By Jim Hopper, Ph.D.
(last revised 3/28/2011)
kw: repressed false memory syndrome; repressed false memory syndrome; repressed false memory syndrome; child abuse, child abuse

Amnesia for childhood sexual abuse is a condition.

The existence of this condition is beyond dispute.


Repression is merely one explanation

– often a confusing and misleading one –

for what causes the condition of amnesia.


Some people sexually abused in childhood

will have periods of amnesia for their abuse,

followed by experiences of delayed recall.

(Based on published research. See below.)


Notes on Usage & Presentation

This is a very large individual Web page (over 50 printed pages). Please be patient as it loads. For your convenience, I suggest that you begin by checking out the Table of Contents, then scrolling down to read the Preface, Words of Caution, and Introduction. If you try to follow links in the Table of Contents before the page has fully loaded, you will have to reload it.

I have highlighted in red those passages which particularly fit with my goals. These do not correspond to emphases in the original texts. Again, this is a very large page, and the highlights can be used for browsing too.


Table of Contents

  • Preface - Author Info. & Aims for this Page
  • Words of Caution I - Caveats on Research Evidence, Theory & Controversy
  • Words of Caution II - Personal Concerns & Questions About Your Memories?
  • Introduction: Empirical Evidence, Psychological Constructs & Scientific Progress

  • Hypertext Table of Research Findings - Perfect for Fast Browsing!

  • The Journal of Psychiatry and Law - 1996 Review; Perpetrator Confessions
  • Linda Meyer Williams - Great Research (prospective, community sample)
  • Cathy Spatz Widom - Great Research (prospective, large sample, gender effects)
  • Diana Elliott - Great Research (random national sample, various traumas)
  • Bessel van der Kolk - Traumatic Memories & Dissociation; 4 Papers on Web
  • Judith Lewis Herman - Verified Memories; Social Contexts; Dissociation
  • Ross Cheit - Recovered Memory Project Archive of Corroborated Cases
  • Elizabeth Loftus - What the Popular Media Haven't Reported
  • Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition
    - Dissociative Amnesia is an Established Psychiatric Diagnosis
  • Journal of Traumatic Stress - Special Issue: Traumatic Memory Research
  • John Briere - Two Research Studies
  • Shirley Feldman-Summers - Study of Therapists; Verified Memories
  • Jennifer Freyd - Betrayal of Children & Memory Loss
  • Chris Brewin - Explanations Based on Cognitive Science
  • Cynthia Bowman & Elizabeth Mertz - Legal Argument & Scientific Review
  • Judge Edward Harrington, U.S. District Court - Recovered Memory Ruling
  • Selected Books on Recovered & Traumatic Memories

  • Media Coverage of Recovered Memories - Sources of Bias & Deceptiveness
  • Additional Resources - Including Articles & Web Resources

  • Related Pages at This Site

  • Contents

    Preface

    I am a researcher and therapist with a doctorate (Ph.D.) in clinical psychology. I am a licensed clinical psychologist, and for nearly 20 years I have been a therapist to men and women abused in childhood, providing individual and group treatment. I have studied the characteristics of traumatic memories and the effects of psychological trauma on biological systems involved in emotion regulation. My collaborators include Dr. Bessel van der Kolk, a leader in the psychological trauma field at The Trauma Center and Boston University. I am an independent consultant, Clinical Instructor in Psychology at Harvard Medical School, and consultant on psychological trauma at the Outpatient Addictions Service of the Cambridge Health Alliance. The contents of this page reflect my level of experience and expertise, as well as opinions I have formed over the years.

    I have published this page to direct people to quality scholarly work on traumatic memory, especially:

    1. Research evidence showing that it is NOT RARE for people who were sexually abused in childhood to experience amnesia and delayed recall for the abuse. This body of work shows that claims to the contrary are contradicted by scientific evidence.

    2. Research and theoretical works by qualified specialists who increasingly agree that: a) traumatic and nontraumatic memories have some different characteristics; b) the construct of "dissociation" best explains many traumatic memories, e.g., those involving fragmentary sensations and feelings which are disconnected from verbal narratives, and associated with amnesia and delayed recall. These works show that making claims about traumatic memory based on generalizations from research on nontraumatic memory, and focusing on the constructs of "repression" and "repressed memory," can often be confusing distractions and misleading tactics.

    To accomplish these two goals, this page does not need to be comprehensive, nor up-to-date on the latest research - though I will occassionally make additions, and am always open to suggestions.

    Before proceeding, I want to acknowledge some very important issues that this page, with its limited goals related to recovered memories and dissociation, does not address, except in passing. Please read every item and the entire list very carefully.

    Issues not addressed on this page:

    1. Every instance of recall is a process of reconstruction, and therefore involves some degree of distortion.

    2. This process of reconstruction is never random, and is always influenced by factors internal and external to the person attempting accurate recall.

    3. There is strong evidence that people can sincerely believe they have recovered a memory or memories of abuse by a particular person, but actually be mistaken.

    4. There is strong evidence that such memories have led to accusations about particular events that never happened and accusations of people who never committed such acts.

    5. In some cases mistaken memories and accusations have caused extraordinary pain and damage to individuals and families.

    6. One of the preventable causes of these tragedies is incompetence by therapists, who sometimes contribute to the creation of false memories and/or believe them without good reason.

    7. Currently, there are no reliable statistics on the occurences listed as numbers 3 through 6 above. Along these lines, see two articles by Dr. Kenneth Pope: "Questioning Claims About the False Memory Syndrome Epidemic," and "Science as Careful Questioning: Are Claims of a False Memory Syndrome Epidemic Based on Empirical Evidence?" (For more information about these articles and online ordering of copies, follow the link to Pope's site in the "Additional Resources" section of this page.)

    8. Most of these issues are addressed at the Web site of the False Memory Syndrome Foundation. I do not endorse that organization, their Web site, nor their treatment of these issues, which is clearly extreme in many ways. But I do encourage you to consider all positions, to contrast what you learn here with the materials presented at the FMSF site, and to come to your own conclusions.


    Finally, I strongly encourage you to seek out and read some of the scholarly works cited below. These will help you to make your own judgements rather than relying on what you hear or read in the popular media, or what is available on the Internet – including this page. It is my aim and hope, however, that reading this page will give you powerful knowledge and tools for thinking more critically about whatever else you hear and read on this topic.


    Contents

    Words of Caution I

    • Research and theories about amnesia and delayed recall for childhood sexual abuse are extremely controversial.

    • All statistics and interpretations of these phenomena are disputed by some experts.

    • Complex and subtle scientific issues are involved, including criticisms of research methods and theory-based interpretations of research findings and clinical observations.

    • The most controversial issues are:

      1. How common are amnesia and delayed recall for sexual abuse experiences?

      2. How do we understand the evidence? For example, do people "simply forget" sexual abuse just as they might temporarily forget any other unpleasant experience, or are different brain mechanisms and psychological defensive processes involved?

    • Emotions and moral commitments influence everyone's reasoning and judgement to some extent.

    • Even experts who claim to be without bias are fooling themselves or trying to fool you.

    • The presentation of research, statistics and theories on this page is influenced by my values, my informed opinions, and my experiences as a therapist and researcher over the past 20 years.


    Contents

    Words of Caution II - Personal Concerns & Questions

    You may be reading this page to gain better understanding of your own memories, or lack of memories of (suspected) sexual abuse in childhood. Or you may have questions about whether remembering child abuse experiences can improve your life. If so, please take the time to read this entire section (about three printed pages). At its end I suggest a book with effective tools for managing painful and unpredictable memories, and link to more information on the stages of recovery and how to find professional help.

    For those who find this section particularly helpful, it can be downloaded as a PDF file, for easier printing.

    • People who read this web page sometimes have questions like these:

      • "How can I recover (more) memories?"

      • "How can I find someone to hypnotize me?"

      • "How can I know for sure whether I was abused?"

    • It is natural that people ask these questions, particularly given how the popular media present these issues.

    • It is more helpful, however, to step back and look at the bigger picture. . .

      • "Why do I want to recover (more) memories?"

      • "What do I hope that recovering memories will do for me?"

      • "Why do I wish I could know for sure whether I was abused?"

      • "What problems and suffering in my life now do I believe will be changed by remembering abuse?"

    • These are extremely important questions. They go to the heart of who you are, your deepest hopes, and your current struggles. There are no right or wrong answers. The point is that, first, you need to better understand your current problems, and to clarify what you want to achieve for yourself and your life. This must come before learning about whether recovering memories might be helpful.

    • Who knows, maybe recovering memories could help you. But this is not the key to healing the effects of child abuse and having a better life, and what you hope to gain by recovering memories is usually better achieved in other ways.

    • Remembering how you got through painful experiences, with whatever strengths and resources you had at the time, is usually much more helpful than remembering details of abuse. This is understood by the experts on these issues, and by any therapist qualified to help people heal from painful childhoods.

    • Healing from the effects of abuse is a process that takes place in stages, and the point of the first stage is not about recovering memories, or even focusing on the contents of the memories you already have.

    • The first stage of healing and recovery, and any helpful therapy or counseling, is about:

      • Getting a "road map" of the healing process, including the possible stages and the most helpful approaches to memories at each stage.

      • Establishing safety and stability in your body, your relationships, and the rest of your life.

      • Tapping into and developing your own inner strengths and all the resources potentially available to you.

      • Learning how to regulate your emotions and manage symptoms that make you feel unsafe or cause suffering.

      • Developing and strengthening skills for managing painful memories and other experiences, and minimizing unhelpful responses.

    • Of course, everything is not always so perfectly ordered and sequential. During the first stage of recovery, it may be necessary to discuss the contents of memories that are disrupting your life. This may be required, for example, to help you manage them, or to understand why you find it is hard to care for yourself (the abuser communicated that you were unworthy of care or love, etc.). However, in this case addressing memories is not the focus of therapy, but a means to achieving safety, stability and greater ability to take care of yourself.

    • Therefore, here are two more important questions that you need to answer, which will require more research and, in most cases, consultation with a qualified professional:

      • "What must I learn before discussing or "working through" abuse memories could help to improve my current life and help me achieve future goals?"

      • "What skills and capacities must I develop to manage the memories I already have - so that I can make sense of them or address any new memories that might emerge?"

    • Only after establishing a solid foundation of understanding, self-regulation skills, and safety and stability in one's life should one decide - freely, thoughtfully, mindful of the dangers - whether or not to focus on memories of abuse in order to, for example, place them into a larger understanding of one's life and identity. In fact, once such a foundation is in place, some people realize that thinking and talking about their abuse memories is not necessary to achieve their life goals, and that those memories are no longer of interest to them. (And sometimes people need to educate their therapists about this!)

    • For those who do need to focus on abuse memories, or decide that this could be helpful, making sense of what happened and how it fits into one's life story is part of a second stage of recovery, sometimes referred to as "remembrance and mourning." ("Mourning" refers to working through grief about the remembered abuse and its negative effects, grief about good experiences one didn't have and, for some, grief about not even being able to remember important experiences. However, this may not be necessary either.)

    • It is true that, for some people, focusing on the contents of abuse memories, including recovered memories, can be part of a second stage of the healing process. (Again, for some people this may not be necessary and may not be something they are interested in doing.) For those who do choose to explore their memories, several important cautionary points should be kept in mind:

      • If abuse memories do not emerge spontaneously, this may be due to healthy and protective psychological "defense mechanisms."

      • "Digging for memories," or trying to force abuse memories to emerge, is almost never a helpful approach, and can cause a great deal of harm. This can cause increased distress and confusion, and behaviors that are harmful to oneself and important relationships (including false memories and mistaken accusations).

      • Attempting to recover abuse memories using hypnosis or other mind-altering techniques is almost never a good idea. The risk of creating very distorted or outright false memories is increased by such methods.

      • Even focusing on abuse memories one already has, without proper preparation, will almost always increase distress, instability and self-destructiveness.

      • Though new memories may emerge during the course of therapy, and managing and making sense of such memories can be part of the healing process, recovering memories of abuse should never be the focus, or even a goal, of therapy or counseling.

    • Finally, here are a few more things to consider:

      • No matter how much abuse someone has experienced, or how complete her or his memories are, there is always much more to that person than "abuse victim" or "abuse survivor."

      • There is a danger of constructing a personal identity, or reinforcing a sense of self, that is too identified with, too constricted by, and too focused on being a "victim" or "survivor."

      • Intellectual learning, therapy, and many other activities and relationships can help people heal from harmful effects of child abuse, including help people deal with troubling memories. But if improving of one's current life and creating a better future take a back seat to exploring the past, healing will be slowed down, and may even be prevented.

    If you want to start learning and practicing the self-regulation skills essential to dealing with traumatic memories and the first stage of recovery, I strongly recommend this book: Growing Beyond Survival: A Self-Help Toolkit for Managing Traumatic Stress, by Elizabeth Vermilyea. To learn more and/or order it directly from the publisher (for a higher price than Amazon), go to the Growing Beyond Survival page of the Sidran Press catalog.

    To learn more about the potential stages of recovery from traumatic child abuse, and how to find competent professional help, see the About Recovery & Therapy section of my Child Abuse web page

    If you found this section particularly helpful, you can download it as a PDF file, for easy printing.


    Contents

    Introduction:
    Empirical Evidence, Psychological Constructs & Scientific Progress

    Reading this brief introduction will make it much easier to benefit from the rest of the information on this page.

    Empirical Evidence

    Physical evidence of assaults, corroboration from witnesses, and confessions by perpetrators are empirical evidence. When it comes to research on recovered child abuse memories, there IS empirical evidence of this kind, though a lot less than of the next type. . .

    The things people say about their abuse memories, including how they respond to researchers' questions – these are empirical evidence too. Of course, these kinds of data are not necessarily about objective events, nor conclusive evidence that abuse occurred. But they are the only evidence we have about people's memories for abuse experiences (real, imagined, or some mixture of the two).

    Both of these forms of evidence are extremely important, and people on all sides of the recovered memories debate acknowledge that what people say about their memories is one kind of empirical evidence, and one worth researching (whether or not a person has physical proof or corroboration from others).

    Theoretical Constructs

    Scientists try to understand and explain empirical evidence by using theoretical constructs, that is, ideas devised to integrate systematically a group of related observations or phenomena in a useful way.

    Constructs should not be confused with empirical evidence. Constructs should not be considered actual things, events, processes, or experiences. Rather, constructs are conceptual tools. They are conceptual tools that focus our attention on certain things, events, processes, and experiences – and help us try to make sense of them. But every construct directs our attention away from certain phenomena too, and can make it harder for us to notice and understand some empirical evidence.

    Therefore, when we are dealing with complex phenomena which we do not fully understand – like memories of child abuse – we must not get too attached to any one construct – whether it's "forgetting," "amnesia," "repression" or "dissociation." Otherwise we'll surely overlook important data, and fool ourselves into thinking we understand when we don't.

    Just as important, before drawing firm conclusions about a controversial issue – like recovered memories – we should be familiar with the various constructs used to describe and explain the empirical evidence – including constructs used by those who have studied it the most. Otherwise we leave ourselves highly vulnerable to being confused and misled.

    Child Abuse Memories:
    Empirical Evidence, Psychological Constructs & Scientific Progress

    It is not rare for people to say they don't remember an abuse experience that actually happened.

    It is not rare for people to report that there were times when they didn't remember an abuse experience that they remember now.

    When people say these things, we try to describe and explain what they are reporting with psychological constructs:
    • "forgetting"
    • "amnesia"
    • "repression"
    • "dissociation"
    Four crucial points:

    1. "Amnesia" is a descriptive construct. It directs our attention to the condition of being unable to remember experiences like childhood sexual abuse.
    2. "Repression" and "dissociation" are explanatory constructs. They point to hypothesized psychological mechanisms that may be responsible for the condition of amnesia.
    3. All constructs exist on a continuum from descriptive to explanatory. When it comes to empirical evidence of traumatic and recovered memories, dissociation is more descriptive of more empirical evidence than is repression.
    4. The persistence and the accuracy of a memory are completely separate issues, and not keeping them separate as constructs leads to considerable confusion. People can have memories that are largely true or largely false whether or not those memories have been recovered or continuously available. Thus it is very misleading to discuss "recovered versus false memories of abuse" or present these as mutually exclusive categories.


    It is not rare for people to say that at some point they came to remember a past abuse experience which they had not previously remembered.
    When people say things along these lines, again we use psychological constructs as we strive to describe and explain what happened to them:
    • "He remembered."
    • "She recovered a memory."
    • "Before beginning therapy, the patient experienced delayed recall."
    • "Some research subjects had a return of previously repressed memories."
    • "Some subjects in the study made new associative linkages among dissociated memory fragments, and integrated these with their conscious, verbal and narrative autobiographical memories."
    In short, we use psychological constructs to describe and explain people's inabilities to remember and their recovered memories of child abuse – which are far too varied and complex to be captured by any one construct alone. And we use separate constructs to describe memories on a continuum from continuous to recovered, and a continuum from accurate to inaccurate.

    As noted above, no matter which constructs we use, we should never confuse constructs with empirical evidence. And no matter which constructs we prefer, this does not change the empirical evidence we already have (though our constructs can influence our interpretations of it). Finally, better constructs lead to better research questions and methods, better empirical evidence, better interpretations of evidence and still-better constructs. . . That's the self-perpetuating process of scientific progress, of course.

    This Web page documents scientific progress by those who study child abuse memories:

    1. A substantial body of empirical evidence of amnesia and delayed recall for abuse has existed for years.

    2. Significant progress has occurred in how such empirical evidence is described and explained in ways that do not confuse and mislead people, particularly in shifting from "repression" to more descriptive constructs like dissociation and explanatory constructs from cognitive science and neuroscience.


    Contents

    Hypertext Table of Research Findings

    Amnesia and delayed recall for sexual abuse experiences are NOT rare. This table presents published research studies on whether some people with histories of child sexual abuse experience periods of amnesia and delayed recall.

    This is a HYPERTEXT table: Click on authors' names to go directly to abstracts of their studies; then click on your browser's "Back" button to come back to the table.

    Methodological notes: 1) Data from "community" samples are more representative than data from "clinical" samples; community samples represent the general population, while clinical ones represent people in mental health treatment. 2) "Prospective" studies are better than "retrospective" ones; in the former, researchers follow and later question confirmed people with abuse histories, while the latter rely on subjects' reports of past abuse. 3) Each of these studies has some methodological flaws or limitations, but their relative consistency strongly suggests that these findings are not spurious.

    A note on this table's limited scope: The table below presents only a small selection of studies. As early as 1997, Scheflin and Brown's review of the scientific research on recovered memories of sexual abuse (see next section) could present a table of 25 studies – every single one of which found periods of total and/or partial amnesia in a subpopulation of people with histories of sexual abuse.

    Selected Studies of Amnesia and Delayed Recall for Experiences of Childhood Sexual Abuse
    Author(s) &
    Date of Study
    Type of
    Sample
    Nature of
    Data Collection
    # of Subjects With Abuse or Trauma Histories % With a Period of Possible Amnesia
    (some with delayed recall)
    Go to abstracts from authors' names - Use browser "Back" button to return Partial Total
    Elliott (1997) Community
    (random national)
    Retrospective 357
    (variety of traumas)
    17 15
    Williams (1995) Community Prospective
    (abuse documented 17 years earlier)
    75* NA 16*
    Widom & Morris (1997) Community
    (social services)
    Prospective
    (abuse documented 20 years earlier)
    96 NA Females: 32
    Males: 58**
    Elliott & Briere (1995) Community (random) Retrospective 116 22 20
    Loftus, Polonsky, & Fullilove (1994) Clinical Retrospective 52 12 19
    Feldman-Summers & Pope (1994) Community (therapists) Retrospective 79
    (sexual and/or physical abuse)
    40.5
    (not distinguished)
    Briere & Conte (1993) Clinical Retrospective 450 NA 59.3
    Herman & Schatzow (1987) Clinical Retrospective 53 64
    (not distinguished)

    *  There were 129 subjects with documented sexual abuse incidents, but 42 (38%) did not report those experiences, and it was concluded that some of those subjects actually did not remember (see Williams, Study 1, below). Clearly, some of those subjects might experience delayed recall later, which would suggest that the the 16% figure is an underestimate. (Also, 5 of the 80 who did remember were inadvertently not asked about whether they had ever experienced amnesia for the documented abuse incident.)

