DISSOCIATIVE AMNESIA: What is it, Symptoms, Types and Treatment

Most of us have experienced the well-known blackouts, whereby we are not able to remember something that we normally have on the tip of our tongue every day (for example, birthdays or names of some known). Sometimes we are not able to remember how we got to the room or why we entered the room and we have to go back to try to remember.

In dissociative amnesia, waiting or returning to the room where we were in order to remember something is not functional. Therefore, in this Psychology-Online article we explain what is dissociative amnesia: its symptoms, types and treatment.

Index

1. What is dissociative amnesia
2. Dissociative amnesia: symptoms
3. Dissociative amnesia: types
4. Duration of dissociative amnesia
5. Risks when remembering the forgotten
6. Causes of dissociative amnesia
7. Dissociative amnesia: treatment
8. Dissociative amnesia: clinical case

DSM 5 (2013) defines dissociative amnesia as a inability to recall autobiographical information

The characteristic of dissociative amnesia is thus the inability to recall important autobiographical information that, generally, is traumatic in nature (for example, sexual abuse, violence or having been a spectator of the traumatic event).

This autobiographical information should normally be successfully stored in memory and should be easily remembered, as head injuries have been ruled out, infections, diseases in areas of the brain involved with memory or related to the decoding of traumatic stimuli, neurodegenerative diseases and synucleinopathies.

Here are the characteristic symptoms of dissociative amnesia:

• Inability to remember dates or years (may be related to abuse received or witnessed).
• Inability to remember addresses (including your own address).
• Inability to remember names
• Inability to remember certain events, people, or even personal information (one's name, address, age).
• Feeling of separation from oneself.
• Inability to recall some prior knowledge (for example, semantic knowledge that causes problem for object recognition or remembering the name of objects [anomie]).
• Agnosia: the inability to process sensory information.
• Alteration of procedural knowledge (long-term memory). Procedural learning are the actions that we know how to do and that we have automated, such as speaking our language or driving.
• Associative visual agnosia (inability to match photographs or semantically related objects).
• Disorientation.
• Dissociative fugue (aimless wandering in the streets), this symptom of dissociative amnesia is usually what begins to attract attention.
• Anosognosia: People are unable to recognize their memory problems or are only partially aware.
• Chronic difficulty in the ability to form and maintain satisfactory relationships.
• Dissociative flashbacks (for example, re-experiencing traumatic events).
• Depressive symptoms and functional neurological symptoms such as depersonalization are common.
• Sometimes the sexual dysfunctions.
• Feeling of wasted time or not having felt the passage of time.

Below are the types of dissociative amnsesia that exist according to DSM 5 (2013):

• Located: is the inability to remember facts during a period of time Restricted, it is the most common form of dissociative amnesia. This type of amnesia can be more extensive or extensive than single-event amnesia. For example, months or years of abuse are forgotten during childhood.
• Selective: In selective amnesia the person can remember some, but not all, of the events during a circumscribed period of time. For example you can remember part of a traumatic event but not other parts; external and internal stimuli such as intensity and color can be recalled in a fragmented way of the light that was there while the sexual abuse occurred, the face or just the height of the sexual abuser. Some may state that they present both selective and localized.
• Generalized: is the total memory loss that covers the entire life of the person and is the least frequent. In this type of amnesia, personal identity, prior and procedural knowledge can be forgotten.
• Systematized: the person loses memory for a specific category of information. For example only memories associated with one's own family or memories with a particular person or only memories of sexual abuse.
• Keep going: in this type of amnesia the person forgets each new event that occurs from a certain event to the present.

Dissociative amnesia usually has a sharp start (sudden or fast). The length of forgotten events can vary from minutes to decades. Some episodes of dissociative amnesia usually resolve quickly (for example, when a person is withdrawn from the stressful situation or stimulus). Dissociative abilities may decrease with age but it does not always happen.

As the amnesia subsides, a deep and marked anguish, suicidal behaviors and characteristic symptoms of post-traumatic stress disorder (PTSD). These risks, especially suicidal behavior can arise from intolerable memories that start to show up.

Dissociative disorders arise many times as a consequence of trauma (for example sexual abuse, war, physical abuse, child abuse, natural disasters, automobile accidents, homicides, and physical torture). But, although they do not fall into the category of trauma and stressor-related disorders, they do reflect a close relationship between these two types of diagnoses.

