Suppressed or Repressed memories and what it means for those with Complex PTSD or Trauma

Suppressed or Repressed memories are terms that refer to the recall of traumatic events, typically but not exclusively, of child sexual abuse, by adults who have exhibited little or no previous awareness of such experiences. This is also called “traumatic amnesia”.

The phenomenon of traumatic amnesia has been noted in a variety of populations over the last century, including war veterans, Holocaust survivors, and survivors of natural disasters. By the mid-1980s, a significant body of research indicated that many adult survivors of child sexual abuse also suffer from traumatic amnesia this includes those suffering from Complex PTSD. While some people always remember having been abused, others do not remember anything about their experiences for many years, whilst others recall some but not all of the details of their abuse. I surpassed my memories for over thirty years and it was only with the advent of the Royal Commission into Institutional Child Abuse here in Australia that my PTSD was triggered and I was plunged into depression, high anxiety and chronic suicidality inexplicably. It has taken four years of intensive Psychotherapy and EMDR to move forward with my life.

Traumatic amnesia can be a major obstacle to the prosecution of child sexual abuse. Prior to the 1980s, survivors were often unable to pursue civil charges, because the crime had occurred so long previously that they were not permitted to sue by law. In criminal cases, defendants often claimed that adult survivors were unreliable witnesses because they had not reported the abuse until years or decades later.

By the late 1980s, lawyers argued that the limitation period (or the “statute of limitations”) for child sex offenses should be extended in cases where a complainant has suffered from traumatic amnesia. Parents accused of sexual abuse sought defence lawyers and psychological experts to help defend against these claims. A new concept, “False Memory Syndrome”, was created to explain delayed memories of sexual abuse in court.

The debate on “recovered memories” and “false memories” dominated the media coverage of child abuse for much of the 1990s. In the media, proponents of the “false memory” position argued that there was no evidence for traumatic amnesia, and that “recovered memories” of sexual abuse were unreliable, and often the product of overly zealous therapists, and hysterical, malicious or confabulating women. Since then, this debate has become less heated, with science increasingly affirming the existence of traumatic amnesia and the reliability of “recovered memories”. Also since Psychiatry has come to understand the complexities of Complex PTSD and PTSD the Law is coming to terms with how to deal with this tricky area of Prosecution.

Inevitably, at some point during a traumatic experience, fear kicks in James Hopper at Harvard Medical School argues. When it does, it is no longer the prefrontal cortex running the show, but the brain’s fear circuitry – especially the amygdala. Once the fear circuitry takes over, it – not the prefrontal cortex – controls where attention goes. It could be the sound of incoming mortars or the cold facial expression of a predatory rapist or the grip of his hand on one’s neck. Or, the fear circuitry can direct attention away from the horrible sensations of sexual assault by focusing attention on otherwise meaningless details. Either way, what gets attention tends to be fragmentary sensations, not the many different elements of the unfolding assault. And what gets attention is what is most likely to get encoded into memory.

The brain’s fear circuitry also alters the functioning of a third key brain area, the hippocampus. The hippocampus encodes experiences into short-term memory and can store them as long-term memories. Fear impairs the ability of the hippocampus to encode and store “contextual information,” like the layout of the room where the rape happened. Fear also impairs its ability to encode time sequencing information, like whether the perpetrator ripped off a shirt before or after saying “you want this.”

Our understanding of the altered functioning of the brain in traumatic situations is founded on decades of research, and as that research continues, it is giving us a more nuanced view of the human brain “on trauma.” Recent studies suggest that the hippocampus goes into a super-encoding state briefly after the fear kicks in. Victims may remember in exquisite detail what was happening just before and after they realised they were being attacked, including context and the sequence of events. However, they are likely to have very fragmented and incomplete memories for much of what happens after that.

Piecing together the trauma story becomes a comer complicated project with survivors of prolonged, repeated abuse. Techniques that are effective for approaching circumscribed traumatic events mThe time required to reconstruct a complete story is usually far long than ten to twelve sessions. We may be tempted to resort to all sorts of powerful treats, both conventional and unconventional, in order to hasten the process it is so painful. Large-group marathons or inpatient “packages” programs frequently attract survivors with unrealistic promise that a “blitz” approach will affect a cure. Programs that promote the raid uncovering of traumatic memories with providing an adequate connect for integration and therapeutically irresponsible and potentially dangerous, for they leave the patient with the resources to cope with the memories uncovered.

Breaking through the barrier of amnesia is not in fact the difficult part of reconstruction, for any number of techniques will usually work. The hard part of the task is to come face-to-face with the horrors on the other side of the amnesiac barrier and to integrate these experiences into a full developed life narrative.  This slow, painstaking, often frustrating process resembles putting together a difficult picture puzzle. The reward for patience is the occasional breakthrough moment when a number of pieces suddenly fall into place and a new part of the picture becomes clear.

During therapy, once memories begin to recover your daily experiences are usually rich in clues to dissociated past memories. The observance of holidays and special occasions often afford an entry into past associations. Careful guidance is necessary and each recovered memory needs to be processed fully and professionally in therapy.  In the majority of cases, an adequate narrative can be constructed with or resorted to formal induction to altered states. However, should altered states such as hypnotherapy or EMDR be required this requires a high degree of skill. Each venture into uncovering work must be preceded by careful preparation and followed by an adequate period for integration and processing.

It is vital that a trusting and professional patient/therapist relationship has been established before entering into any altered state recovery techniques are used. Ensure as previously stated that correct debriefing takes place. This is crucial for the management of flashbacks and recurring memories that remain troublesome and can be dangerous exacerbating suicidality. Seek therapy from only registered professionals.

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