    **  As discussed in the paper, it is highly unlikely that all subjects who did not report sexual abuse (despite it being substantiated in childhood) simply did not remember that the events had occurred. Instead, as in all such studies, some percentage did not report prior abuse for other reasons – including unwillingness to disclose the information to researchers, current interpretations of those experiences as not abusive, etc. – and it appears these influences are greater for males than females.


    Contents

    The Journal of Psychiatry and Law
    Special Issue on Recovered Memories of Sexual Abuse

    The Summer 1996 volume of The Journal of Psychiatry and Law, published in February of 1997, is an indispensable resource. Its six articles include Scheflin and Brown's comprehensive review of scientific studies of recovered memories of sexual abuse, and Dalenberg's study of the accuracy of sexual abuse memories recovered in psychotherapy (she actually conducted interviews with both victims and perpetrators, some of whom confessed). Directions for ordering this special issue, as well as the Fall 1995 special issue that focused on claims of false memories, are at the end of this section.

    Brown, D., & Scheflin, A. W. Editors' Page.

    Excerpt: "The Fall 1995 issue of The Journal of Psychiatry and Law  was a special issue on the false-memory controversy. It contained a number of papers originally given at a 1994 conference at Johns Hopkins University sponsored by the False Memory Syndrome Foundation. These papers represented only one side of the complex issues involved in the false-memory controversy. We appreciate the gracious invitation of Howard Nashel, editor-in-chief of this journal, to serve as guest editors to prepare a second issue that is representative of the work in the trauma field in response to false-memory claims. Our hope is that the readers of this journal will consider the Fall 1995 issue along with this Summer 1996 issue as a unit in order to get a more balanced overview of the controversy (p.139).
          ". . . . Taken as a whole, these six articles demonstrate that false-memory claims need to be made much more cautiously, especially in courts and in the media, as recent databased studies have either failed to support important false-memory claims or have shown that these claims have been overstated. Most importantly, the science of memory must be permitted to continue untainted by ideological considerations. The false-memory controversy must be converted from a political debate to a scientific inquiry. It is our hope that this issue of The Journal of Psychiatry and Law will help accomplish that goal."

    Scheflin, A. W., & Brown, D. Repressed memory or dissociative amnesia: What the science says.

    Abstract: "Legal actions of alleged abuse victims based on recovered memories of childhood sexual abuse (CSA) have been challenged arguing that the concept of repressed memories does not meet a generally accepted standard of science. A recent review of the scientific literature on amnesia for CSA concluded that the evidence was insufficient. The issues revolve around: (1) the existence of amnesia for CSA, and (2) the accuracy of recovered memories. A total of 25 studies on amnesia for CSA now exist, all of which demonstrate amnesia in a subpopulation; no study failed to find it, including recent studies with design improvements such as random sampling and prospective designs that address weaknesses in earlier studies. A reasonable conclusion is that amnesia for CSA is a robust finding across studies using very different samples and methods of assessment. Studies addressing the accuracy of memories show that recovered memories are no more or no less accurate than continuous memories for abuse.

    Excerpts: "Even more significantly, no study has surfaced that refutes the dissociative amnesia hypothesis by failing to get reports of inability to voluntarily recall repeated childhood abuse (pp.145-146).
         "Most scientific studies can be criticized for methodological weaknesses, but such design limitations should not obscure the fact that the data reported across every one of the 25 studies demonstrate that either partial or full abuse-specific amnesia, either for single incidents of childhood sexual abuse or across multiple incidents of childhood sexual abuse, is a robust finding. Partial or full amnesia was found across studies regardless of whether the sample was clinical, nonclinical, random or non-random, or whether the study was retrospective or prospective. Every known study has found amnesia for childhood sexual abuse in at least a portion of the sampled individuals (pp.178-179, italics in original).
          "These studies, when placed together, meet the test of science – namely, that the finding holds up across quite a number of independent experiments, each with different samples, each assessing the target variables in a variety of different ways, and each arriving at a similar conclusion. When multiple samples and multiple sampling methods are used, the error rate across studies is reduced. Even where a small portion of these cases of reported amnesia may be associated with abuse that may not have occurred or at least could not be substantiated, the great preponderance of the evidence strongly suggests that at least some subpopulation of sexually abused survivors experiences a period of full or partial amnesia for the abuse. Moreover, a significant portion of these amnestic subjects, at least in some of the studies, later acquired some form of corroboration of the abuse (p.179).
          "Furthermore these 25 studies. . . illustrate how scientific inquiry evolves, in the best sense. The earliest clinical surveys were appropriately criticized on the grounds of possible sample and experimenter bias. Perhaps those reporting amnesia represented a highly select group of patients, or perhaps their report of recovered memories was influenced, or even 'implanted,' by the therapist-experimenters. Nonclinical samples began to appear as a way to address the sample bias problem. A number of subsequent studies clearly demonstrated that psychotherapy was not  frequently endorsed as the reason for recovery of memories, nor responsible for them. When the nonclinical-sample experiments were criticized on the grounds of possible selection bias, a number of random-sample studies appeared that addressed this objection. All of the self-report studies were then criticized because they allegedly lacked objective verification of the reported childhood sexual abuse. In response to these criticisms, well-designed prospective studies were conducted. These studies also document an inability to recall a critical childhood abuse incident up to one or two decades after the event in a subpopulation of sexually abused individuals. Not surprisingly, the prospective studies were criticized for failure to include a follow-up interview to distinguish between memory failure and memory denial. However, these criticisms failed to take into consideration that such an interview could not easily be conducted without introducing response bias and other possible expectation and suggestive effects. The prospective studies specifically attempted to reduce interviewing bias and to approximate the conditions of free recall in the research design because the memory error rate is minimized under the conditions of free recall" (pp. 179 & 182, italics in original).

          "These studies should have a direct impact on two significant and currently volatile legal issues. First, courts holding a Frye  or Daubert  evidentiary hearing involving expert or lay testimony on the issue of whether 'repressed memory' is reliable must, consistent with the science, hold either that such memories are reliable or that all memory, repressed or otherwise, is unreliable. The first solution is the wiser and better choice. Second, judges and legislators deciding whether the delayed-discovery doctrine should be applied to toll the statute of limitations in 'repressed' memory must acknowledge that a class of sexual abuse victims with repressed memories truly exists. The extent to which they are entitled to legal protection is a legal question, not a scientific one. Some jurisdictions have favored victims with 'repressed' memories; others have not. . . As a result of these studies, no person should in the future be denied proper legal consideration on the grounds that 'repressed' memory, as one judge unscientifically stated, 'transcends human experience.'
          "It appears that the repressed memory controversy will follow Arthur Schopenhauer's wise observation: 'All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident'" (p.183, some references omitted).

    Dalenberg, C. J. Accuracy, timing and circumstances of disclosure in therapy of recovered and continuous memories of abuse.

    Abstract: "Seventeen patients who had recovered memories of abuse in therapy participated in a search for evidence confirming or refuting these memories. Memories of abuse were found to be equally accurate whether recovered or continuously remembered. Predictors of number of memory units for which evidence was uncovered included several measures of memory and perceptual accuracy. Recovered memories that were later supported arose in psychotherapy more typically during periods of positive rather than negative feelings toward the therapist, and they were more likely to be held with confidence by the abuse victim."

    Excerpts: "[I]n the present research the author was able to substantiate the existence of the evidence offered by the clients and to have this evidence rated for evidentiary value. Further, both alleged victims and perpetrators participated in the evidence collection, providing a better balance for the search for confirming and refuting evidence (p.234).
         "Both father and daughter participating in locating 'evidence.' The evidence was of two types, primary and contextual (p.242)

          "Subjects were not significantly younger at the time of the event relating to their first recovered memory (M = 5.53) than at the time of their first reported continuous memory (M = 5.29; t(16) = .48, ns). . . . Average confidence in the truth of the memory before evidence was gathered was significantly lower for recovered than for continuous memories (t(16) = 2.79, p < .02).
          "Of those memories for which some evidence was submitted (70% of all memories), 74.6% of continuous and 74.7% of recovered memories were judged by the full set of raters as having at least one piece of Category 1 [primary] or Category 2 [contextual] support. Support for the identity of the perpetrator was found for at least one recovered memory for 10 subjects and for at least one of the continuous memories for 12 subjects. . . At least one memory was supported by confession in seven recovered memory cases and 10 continuous memory cases (underline added).
          "Overall there was no consistent pattern of subjects showing superior recovered or continuous memory for abuse. However, four subjects had significantly more evidence for accuracy of their recovered memory (using the general abuse memory data), two showed significantly more evidence for accuracy (and two for marginally more evidence) for continuous memory, and nine were equal in amount of confirming evidence. These individual differences might be worth further exploration (pp.245-247).

          "The likelihood of finding evidence of accuracy for a recovered memory did relate to both timing and affective tone of therapy. . . Seven subjects found significantly more evidence for accuracy of memories reported during the last six months of therapy than during the first three months, a pattern that crossed recovered and continuous memories. . . Supported recoveries were also more likely in the 'de-repression' sessions (identified either by the presence of an alliance repair or the presence of higher than average [top 12%] ratings of positive affect toward the therapist). These sessions comprised 15% of the total (p.250).
          "An alternative method for expressing these data is in likelihood ratios. As implied earlier, the ratio of supported to nonsupported memories in this data set was approximately 3:1. The ratio drops to 2:1 in the negative-emotion or state-dependency sessions, but rises to 14:1 in the alliance repair sessions (pp.250-251).
          "Recovered and continuous memories also differed in the degree to which they were associated with specific affective descriptions. . . When affective terms were counted in the accounting of each abuse episode, explicit statements regarding fear/terror and shame were more likely to appear in recovered accounts, and sadness/loss/depression was more likely to appear in continuous accounts. Considering the episodes as independent units, the probability of fear/terror mentioned (explicitly) in a recovered memory was .72 (compared with .52 for continuous memories). Shame was mentioned explicitly in 54% of the 57 recovered memory episodes and in 32% of the continuous memory descriptions. Anger appeared equally in all memory types, and sadness appeared more frequently for continuous memories (.67 compared with .28). The difference in patterns (testing the most frequently named emotion in each memory description) was significant (Chi Square = 37.00, p < .001) (pp.251-252).
          "Finally, on an exploratory note, 13 of the 17 subjects showed an increase in the level of symptoms and 12 showed an increase in the variance of symptoms. . . on their contemporaneous self-report comparing the six weeks prior to the first recovery with the 12 weeks following their first recovery. Resolution of symptoms typically occurred by four to six months following recovery (p.252).

    Olio, K. A. Are 25% of clinicians using potentially risky therapeutic practices? A review of the logic and methodology of the Poole, Lindsay, et al. study.

    Abstract: "Conclusions from the Poole, Lindsay et al. study are often cited to document claims regarding the frequency and potential risks of using so-called suggestive memory recovery techniques or memory recovery therapies. This study has also been used to document the alleged number of persuaded clients who have developed false memories of childhood abuse. The basis for these claims seems questionable when the Poole, Lindsay et al. study is examined carefully. Lack of operational definitions, flawed survey construction, lack of face validity, misclassification of techniques, and fallacious inferences about causality, such as mistaking correlation for causation, make it impossible to use these data to draw scientific conclusions about the nature and outcomes of clinicians' practices."

    Roe, C. M., & Schwartz, M. F. Characteristics of previously forgotten memories of sexual abuse: A descriptive study.

    Abstract: "The present study is a first attempt to describe what people remember when they initially recall childhood sexual abuse after a period of self-reported amnesia for that abuse. Subjects were 52 white women who had previously been hospitalized for treatment of sexual trauma. Participants completed a questionnaire that inquired about their first suspicions of having been sexually abused, their first memories of sexual abuse, other memories of abuse, and details of their abuse history. Participants were more likely to recall part of an abuse episode, as opposed to an entire abuse episode, following a period of no memory of the abuse. Additionally, first memories tended to be described as vivid rather than vague. Descriptive statistics are used to present and summarize additional findings."

    Williams, M. R. Suits by adults for childhood sexual abuse: Legal origins of the "repressed memory" controversy.

    Abstract: "In the last decade there has been a proliferation of civil lawsuits by adults claiming to be survivors of childhood sexual abuse (CSA). Many states have permitted such suits to go forward by applying some form of 'delayed discovery of injury' exception to the statute of limitations. Advocates for those claiming to have been falsely accused have generated a new concept – 'false memory syndrome' – as an alternative explanation for delayed memories of CSA. Its proponents claim that there is an epidemic of therapy-induced 'false memories' of CSA. Psychotherapists and the profession as a whole have become involved in a heated controversy, whose substance as well as intensity is to a large extent litigation driven. To understand the controversy and get a handle on its future, it is important to examine its legal origins, history and context."

    Hovdestad, W. E., & Kristiansen, C. M. A field study of "false memory syndrome": Construct validity and incidence.

    Abstract: "False memory syndrome (FMS) is described as a serious form of psychopathology characterized by strongly believed pseudomemories of childhood sexual abuse. A literature review revealed four clusters of symptoms underlying the syndrome regarding victims' belief in their memories of abuse and their identity as survivors, their current interpersonal relationships, their trauma symptoms across the lifespan, and the characteristics of their therapy experiences. The validity of these clusters was examined using data from a community sample of 113 women who identified themselves as survivors of girlhood sexual abuse. Examining the discriminant validity of these criteria revealed that participants who had recovered memories of their abuse (n = 51), and who could therefore potentially have FMS, generally did not differ from participants with continuous memories (n = 49) on indicators of these criteria. Correlational analyses also indicated that these criteria typically failed to converge. Further, despite frequent claims that FMS is occurring in epidemic proportions, only 3.9%-13.6% of the women with a recovered memory satisfied the diagnostic criteria, and women with continuous memories were equally unlikely to meet these criteria. The implications of these findings for FMS theory and the delayed-memory debate more generally are discussed."

    To purchase a copy of this Summer 1996 issue and/or the Fall 1995 issue, send a letter or fax, including your name and address, and the complete name and volume (e.g., "The Journal of Psychiatry and Law, Summer 1996") to:
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    Contents

    Linda Meyer Williams

    University of New Hampshire psychologist Linda Meyer Williams has conducted the best research to date on amnesia and delayed recall for experiences of childhood sexual abuse. The two papers below are essential reading for anyone who seeks knowledge of the best available scientific evidence that people experience amnesia and delayed recall for memories of abuse.

    Both studies are part of a research project involving detailed interviews with 129 women who, 17 years before, had been evaluated in a hospital emergency room after being sexually abused.

    Study 1

    Williams found that for the documented incidents of sexual abuse that had occurred 17 years earlier, one in three  women did not report those abuse experiences. In these interviews the women shared intimate details of their sexual lives, and 68% of those who did not report the documented incident of sexual abuse reported other sexual assaults experienced in childhood. Williams concluded that most if not all of these women actually did not remember their previously documented abuse experiences. Williams also found that the closer the relationship to the perpetrator and the younger the child at the time, the greater the likelihood an incident was (apparently) not remembered.

    The group of three articles listed below provide you with a unique opportunity to witness leading scholars and researchers debate over amnesia for child abuse experiences – and to evaluate the research and arguments for yourself. The first is Williams' report of the study. The second is a critique of this study by Elizabeth Loftus (who has declared and argued that repressed memory is a "myth") and two of her colleagues. The third is Williams' response.
         I strongly  encourage you to call local college and university libraries to find one with this journal (a very reputable and popular one), to make the trip and make copies.

    Williams, L. M. (1994). Recall of childhood trauma: A prospective study of women's memories of child sexual abuse. Journal of Consulting and Clinical Psychology, 62, 1167-1176.

    Loftus, Elizabeth E. F., Garry, M., & Feldman, J. (1994). Forgetting sexual trauma: What does it mean when 38% forget. Journal of Consulting and Clinical Psychology, 62, 1177-1181.

    Williams, L. M. (1994). What does it mean to forget child sexual abuse: A Reply to Loftus, Garry, and Feldman. Journal of Consulting and Clinical Psychology, 62, 1182-1186.

    Study 2

    This study is the second from Williams' research interviews with 129 women, 17 years after they were sexually abused and evaluated in a hospital emergency room. This paper reports the most important research to date on recovered memories of child sexual abuse, and is essential reading for anyone who wishes to evaluate the highest quality evidence currently available. The relatively young Journal of Traumatic Stress  may not be easy to find, but it is highly respected in the field of psychological trauma studies. (This article is from a special issue of the journal, which is presented elsewhere on this page, as is ordering information.)

    Williams, L. M. (1995). Recovered memories of abuse in women with documented child sexual victimization histories. Journal of Traumatic Stress, 8, 649-673.

    Abstract: "This study provides evidence that some adults who claim to have recovered memories of sexual abuse recall actual events that occurred in childhood. One hundred twenty-nine women with documented histories of sexual victimization in childhood were interviewed and asked about abuse history. Seventeen years following the initial report of the abuse, 80 of the women recalled the victimization. One in 10 women (16% of those who recalled the abuse) reported that at some time in the past they had forgotten about the abuse. Those with a prior period of forgetting – the women with 'recovered memories' – were younger at the time of abuse and were less likely to have received support from their mothers than the women who reported that they had always remembered their victimization. The women who had recovered memories and those who had always remembered had the same number of discrepancies when their accounts of the abuse were compared to the reports from the early 1970's."

    Excerpt: "[T]hese findings are important because they are based on a prospective study of all reported cases of child sexual abuse in a community sample. Because the abuse was documented in hospital records this is the first study to provide evidence that some adults who claim to have recovered memories of child sexual abuse recall actual events which occurred in childhood. These findings are also not limited to a clinical sample of women in treatment for child sexual abuse. The findings document the occurrence of recovered memories. There is no evidence from this study of child sexual abuse experienced by this community sample of women that recovery of memories was fostered by therapy or therapists. For this sample of women memories resurfaced in conjunction with registering events or reminders and an internal process of rumination and clarification. For women with greater economic means than those of the women who comprised this sample, therapy may play a greater role in recovering memories of child sexual abuse.
         Regarding the accuracy of the accounts, this study suggests that while the women's reports of some details have changed (N.B., this may be a problem in the original account, not the adult memory) the women's stories were in large part true to the basic elements of the original incident. Interestingly, despite limited discrepancies, the women themselves were very often unsure about their memories and said things such as 'What I remember is mostly a dream.' Or, 'I'm really not too sure about this.' These are statements which may arouse skepticism in individuals who hear the accounts of women who claim to have recovered memories of child sexual abuse (e.g., therapists, judges, family members, researchers, the media). The findings from this study suggest that such skepticism should be tempered. Indeed, the woman's level of uncertainty about recovered memories was not associated with more discrepancies in her account. While these findings cannot be used to assert the validity of all  recovered memories of child abuse, this study does suggest that recovered memories of child sexual abuse reported by adults can be quite consistent with contemporaneous documentation of the abuse and should not be summarily dismissed by therapists, lawyers, family members, judges, or the women themselves" (pp.669-670).


