Posted by badhaircut on February 27, 2004, at 9:34:44
The latest article from literary scholar Frederick Crews on trauma memories, PTSD, MPD, repression and psychotherapy is in the current 'New York Review of Books' (March 11, 2004: "The Trauma Trap"). It's free online for now at http://www.nybooks.com/articles/16951
He belittles the very idea of "robust repression" of traumatic memory — that is, that someone would utterly forget consciously experienced episodes of trauma yet be pervasively influenced by them. It's a necessary ingredient of multiple personality disorder (MPD), dissociative disorder, recovered memory, "betrayal trauma," and other popular diagnoses, as well as the traditional idea of repression itself. It would be, says Crews, «a startlingly maladaptive behavior that, if actual, ought to have aroused wonder and consternation from the earliest times until now, if indeed it didn't lead to the extinction of our species.»
He boils down the studies reviewed: «[N]o unanswerable evidence has been adduced to prove that anyone, anywhere, has ever repressed or dissociated the memory of any occurrence.»
Crews addresses the current explosion of diagnoses related to post-traumatic stress disorder (PTSD). He suggests that its widespread occurrence results in part from recovered-memory-inspired changes to the official diagnostic criteria that were previously based on respectable observations of battlefield sequelae.
«The key sign of PTSD, as first conceived, was that accurate recollections of the trauma keep intruding on the patient's conscious mind; this was just the opposite of repressed or dissociated memory. But between DSM-III and its revised edition of 1987, PTSD patients were discovered to have been harboring a convenient new symptom. In 1980 they had shown only some incidental "memory impairment or trouble concentrating" on daily affairs, but the updated edition replaced routine forgetfulness with "inability to recall an important aspect of the trauma"....»
Scroll down to section 3 for criticisms of the American Psychological Association's reliance on *intuition* over evidence: «Ever since 1971, when the association gave its blessing to Ph.D. and Psy.D. programs that omitted any scientific training, the APA has guided its course by reference to studies indicating that the intuitive competence of clinicians, not their adherence to one psychological doctrine or another, is what chiefly determines their effectiveness.»
Crews sums up: «Attention to the chimerical task of divining a patient's early traumas is attention subtracted from sensible help in the here and now.»
-bhc
poster:badhaircut
thread:318184
URL: http://www.dr-bob.org/babble/psycho/20040225/msgs/318184.html