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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
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
Posted by DaisyM on February 27, 2004, at 17:49:32
In reply to latest from Frederick Crews, posted by badhaircut on February 27, 2004, at 9:34:44
I read the reviews and I'm not sure what I think. For me, the danger is in children not being believed. The concept of faulty memories seems to be "allowed" but not completely. Children might "suddenly" remember, we see this in all kinds of things, not just abuse and trauma.
I question often this idea that something so awful could happen and you don't remember it. But in my own experience, while I remembered parts of it, I didn't remember the worst of it, until I allowed myself to talk about the parts I did remember.
But maybe it is in the details. Like, if you think about your room as a child, you can give a basic account of it, like there was a bookshelf. But if you start thinking or talking about playing with your bookshelf in the corner, you might remember the details of what was in or on the shelves, color, etc. Like memories trigger other memories, etc.
It is hard to wrestle with what to believe, but most of what happens around therapy is hard for me to understand because it is about all these illogical emotions that won't conform to an intellectual process or formula. I often think that is why CBT does better in the studies. If psychotherapy must be individualized for each person to work optimally, then of course it won't do as well in a tightly controlled study. Because it doesn't work as well when not adjusted to fit the individual. And a tightly controlled study doesn't allow for the adjustments.
Anyway...my thoughts.
Posted by terrics on February 27, 2004, at 18:00:32
In reply to latest from Frederick Crews, posted by badhaircut on February 27, 2004, at 9:34:44
I liked that article and basically agree with it. terrics [What do you think]?
Posted by badhaircut on February 27, 2004, at 21:41:15
In reply to Re: latest from Frederick Crews » badhaircut, posted by terrics on February 27, 2004, at 18:00:32
> I liked that article and basically agree with it. terrics [What do you think]?
My friend hunts squirrels competitively. They don't actually shoot them. Each hunter has a dog that goes romping through a woods, smells a squirrel, follows it from branch to branch overhead in "full cry", and finally stands up against the tree where it's holed. The dog howls and the judges come, awarding points for proper form & so on and, of course, the presence of a squirrel. (Which is then left alone.)
A major problem for the trainer of a "squirrel dog" is the scent of deer. Deer musk is apparently a wonderful, overpowering, almost intoxicating lure to dogs. If a dog on the trail of a puny squirrel comes across a deer scent, it is likely to forget everything it has ever known and run barking like mad after the huge, glorious phantom deer.
Of course, no deer hearing a dog behind it will hang around. The big, fleet, woods-adapted creature will be half a mile away before the yapping dog gets its bearings. A dog really can't catch a deer. (And it's illegal.) But the enticing possibility! It's too much for many dogs to resist.
Trainers use various techniques for keeping dogs off deer trails, including tying a rag soaked in bottled deer musk to the dog's muzzle for a day. They get altogether sick of the scent, I guess.
My point is (and this is what I think about repression issues in therapy), it's better not to chase deer — those glorious phantom epiphanies we just get a whiff of passing through our minds. Some hidden truth we suspect must explain it all. There're hints of deep, buried treasure, the wisdom of the ages and peace everlasting. We therapy hounds think there must be *something* there, a thought, a memory, an insight, just barely beyond conscious reach, just around the next corner, just one more cathartic transference away. If I can just catch that thing it will Change Me.
But I believe such psychotherapeutic quarry are to us like deer are to squirrel dogs. It seems like there's something awesome to be treed, but the intoxicating lure turns out over & over & over again to be simply a distraction. Wildly exciting, maybe, but a waste of time otherwise.
Most therapists encourage deer-chasing and many don't know anything else to do. Many are deeply committed to finding a magic key that solves everything and dissociated memories look promising. Maybe some just like to see their clients revved up, hot on the trail of the repressed.
Squirrels in this analogy would be smaller, less sexy issues, along the lines of what Albert Ellis & Aaron Beck & so on deal with. Like Crews's "sensible help in the here and now," I suppose.
What do I think? Be a champion squirrel dog. Don't chase deer.
-bhc
Posted by Dinah on February 28, 2004, at 10:20:11
In reply to latest from Frederick Crews, posted by badhaircut on February 27, 2004, at 9:34:44
I think it's impossible to make generalizations about something as complex as the brain, when clearly we don't know enough about how it works to make global pronouncements.