    Contents

    Cathy Spatz Widom

    Cathy Spatz Widom is Professor of Criminal Justice and Psychology at the State University of New York in Albany, and a recognized national expert on the causes and consequences of child abuse and neglect. Her highly respected research includes an important and ongoing longitudinal study of a large sample of children with confirmed severe abuse in childhood. Such prospective studies, in which abused children are followed over time, are particularly valuable in the present context because they can be used to study current memories of people who were definitely abused as children. In the two studies below, one on physical abuse on the other sexual abuse, the findings suggest that for both forms of abuse the accuracy of retrospective reports depends on a complex array of factors, including sample selection and assessment methods, whether the person is male or female, and current mental health status (e.g., suffering from depression or not).

    Widom, C. S. & Shepard, R. L. (1996). Accuracy of adult recollections of childhood victimization: Part 1. Childhood physical abuse. Psychological Assessment, 8, 412-421.

    Abstract: Using data from a study with prospective-cohorts design in which children who were physically abused, sexually abused, or neglected about 20 years ago were followed up along with a matched control group, accuracy of adult recollections of childhood physical abuse was assessed. Two hour in-person interviews were conducted in young adulthood with 1,196 of the original 1,575 participants. Two measures (including the Conflict Tactics Scale) were used to assess histories of childhood physical abuse. Results indicate good discriminant validity and predictive efficiency of the self-report measures, despite substantial underreporting by physically abused respondents. Tests of construct validity reveal shared method variance, with self-report measures predicting self-reported violence and official reports of physical abuse predicting arrests for violence. Findings are discussed in the context of other research on the accuracy of adult recollections of childhood experiences.

    Excerpts from the Discussion:
         ". . . In many ways, these findings indicate accuracy in retrospective self-reports and good discriminant validity. Individuals who were physically abused, based on official records, retrospectively reported the highest rates of childhood physical abuse in the sample. On the CTS (Severe Violence and Very Severe Violence subscales) and the SRCAP [Self-Report Measure of Childhood Physical Abuse], physically abused individuals reported significantly higher rates of physical abuse than did individuals who had experienced sexual abuse or neglect in childhood and individuals who were part of a matched control group. The extent of remembering (i.e., the percentage of individuals who had been physically abused who reported having been physically abused on one of the measures used here) is in line with previous research. These results also reveal that the extent of reporting a history of childhood physical abuse varied dramatically by the criterion (or measure) used.

         "At the same time, there is a problem in underreporting of physical abuse. A substantial group of individuals who were physically abused do not report having been physically abused in childhood. Of the 110 people in the sample who had documented cases of physical abuse in childhood, 60-62% reported abuse using the CTS-VSV and SRCAP. This means that approximately 40% of individuals with documented histories of physical abuse did not report. Whether these people did not report (as suggested by Della Femina et al., 1990) because of embarrassment, a wish to protect parents, a sense of having deserved the abuse, a conscious wish to forget the past, or lack of confidence in or rapport with the interviewer, we do not know. But these findings suggest that a substantial minority would not be included in retrospective self-report assessments of childhood physical abuse. A more lenient criterion (such as the CTS-Minor Violence subscale) would capture most of the physically abused people (see Table 2); however, this criterion also identifies 92% of the sexual abuse and neglect cases and 86% of the control participants as having been physically abused in childhood. Using the CTS-Minor Violence subscale, the rate of false positives (as presented in Table 5) approaches almost half the sample. These findings illustrate that the rate of false positives is directly related to the measure of childhood physical abuse used. . .

         "Henry et al. (1994) concluded that reliance on retrospective reports about psychosocial variables should be treated with caution. They suggested that "the use of retrospective reports should be limited to testing hypotheses about the relative standing of individuals in a distribution and should not be used to test hypotheses that demand precision in estimating event frequencies and event dates" (p. 92). We support their recommendation to use caution against overly simplistic interpretations that take retrospective reports at face value.

         "These methodological problems pose significant challenges to researchers in the field. Notwithstanding the real difficulties involved, there is a critical need to develop reliable and valid ways to assess histories of childhood victimization. . . ."

    Widom, C. S. & Morris, S. (1997). Accuracy of adult recollections of childhood victimization: Part 2. Childhood sexual abuse. Psychological Assessment, 8, 412-421.

    Abstract: Questions have been raised about the accuracy of retrospective self-reported information about childhood sexual abuse. Using data from a prospective-cohorts-design study, a large group of children who were sexually and physically abused or neglected approximately 20 years ago were followed up and compared with a matched control group. Accuracy of adult recollections of childhood sexual abuse was assessed using 4 different measures, completed in the context of a 2-hr in-person interview in young adulthood ( N = 1, 196). Results indicate gender differences in reporting and accuracy, substantial underreporting by sexually abused respondents in general, good discriminant validity and predictive efficiency of self-report measures for women, and some support for the construct validity of the measures. Implications for researchers and practitioners are discussed.

    Excerpts from the Introduction:
         ". . . [A] significant risk of distortion and loss of information is associated with the recollection of events from a prior time period. If asked to recall childhood events, it is possible that respondents forget or redefine their behaviors in accordance with later life circumstances or their current situation. It is also possible that a person might redefine someone else's behavior in light of current knowledge. Unconscious denial (or repression of childhood traumatic events) may also be at work in preventing the recollection of severe cases of childhood abuse. Furthermore, given society's disapproval of various forms of family violence, a person may be embarrassed to report such experiences or unwilling to reveal such private information in the context of an interview setting. Thus, for a variety of reasons, there may be considerable slippage in accuracy in retrospective reporting. . . .

         "Empirical findings suggest that a person's cognitive appraisal of life events strongly influences his or her response (Lazarus & Launier, 1978). The same event may be perceived by different individuals as irrelevant, benign, positive, or threatening and harmful. It is likely that a child's cognitive appraisal of early childhood events will also determine at least in part whether they are experienced as neutral, negative, or harmful. The child's perception might reflect events occurring subsequent to the abuse experience as well as the child's perception of the experience. Theoretically, this is also important because long-term consequences may depend on the person's awareness or memory of the earlier abusive experience or experiences. Considering Lazarus and Folkman's (1984) discussion of the role of cognitive appraisal in mediating one's response to stress, it may be that children who do not define their early childhood experiences as abusive will show better outcomes.

         "There may also be gender differences in reporting or willingness to report childhood sexual abuse for a variety of reasons. Female psychiatric patients have been found more likely than male patients to report histories of sexual abuse. . ., female patients have been found more likely than male patients to reveal childhood sexual assault experiences to therapists (Jacobson & Richardson, 1987), and women have reported greater likelihood than men of being a victim of sexual assault (Burnam et al., 1988). Social pressures against reporting early childhood sexual experiences and embarrassment may lead to greater reluctance among men to report, whereas it may be socially more acceptable for women to report such histories. On the other hand, some of the apparent underreporting may be associated with the small number of male victims of sexual abuse in most studies (Finkelhor, 1990).

         "One approach to assessing the power or efficiency of retrospective self-report measures is to calculate the relative improvement over chance (RIOC). Loeber and Dishion (1983) devised this index to represent the improvement over chance as a function of the range of its possible predictive efficiency. . . .

         "A second approach to establishing the usefulness of retrospective reports of childhood sexual abuse is based on the construct validation process, one of the techniques used to establish the psychometric qualities of assessment instruments. In addition to establishing the validity of retrospective self-report measures using "known groups," construct validity attempts to assess how these self-report measures theoretically relate to other variables or indexes. That is, there are certain theoretical expectations about the way people who have a history of childhood sexual abuse should behave or should manifest certain outcomes. Based on logical relationships, then, tests of construct validity can offer evidence that these measures do or do not measure childhood sexual abuse, without providing definitive proof."

         "To validate our retrospective self-report measures of childhood sexual abuse, three outcomes frequently associated with childhood sexual abuse (depression, alcohol problems, and suicide attempts) will be assessed. Ideally, retrospective reports of childhood sexual abuse should relate to subsequent outcomes similar to the way official reports of childhood sexual abuse relate to these outcomes.

    Excerpts from the Discussion:
         "We examined the accuracy of four retrospective self-report measures of childhood sexual abuse. In general, we found that women and men differ in the extent to which they recall or report having experienced childhood sexual abuse. Approximately 16% of men with documented cases of sexual abuse considered their early childhood experiences sexual abuse, compared with 64% of women with documented cases of sexual abuse. These gender differences may reflect inadequate measurement techniques or an unwillingness on the part of men to disclose this information. They may also reflect differences in the meaning of these behaviors for men and women, particularly viewed in a cultural context. Gender differences in reporting and in perceptions of early childhood experiences may reflect early socialization experiences in which men learn to view these behaviors as nonpredatory and nonabusive. Many of the sexual experiences considered to be sexual abuse (e.g., showing/touching sex organs, kissing in a sexual way) may be seen as developmental rites of passage, part of a learning process. Men reported more sexual experiences in which they touched the other person. Social pressures against reporting certain kinds of early childhood experiences may also lead to greater reluctance among men to report. Future research ought to examine whether the underreporting by men is due to embarrassment or to perceptions about sexual experiences.

         "In our examination of the validity of retrospective self-report measures of childhood sexual abuse using known groups, we also found gender differences in the discriminant validity of the four measures. Our results indicate good discriminant validity for the self-report measures used here for women but much less so for men. A higher percentage of women with official histories of childhood sexual abuse recall or report sexual abuse in young adulthood than do women with histories of physical abuse or neglect, who in turn report higher levels than nonabused and nonneglected controls (Table 3). On the other hand, men in our sample with documented cases of sexual abuse do not report higher levels of sexual experiences (any sex before age 12) than do men with documented cases of physical abuse or neglect or control men. Sexually abused men are significantly more likely to consider that they were sexually abused and to report more often having had sex against their will than are controls, but so are physically abused or neglected men. It is noteworthy that more physically abused or neglected men reported having had sex with an older person than did sexually abused men, none of whom reported having had this experience in childhood.

         "Overall, we found substantial underreporting of sexual abuse among known victims of childhood sexual abuse. This is particularly impressive because these are court-substantiated (documented) cases of childhood sexual abuse. Much attention has been paid to the lack of recall or failure to report histories of childhood sexual abuse among known victims of abuse. Although this lack of reporting is significant, it may not be surprising when viewed in a somewhat different context. Nonreporting by crime victims in the context of victimization surveys has been studied for a number of years (Garofalo & Hindelang, 1977), and problems with respondent embarrassment about the incident or "protective mechanisms," or simply memory decay or forgetting have been described. . . .

         "For women, we found strong relationships between retrospective self-report measures of childhood sexual abuse and the three outcomes examined here: DSM-III-R diagnoses of depression and alcohol abuse/dependence and suicide attempts. We also found that women with documented cases of childhood sexual abuse who were followed up prospectively into young adulthood were at increased risk for having alcohol abuse/dependence diagnosis and for making suicide attempts.

         "It was surprising that we did not find that women or men with documented cases of childhood sexual abuse were at increased risk of being diagnosed with depression according to DSM-III-R criteria, despite the widespread belief that childhood sexual abuse leads to depression. We did, however, find a significant relationship between retrospective self-report measures of childhood sexual abuse and depression diagnosis. Thus, this pattern of findings suggests that the relationship between childhood sexual abuse and depression is complicated and may depend on a person's cognitive appraisal of early life events (cf. Lazarus & Folkman, 1984). Individuals who meet the criteria for a DSM-III-R depression diagnosis (current or remitted) are more likely to recall having been sexually abused in childhood than individuals without depression diagnoses, although individuals with documented cases of sexual abuse in childhood who were followed up into young adulthood were not at increased risk of receiving a depression diagnosis. This was true for men as well as women in this sample. . . .

         "The underreporting we found means that there is a substantial group of people with documented histories of childhood sexual abuse who do not report these experiences when asked in young adulthood to do so. Whether this is due to loss of memory, denial, or embarrassment is not known. However, there are important implications from these these findings for other researchers and clinicians. For researchers, the underreporting of childhood sexual abuse poses a serious concern for epidemiological research, especially that which involves a large proportion of men. For clinicians, these findings reinforce the need to develop more sensitive techniques to elicit this information from men.


    Contents

    Diana Elliott

    Diana Elliott is a psychologist at the University of California at Los Angeles (UCLA) School of Medicine. She has published two important studies of delayed recall of abuse and other traumatic experiences, based on data from a stratified random sample of the general US population. The most recent of these publications is an investigation of rates of partial and complete delayed recall for a variety of traumatic experiences, not just sexual abuse. It was published in the October 1997 Journal of Consulting and Clinical Psychology, the methodologically rigorous and most prestigious journal of the American Psychological Association. In that paper, extensively excerpted below, Elliott uses her findings to address the validity of the construct of psychogenic or dissociative amnesia and the claim that recovered memories are the product of questionable therapy practices.

    Elliott, D. M. (1997). Traumatic events: Prevalence and delayed recall in the general population. Journal of Consulting and Clinical Psychology, 65, 811-820.

    Abstract: A random sample of 724 individuals from across the United States were mailed a questionnaire containing demographic information, an abridged version of the Traumatic Events Survey (DM Elliott, 1992), and questions regarding memory for traumatic events. Of these, 505 (70%) completed the survey. Among respondents who reported some form of trauma (72%), delayed recall of the event was reported by 32%. This phenomenon was most common among individuals who observed the murder or suicide of a family member, sexual abuse survivors, and combat veterans. The severity of the trauma was predictive of memory status, but demographic variables were not. The most commonly reported trigger to recall of the trauma was some form of media presentation (i.e., television show, movie), whereas psychotherapy was the least commonly reported trigger.

    Excerpts from the literature review:
         "In contrast to normal forgetting, theoretical writers in the area of trauma have suggested that some memory loss in trauma survivors may reflect dissociative avoidance strategies developed by the victim to reduce trauma-related distress. . . From this perspective, traumatic memory loss may be understood as a form of avoidance conditioning, whereby access to memory is punished by the negative affect that accompanies the recall, thereby motivating the development of memory-inhibiting mechanisms. Such avoidance strategies might interfere with memory at any point during rehearsal, storage, or retrieval of material. . . There are other reasons for memory loss, such as organic impairment, lack of significance of the event, and infantile amnesia. However, if access to events is lost because of avoidance conditioning, the more severe and chronic the trauma, the more painful the resultant affect should be, and thus, the more likely the victim's avoidance behavior would be reinforced. . .
         ". . . [S]ome memory disruption seems to occur at the retrieval level, rather than solely at rehearsal and storage levels. According to Tulving (1983), cues that assist in the recall of events are typically those that match the original encoded material. This suggests that dissociative avoidance strategies may be effective if they reduce the individual's responsiveness to relevant cues in the environment that otherwise may activate the original memory traces. However, when recognition cues are sufficient in number, intensity, or meaningfulness, they may overwhelm existing avoidance defenses, resulting in the emergence of previously unavailable memories. Extreme dissociative avoidance (i.e., in response to a highly aversive experience), however, might be relatively resistant to external cuing and, thus, less likely to remit in response to environmental triggers.
         "Understood from this perspective, dissociative amnesia for previous traumatic events would be best predicted by the severity of the trauma and most apt to be triggered by intrapersonal, interpersonal, or environmental cues that closely match the original trauma. Although certain forms of memory loss (e.g., infantile amnesia, normal forgetting, organic impairment) may best be predicted by demographic variables (e.g., age at time of trauma, length of time since the event, current age), avoidance-related traumatic memory loss should be less a function of demographic variables and more related to characteristics of the trauma" (p.812).

    Excerpts from the results section:
         "Participants were most likely to report continuous memories of adult sexual assault that did not include penetration (94%), major motor vehicle accidents (92%), and natural disasters (89%). A history of partial memory loss was most common when an individual had witnessed murder or suicide of a loved one (38%), had been victim of child sexual abuse (22%), and had been a victim of child physical abuse (22%). A history of complete memory loss was most common among victims of child sexual abuse (20%), witnesses of combat injury (16%), victims of adult rape (13%), and witnesses of domestic violence as a child (13%)" (p.814).

         ". . . . [T]hose who reported delayed recall (partial or complete memory loss) of any trauma also reported significantly (a) more types of trauma, (b) more distress about the trauma (both at the time of the event and at the time of data collection), and (c) a younger age at the time of the earliest trauma.
         "The relationship between age and a history of memory loss could be due to the normal lack of recall for events occurring in the first 3 to 4 years of life (i.e., infantile amnesia) for those victimized in early childhood (Loftus, 1993). To examine this hypothesis, I completed a second analysis, deleting the 24 participants who reported trauma before the age of 5. This produced no change in the results, with memory loss more frequently reported when the trauma occurred at a younger age. . ."
    (p.814)

         ". . . Across traumas, participants reported that recall was most commonly triggered by some sort of media presentation (54%), an experience similar to the original trauma (37%), and a conversation with a family member. Recall of the trauma was least likely to have been triggered by a sexual experience (17%), or psychotherapy (14%)" (p.815).

    Excerpts from the discussion section:
         "The findings of the present study suggest that a history of trauma is common in the United States. For example, 40% of respondents experienced a major motor vehicle accident or natural disaster, 43% had witnessed violence, and 50% had been victims of interpersonal violence. . . .
         "These data also suggest that delayed recall of traumatic experiences may not be uncommon, with some proportion of individuals reporting impaired recollection for virtually every type of trauma. This phenomenon appears to be more common among events considered particularly upsetting or distressing (e.g., among childhood sexual abuse survivors, those who witnessed the murder or suicide of a loved one, and veterans who witnessed combat injury) and less common for events that contained no interpersonal violence (e.g., major motor vehicle accidents, disasters, and having a child die under the age of 18)" (p.816).

         "Race was the only demographic variable that was even marginally associated with delayed recall of a trauma, and the race-memory relationship was mediated by the severity of the trauma experienced. However, several characteristics of trauma severity predicted memory status. Such data support an avoidance defense mechanism hypothesis as a partial explanation for the findings, because more traumatic events would appear more likely to be remembered, not forgotten, if no defensive response was involved" (p.817).

         "The extent to which the questions used in the present study may have been misunderstood by participants is unclear. However, a pretest of the questions used in this study indicated that 96% of the individuals understood the questions to refer to a period of time in which the individual was unable to access part or all of the memory of the traumatic event, as opposed to simply not thinking about the trauma. Additionally, participants in the present study went on to record their age at recall of each specific trauma and indicated what it was that cued their recall. Given these data, misinterpreting the questions to be about normal forgetting is not likely to be a sufficient explanation for the memory findings reported here" (p.818).

         "This study does not support the notion that delayed recall is limited to sexual abuse. It suggests that the phenomena occurs across a variety of traumas and is especially high for traumatic events involving interpersonal victimization" (p.818).

         "With regard to the claim [that therapy creates recovered memories], only 14% of the participants in this study who reported delayed recall of a trauma reported having their memory triggered during the course of therapy. Even if all the individuals who had ever been in treatment reported delayed recall of trauma (a conservative assumption), 86% of the sample, nevertheless, reported recovering memory through other means. This finding suggests that the process of psychotherapy, per se, does not intrinsically explain the recovered memory phenomenon. Rather, these data suggest that, like other posttraumatic stress responses, intrusion of previously avoided memory can be cued by environmental stimuli, perhaps in the same way as has been documented with posttraumatic flashbacks. . ." (p.818)

    The final paragraph:
         "As previously noted, the best predictor of memory status was the severity of the trauma, rather than demographic variables. These findings suggest that the traumatic impact of the event – rather than childhood amnesia, normal forgetting, secondary gain, or iatrogenic treatment effects – provides a good conceptual fit to the data. Many authors (Herman, 1992; Terr, 1994; van der Kolk, et al., 1996) have noted that traumatic amnesia is a complex phenomenon that involves biological, cognitive, and psychological aspects that may vary from traditional notions of 'normal' memory. In this regard, future research might focus on such processes as they relate to normal versus traumatic encoding, forgetting, and recalling" (p.818).

