by showing her with her identification document the surnames of the father and mother who had forgotten (which with a psychoanalytic interpretation was a defense mechanism to forget and protect oneself from those people or agents who had caused the trauma or pain)
This article is merely informative, in Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.
If you want to read more articles similar to Dissociative Amnesia: what it is, symptoms, types and treatment, we recommend that you enter our category of Clinical Psychology.
Bibliography- American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM 5). Editorial Panamericana.
- Janet, P. (1986). Dissociation: the first tranference theory and its origins in hypnosis. American Journal of Clinical .
- Van der Kolk, B. (2015). The body keeps score. Editorial Eleftheria. Barcelona, Spain.
- Wilbur, CB (1984). Treatment of Multiple Personality. Psychiatric Annals.