Did he really say?
> 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.»
>About any occurrence? Not just major life shattering ones but any ones? Because I can't believe he would say something so definitive. I thought that people in accidents often forgot the actual accident, even in the absence of head trauma. "The last thing I remember was...." And I certainly have had whole conversations with people during which I just wasn't there, and can't remember a thing afterwards.
Are there therapists who go hunting for and help to implant false memories in vulnerable clients? The evidence is overwhelmingly yes. Enough licenses have been very publicly yanked for me to believe that. Is it possible to manufacture memories? Certainly research has convincingly shown that. Is it possible to forget even traumatic memories? I think the research is there for that. Can such memories later be retrieved? I don't know. There have been some cases where retrieved memories have been corroborated by medical and family testimony. Were they ever truly lost and later retrieved? I don't know.
Should therapists and clients alike be cautious with the idea? Certainly.
But I'm not going to discount someone else's experience or refuse to believe it. Because we just don't know enough about how the brain in general, and individual brains in particular, work.
Posted by antigua on February 29, 2004, at 10:12:47
In reply to Don't chase deer » terrics, posted by badhaircut on February 27, 2004, at 21:41:15
Have you ever chased the deer?
antigua
Posted by badhaircut on February 29, 2004, at 20:51:00
In reply to Re: Don't chase deer » badhaircut, posted by antigua on February 29, 2004, at 10:12:47
> Have you ever chased the deer?
> antiguaOh, yes. For years. Under the supervision of an eclectic therapist and later with a neo-Freudian psychoanalyst. And by myself in journaling and reading and thinking.
And I loved it! That's why the deer-chasing analogy speaks so strongly to me. I've pursued all kinds of insights and intuitions that *felt right*, that resonated, that HAD TO BE REAL. Some of them were undoubtedly authentic in many ways. But they didn't really do much for me except give me a burst of enthusiasm for a few hours. An insight fix.
To be clear, in my case I'm not talking about recovered memories of abuse. Such abuse as I experienced as a child I've always been quite conscious of. I'm talking about the insights on inner motivation and the belief in some magic inner key that's controlling the problems of one's emotional life. The sort of trade that traditional psychotherapy spends one's time on.
The heightened expectation in such a search for *hidden* inner controlling factors means inevitably, I think, looking for at least some things that simply won't be there — including malignant false memories. Even in everyday therapy it means finding things (such as theories about one's subterranean emotional motivations) that are therapeutically useless, even if "true."
As William James asked 100 years ago, if it's useless, how can it be true?
The long, boring story of my disillusionment with insight therapy can be found at
http://www.dr-bob.org/babble/psycho/20031221/msgs/292577.html
and in the thread above it.-bhc
Posted by noa on March 2, 2004, at 18:38:09
In reply to Don't chase deer » terrics, posted by badhaircut on February 27, 2004, at 21:41:15
I think that more research is needed to understand how traumatic memories are processed. I do believe it is possible for people to repress traumatic memories.
I did like your analogy of the deer. And although I do think it can be important to process memories of past experiences (and that there are people who do have repressed or difficult-to-access memories that can shed light on their difficulties), I agree that it can be easy to get stuck on the idea of needing to uncover that one thing, THE KEY to solving all the puzzles of one's difficulties, some kind of romanticized deep dark secret, that once discovered will reveal all the why's and wherefore's and put all the pieces in place, lead the way to the cure, resolve all the issues.
For me, it was important to come to grips with the ordinariness of my pains and hurts and to accept that there isn't likely to be that secret code to feeling different. It was really about accepting myself and letting go of the idea of finding the magical secret to free me of the bad feelings. It was about accepting that these feelings are here and I can tolerate them and live with them and manage them.
I think this idea of the "holy grail" of psychotherapeutic discovery through uncovering is also perpetuated by romantic portrayals of the process in literature and movies. Two examples readily come to mind, and I'm sure we can come up with many more---"August" by Judith Rossner, Mariner Books; (September 1997) and "Prince of Tides".
I guess it also seems similar to how fairy tales work--kind of like, "If only we can figure out who the prince/frog is that knows the true secret to how I became imprisoned in this miserable existence and is therefore destined to find the magical key and free me from the shackles of my painful emotional life, etc........"
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