    Elliott, D. M., & Briere, J. (1995). Posttraumatic stress associated with delayed recall of sexual abuse: A general population study. Journal of Traumatic Stress, 8, 629-647.

    Abstract: "This study examined delayed recall of childhood sexual abuse in a stratified random sample of the general population (N = 505). Of participants who reported a history of sexual abuse, 42% described some period of time when they had less memory of the abuse than they did at the time of data collection. No demographic differences were found between subjects with continuous recall and those who reported delayed recall. However, delayed recall was associated with the use of threats at the time of the abuse. Subjects who had recently recalled aspects of their abuse reported particularly high levels of posttraumatic symptomatology and self difficulties (as measured by the IES, SCL, and TSI) at the time of data collection compared to other subjects."


    Contents

    Bessel van der Kolk

    Boston University psychiatrist Bessel van der Kolk is one of the foremost authorities on traumatic memory, particularly the possible roles of biological and dissociative phenomena in the processes of encoding and retrieval. (I have conducted research with Dr. van der Kolk and co-authored papers on traumatic memories with him.) The five papers below, four of which are available on the web, cover some of Dr. van der Kolk's key contributions to the study of traumatic memory.
         The first three papers are available on the web, and these document progress in the measurement of traumatic memory characteristics with the Traumatic Memory Inventory. The introduction to "Exploring the Nature of Traumatic Memories" addresses important historical and methodological issues in research and theory concerning traumatic memories, and how these necessarily differ from research and theory concerning normal memories. "Retrieving, Assessing, and Classifying Traumatic Memories," of which I am the primary author, introduces a new method for evoking and assessing the nature of traumatic memories, is rich with clinical data, and has extensive discussions of methodological and theoretical issues. "Dissociation and the Fragmentary Nature of Traumatic Memories" is a classic in the field, and essential reading for anyone who wants to understand how the psychological construct of dissociation sheds much more light on the nature of many traumatic memories than that of repression.

    van der Kolk, B. A., Hopper, J. W., & Osterman, J. E. (2001). Exploring the Nature of Traumatic Memory: Combining Clinical Knowledge with Laboratory Methods. Journal of Aggression, Maltreatment, & Trauma, 4, 9-31; and Freyd, J. F., & DePrince, A. P. (Editors). Trauma and Cognitive Science (pp. 9-31). Binghamton, NY: Haworth Press.
    Abstract: "For over 100 years clinicians have observed and described the unusual nature of traumatic memories. It has been repeatedly and consistently observed that these memories are characterized by fragmentary and intense sensations and affects, often with little or no verbal narrative content. Yet, possibly because traumatic memories cannot be precipitated under laboratory conditions, the organization of traumatic memories has received little systematic scientific investingation. In our laboratory we have developed an instrument, the Traumatic Memory Inventory (TMI), which systematically assesses the ways that memories of traumatic experience are organized and retrieved over time. In this paper we report findings from our third study using the TMI, of 16 subjects who had the traumatic experience of awakening from general anesthesia during surgery. We assessed changes in traumatic memory characteristics over time and differences between memories of subjects with and without current Posttraumatic Stress Disorder. Our findings suggest the need for more rigorous methods for the assessment of the evolution of traumatic memories. In order to develop a comprehensive and integrated understanding of the nature of traumatic memory, we need to combine careful clinical observations with replicable laboratory methods, including those of cognitive science and neuroscience."

    Excerpts: "The understanding of how people process traumatic events has, until recently, been entirely within the domain of clinical practice and observation. Traditionally, the fields of clinical psychology and psychiatry on the one hand, and cognitive science and neuroscience on the other, have had such widely divergent samples, methodologies and concepts on which they based their understandings of memory processes, that there has been a veritable confusion of tongues between these disciplines. During the past decade, when the observation that people may lose all memory for sexual abuse experiences and retrieve them at a later time was brought to the public's attention, many cognitive scientists took an incredulous stance. Yet for over a century this observation had been consistently reported in the psychiatric literature on other traumatized populations. Despite dozens of reports, starting with Pierre Janet (1889) in the 1880s, followed by Breuer and Freud (1893), repeated during the first World War (Meyers, 1915; Southard, 1919), the second World War (Sargant and Slater, 1941) and the Vietnam War (van der Kolk, 1987), most laboratory scientists disregarded the validity of these observations. In the past decade a small group of cognitive scientists began to take clinical reports seriously (Freyd, 1991, 1994; Morton, 1994; Schooler, 1994). However, because amnesia and delayed recall for traumatic experiences had never been observed in the laboratory, many cognitive scientists adamantly denied that these phenomena existed (e.g., Loftus, 1993; Loftus & Ketcham, 1994), or that retrieved traumatic memories could be accurate (Kihlstrom, 1995).
          "In both science and therapy we often are confronted with unexpected findings. Whether one is a laboratory scientist or a clinician, such phenomena ideally should provoke new insights and creative theoretical and methodological advances. Laboratory scientists' practice of "controlled" research may render them more prone to observe the phenomena that they set out to measure, while clinicians cannot help but be frequently confronted with unexpected phenomena that don't fit their constructs and models. This often forces them to suspend disbelief and to attend to the unfolding of clinical data for which they have no pre-existing explanations" (pp. 10-11).

          "Despite the power of these clinical observations, these phenomena have not been systematically studied in the laboratory. The problem is not that laboratory science cannot study traumatic memories, but that laboratory science cannot study traumatic memories under conditions in which the memories studied are for events that take place in the laboratory. The event encoded into memory simply cannot be a 'controlled' variable in the laboratory science sense, as in landmark work of Loftus and her colleagues with systematically altered films of car accidents (Loftus, 1975, 1979). This is so because, for ethical reasons, not scientific ones, the extreme terror and helplessness that precede the development of PTSD simply cannot be replicated in such a setting. Roger Pitman (personal communication, July, 1996) attempted to simulate a truly traumatic stressor by having college students watch "The Faces of Death," a film consisting of actual footage of deaths and mutilations of people and animals, in the laboratory. Even this stimulus, which is probably as extreme as any institutional review board would allow, failed to precipitate PTSD symptoms in these normal volunteers.       "Hence it appears inescapable that to study the nature of traumatic memories one must study the memories of people who have actually been traumatized..." (pp. 11-12)

          "Shobe and Kihlstrom (1997) recently published an article claiming that traumatic memories are qualitatively not any different from memories of ordinary events. Without actually having studied the memories of traumatized individuals themselves, they dismissed all existing observational studies of the memories of individuals with PTSD out of hand. Their rationale for doing so is found in the article's final section, "Clinical lore and scientific evidence."

    Although their ideas about the underlying mechanisms are different, Terr, van der Kolk and Whitfield all agree on the outcome: Memories of trauma, or at least of certain forms of trauma, are encoded by processes, such as repression and dissociation, that make them difficult to retrieve as coherent verbal narratives. The result is that traumatic memories are primarily available as isolated, nonverbal, sensory, motor, and emotional fragments. If this conclusion were valid... (1997, p.74).
          "Shobe and Kilhstrom have reversed the order of things. First, clinicians working with traumatized individuals found themselves confronted with unexpected observations: incoherent memories of 'isolated, nonverbal, sensory, motor, and emotional fragments.' Second, once they were struck by the consistency of this observation, clinician-scientists looked for theoretical constructs to make sense of the data.
          "Initially, the constructs of repression and dissociation were the best they could find. It is not that pioneering students of traumatic memory ignored laboratory evidence, or that they did not search among laboratory scientists' constructs for ones that could help them explain the data they were encountering. It is just that when it came to delayed recall and the fragmentary nature of many traumatic memories, clinician-scientists encountered a conceptual void in the laboratory memory research literature. Laboratory scientists had studied memories for events they had created under controlled conditions, and thus had never encountered fragmentary traumatic memories. In short, laboratory scientists never had a reason to create constructs explicitly addressing fragmentary traumatic memories.
          "After first encountering inescapable empirical evidence of how traumatic memories can differ from non-traumatic ones, and second, searching for constructs to describe and explain their observations, more recent students of traumatic memory then set out to conduct systematic research on the characteristics of traumatic memory. Early studies focused on the controversial phenomena of amnesia and delayed recall... Laboratory memory scientists like Kilhstrom (1995) and Loftus (1993) have vigorously attacked this line of research. However, others including Freyd (1991, 1994, 1996), Morton (1994) and Schooler (1994) have taken seriously the observations of clinicians and clinician-scientists' research on traumatic memory. These researchers have led the way in applying cognitive science constructs to the full complexity of traumatic memories, including phenomena like delayed recall and fragmentation"
    (pp. 13-14).
    Hopper, J. W., & van der Kolk, B. A. (2001). Retrieving, Assessing, and Classifying Traumatic Memories: A Preliminary Report on Three Case Studies of a New Standardized Method. Journal of Aggression, Maltreatment, & Trauma, 4, 33-71; and Freyd, J. F., & DePrince, A. P. (Editors). Trauma and Cognitive Science (pp. 33-71). Binghamton, NY: Haworth Press.
    Abstract: "The study of traumatic memories is still an emerging field, both methodologically and theoretically. Previous questionnaire and interview methods for studying traumatic memories have been limited in their ability to evoke and assess remembrances with the characteristics long observed by clinicians. In this paper, we introduce a new standardized method that incorporates a laboratory procedure for retrieving memories of traumatic events and a clinically informed measure for assessing these memories' characteristics. We present three case studies to demonstrate the data yielded by script-driven remembering and the Traumatic Memory Inventory - Post-Script Version (TMI-PS). We then discuss subjects' script-driven remembrances in terms of methodology, theoretical classification of traumatic memories, and the interplay between the two. Finally, we critique our method in detail and offer suggestions for future research. If validated as a method for evoking and assessing traumatic memories, and shown to yield reliable data, this integrative method shows great promise for advancing both clinical and cognitive research on traumatic memories."

    Excerpt: "In recent years, much of the research on traumatic memories has focused on recovered memories, true or false, and much of the theory on speculations about encoding and storage processes responsible for amnesia and delayed recall. This state of affairs has largely been a function of social and cultural factors. Scientifically speaking, however, the cart may have been put before the horse. That is, even though research on episodic traumatic memories is dependent on subjects' reports of memories they have just retrieved, research has shed little light on the processes and contents of memory retrieval in traumatized individuals. In this paper, we present a new method for evoking traumatic memories and assessing some of their basic characteristics. Our method brings together a laboratory procedure for standardized retrieval of memories, and a semi-structured interview for assessing memory characteristics based on well-established observations by clinicians dealing with traumatized patients. We offer this easily adapted approach to promote controlled research on the characteristics of traumatic memories, particularly prospective studies of their transformations over time.
         "Endel Tulving's (1972) classic chapter on episodic and semantic memory begins, "One of the unmistakable signs of an immature science is the looseness of definition and use of its major concepts" (p.381). This certainly appears to be the case today for the scientific study of traumatic memories. Use of the unitary construct of "traumatic memory" is common, though clinical experience and recent empirical and theoretical work suggest that memories for traumatic experiences are complex and heterogeneous phenomena, which change over time in a variety of ways. At this early stage, it might be more helpful to use the super-ordinate and plural construct of "traumatic memories" and methodically build a definitional taxonomy - just as traditional memory researchers have done since Tulving's incisive statement nearly 30 years ago.
          "A primary goal of this paper is to demonstrate that progress toward an empirically derived taxonomy of traumatic memories will be advanced by more attention to the following: (1) memory retrieval or evocation methods, and (2) instruments for assessing memory characteristics. We also aim to show that the former must draw more from laboratory research, and the latter from clinical experience and understanding... We believe such changes in shared theoretical and methodological frameworks can foster the understanding, communication and collaboration needed to advance the field (pp. 34-35).

    van der Kolk, B. A., & Fisler, R. (1995). Dissociation and the fragmentary nature of traumatic memories: Overview and exploratory study. Journal of Traumatic Stress, 8, 505-525.
    Abstract: "Since trauma arises from an inescapable stressful event that overwhelms people's coping mechanisms, it is uncertain to what degree the results of laboratory studies of ordinary events are relevant to the understanding of traumatic memories. This paper reviews the literature on differences between recollections of stressful and of traumatic events. It then reviews the evidence implicating dissociation as the central pathogenic mechanism that gives rise to posttraumatic stress disorder (PTSD). A systematic exploratory study of 46 subjects with PTSD indicated that traumatic memories were retrieved, at least initially, in the form of dissociated mental imprints of sensory and affective elements of the traumatic experience: as visual, olfactory, affective, auditory, and kinesthetic experiences. Over time, subjects reported the gradual emergence of a personal narrative that can be properly referred to as 'explicit memory.' The implications of these findings for understanding the nature of traumatic memories are discussed."

    Excerpt: "Trauma and dissociation.  Dissociation refers to the compartmentalization of experience: elements of the experience are not integrated into a unitary whole, but are stored in memory as isolated fragments consisting of sensory perceptions or affect states. . . However, the word dissociation is currently used to describe four distinct, but interrelated phenomena: (1) the sensory and emotional fragmentation of experience. . . (2) depersonalization [feeling that you are not real] and derealization [feeling the world is unreal] at the moment of the trauma. . . (3) ongoing depersonalization or 'spacing out' in everyday life. . . (4) containing traumatic memories within distinct ego-states (Dissociative Disorder). . . . The precise interrelationships among these various phenomena remain to be spelled out: not all people who have vivid sensory intrusions of traumatic events also experience depersonalization, while only a small proportion of people who have both of these experiences will go on to chronically dissociate, or to develop a full-blown dissociative disorder" (pp.510-511).
         Christianson (1982) has described how, when people feel threatened, they experience a significant narrowing of consciousness, and remain merely focussed on the central perceptual details. As people are being traumatized, this narrowing of consciousness sometimes evolves into amnesia for parts of the event, or for the entire experience. Students of traumatized individuals have repeatedly noted that during conditions of high arousal 'explicit memory' may fail. The individual is left in a state of 'speechless terror' in which he or she lacks words to describe what has happened. . . However, while traumatized individuals may be unable to give a coherent narrative of the incident, there may be no interference with implicit memory: they may 'know' the emotional valence of a stimulus and be aware of associated perceptions, without being able to articulate the reasons for feeling or behaving in a particular way" (p.511).

    Excerpts from the study's results:

    • "Of the 36 subjects with childhood trauma, 15 (42%) had suffered significant or total amnesia for their trauma at some time in their lives" (p.516).

    • "Twenty-seven of the 36 subjects with childhood trauma reported confirmation of their childhood trauma from a mother, sibling, or other source who knew about the abuse, from court or hospital records, or from confessions or convictions of the perpetrator(s)" (pp.516-517).

    • "Subjects considered most questions about the [comparison] nontraumatic memory nonsensical: none had olfactory, visual, auditory, kinesthetic reliving experience related to such events as high school graduations, birthdays, weddings, or births of their children. They also denied having vivid dreams or flashbacks about these events. Subjects claimed not to have periods in their lives when they had amnesias for any of these events, and none of the subjects felt the need to make special efforts to suppress memories of these events" (p.517).

    • "No subject reported having a narrative for the traumatic event as their initial mode of awareness (they claimed not having been able to tell a story about what had happened), regardless of whether they had continuous awareness of what had happened, or whether there had been a period of amnesia. . . [A]ll subjects, regardless of age at which the first trauma occurred, reported that they initially 'remembered' the trauma in the form of somatosensory or emotional flashback experiences. At the peak of their intrusive recollections all sensory modalities were enhanced, and a narrative memory started to emerge" (p.517).

    • "[The score of subjects on the Dissociative Experiences Scale] was significantly correlated with the event-related variables of duration of the trauma. . . , presence of physical abuse. . ., and presence of neglect. . . Also, level of dissociation was correlated with affective reliving. . ., kinesthetic reliving. . . lack of current narrative memory. . . and with self-destructive self-soothing behaviors. . . Dissociation was not correlated with the self-soothing behaviors of talking things over, working, cleaning, sleeping or turning to religion" (p.517-518).

    van der Kolk, B. A. (1994). The body keeps the score: Memory and the evolving psychobiology of posttraumatic stress. Harvard Review of Psychiatry, 1, 253-265.

    Excerpt: "[Posttraumatic Stress Disorder], by definition, is accompanied by memory disturbances, consisting of both hypermnesias [inabilities to forget] and amnesias. . . Research into the nature of traumatic memories. . . indicates that trauma interferes with declarative memory, i.e. conscious recall of experience, but does not inhibit implicit, or non-declarative memory, the memory system that controls conditioned emotional responses, skills and habits, and sensorimotor sensations related to experience. There now is enough information available about the biology of memory storage and retrieval to start building coherent hypotheses regarding the underlying psychobiological processes involved in these memory disturbances. . ."

    van der Kolk, B. A., & van der Hart, O. (1989). Pierre Janet and the breakdown of adaption in psychological trauma. American Journal of Psychiatry, 146, 1530-1540.

    Abstract: "In the reappraisal of the work of Pierre Janet at the centenary of the publication of L'automatisme psychologique, the authors review his investigations into the mental processes that transform traumatic experience into psychopathology. Janet was the first to systematically study dissociation as the crucial psychological process with which the organism reacts to overwhelming experiences and show that traumatic memories may be expressed as sensory perceptions, affect states, and behavioral reenactments. Janet provided a broad framework that unifies into a larger perspective the various approaches to psychological functioning which have developed along independent lines in this century. Today his integrated approach may help clarify the interrelationships among such diverse topics as memory processes, state-dependent learning, dissociative reactions, and posttraumatic psychopathology."

    Excerpt: "[Janet wrote that when] people become too upset to tell their story, these [traumatic] memories cannot be transformed into a neutral narrative: 'the person is unable to make the recital which we call narrative memory, and yet he remains in the difficult situation'. . . This results in a 'phobia of memory' . . . that prevents the integration ('synthesis') of traumatic events and splits off the traumatic memories from ordinary consciousness. . . The memory traces of the trauma linger as subconscious fixed ideas that cannot be 'liquidated' as long as they have not been transformed into a personal narrative and instead continue to intrude as terrifying perceptions, obsessional preoccupations, and somatic experiences, such as anxiety reactions" (p.1533).


    Contents

    Judith Lewis Herman

    These four papers by Harvard psychiatrist Judith Herman and her colleagues Mary Harvey and Emily Schatzow address fundamental issues in the memory controversy. Judith Herman is the author of Trauma and Recovery, which is widely viewed as the best book yet written on psychological trauma and recovery; it includes an excellent chapter entitled "Remembrance and Mourning."
         The first paper below was published in 1987, before the False Memory Syndrome Foundation had come into existence. Herman and Schatzow present evidence that patients may recover verifiable  memories of childhood sexual abuse in the course of group treatment. In the second paper, Harvey and Herman show how the knowledge of clinicians should inform scientific research on traumatic memory. In the third paper, Herman articulates the "dialectic of psychological trauma" which characterizes both individuals' struggles with their traumatic memories and social controversies like that over recovered memories. She illuminates the ways that victims, perpetrators and bystanders respond to crimes ranging from organized political violence to the private crimes of sexual and domestic violence – and the moral obligations of mental health professionals who find themselves embroiled in such situations. I have provided an extended excerpt in which Herman addresses the utility of the construct of dissociation for understanding paradoxical qualities of traumatic memories. In the fourth paper and most recent paper, Herman and Harvey review 77 intake evaluations conducted in their own outpatient program, and report that trauma-specific reminders and recent life crises, not previous psychotherapy, are the typical precipitants of delayed recall.