As Van der Kolk (2015) refers, if the thalamus is altered, trauma is not remembered as a storya, a story with a beginning, a development, and an end, but rather as isolated sensory traces: images, sounds, and physical sensations.

The treatment given to dissociative amnesia must be understood in these aspects where sensory experiences are integrated.

The psychological treatment that can be offered in dissociative amnesia is called EMDR. The Eye Movement Desensitization and Reprocessing (EMDR) allows the reprocessing of freely associated images and memories from the past. This seems to help put the traumatic experience in a larger context or perspective. EMDR them lets you look at your experiences in a new way, without a verbal exchange with another person.

Below is a clinical case of a woman with dissociative amnesia as a consequence of having suffered intrafamily sexual abuse:

It is a 20 year old young man who went to the National Hospital of Guatemala, asked about a acute abdominal pain. The clinical laboratory tests carried out showed only some values ​​outside the normal parameters. What caught the attention of the clinical staff is the overweight of the patient and some unusual purple lesions on the breasts and abdomen.

The gastroenterologist orders an X-ray or endoscopy of the patient to rule out any injuries and laboratory tests to be able to measure the level of cortisol and the hormone T3 and T4. The X-ray results showed gastric ulcers that were probably related to the laboratory results they presented high cortisol levels.

In addition to these clinical manifestations, the patient was unable to provide some data related to her personal information. She mentioned remembering only her name but not his last name, nor could she remember his address. The patient therefore presented autopsychic and allopsychic disorientation (she is unable to identify the people around her and personal data).

The clinical staff suggests that memory disorders are related to the physical symptoms that were the reason for consultation, but needed to rule out that they were not brain alterations (especially the areas involved in the adrenal gland, which is the one that could be related to your high cortisol levels [by hormonal biochemical examination supporting ACTH assessment]) or due to a cause psychological.

Pierre Janet (1986) highlighted the link between trauma and dissociation, posing a theory of pathological dissociation as a consequence of people who have experienced a traumatic event. Conceptualizing there dissociation as a defense against anxiety originated by traumatic experiences, which can be maintained as "subconscious fixed ideas" in the patient's mind, damaging their mood and her behavior.

Sigmund Freud she was able to observe that repressed experiences do not remain in a latent state, but are re-experienced through dreams and nightmares, regressions and the overflow of feelings and sensations related to traumatic experiences.

Wilbur (1984) maintains that abuse creates in boys and girls a state of threatening and unacceptable anger. Thus, they learn that these feelings are not okay to be expressed and they should not be felt either. consciously, so she represses these sensations and the memories that cause them remain in the unconscious.

Dissociative amnesia is usually due to a long-term repressed memory as a result of either psychological or emotional trauma. In the present case, it was arrived at through an interview with the patient and people close to her the probable relationship that there is with her difficulty to remember and her physical symptoms.

The psychologist in charge was in charge of exploring her history and the patient reported having lived her entire life on the street, but the person who She was accompanying her, she explained that a few weeks ago the 20-year-old had never been seen on the streets and that she knew her family: an alcoholic father and two guys, well the mother had abandoned her she with them from a very young age.

As Van der Kolk (2015) referred when problems are solutions; Generally, patients who have been sexually abused use their own body as a defense mechanism, begin to eat in exorbitant amounts with the intention of gaining weight and thus not appear more attractive to the abuser. In the case of the patient, her overweight was also related to her high cortisol levels, which in turn caused the ulcers and were the ones that caused her acute abdominal pain.

Through the application of EMDR and psychoanalysis, the patient was able to reprocess through recall induction, the regression and the transfer of all those memories of the abuse that had been repressed, starting by showing the surnames of the father and mother with their identification document that he had forgotten (that with a psychoanalytic interpretation it was a defense mechanism to forget and protect himself from those people or agents who had caused the trauma or pain).

This article is merely informative, in Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.

If you want to read more articles similar to Dissociative amnesia: what is it, symptoms, types and treatment, we recommend that you enter our category of Clinical psychology.

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM 5). Editorial Panamericana.
• Janet, P. (1986). Dissociation: the first tranference theory and its origins in hypnosis. American Journal of Clinical.
• Van der Kolk, B. (2015). The body keeps score. Editorial Eleftheria. Barcelona, ​​Spain.
• Wilbur, C. B. (1984). Treatment of Multiple Personality. Psychiatric Annals.