    Herman, J. L., & Schatzow, E. (1987). Recovery and verification of memories of childhood sexual trauma. Psychoanalytic Psychology, 4, 1-14.

    Abstract: "Fifty-three women outpatients participated in short-term therapy groups for incest survivors. This treatment modality proved to be a powerful stimulus for recovery of previously repressed traumatic memories. A relationship was observed between the age of onset, duration, and degree of violence of the abuse and the extent to which the memory of the abuse had been repressed. Three out of four patients were able to validate their memories by obtaining corroborating evidence from other sources. The therapeutic function of recovering and validating traumatic memories is explored."

    Excerpts: "The majority of the patients (64%) did not have full recall of the sexual abuse but reported at least some degree of amnesia. . . Just over one quarter of the women (28%) reported severe memory deficits [i.e., recalled very little from childhood, reported recent eruption of previously inaccessible memories, or had such recall during the course of group treatment]" (p.4).
         "The majority of patients (74%) were able to obtain confirmation of the abuse from another source. Twenty-one women (40%) obtained corroborating evidence from the perpetrator himself, from other family members, or from physical evidence such as diaries or photographs. Another 18 women (34%) discovered that another child, usually a sibling, had been abused by the same perpetrator. An additional 5 women (9%) reported statements from other family members indicating a strong likelihood that they had also been abused, but did not confirm their suspicions by direct questioning. The three following case examples illustrate corroboration of the incest histories by, respectively, admission of the perpetrator, testimony of other family members, and physical evidence.

    "Andrea (Case Example 1) wrote a letter to her stepfather confronting him about the sexual abuse and demanding an apology. Her stepfather responded by phone. He acknowledged 'fooling around' with her but refused to apologize, stating that she knew she 'wanted it as much as he did.' He did not believe the abuse had been harmful because vaginal intercourse had not occurred, and added resentfully that he had respected her virginity, only to have her 'throw it away on a bum.' He concluded the conversation by exhorting her to stop blaming the family for the troubles she had brought upon herself.

    "Bernadette (Case Example 2) disclosed the sexual abuse to her mother, who burst into tears and cried, 'Oh no! Not you too!' She then told Bernadette that after she left home, her younger sisters had complained that their father tried to molest them.

    "After a heroic military career, Claudia's brother (Case Example 3) was killed in combat in Vietnam. Her parents continued to make pilgrimages to his grave, and had transformed their home into a shrine dedicated to his memory. His room with all of his belongings, had been left untouched. During a visit to her parents home, Claudia conducted a search of her brother's room. In a closet she found an extensive pornography collection, handcuffs, and a diary in which he planned and recorded his sexual 'experiments' with his sister in minute detail" (p.10).

    Harvey, M. R., & Herman, J. L. (1994). Amnesia, partial amnesia, and delayed recall among adult survivors of childhood trauma. Consciousness and Cognition, 4, 295-306.

    Abstract: "Clinical experience suggests that adult survivors of childhood trauma arrive at their memories in a number of ways, with varying degrees of associated distress and uncertainty and, in some cases, after memory lapses of varying duration and extent. Among those patients who enter psychotherapy as a result of early abuse, three general patterns of traumatic recall are identified: (1) relatively continuous recall of childhood abuse experiences coupled with changing interpretations (delayed understandings) of these experiences, (2) partial amnesia for abuse events, accompanied by a mixture of delayed recall and delayed understanding, and (3) delayed recall following a period of profound and pervasive amnesia. These patterns are represented by three composite clinical vignettes. Variations among them suggest that the phenomena underlying traumatic recall are continuous and not dichotomous. Future research into the nature of traumatic memory should be informed by clinical observation."

    Excerpt: "One aim of this paper is simply to describe the variations in traumatic recall that are frequently witnessed in clinical settings by ethical, observant, and reliable psychotherapists. Another is to counter an increasingly adversarial relationship between memory researchers who are relatively less familiar with clinical realities than they might be and clinicians who feel placed on the defensive by sweeping accusations of professional malfeasance" (p.297).

    Herman, J. L. (1995). Crime and memory. Bulletin of the American Academy of Psychiatry and the Law, 23, 5-17.

    Abstract: "The conflict between knowing and not knowing, speech and silence, remembering and forgetting, is the central dialectic of psychological trauma. This conflict is manifest in the individual disturbances of memory, the amnesias and hypermnesias [inabilities to forget], of traumatized people. It is manifest also on a social level, in persisting debates over the historical reality of atrocities that have been documented beyond any reasonable doubt. Social controversy becomes particularly acute at moments in history when perpetrators face the prospect of being publicly exposed or held legally accountable for crimes long hidden or condoned. This situation obtains in many countries emerging from dictatorship, with respect to political crimes such as murder and torture. It obtains in this country with respect to the private crimes of sexual and domestic violence. This article examines a current public controversy, regarding the credibility of adult recall of childhood abuse, as a classic example of the dialectic of trauma."

    Excerpt: "On the one hand, traumatized people remember too much; on the other hand, they remember too little . . . . The memories intrude when they are not wanted, in the form of nightmares, flashbacks, and behavioral reenactments. Yet the memories may not be accessible when they are wanted. Major parts of the story may be missing, and sometimes an entire event or series of events may be lost. We have by now a very large body of data indicating that trauma simultaneously enhances and impairs memory. How can we account for this? If traumatic events are (in the words of Robert J. Lifton) 'indelibly imprinted,' then how can they also be inaccessible to ordinary memory?"
         When scientific observations present a paradox, one way of resolving the contradiction is to ignore selectively some of the data. Hence we find some authorities even today asserting that traumatic amnesia cannot possibly exist because, after all, traumatic events are strongly remembered. Fortunately for the enterprise of science, empirical observations do not go away simply because simplistic theories fail to explain them. On the contrary, I believe that some of the most important discoveries arise from attempts to understand apparent paradoxes of this kind. I would like to offer two theoretical constructs that may help us clarify and organize our thinking in this area. The first is the concept of state-dependent learning; the second is the distinction between storage and retrieval of memory. . . .
         When people are in a state of terror, attention is narrowed and perceptions are altered. Peripheral detail, context, and time sense fall away, while attention is strongly focused on central detail in the immediate present. When the focus of attention is extremely narrow, people may experience profound perceptual distortions, including insensitivity to pain, depersonalization, time slowing and amnesia. This is that state we call dissociation. . . .
         Traumatic events have great power to elicit dissociative reactions. Some people dissociate spontaneously in response to terror. Others may learn to induce this state voluntarily, especially if they are exposed to traumatic events over and over. Political prisoners instruct one another in simple self-hypnosis techniques in order to withstand torture. In my clinical work with incest survivors, again and again I have heard how as children they taught themselves to enter a trance state.
         These profound alterations of consciousness at the time of the trauma may explain some of the abnormal features of the memories that are laid down. It may well be that because of the narrow focusing of attention, highly specific somatic and sensory information may be deeply engraved in memory, whereas contextual information, time-sequencing, and verbal narrative may be poorly registered. In other words, people may fail to establish the associative  linkages that are part of ordinary memory.
         If this were so, we would expect to find abnormalities not only in storage of traumatic memories, but also in retrieval. On the one hand, we would expect that the normal process of strategic search, that is, scanning autobiographical memory to create a coherent sequential narrative, might be relatively ineffective as a means of gaining access to traumatic memory. On the other hand, we would expect that certain trauma-specific sensory cues, or biologic alterations that produce a state of hyperarousal, might be effective. We would also expect that traumatic memories might be unusually accessible in a trance state.
         This is, of course, just what clinicians have observed for the past century. The role of altered states of consciousness in the pathogenesis of traumatic memory was discovered independently by Janet and Freud and Breuer 100 years ago"
    (pp.7-9).

    Herman, J. L., & Harvey, M. R. (1997). Adult memories of childhood trauma: A naturalistic clinical study. Journal of Traumatic Stress, 10, 557-571.

    Abstract: "The clinical evaluations of 77 adult outpatients reporting memories of childhood trauma were reviewed. A majority of patients reported some degree of continuous recall. Roughly half (53%) said they had never forgotten the traumatic events. Two smaller groups described a mixture of continuous and delayed recall (17%) or a period of complete amnesia followed by delayed recall (16%). Patients with and without delayed recall did not differ significantly in the proportions reporting corroboration of their memories from other sources. Idiosyncratic, trauma-specific reminders and recent life crises were most commonly cited as precipitants to delayed recall. A previous psychotherapy was cited as a factor in a minority (28%) of cases. By contrast, intrusion of memories after a period of amnesia was frequently cited as a factor leading to the decision to seek psychotherapy. The implications of these findings are discussed with respect to the role of psychotherapy in the process of recovering traumatic memories."

    Excerpts: "The types of childhood trauma reported were as follows: 59% patient (77%) reported sexual abuse, 53 (69%) reported physical abuse, and 24 (31%) reported witnessing intrafamilial violence. Of the group who reported witnessing violence, all but two patients reported having been directly victimized as well. Forty five patients (58%) reported exposure to two or more types of childhood trauma, and 12 (16%) reported exposure to all three types.
         "Table 1 [see below] summarizes the manner in which patients described the continuity of their memories. A majority of patients reported that they had always remembered their childhood experiences. Thirteen patients reported a mixture of continuous and delayed recall. In this category, some patients who had experienced more than one type of abuse made a distinction between their continuous memories for one type of abuse and delayed recall of another. Others reported that they had always known that they were abused, but had initially remembered other, often earlier instances of abuse. Twelve patients described a period of complete amnesia followed by delayed recall" (p.563).
         ". . . The type of precipitant most frequently identified was an idiosyncratic, trauma-specific reminder whose meaning could only be understood in the context of the patient's history. Examples included a chance meeting with a childhood friend, returning to a former neighborhood, or learning of the violent death of a relative (pp.563-564).
         "Although patients were not asked whether they had any information which might confirm their memories of childhood abuse, 33 patients (43%) spontaneously described some type of corroboration. Only seven patients described having undertaken an active search for evidence that might confirm their memories; the majority of the patient who had such evidence had not actively sought it. Among the 25 patients who reported some degree of amnesia and delayed recall, nine (36%) reported having obtained confirming evidence for their memories, while among the patients who did not report any memory deficits, a slightly larger proportion (24 of 52, or 46%) reported obtaining corroboration. The difference between the two groups was not statistically significant" (p.565).
         "The most common types of confirmation came from family members who told the patient that they had either directly witnessed or indirectly known of the abuse. Eleven patients described confirming information that was meaningful only in context and hence difficult to categorize. For example, one patient had recently learned from a former classmate that her abuser, a revered junior high school teacher, suddenly left the school 'under a cloud,' and soon afterwards married an adolescent girl who had been his pupil. This type of information is listed as an idiosyncratic source [see Table 4 below]. Of the patients who reported this type of evidence, seven also had confirmatory information from other sources. Ten patients reported obtaining more than one type of confirmation. It should be noted that interviewers did not attempt to verify independently the information given by the patients (pp.565-566).
         "The Victims of Violence Program. . . is a setting known for offering feminist-informed treatment to crime victims, both men and women. As such, it might be expected to attract patients who identify themselves as survivors of childhood abuse. The selective nature of our patient population may account for some differences between our findings and those of previous investigators, and may limit the generalizability of our data. However, the main findings of this study are congruent with previous studies documenting memory disturbances in a considerable proportion of patients with histories of childhood trauma" (pp.566-567).
         "Our data also suggest that delayed recall of childhood trauma is often a process that unfolds over time rather than a single event, and that it occurs most commonly in the context of a life crisis or developmental milestone, with a trauma-specific reminder serving as a proximal cue to new recall. Psychotherapy was not implicated in the early stages of delayed recall in most cases. However, the retrieval of memories, once begun, proved to be a powerful incentive for entering psychotherapy. Patients rarely sought treatment with the goal of recovering more memories; rather, they wished to gain more control over intrusive, involuntary reliving experiences and to make sense of the fragmented, often confusing and disturbing recollections they already had" (p.567).
         "Though psychotherapy may turn out to play a minor role in initiating recall of traumatic events, it often does play a role in enlarging and changing patients' understanding of their past. We believe that the proper role of psychotherapy is to provide an environment of confidentiality and empathic, nonjudgemental attention, where uncertainty, complexity and ambivalence are tolerated. A stance of open-minded, reflective curiosity should prevail. Such an environment stands in marked contrast to the adversarial, polarized environment of the courtroom. We believe, however, that for most patients it is a far more appropriate setting for gaining understanding of the impact of traumatic events. Within such an environment, and with careful timing and pacing, exploration of abusive childhood experiences may be carried out safely. The purpose of such exploration is not the forensic documentation of facts, but the construction of an integrated, personally meaningful narrative that helps free the patient from the persistent noxious effects of traumatic events in the distant past. . . Future clinical research is needed in order systematically to document treatment outcome and establish preferred modalities of psychotherapy for patients with histories of childhood trauma" (pp.568-569).


    Three tables from the paper:

    Table 1
    Continuity of Memory
    Continuity of Memory Number of patients % of Total
    Continuous recall 41 53
    Continuous memory and delayed recall 13 17
    Complete amnesia and delayed recall 12 16
    Uninformative charts 11 14
    Total 77 100


    Table 2
    Precipitants to Delayed Recall of Childhood Trauma
    Type of Precipitant Patients with Delayed
    Recall (n = 25)
    %
    Trauma-specific reminder 12 48
    Recent life crises/milestone 10 40
    Psychotherapy 7 28
    New information from another person 5 20
    Change in close relationship 5 20
    Abstinence from drugs or alcohol 5 20
    Altered state experience 5 20
    Unspecified precipitant 4 16
    Illness or injury 2 8
    Book, article, or TV program 2 8


    Table 4
    Sources of Memory Confirmation
    Confirmation Source Number of Patients % of Total
    Indirect witness (e.g., family member knew of abuse) 12 16
    Idiosyncratic sources 11 14
    Direct witness (e.g., family member witnessed abuse) 10 13
    Disclosure by another victim of same perpetrator 10 13
    Multiple sources 10 13
    Perpetrator charged with similar crime 6 8
    Indirect evidence (e.g., medical record of injuries) 4 5
    Physical evidence 1 1
    Admisssion by perpetrator 1 1



    Contents

    Ross Cheit

    Ross Cheit is a political scientist at Brown University who conducts important research on sexual abuse and public policy in the United States. He maintains the Recovered Memory Project, a Web site with an archive of corroborated cases of recovered memories of sexual abuse. The Recovered Memory Project Archive includes cases in which sexual abuse had gone on for years – occurrences still claimed to be impossible by those now unable to deny the existence of recovered memories. Cheit provides the criteria for inclusion in the Archive and invites Web-based submission of additional cases, as well as criticism and contrary evidence. It's an extremely valuable Web site, and I strongly encourage you to educate yourself there – especially if you're still skeptical about the reality of recovered memories of abuse.

    Here's an outline of the Archive's 80 Corroborated Cases of Recovered Memory:

    • 38 Cases from Legal Proceedings
    • 19 Clinical Cases and other Academic/Scientific Case Studies
    • 23 Other Corroborated Cases of Recovered Memory


    Contents

    Elizabeth Loftus

    University of Washington psychologist Elizabeth Loftus is an accomplished researcher with expertise in eyewitness testimony, particularly how the memories of crime witnesses can be distorted by post-event questioning. Loftus is a prominent spokesperson for the False Memory Syndrome Foundation, and her views have by and large been very well received by the mass media in the United States. Loftus also testifies as an expert witness on the behalf of people accused of child abuse on the basis of recovered memories. She has co-authored a book entitled The Myth of Repressed Memory.
         You've probably heard of Dr. Loftus, and seen her quoted approvingly and uncritically in the popular media. No doubt, as reported in the media, she has prevented some wrongly accused people from being unjustly convicted. She has also played a valuable role by bringing attention and accountability to bear on some irresponsible practices by some incompetent therapists. Yet Dr. Loftus has also claimed that recovered memory is a "myth," and that the majority of such memories are false and implanted by therapists.
         Unfortunately, thus far reporters and journalists have almost completely failed to critically evaluate her claims. Nor have they addressed three crucial facts about her work:

    1. Loftus herself conducted and published a study in which nearly one in five women who reported childhood sexual abuse also reported completely forgetting the abuse for some period of time and recovering the memory of it later.

    2. Loftus misrepresented the facts of a legal case in a scholarly paper and, after finally apologizing to the victim of her misrepresentations, continued to promote the article with falsehoods. (See Consider the Evidence for Elizabeth Loftus' Scholarship and Accuracy, by Jennifer Hoult, whose case Loftus misrepresented.)

    3. Loftus is aware that those who study traumatic memory have for several years, based on a great deal of research and clinical experience, used the construct of dissociation to account for the majority of recovered memories. However, she continues to focus on and attack "repression" and "repressed memories," which has the effect of confusing and misleading many people.
    Here is the study almost never mentioned by Dr. Loftus or the media:

    Loftus, E.F., Polonsky, S., & Fullilove, M. T. (1994). Memories of childhood sexual abuse: Remembering and repressing. Psychology of Women Quarterly, 18, 67-845.

    Abstract: "Women involved in out-patient treatment for substance abuse were interviewed to examine their recollections of childhood sexual abuse. Overall, 54% of the women reported a history of childhood sexual abuse. The majority (81.1%) remembered all or part of the abuse their whole lives; 19% reported they forgot the abuse for a period of time, and later the memory returned. Women who remembered the abuse their whole lives reported a clearer memory, with a more detailed picture. They also reported greater intensity of feelings at the time the abuse happened. Women who remembered the abuse their whole lives did not differ from others in terms of the violence of the abuse or whether the abuse was incestuous. These data bear on current discussions concerning the extent to which repression is a common way of coping with child sexual abuse trauma, and also bear on some widely held beliefs about the correlates of repression."
    If you read this paper (and I strongly encourage you to do so, especially if you are presenting this issue to others), you will find that Loftus devotes most of it to attacking the construct of repression. If you read this paper, you will probably find it interesting and ironic that Loftus, after her sustained attack on the construct of repression, uses it to explain the recovered memories of her own study's subjects. If you read this paper and some of the other works cited on this page, you will understand that experts in psychological trauma would not explain the recovered memories of her research subjects in that way, but in terms of dissociation.

    Here are the findings at issue:

    "Forgetting was associated with a different quality of memory, compared to those who did not forget. Forgetting was associated with a current memory that was deteriorated in some respects. The deteriorated memory was less clear; it contained less of a 'picture,' and the remembered intensity of feelings at the time of the abuse was less" (p.79).
    Notice the use of the word "deteriorated" to describe memory characteristics that most trauma specialists would describe as "dissociative." The principle that initially whole memories deteriorate over time is derived from research on nontraumatic memory. In contrast, just as dissociation involves a fragmentation of experience during abuse, subsequent memories tend to appear as fragments too – from the beginning. Thus, if a subject had dissociated during the abuse experience, such fragmentation would likely cause her memory to be "less clear," and to involve less of a "picture." Further, dissociative fragmentation during abuse typically involves a defensive attempt to split (dis-associate) physical and emotional pain from one's conscious experience. This could explain the finding that the women who had forgotten for some time, compared to those who had not, remembered the intensity of their feelings being less during the abuse. But Loftus and her colleagues, understandably wedded to their traditional model of memory and either unable or unwilling to apply the construct of dissociation, can only characterize such memories as "deteriorated."

    Ironically, this leads Loftus to use repression as an explanation for these lost memories – though no psychological trauma expert would do so:

    "Suppose instead we define repression more conservatively. . . . Just under one fifth of the women reported that they forgot the abuse for a period of time and later regained the memory. One could argue that this means that robust repression was not especially prevalent in our sample" (p.80).
    In summary:
    • Loftus has conducted and published research which calls into question her public statements on recovered memories; her own study demonstrated that the conditions of amnesia and delayed recall for sexual abuse do exist.
    • She has relentlessly attacked the construct of repression in her scholarly work, in her expert testimony to judges and juries, and in her statements to the media; this behavior causes many uninformed people to believe she is arguing that the conditions of amnesia and delayed recall for sexual abuse do not exist.
    • She has misrepresented the facts of a legal case in a scholarly paper and, after finally apologizing to the victim of her misrepresentations, continued to promote the article riddled with falsehoods (see Consider the Evidence for Elizabeth Loftus' Scholarship and Accuracy)

    • She is aware that experts on traumatic and recovered memories, when they do employ explanatory constructs, use dissociation much more than repression to understand these phenomena.
    • She has used repression to explain recovered memories reported by subjects in her own research, though experts in traumatic memory would argue that they are more likely dissociative in nature.
    • For most of you, this is the first time you are learning these facts, because most members of the popular media addressing this issue have note done their homework or made any of these facts known. (For more on the unreliability and poor track record of the popular media on this issue, see Mike Stanton's piece in the Columbia Journalism Review, U-Turn on Memory Lane).


    Contents

    DSM-IV : The Diagnosis of Dissociative Amnesia

    The Diagnostic and Statistical Manual of Mental Disorders, currently in its fourth edition (DSM-IV), is the "bible" of psychiatric diagnosis. Decisions about treatment, communication among mental health professionals, and whole traditions of psychiatric research depend on use of the DSM  system. Insurance companies will not pay for treatment unless the client has a DSM  diagnosis. While it's true that developing diagnostic categories can be an inexact science, and that some disorders have come and gone, years  of empirical research and clinical observation go into each subsequent revision of this document. In short, if the diagnosis of Dissociative Amnesia exists in DSM-IV, it's likely there for good reasons.

    There are often politicized battles among different groups of psychiatrists and psychologists invested in certain diagnostic approaches, and certain diagnoses are contested by some clinicians and researchers. But two characteristics of DSM  itself, which stem from the nature of the revision process, are particularly relevant here:

    1. Since the 1970s the DSM  approach to diagnosis has been highly descriptive; that is, diagnostic categories and their revisions are grounded in empirical evidence and observable phenomena, not  theoretical constructs involving assumptions about causal mechanisms (though in the case of trauma-induced disorders, to some extent this cannot be avoided).

    2. Because committees and decisions tend to be dominated by older, "establishment" psychiatrists, the DSM  is a quite conservative  document.
    Both of these characteristics of DSM  have clear implications for the diagnosis of Dissociative Amnesia:
    1. "Dissociative Amnesia" is a descriptive  diagnosis that adheres closely to empirical data and clinically observed symptomology (there is no theory-laden diagnosis of "Repressive Amnesia," and it was never even considered).

    2. "Dissociative Amnesia" did not enter the DSM  diagnostic system because a small group of ignorant and radical therapists hijacked the DSM-revision process. (The Working Group on Dissociative Disorders included, among others, David Spiegel, a Stanford psychiatrist and researcher whose work has been funded by the National Institutes of Health and the MacArthur Foundation; see the pre-DSM-IV  paper he wrote with Etzel Cardena, in which they review empirical research on trauma and dissociation and offer recommendations for DSM-IV  dissociative diagnoses [Spiegel & Cardena, 1991, "Disintegrated Experience: The Dissociative Disorders Revisited," Journal of Abnormal Psychology, 100, 366-378]).
    Please note: Many clinicians have worked with clients who were doing well until returning memories sent them into treatment. As indicated below, to have the disorder  of Dissociative Amnesia a person must experience distress or impairment  because he or she cannot remember past (traumatic) events. Thus people can experience dissociative amnesia for memories of childhood sexual abuse without having this disorder.

    The below excerpts from DSM-IV  clarify the nature of dissociation and show just how accepted this psychological construct is in the field of psychiatry. For starters, the same scientific progress which has led to increasing reliance on the construct of dissociation also brought about the change of the disorder's name – from the vague "Psychogenic Amnesia" to the more accurately descriptive "Dissociative Amnesia" in DSM-IV.


    "Dissociative Disorders

    "The essential feature of the Dissociative Disorders is a disruption of the usually integrated functions of consciousness, memory, identity, or perception of the environment. The disturbance may be sudden or gradual, transient or chronic. The following disorders are included in this section:
         "Dissociative Amnesia  is characterized by an inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by ordinary forgetfulness" (p.477).


    "300.12  Dissociative Amnesia
    (formerly  Psychogenic Amnesia)

    "Diagnostic Features

    "The essential feature of Dissociative Amnesia is an inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by normal forgetfulness (Criterion A). This disorder involves a reversible memory impairment in which memories of personal experience cannot be retrieved in a verbal form (or, if temporarily retrieved, cannot be wholly retained in consciousness). The disturbance does not occur exclusively during the course of Dissociative Identity Disorder [formerly Multiple Personality Disorder], Dissociative Fugue, Posttraumatic Stress Disorder, Acute Stress Disorder, or Somatization Disorder and is not due to the direct physiological effects of a substance or a neurological or other general medical condition (Criterion B). The symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion C).
         "Dissociative Amnesia most commonly presents as a retrospectively reported gap or series of gaps in recall for aspects of the individual's life history. These gaps are usually related to traumatic or extremely stressful events. Some individuals may have amnesia for episodes of self-mutilation, violent outbursts, or suicide attempts. Less commonly, Dissociative Amnesia presents as a florid episode with sudden onset. This acute form is more likely to occur during wartime or in response to a natural disaster" (p.478).

    "Prevalence

    "In recent years in the United States, there has been an increase in reported cases of Dissociative Amnesia that involves previously forgotten early childhood traumas. This increase has been subject to very different interpretations. Some believe that the greater awareness of the diagnosis among mental health professionals has resulted in the identification of cases that were previously undiagnosed. In contrast, others believe that the syndrome has been overdiagnosed in individuals who are highly suggestible" (p.479).

    The above paragraph was written in 1993, prior to the publication of nearly all of the more than 85 research studies of amnesia and delayed recall that have now been published.

    American Psychiatric Association. (1994). Diagnostic and statistic manual of mental disorders  (4th ed.). Washington, DC: Author.

    Contents

    Journal of Traumatic Stress
    Special Issue: Traumatic Memory Research

    This October 1995 special issue is an important and rich resource. I have provided an excerpt of Editor Bonnie Green's introduction, and abstracts of relevant papers. A version  of the entire paper by van der Kolk and Fisler is accessible via hyperlink to David Baldwin's Trauma Information Pages. Finally, if you want a copy of this journal, ordering information appears at the end of this section.

    Special Issue: Traumatic Memory Research. Journal of Traumatic Stress, Volume 8, Number 4, October, 1995.
    Contents and Abstracts

    Green, B. L. Introduction to special issue on traumatic memory research.

    Excerpt: "The present issue of JTS  is dedicated to the topic of research on traumatic memory. While a few of the articles fall slightly outside of this overall designation, all articles were seen to be pertinent to clinicians and scholars who study and treat individuals with a history of traumatic exposure. The issue is sparked, to some extent, by the controversy raging within and between mental health professionals and academics about whether individuals can 'forget' traumatic events in their pasts, and whether they can 'remember' events that never took place. While the issue is not focused on this controversy per se, it was undertaken to inform clinicians and researchers about a variety of topics related to traumatic memory, 'recovered' or otherwise" (p.501).

    van der Kolk, B., & Fisler, R. Dissociation and the fragmentary nature of traumatic memories: Overview and exploratory study.

    Abstract: "Since trauma arises from an inescapable stressful event that overwhelms people's coping mechanisms, it is uncertain to what degree the results of laboratory studies of ordinary events are relevant to the understanding of traumatic memories. This paper reviews the literature on differences between recollections of stressful and of traumatic events. It then reviews the evidence implicating dissociation as the central pathogenic mechanism that gives rise to posttraumatic stress disorder (PTSD). A systematic exploratory study of 46 subjects with PTSD indicated that traumatic memories were retrieved, at least initially, in the form of dissociated mental imprints of sensory and affective elements of the traumatic experience: as visual, olfactory, affective, auditory, and kinesthetic experiences. Over time, subjects reported the gradual emergence of a personal narrative that can be properly referred to as 'explicit memory.' The implications of these findings for understanding the nature of traumatic memories are discussed."

    Read excerpts from this paper.

    Bremner, J. D., Krystal, J. H., & Charney, D. S. Functional neuroanatomical correlates of the effects of stress on memory.

    Abstract: "Recently there has been an increase in interest in the relationship between stress and memory. Brain regions which are involved in memory function also effect the stress response. Traumatic stress results in changes in these brain regions; alterations in these brain regions in turn may mediate symptoms of posttraumatic stress disorder (PTSD). Neural mechanisms which are relevant to the effects of stress on memory, such as fear conditioning, stress sensitization, and extinction, are reviewed in relation to their implications for PTSD. Special topics including neural mechanisms in dissociation, neurobiological approaches to the validity of childhood memories as they apply to controversies over the "False Memory Syndrome," and implications of the effects of stress on memory for psychotherapy, are also reviewed. The findings discussed in this paper are consistent with the formulation that stress-induced alterations in brain regions and systems involved in memory may underlie many of the symptoms of PTSD, as well as dissociative amnesia, seen in survivors of traumatic stress."

    Fivush, R., & Schwarzmueller, A. Say it once again: Effects of repeated questions on children's event recall.

    Abstract: "In this paper, we review research examining the influences of repeated questioning on children's event recall. Issues addressed include how children's free recall changes across multiple recounts of the same event, whether responding to specific questions about an event affects subsequent responses to those same questions, and whether there are developmental differences in how children respond to repeated questioning. Both naturalistic studies of conversational remembering and more controlled studies using standardized interviews are discussed. Effects of repeated questioning both within and across interviews are assessed. In integrating the research findings, we present a developmental framework for understanding the effects of repeated questioning that relies on children's developing memory and narrative skills as well as their social understanding of the recall context."

    Excerpt: "Certainly, when children are abused, they are often sworn to secrecy, or even threatened with aversive consequences if they tell. In these kinds of situations, what happens to memory? Given the theoretical framework laid out here, we would predict that these memories may become especially difficult to retrieve and recall. If young children are dependent to some extent on talking about events with others who help them organize their verbal recount, which in turn leads to long-term retention of these events, then it seems quite likely that if children are not given the opportunity to engage in this kind of verbal work, their memories of the event would not be as good as memories of events that are discussed. Indeed, Goodman [et al.] (1994) recently reported results that support this prediction [Consciousness & Cognition, 3, 369-394]. They examined children's memories for a painful medical procedure involving catheterization and voiding. Those children whose mothers subsequently talked with them about their experience had more accurate memories of the event than children whose mothers did not discuss the event. More research focusing on the consequences of discussing or not discussing experiences on the fate of these event memories is clearly necessary. This is a critical question, both for a theoretical understanding of the role of rehearsal on memory, as well as applied issues concerning children's memories for abusive experiences, and adults' ability to recall abusive experiences from their childhood" (pp.576-577).

    Ornstein, P. A. Children's long-term retention of salient personal experiences.

    Tromp, S., Koss, M. P., & Tharan, M. Are rape memories different? A comparison of rape, other unpleasant, and pleasant memories among employed women.

    Abstract: "The study examined empirically-measured memory characteristics, compared pleasant and unpleasant intense memories as well as rape and other unpleasant memories, and determined whether rape memories exhibited significantly more "flashbulb' characteristics. Data consisted of responses to a mailed survey of women employees of a medical center (N = 1,037) and a university (N = 2,142). Pleasant and unpleasant memories were differentiated by feelings, consequences, and level of unexpectedness. The most powerful discriminator of rape from other unpleasant memories was the degree to which they were less clear and vivid, contained a less meaningful order, were less well-remembered, and were less thought and talked about. Few 'flashbulb' characteristics discriminated among memory types. Implications for clinical work with rape survivors were discussed."

    Elliott, D. M., & Briere, J. Posttraumatic stress associated with delayed recall of sexual abuse: A general population study.

    Abstract: "This study examined delayed recall of childhood sexual abuse in a stratified random sample of the general population (N = 505). Of participants who reported a history of sexual abuse, 42% described some period of time when they had less memory of the abuse than they did at the time of data collection. No demographic differences were found between subjects with continuous recall and those who reported delayed recall. However, delayed recall was associated with the use of threats at the time of the abuse. Subjects who had recently recalled aspects of their abuse reported particularly high levels of posttraumatic symptomatology and self difficulties (as measured by the IES, SCL, and TSI) at the time of data collection compared to other subjects."

    Williams, L. M. Recovered memories of abuse in women with documented child sexual victimization histories.

    Abstract: "This study provides evidence that some adults who claim to have recovered memories of sexual abuse recall actual events that occurred in childhood. One hundred twenty-nine women with documented histories of sexual victimization in childhood were interviewed and asked about abuse history. Seventeen years following the initial report of the abuse, 80 of the women recalled the victimization. One in 10 women (16% of those who recalled the abuse) reported that at some time in the past they had forgotten about the abuse. Those with a prior period of forgetting – the women with 'recovered memories' – were younger at the time of abuse and were less likely to have received support from their mothers than the women who reported that they had always remembered their victimization. The women who had recovered memories and those who had always remembered had the same number of discrepancies when their accounts of the abuse were compared to the reports from the early 1970's."

    Read an excerpt from this paper.

    Foa, E. B., Molnar, C., & Cashman, L. Change in rape narratives during exposure therapy for posttraumatic stress disorder.

    Rogers, M. L. Factors influencing recall of childhood sexual abuse.

    Wolfe, J. Trauma, traumatic memory, and research: Where do we go from here?

    To purchase a copy of this issue, send a personal check to:
         Plenum Publishing
         233 Spring Street
         New York, New York 10013
         Attn: Back Issues
    It's 225 pages, $23.45 for individuals, and $67 for institutions.
    If you have questions, call the Back Issues Dept. at (212) 620-8069.


    Contents

    John Briere

    Psychologist John Briere, of the University of Southern California (USC) Medical School, is a highly respected researcher and clinician in the field of traumatic stress studies. He has written numerous articles and several books on the lasting effects of child sexual abuse and the treatment of adults sexually abused in childhood. These include the papers below, which report research studies on amnesia for and delayed recall of memories of child sexual abuse.

    Briere, J., & Conte, J. (1993). Self-reported amnesia for abuse in adults molested as children. Journal of Traumatic Stress, 6, 21-31.

    Abstract: "A sample of 450 adult clinical subjects reporting sexual abuse histories were studied regarding their repression of sexual abuse incidents. A total of 267 subjects (59.3%) identified some period in their lives, before age 18, when they had no memory of their abuse. Variables most predictive of abuse-related amnesia were greater current psychological symptoms, molestation at an early age, extended abuse, and variables reflecting especially violent abuse (e.g., victimization by multiple perpetrators, having been physically injured as a result of the abuse, victim fears of death if she or he disclosed the abuse to others). In contrast, abuse characteristics more likely to produce psychological conflict (e.g., enjoyment of the abuse, acceptance of bribes, feelings of guilt or shame) were not associated with abuse-related amnesia. The results of this study are interpreted as supporting Freud's initial 'seduction hypothesis,' as well as more recent theories of post-traumatic stress disorder."

    Elliott, D. M., & Briere, J. (1995). Posttraumatic stress associated with delayed recall of sexual abuse: A general population study. Journal of Traumatic Stress, 8, 629-647.

    Abstract: "This study examined delayed recall of childhood sexual abuse in a stratified random sample of the general population (N = 505). Of participants who reported a history of sexual abuse, 42% described some period of time when they had less memory of the abuse than they did at the time of data collection. No demographic differences were found between subjects with continuous recall and those who reported delayed recall. However, delayed recall was associated with the use of threats at the time of the abuse. Subjects who had recently recalled aspects of their abuse reported particularly high levels of posttraumatic symptomatology and self difficulties (as measured by the IES, SCL, and TSI) at the time of data collection compared to other subjects."


    Contents

    Shirley Feldman-Summers

    Psychologist Shirley Feldman-Summers is an independent practitioner in Washington state, and serves as an expert witness in civil and criminal cases. The paper below (follow link for full text) is a research study with data on rates of amnesia and delayed recall for child abuse experiences among a national sample of psychotherapists.

    Feldman-Summers, S., & Pope, K. S. (1994). The experience of "forgetting" childhood abuse: A national survey of psychologists (full text) . Journal of Consulting and Clinical Psychology, 62, 636-639.

    Abstract: "A national sample of psychologists were asked whether they had been abused as children and, if so, whether they had ever forgotten some or all of the abuse. Almost a quarter of the sample (23.9%) reported childhood abuse, and of those, approximately 40% reported a period of forgetting some or all of the abuse. The major findings were that (a) both sexual and nonsexual abuse were subject to periods of forgetting; (b) the most frequently reported factor related to recall was being in therapy; (c) approximately one half of those who reported forgetting also reported corroboration of the abuse; and (d) reported forgetting was not related to gender or age of the respondent but was related to severity of the abuse."

    Two tables from the paper:

    Table 2
    Events, Experiences, or Circumstances That Triggered Recovery of the Memories of Abuse
    Experience Number
    of Subjects
    Percentage
    of Subjects
    A book, article, lecture, movie, or TV show reminded me. 8 25.0
    Someone who knew about the abuse reminded me. 6 18.8
    In therapy, the memory began to return. 18 56.2
    In a self-help or peer group (i.e., not a therapy group), the memory began to return. 2 6.2
    Some other event seemed to trigger or elicit the memory (please describe). 9 28.1
    Nothing seemed to be related to my remembering the abuse. 3 9.4


    Table 3
    Sources That Support, Corroborate, or Confirm the Recovered Memory of the Abuse
    Source Number
    of Subjects
    Percentage
    of Subjects
    The abuser(s) acknowledged some or all of the remembered abuse. 5 15.6
    Someone who knew about the abuse told me. 7 21.9
    Journals or diaries kept by the abuser(s) described or referred to the abuse. 0 0.0
    My own journals or diaries (that I had forgotten about) described the abuse. 2 6.2
    Someone else reported abuse by the same perpetrator. 5 15.6
    Medical records referred to or described the abuse. 2 6.2
    Court or legal records referred to or described the abuse. 0 0.0
    No support, corroboration, or confirmation has been found. 16 50


    Contents

    Jennifer Freyd

    University of Oregon psychologist Jennifer Freyd has written an acclaimed book (and an article) in which she advances her theory of why it is adaptive  for some children not to remember childhood abuse experiences. She focuses on the issue of betrayal, and argues that the need for mental and physical survival, not merely the avoidance of painful feelings, leads children abused by caregivers to block out information about the abuse. Dr. Freyd and two of her colleagues conducted a study to test her theory, and the results are reported in a 2001 paper that is referenced below and available online as a pdf file.

    Siver, H., Schooler, J., Freyd, J. J. (2002). Recovered memories (pdf). In V. S. Ramachandran (Ed.), Encyclopedia of the Human Brain (pp. 169-184). New York: Academic Press.

    Excerpt: "We begin by briefly summarizing the proposed social situation in which the current debate arose. Then, we present a sample of published research that has attempted to document the forgetting and recovery of memories for childhood sexual abuse. This is followed by a discussion of possible mechanisms for recovered memories, including ones proposed to be specific to traumatic events and others that are more standard mechanisms for remembering and forgetting. Finally, we discuss issues of accuracy in recovered memories." (p.170).


    Freyd, J. J. (1996). Betrayal trauma: The logic of forgetting childhood abuse. Cambridge: Harvard University Press. (Follow link for promotional information at HUP.)

    Here are excerpts from the New York Times Book Review:

    "Betrayal Trauma  is a thoughtful, judicious and thorough scholarly analysis of a subject that has hitherto generated more heat than light. . .

    "Although the mechanisms involved [in memory loss and retrieval] are far from fully understood, Ms. Freyd marshals the psychological, neurological and cognitive-science literature with impressive skill to suggest several plausible possibilities. Her work serves as a salutary reminder that if treated as serious science rather than media hoopla the recovered-memory debate could provide a significant window on mind-brain relationships; anyone interested in the latter will find much stimulating material here. . .

    "She has a complex enough case to argue; she argues it fairly and with virtuoso skill, blending vivid anecdote with statistical evidence, first-person accounts with research reports, in a highly literate and engaging style. Partisan passions, alas, are seldom quenched by reason. But unblinkered readers will surely agree that Ms. Freyd's book places recovered memories squarely on the cognitive-science agenda. Her diagnosis of their source may well turn out to be correct."
         - Derek Bickerton, New York Times Book Review


    Freyd, J. (1994). Betrayal trauma: Traumatic amnesia as an adaptive response to childhood abuse. Ethics & Behavior, 4, 307-329.

    Abstract: "Betrayal trauma theory suggests that psychogenic amnesia is an adaptive response to childhood abuse. When a parent or other powerful figure violates a fundamental ethic of human relationships, victims may need to remain unaware of the trauma not to reduce suffering but rather to promote survival. Amnesia enables the child to maintain an attachment with a figure vital to survival, development, and thriving. Analysis of evolutionary pressures, mental modules, social cognitions, and developmental needs suggests that the degree to which the most fundamental human ethics are violated can influence the nature, form, and process of trauma and responses to the trauma."

    Excerpt: "Child abuse is especially likely to produce a social conflict or betrayal for the victim. . . Further, there is evidence that the most devastating psychological effects of child abuse occur when the victims are abused by a trusted person who was known to them. . . If a child processed the betrayal in the normal way, he or she would be motivated to stop interacting with the betrayer. Instead, he or she essentially needs to ignore the betrayal. If the betrayer is a primary caregiver, it is especially essential that the child does not stop behaving in such a way that will inspire attachment. For the child to withdraw from a caregiver on which he or she is dependent would further threaten the child's life, both physically and mentally. Thus the trauma of child abuse by its very nature requires that information about the abuse be blocked from mental mechanisms that control attachment and attachment behavior. The information that gets blocked may be partial (for instance, blocking emotional responses only), but in many cases partial blocking will lead to a more profound amnesia" (p.312).

    Freyd, J.J., DePrince, A.P., & Zurbriggen, E.L. (2001). Self-reported memory for abuse depends upon victim-perpetrator relationship. Journal of Trauma & Dissociation, 2, 5-17.

    Abstract: "We present preliminary results from the Betrayal Trauma Inventory (BTI) testing predictions from betrayal trauma theory (Freyd 1994, 1996, in press) about the relationship between amnesia and betrayal by a caregiver. The BTI assesses trauma history using behaviorally defined events in the domains of sexual, physical, and emotional childhood abuse, as well as other lifetime traumatic events. When participants endorse an abuse experience, follow-up questions assess a variety of factors including memory impairment and perpetrator relationship. Preliminary results support our prediction that abuse perpetrated by a caregiver is related to less persistent memories of abuse. This relationship is significant for sexual and physical abuse. Regression analyses revealed that age was not a significant predictor of memory impairment and that duration of abuse could not account for the findings."

    Dr. Freyd's web site has a wealth of helpful and clarifying information on traumatic and recovered memories, including the following pages: What is a Betrayal Trauma? What is Betrayal Trauma Theory? - What is Shareability? - What is DARVO? - What about Recovered Memories?

    Some of Dr. Freyd's most important recent work addresses how media coverage of the recovered memory debate in general, and certain research studies in particular, confuses and misleads many people: Commentary: Response to 17 February 2003 Media Reports on Loftus' Bugs Bunny Study - Misleading and confusing media portrayals of memory research

    Dr. Freyd and Dr. Chris Brewin organized the 1998 Meeting on Trauma and Cognitive Science. At the site there is an order form for a set of 10 tapes of presentations by leading researchers. The conference was offered by the University of Oregon's Institute of Cognitive and Decision Sciences, Department of Psychology, and Center for the Study of Women in Society. Its aim was "to share knowledge and theory relvant to understanding the way in which trauma interacts with information processing," including "a particular focus on how traumatic information is encoded, stored, and later retrieved from memory." The conference had a research focus, but also addressed the significant ethical, clinical, and societal implications of the researchers' work. Speakers represented a broad spectrum of research approaches and points of view. Trauma and Cognitive Science is a book based on the conference.



    Contents

    Chris Brewin

    Chris R. Brewin, Ph.D., is a Professor and Co-director of the Cognition, Emotion and Trauma Group, in the Department of Psychology, Royal Holloway University of London. He is a clinical psychologist specializing in trauma and memory. In addition to publishing several studies on intrusive memories with his colleagues, Dr. Brewin is the first author of two important review articles that bring the latest cognitive science theory and research to the issue of traumatic memories, including recovered memories. Both are featured below.

    Brewin, C. R., & Andrews, B. (1998). Recovered memories of trauma: Phenomenology and cognitive mechanisms. Clinical Psychology Review, 4, 949-970.

    Abstract: "We outline four current explanations for the reported forgetting of traumatic events, namely repression, dissociation, ordinary forgetting, and false memory. We then review the clinical and survey evidence on recovered memories, and consider experimental evidence that a variety of inhibitory processes are involved in everyday cognitive activity including forgetting. The data currently available do not allow any of the four explanations to be rejected, and strongly support the likelihood that some recovered memories correspond to actual experiences. We propose replacing the terms repression and dissociation as explanations of forgetting with an account based on cognitive science."

    Excerpts: "Given that the recovery of essentially accurate memories of trauma after a period of forgetting is agreed to occur in some cases, the plausibility of competing accounts of forgetting depends on whether: (a) clients report active attempts to forget memories or banish them from consciousness, and the strategies they use to do this; (b) the memories recalled possess the hallmarks of disrupted encoding, such as fragmentation, intense sensory and perceptual features, and the experience of reliving the event in the present; (c) evidence for inhibitory processes can be found in everyday cognitive tasks; (d) ordinary individuals display a selective problem in processing negative memories. In the next two sections of this article, we consider the clinical and experimental evidence relevant to these issues" (p.953).
         "Of particular value is the evidence that memory recovery can take several forms. Amnesia may be partial or profound, and individuals can often give accounts of deliberate strategies they use to banish distressing memories from consciousness. Recovered memories may be fragemented, emotion-laden, and similar to intrusive memories of the PTSD patient, or (less often) they may more closely resemble ordinary memories. These observations suggest that several different kinds of underlying cognitive processes are likely to be necessary to explain such diverse phenomena. In search of such processes we now turn to the experimental literature" (p.958).
         "Studies of retrieval inhibition suggest a mechanism to explain how instructions to forget generated by the self or others might lead to profound amnesia for an event, which could subsequently be lifted by exposure to relevant cues.... Retrieval inhibition may apply to an entire set of items in memory and can explain profound amnesia. In the case of partial forgetting, however, the individual has to forget a subset of items from a larger, interrelated item pool, some of which is accessible to working memory....      "Johnson (1994 [Psychol Bull, 116, 274-292]) argued that once this mixture of [to be forgotten] and [to be remembered] information was in memory, forgetting could not be explained solely by representational processes operating on the storage of information to prevent retrieval. It would additionally have to be assumed that some material had been partially retrieved but was not fully processed or expressed because of some decisional processes.... This kind of model is consistent with reports of partial forgetting in which clients describe remaining unaware of particular aspects of their trauma by choosing not to remember them. They typically describe a state of mind in which they know that they know something, but prefer to remain in ignorance of it.... (pp.963-964)
          "Although repression and dissociation have proved useful in carrying forward the idea of defensive strategies for forgetting trauma, and can plausibly be used to refer to different types of forgetting, we argue that neither is adequate to explain recovered memories of trauma. Use of the term repression has led to confusion because it can be defined in quite different ways, and dissociation, although often coexistent with traumatic amnesia, is concerned with alterations in consciousness rather than specifically with forgetting. Neither concept can account for the range of empirical data.
         "An adequate account of recovered memories of trauma must explain the large variations both in the degree of prior amnesia and in the quality of the memories recovered. We have argued that these variations may be explicable in terms of three processes familiar to cognitive psychologists, retrieval inhibition, postretrieval decisional processes, and implicit memory. Also integral to the explanation is the idea that there are dual representations of trauma in memory, one explicit and deliberately accessible (verbally accessible memory) and one automatically triggered by situational cues (situationally accessible memory)"
    (p.966).

    Brewin, C. R., Dalgleish, T., & Joseph, S. (1996). A dual representation theory of posttraumatic stress disorder. Psychological Review, 103, 670-686.

    Abstract: "A cognitive theory of posttraumatic stress disorder (PTSD) is proposed that assumes traumas experienced after early childhood give rise to 2 sorts of memory, 1 verbally accessible and 1 automatically accessible through appropriate situational cues. These different types of memory are used to explain the complex phenomenology of PTSD, including the experiences of reliving the traumatic event and of emotionally processing the trauma. The theory considers 3 possible outcomes of the emotional processing of trauma, successful completion, chronic processing, and premature inhibition of processing We discuss the implications of the theory for research design, clinical practice, and resolving contradictions in the empirical data."



    Contents

    Cynthia Bowman & Elizabeth Mertz

    Northwestern University Law professors Cynthia Bowman and Elizabeth Mertz have written an important paper of interest to therapists, lawyers and judges concerned with legal and liability issues in criminal cases based on recovered memories. Their paper includes an excellent pre-1996 review of the scientific evidence as well. Directions for ordering a copy follow the excerpt.

    Bowman, C. G., & Mertz, E. (1996). A dangerous direction: Legal intervention in sexual abuse survivor therapy. Harvard Law Review, 109, 551-639.

    Abstract: "In this article, Professors Brown and Mertz question recent popular and academic commentary that disputes the validity of all delayed-recall memories of childhood sexual abuse. They examine one court's decision to allow a father, accused by his daughter of childhood sexual abuse, to recover malpractice damages from his daughter's therapist in connection with therapy during which the daughter recovered memories of the abuse. The authors argue that such third-party liability is unsound in terms of established principles of tort doctrine and in terms of public policy. After a review of the scientific evidence, the authors further conclude that, although some memories may be inaccurate, delayed-recall memory can also accurately reflect that past abuse occurred. Permitting third-party liability against therapists when accurate memories of abuse surface in therapy gives abusers a weapon to use against their victims. Because such suits exclude the party in privy (the client), they effectively erase the victim's voice. Professors Bowman and Mertz argue that such a novel extension of third-party liability is at best a misuse of the court's resources and ultimately harms abuse survivors, therapists, and the community far more than it helps any wrongfully accused parents."

    Excerpt: "Part I discusses the California case that is the immediate impetus for this article, Ramona vs. Isabella.  Part II explores existing law relating to therapist liability, discussing doctrines about third-party liability in tort, medical malpractice by psychotherapists, and the like. Part III discusses policy issues raised by the background law. In Part IV, we examine what is known about the delayed recall of memories involving abuse. Based on this discussion, we evaluate in Part V the problems involved in translating psycho/social knowledge into legal standards for the sexual abuse context and, in Part VI, discuss the implication for survivors' agency and personhood of permitting third-party suits against their therapists. We conclude that allowing recovery [of damages] in a case like Ramona  is unsound. Part VII sets forth recommendation based upon our analysis" (p.555).

    To order a copy of this issue, send a check for $9 to:
         Harvard Law Review
         Gannet House
         Harvard University
         Cambridge, MA 02138


    Contents

    Judge Edward Harrington, U.S. District Court

    Judge Edward Harrington of the U.S. District Court, District of Massachusetts, has written an important decision on the validity of "repressed memory." Judge Harrington based his ruling on those factors the U.S. Supreme Court has decided must be considered when deciding if proffered testimony is valid "scientific knowledge," and therefore reliable.  Here are some key passages in the decision:

    "After considering these factors, this Court finds that the reliability of the phenomenon of repressed memory has been established, and therefore, will permit the plaintiff to introduce evidence which relates to the plaintiff's recovered memories (p.3).

    "In brief, Dr. van der Kolk testified that repressed memories is not a scientific controversy, but merely a political and forensic one (p.5).

    "Diagnostic and Statistical Manual of Mental Disorders (DSM-IV, 1994), which is a widely used manual by psychiatrists to define mental diagnostic categories and is published by the American Psychiatric Association, also recognizes the concept of repressed memories (p.7).

    "It is important to stress that, in considering the admissibility of repressed memory evidence, it is not the role of the Court to rule on the credibility of this individual plaintiff's memories, but rather on the validity of the theory itself.  For the foregoing reasons, the Court hereby denies the Defendant's Motion in Limine to Exclude Repressed Memory Evidence.  For the law to reject a diagnostic category generally accepted by those who practice the art and science of psychiatry would be folly.  Rules of law are not petrified in the past but flow with the current of expanding knowledge" (p.9).

    I have created a Web page with a copy of this decision: The Validity of Recovered Memory: Decision of United States District Court, District of Massachusetts.


    Contents

    Selected Books on Recovered & Traumatic Memories

    There are now available many good, and some great books on recovered memories of sexual abuse in particular and traumatic memories in general. Below is a short list of books that I have found very informative and thought-provoking. I am confident that these are worthwhile reading for therapists, students, scientists, lawyers, philosophers and anyone else interested in the many facets and implications of traumatic memory.

    You can go directly from the book titles to their pages at Amazon.com, which will give me 5-15% of the price on some purchases (all pages will open in a new browser window or one already open in the background). I have entered into this arrangement in association with Amazon.com to cover some costs of running this website.


    Unchained Memories: True Stories of Traumatic Memories, Lost and Found
    By Lenore Terr. New York: Basic Books, 1994.

         Psychiatrist Lenore Terr University of California's San Francisco Medical School helped found the field of psychological trauma with her study of children involved in the Chowchilla kidnapping incident. In this book, which is accessible to everyone interested in this topic, she recounts her experiences as a therapist working with people who have experienced amnesia and delayed recall for traumatic memories. Written by a competent and ethical therapist and researcher, this book is a matter of fact response to sweeping generalizations about professionals doing this work.


    Recollections of Sexual Abuse: Treatment Principles and Guidelines
    By Christine Courtois. New York: Norton, 1999.

         Psychologist Christine Courtois is therapist in private practice in Washington, D.C., and clinical director of The CENTER: Post-traumatic Disorders Program, at the Psychiatric Institute of Washington. She has authored ground-breaking books on adults with histories of child sexual abuse and treating incest survivors, conducts workshops nationally and internationally, and has received many awards for her writing and other work. This book was written to meet clinicians' needs for balanced educational material on traumatic memories, and proposes guidelines and principles for treatment, including for dealing with recovered memories. More specifically, as Dr. Courtois writes in her introduction, "the intent of this book is (1) to provide explanatory material to the working clinician in a form that is accessible as well as practical; (2) to outline the middle ground and evolving standard of clinical practice and standard of care that encourages the clinician in a stance of supportive neutrality toward the patient and his/her productions in therapy, a stance that neither suggests nor suppresses exploration of memories or suspicions of past abuse; and (3) to provide this material to improve clinical practice and care of patients. . . and as risk management for the clinician" (p. xvii). As many leaders in the traumatic stress field agree, she has spectacularly achieved these goals, and this book is an invaluable resource for clinicians.


    Trauma and Cognitive Science
    Edited by Jennifer J. Freyd & Anne P. DePrince. Binghamton, NY: Haworth Press, 2001.

         This book is based on a ground-breaking 1998 conference hosted by Jennifer Freyd and Chris Brewin, which brought together clinicians, clinical researchers, cognitive scientists and neuroscientists, in an effort to bridge gaps across these disciplines and their respective theoretical frameworks and research methodologies. As indicated by the contents below, this collection of papers addresses a variety of important issues concerning recovered memories of abuse and traumatic memories more generally. (This book contains two papers that I co-authored with Bessel van der Kolk - see links to pdf files below.) For the publisher's information/spin on the book, click here.

    You can order the book from Amazon (easy if you've ordered from Amazon before, 1-2 weeks for delivery), or directly from the publisher, The Haworth Press (harder to order, but probably faster delivery):

    Phone: 800-429-6784
    Email: getinfo@hasworthpressinc.com
    Web: http://www.haworthpressinc.com/store/product.asp?sku=2228
    Chapter titles and authors:
    • Foreword: Entering the Secret Garden: The Interface of Cognitive Neuroscience and Trauma Research - Terence M. Keane
    • The Meeting of Trauma and Cognitive Science: Facing Challenges and Creating Opportunities at the Crossroads - Anne P. DePrince & Jennifer J. Freyd
    • Exploring the Nature of Traumatic Memory: Combining Clinical Knowledge with Laboratory Methods - Bessel A. van der Kolk, James W. Hopper, & Janet E. Osterman
    • Retrieving, Assessing, and Classifying Traumatic Memories: A Preliminary Report on Three Case Studies of a New Standardized Method - James W. Hopper & Bessel A. van der Kolk
    • A Cognitive Analysis of the Role of Suggestibility in Explaining Memories for Abuse - Kathy Pezdek
    • The Role of the Self in False Memory Creation - Mark A. Oakes & Ira E. Hyman, Jr.
    • Discovering Memories of Abuse in the Light of Meta-Awareness - Jonathan W. Schooler
    • Perspectives on Memory for Trauma and Cognitive Processes Associated with Dissociative Tendencies - Jennifer J. Freyd & Anne P. DePrince
    • A Biological Model for Delayed Recall of Childhood Abuse - J. Douglas Bremner
    • Active Forgetting: Evidence for Functional Inhibition as a Source of Memory Failure - Michael C. Anderson
    • Experiential Avoidance and Posttraumatic Stress Disorder: A Cognitive Mediational Model of Rape Recovery - Laura E. Boeschen, Mary P. Koss, Aurelio Jose Figueredo, & James A. Coan
    • Autobiographical Memory Disturbances in Childhood Abuse Survivors - Valerie J. Edwards, Robyn Fivush, Robert F. Anda, Vincent J. Felitti, & Dale F. Nordenberg
    • A Preliminary Report Comparing Trauma-Focused and Present-Focused Group Therapy Against a Wait-Listed Condition Among Childhood Sexual Abuse Survivors with PTSD - Catherine Classen, Cheryl Koopman, Kirsten Nevill-Manning, & David Spiegel
    • Dialogue Between Speakers and Attendees at the 1998 Meeting on Trauma and Cognitive Science: Questions and Answers About Traumatic Memory - Chris R. Brewin & Bernice Andrews
    • Finding a Secret Garden in Trauma Research - Jennifer J. Freyd & Anne P. DePrince


    Memory, Trauma Treatment and the Law
    By Daniel Brown, Alan W. Scheflin, & D. Corydon Hammond. New York: Norton, 1997.

         This book is by far the most comprehensive and acclaimed on this topic. Brown, Scheflin and Hammond's encyclopedic volume is a remarkably thorough treatment of many crucial issues, including memory, suggestibility, therapy, and the law. It is an expensive and massive book, at $100 and over 700 pages, and will be an authoritative work for years to come.

    Chapter titles:

    1. The False Memory Debate
    2. The Contours of the False Memory Debate
    3. The Nature of Memory
    4. Laboratory Simulation Studies on Memory for Negative Emotional Events
    5. Personal Memories
    6. Memory for Events of Impact
    7. Trauma Memory
    8. Misinformation Suggestibility
    9. Interrogatory Suggestion and Coercive Persuasion
    10. Hypnosis and Memory: Analysis and Critique of Research
    11. A Critical Evaluation of Research on Emotion and Memory
    12. The False Logic of the False Memory Controversy and the Irrational Element in Scientific Research on Memory
    13. Phase-Oriented Trauma Treatment
    14. Trauma Treatment and the Standard of Care
    15. Suing Therapists
    16. Repressed Memory and the Law
    17. Distingushing between True and False Memories
    18. Hypnosis and the Law


    Recovered Memories of Abuse: Assessment, Therapy, Forensics
    By Kenneth Pope & Laura Brown. Washington, DC: American Psychological Association, 1996.

          This highly acclaimed book is an excellent practical resource for therapists, lawyers, and expert witnesses.

    Three examples of the praise this book has received:

    "Pope and Brown have presented a careful review of memory science that both appreciates complexity and cautions against overgeneralization. . . . The book presents very pragmatic guidelines for clinicians that serve to improve the standard of care and decrease liability risk. . . . This is a very sane, ethical, and compassionate approach to a very controversial and often irrational debate."
         - Daniel Brown, Ph.D., ABPH, Harvard Medical School

    "Essential reading for lawyers and expert witnesses, this landmark book is scientifically grounded, carefully researched, and – thankfully! – of great practical use. The consent forms, deposition and cross-examination questions, outlines for reviewing treatment plans, and scrupulously fair examinations of the major controversies are major contributions. Avoiding the polarizing polemics and limited points of view that mar so much of the work in this area, this is the best book on this topic."
         - Gary Sampley, Esq., Attorney at Law

    "This is a book that a clinician, researcher, or trainee cannot afford to miss. . . . Only with this type of comprehensive information can we begin to appreciate the complexities of therapeutic and legal issues surrounding child sexual abuse."
         - Gail Elizabeth Wyatt, Ph.D., Department of Psychiatry, UCLA


    Betrayal Trauma: The Logic of Forgetting Childhood Abuse
    By Jennifer Freyd. Cambridge, MA: Harvard University Press, 1996.
         Freyd is a University of Oregon research psychologist. In this acclaimed book she advances her theory of why it is adaptive  for some children not to remember childhood abuse experiences. Freyd focuses on the issue of betrayal, and argues that the need for mental and physical survival, not merely the avoidance of painful feelings, leads children abused by caregivers to block out information about the abuse.

    Here are excerpts from the New York Times Book Review:

    "Betrayal Trauma  is a thoughtful, judicious and thorough scholarly analysis of a subject that has hitherto generated more heat than light. . .
          Although the mechanisms involved [in memory loss and retrieval] are far from fully understood, Ms. Freyd marshals the psychological, neurological and cognitive-science literature with impressive skill to suggest several plausible possibilities. Her work serves as a salutary reminder that if treated as serious science rather than media hoopla the recovered-memory debate could provide a significant window on mind-brain relationships; anyone interested in the latter will find much stimulating material here. . .
          She has a complex enough case to argue; she argues it fairly and with virtuoso skill, blending vivid anecdote with statistical evidence, first-person accounts with research reports, in a highly literate and engaging style. Partisan passions, alas, are seldom quenched by reason. But unblinkered readers will surely agree that Ms. Freyd's book places recovered memories squarely on the cognitive-science agenda. Her diagnosis of their source may well turn out to be correct."
         - Derek Bickerton, New York Times Book Review


    Sexual Abuse Recalled: Treating Trauma in the Era of the Recovered Memory Debate
    Edited by Judith Alpert. Northvale, NJ: Jason Aronson, 1995.

         This collection of thoughtful and informative essays addresses the range of clinical issues encountered in this work, from therapeutic practice and ethics, to scientific bases and legal concerns. Contributors include Judith Alpert, Bessel van der Kolk, Laura Brown, and Daniel Brown. Richard Kluft, an expert on dissociation and dissociative identity disorder, says this about the book:

    "Dr. Alpert and her contributors have produced a foundation resource document for therapists who labor to console and heal patients struggling with issues of trauma. By restraining from indulgence in unseemly polemics. . . they bring thoughtful insight to the study of recollections of sexual traumatization and to the management of such memories in treatment. This is not a gratifying text for the true believer who seeks confirmation of a particular point of view, but it is an excellent text for the honest clinician or scholar willing to grapple with an extremely complex and challenging problem in a candid and circumspect manner. We owe Dr. Alpert and her colleagues a debt of gratitude."


    Holocaust Testimonies: The Ruins of Memory
    By Lawrence Langer. New Haven, CN: Yale University Press, 1991.

         Boston University scholar Lawrence Langer has spent years studying videotapes from the Holocaust Archive at Yale University. Langer's research has focused on Holocaust survivors' oral testimonies. Based on this work he has formulated a distinction between what he refers to as "common memory" and "deep memory." Langer's insights may shed light on memories of the most extreme forms of child abuse.

    Common memory has meaningful continuity with the present for its possessor, and can be linked to the present by a storyline. Common memory can be communicated to a listener who can imagine a relevant past in common with the speaker. It can be communicated to another as a narrative that is, by its nature, comprehensible to its audience. In contrast, deep memory cannot be integrated into a narrative continuous with the present, even by its possessor. Indeed, deep memory ultimately cannot be understood by another person, since a listener has no basis for imagining the past it depicts.

    Langer conveys the experience of watching videotapes of oral Holocaust testimonies:

    "We wrestle with the beginnings of a permanently unfinished tale, full of incomplete intervals, faced by the spectacle of a faltering witness often reduced to a distressed silence by the overwhelming solicitations of deep memory. Witnesses' chronic frustration and skepticism about the audience's ability to understand their testimony is almost a premise of these encounters. Written texts, on the other hand, are designed to avert this possibility – otherwise, one assumes, they would not be published. Indeed, the initial problem surfacing in these oral testimonies with sufficient regularity to call it a 'theme' is exactly the opposite: whether anything can be meaningfully conveyed" (1991, p.21).


    The Recovered Memory/False Memory Debate
    Edited by Kathy Pezdek & William Banks. San Diego: Academic Press, 1996.

         This collection of scholarly papers, including a number of research studies, presents work representing a range of opinion. It is a good resource for therapists, lawyers, graduate and college students, and anyone else interested in these issues.


    Trauma: Explorations in Memory
    Edited by Cathy Caruth. Baltimore, MD: Johns Hopkins University Press, 1995.

         Cathy Caruth of Yale University's English Department edited two 1991 special issues of American Imago, and this book presents the same material. These are historically, culturally and philosophically rich essays on psychological trauma and traumatic memory, from child abuse to Holocaust experiences.

    Special Issue: Psychoanalysis, Culture, and Trauma, I. American Imago, 48(1).

    Special Issue: Psychoanalysis, Culture, and Trauma, II. American Imago, 48(2).


    Contents

    Media Coverage of Recovered Memories

    This short section provides links to two very informative and clarifying articles and a recent presentation. The first article, published by Mike Stanton in the 1997 Columbia Journalism Review, traces the stark reversal in the major media's portrayal of recovered memories of sexual abuse, which corresponded to the rise of the False Memory Syndrome Foundation and its (ongoing) aggressive public relations efforts. The second, a February 2003 online commentary by cognitive psychologist Jennifer Freyd, lucidly demonstrates how the media continues to give the public biased, incomplete and deceptive accounts of research by those who claim it is easy to implant false memories of sexual abuse and that recovered memories are likely false. Dr. Freyd's 2004 presentation addresses these same issues and presents recent research on the effects of such media coverage.

    U-Turn on Memory Lane, by Mike Stanton, in the July/August 1997 issue of Columbia Journalism Review.

    Commentary: Response to 17 February 2003 Media Reports on Loftus' Bugs Bunny Study, by Jennifer J. Freyd, University of Oregon cognitive psychologist.

    Misleading and confusing media portrayals of memory research, a presentation by Jennifer J. Freyd at the Annual Meeting of the American Association for the Advancement of Science, February 2004.



    Contents

    Additional Resources

    If you need immediate information about and/or connection to resources in your own community in the United States, here are three 24-hour toll-free hotlines that you can call:

    Childhelp USA's National Child Abuse Hotline
    1-800-422-4453
    (1-800-4ACHILD)

    Childhelp USA is a non-profit organization "dedicated to meeting the physical, emotional, educational, and spiritual needs of abused and neglected children." Its programs and services include this hotline, which children can call with complete anonymity and confidentiality. To know what to expect when you call, see How We Help. From the site: "The Childhelp USAź National Child Abuse Hotline is open 7 days a week, 24 hours a day. Don't be afraid to call. No one is silly or unimportant to us. If something is bothering you or you want information, CALL!" To learn more about reporting child abuse or neglect in your state, see Report Child Abuse.

    Rape Abuse & Incest National Network
    1-800-656-4673 (HOPE)

    RAINN is a national network of rape crisis centers. This is an automated service that links callers to the nearest rape crisis center automatically. Rape crisis centers are staffed with trained volunteers and paid staff members who also have knowledge of sexual abuse issues and services (though sometimes they are not adequately prepared to refer males with abuse histories). All calls are confidential, and callers may remain anonymous if they wish.

    National Domestic Violence/Abuse Hotline
    1-800-799-SAFE
    1-800-799-7233
    1-800-787-3224 TDD

    This is a 24-hour-a-day hotline, staffed by trained volunteers who are ready to connect people with emergency help in their own communities, including emergency services and shelters. The staff can also provide information and referrals for a variety of non-emergency services, including counseling for adults and children, and assistance in reporting abuse. They have an extensive database of domestic violence treatment providers in all US states and territories. Many staff members speak languages besides English, and they have 24-hour access to translators for approximately 150 languages. For the hearing impaired, there is a TDD number. This is a good resource for people who are experiencing or have experienced domestic violence or abuse, or who suspect that someone they know is being abused (though it is not perfect, and may not have the best number in your area). All calls to the hotline are confidential, and callers may remain anonymous if they wish.

    If you are looking for a therapist or counselor in the United States, even if only for a couple of consultations, the Sidran Foundation has an extensive list of therapists and clinics around the country that specialize in treating people with histories of severe child abuse. See their page About the Help Desk.

    If you want to start learning and practicing the self-regulation skills essential to managing painful memories, or to build on progress you are already making, I strongly recommend that you get this book: Growing Beyond Survival: A Self-Help Toolkit for Managing Traumatic Stress, by Elizabeth Vermilyea. To learn more about the book and/or order it directly from the publisher (for a higher price than Amazon), go to the Growing Beyond Survival page of the Sidran Press catalog.

    For more links to child abuse resources, go from the bottom of this page to "Child Abuse: Statistics, Research, and Resources." There are great resources there that are not here.


    Trauma and Memory, by Victoria Banyard, Ph.D., a Professor of Psychology at the University of New Hampshire, is a concise, 3-page review of research on trauma and memory. The Fall 2000 issue of the PTSD Research Quarterly, a publication of the National Center for PTSD, it covers recent developments and emerging trends, and is supplemented by selected abstracts and additional citations.


    The web site of Ken Pope has several articles on the recovered memory/false memory debate, which can be ordered for free. Pope is an accomplished psychologist who has published many articles and a book on the scientific and therapeutic issues involved. See the Award Address and Other Articles on the Recovered Memory Controversy section of his page, and follow links for the article reprint ordering form.


    University of Orgegan cognitive psychologist Jennifer J. Freyd's web site has a wealth of helpful and clarifying information on traumatic and recovered memories, including the following pages: What is a Betrayal Trauma? What is Betrayal Trauma Theory? - What is Shareability? - What is DARVO? - What about Recovered Memories?


    You can order a set of 10 tapes of presentations by leading researchers at the 1998 Meeting on Trauma and Cognitive Science, organized by Drs. Jennifer Freyd and Chris Brewin. The conference was offered by the University of Oregon's Institute of Cognitive and Decision Sciences, Department of Psychology, and Center for the Study of Women in Society. Its aim was "to share knowledge and theory relvant to understanding the way in which trauma interacts with information processing," including "a particular focus on how traumatic information is encoded, stored, and later retrieved from memory." The conference had a research focus, but also addressed the significant ethical, clinical, and societal implications of the researchers' work. The speakers represented a broad spectrum of research approaches and points of view: Bessel van der Kolk, Jonathan Schooler, Kathy Pezdek, John Morton, Mary Koss, Terence Keane, Ira Hyman, Jennifer Freyd, Robyn Fivush, Catherine Classen, Chris Brewin, J. Douglas Bremner, Bernice Andrews, and Michael Anderson.

    If you are a clinician seeking (non-suggestive) methods to help your clients cope with and integrate traumatic memories, I strongly encourage you to look into Eye Movement Desensitization and Reprocessing (EMDR). This powerful brief treatment has been extensively researched, and clinical efficacy has been shown in methodologically rigorous research, including studies published in top journals like the Journal of Consulting and Clinical Psychology. For more information, including lists of publications and upcoming trainings in your area, visit the Web sites of the EMDR Institute and the EMDR International Association.

    False Memory Syndrome Facts is maintained by Linda Chapman, M.S.W., whose goal is "to offer easy access to accurate foundational information about 'false memory syndrome', in the following arenas: scientific analysis, clinical practice, legal, media, and organizations."

    On the Veracity and Variability of Traumatic Memory is a paper by Kevin Thomas, Holly Laurance, W. Jake Jacobs and Lynn Nadel in Volume 2, Issue 2 of the online journal Traumatology, edited by Charles Figley. Thomas and his colleagues advance a model which specifies: (1) "the conditions under which a memory for a traumatic event has a high, medium or low probability of accurately reflecting the target event," and (2) "the conditions under which a second party might have a large, medium or minimal influence on the content of the traumatic memory." Their theoretically integrative proposal addresses possible neurobiological, neuroanatomical, psychological and interpersonal processes involved in the retrieval of traumatic memory fragments.

    Debunking "False Memory" Myths in Sexual Abuse Cases" is an extremely valuable article by attorney Wendy Murphy. Published in the November 1997 Trial  magazine, it teaches plaintiff's attorneys how "an aggressive litigation strategy can head off defense claims that memories of trauma are all in the victim's head." This Internet copy of the article is at the Web site of Susan K. Smith, Attorney, where you will find a wealth of legal resources on sexual abuse and harassment, for both people with severe abuse histories and their attorneys.

    If you would like to quickly learn more about trauma and dissociation, read psychiatrist Joan Turkus's brief and very clear article, The Spectrum of Dissociative Disorders: An Overview of Diagnosis and Treatment.

    The Sidran Foundation has a wealth of excellent Online Resources, including a Traumatic Memories Brochure written for non-specialists by Joyanna Silberg, Ph.D., and a PsychTrauma Glossary that has clear and concise definitions of terms related to traumatic memory, dissociation, and numerous therapeutic issues.

    The Ottawa Recovered Memory Page, maintained by Wendy Hovdestad, has a variety of resources, including a bibliography with 245 citations.
         "This page aims to be a storehouse of information about the current recovered memories debate. As you will see, below, it offers a wide range of materials, including... "

    Particularly if you're a journalist or reporter, you might be interested in a study of dissociative symptoms in media eyewitnesses to a gas chamber execution. In addition to facilitating understanding of dissociation, this paper raises the possibility that "the act of objective reporting in part consists of a mental state similar to dissociation, which serves the defensive purpose of reducing the emotional impact of traumatic events." The authors end with the suggestion that, given the journalists' experiences, "dissociative symptoms are not an extreme or pathological reaction seen only among victims of disaster, war, and interpersonal violence. Rather, it seems likely that such dissociation is a nonpathological and expectable response to witnessing unusual or extreme physical trauma or violence."

    Freinkel, A., Koopman, C., & Spiegel, D. (1994). Dissociative symptoms in media eyewitnesses of an execution. American Journal of Psychiatry, 151, 1335-1339.

    Clearly the scholarly work cited on this page demonstrates that people experience amnesia and delayed recall for memories of childhood sexual abuse. But there are other traumas for which these phenomena have been found as well – though this is often forgotten in the debate. The following is a sampling of papers reporting findings like those for sexual abuse.

    Combat trauma:
    Karon, B.P., & Widener, A.J. (1997). Repressed memories and World War II: Lest we forget! Professional Psychology: Research and Practice, 28, 338-340.

    Hendin, H., Haas, A. P., & Singer, P. (1984). The reliving experience in Vietnam veterans with posttraumatic stress disorder. American Journal of Psychiatry, 146, 490-495.

    Archibald, H. C., & Tuddenham, R. D. (1956). Persistent stress reaction after combat. Archives of General Psychiatry, 12, 475-481.

    Kubie, L. S. (1943). Manual of emergency treatment for acute war neuroses. War Medicine, 4, 582-599.

    Myers, C. S. (1915, January). A contribution to the study of shell-shock. Lancet, 316-320.

    Thom, D. A., & Fenton, N. (1920). Amnesias in war cases. American Journal of Insanity, 76, 437-448.

    Natural disasters and accidents:
    Madakasira, S., & O'Brian, K. (1987). Acute posttraumatic stress disorder in victims of a natural disaster. Journal of Nervous & Mental Disease, 175, 286-290.

    van der Kolk, B. A., & Kadish, W. (1987). Amnesia, dissociation, and the return of the repressed. In B. A. van der Kolk (Ed.), Psychological Trauma. American Psychiatric Press, Inc., Washington, D.C.

    Victims of torture:
    Goldfeld, A. E., Mollica, R. F., Pesavento, B. H., & Faraone, S. V. (1988). The physical and psychological sequelae of torture: Symptomology and diagnosis. Journal of the American Medical Association, 259, 2725-2729.

    Kinzie, J. D. (1993). Posttraumatic effects and their treatment among Southeast Asian refugees. In J.P. Wilson and B. Raphael (Eds.), International handbook of traumatic stress syndromes. New York: Plenum, pp.311-319.

    Holocaust survivors:
    24 Publications Concerning Traumatic Amnesia in Holocaust Survivors


    To find the latest research in medical and (most) psychological journals, use the PubMed database, provided free by the National Institutes of Health. You can go to the site, or launch your search now using the form below.

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    This page is maintained by Jim Hopper, Ph.D., as are these related pages:

    Child Abuse: Statistics, Research, and Resources

    The Validity of Recovered Memory: Decision of a United States District Court

    Mindfulness and Kindness: Inner Sources of Freedom and Happiness

    Sexual Abuse of Males: Statistics, Potential Lasting Effects, and Resources

    Factors in the Cycle of Violence - Abused Boys, Gender Socialization, and Violent Men

    Trauma and Recovery - Judith Herman's Landmark Book on Child Abuse & Other Traumas

    Jim Hopper's Professional Services - Therapy, Talks, Workshops & Consultation


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