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Objective: To provide an overview of the phenomena of recovered memories and false memories of past traumas and to provide illustrations with clinical vignettes as well as historical observations. Conclusions: The questions concerning the recovery of memories of trauma do not readily reduce to simple dichotomies. Whatever the terminology applied, be it repression, dissociation or forgetting, humans have a capacity to not consciously know about aspects of their traumas for extended periods of time. The nature of memory is reconstructive. Memory is not a digital recording that provides for a totally accurate replay. Multiple factors including the age at which traumas occurred, the relationships to the person responsible or the nature and extent of the traumas influence what will be accessible to memory. In regard to those patients who describe recovered memories, it is important that clinicians take an individualistic approach and remain open-minded. They should not feel pressure to validate or reject the claim; rather, they should respect and empower patients.
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Australasian Psychiatry Vol 13, No 3 September 2005
Warwick Middleton
Chair, Cannan Institute, Brisbane, Qld, Australia.
Lisa De Marni Cromer
PhD Candidate, Department of Psychology, University of
Oregon, Eugene, OR, USA.
Jennifer Freyd
Professor and Director of Undergraduate Studies,
Department of Psychology, University of Oregon, Eugene,
OR, USA.
Correspondence: Assoc Professor Warwick Middleton,
Cannan Institute, Suite 4D, 87 Wickham Terrace, Brisbane,
Qld 4000, Australia. Email: warmid@tpg.com.au
DISSOCIATIVE
DISORDERS
Remembering the past,
anticipating a future
Warwick Middleton, Lisa De Marni Cromer and Jennifer Freyd
Objective: To provide an overview of the phenomena of recovered memories
and false memories of past traumas and to provide illustrations with clinical
vignettes as well as historical observations.
Conclusions: The questions concerning the recovery of memories of trauma
do not readily reduce to simple dichotomies. Whatever the terminology applied,
be it repression, dissociation or forgetting, humans have a capacity to not con-
sciously know about aspects of their traumas for extended periods of time. The
nature of memory is reconstructive. Memory is not a digital recording that pro-
vides for a totally accurate replay. Multiple factors including the age at which
traumas occurred, the relationships to the person responsible or the nature and
extent of the traumas influence what will be accessible to memory. In regard to
those patients who describe recovered memories, it is important that clinicians
take an individualistic approach and remain open-minded. They should not feel
pressure to validate or reject the claim; rather, they should respect and empower
patients.
Key words: abuse, dissociation, false memory, recovered memory, trauma.
The brain function that is conveniently conceptualised as memory is central to almost
every facet of clinical psychiatry. The modification of Descarte’s dictum, ‘I think,
therefore I am,’ to ‘I remember, therefore I am’, is not an extreme departure.[1]
This paper examines memory and, just as relevant, forgetting, in rela-
tion to traumatic experiences. Clinicians have known for over a cen-
tury that traumatic experiences can be forgotten and sometimes later
remembered. This phenomenon has been evidenced for war trauma, or ‘shell
shock’ (Wiltshire, as cited in Brewin), and interpersonal traumas such as
child sexual abuse, rape and torture, to name a few.24Forgetting and later
remembering trauma has raised many questions and has spurred a debate
about ‘recovered’ memories. The questions and controversies have been, and
will continue to be, a catalyst for research about memory systems. By way of
introduction to the debate, we will provide some historical background to
the clinical understanding of amnesia for traumatic events, and the incipient
growth of the recovered memory literature in the 1990s. We examine ‘false
memories’ and the conflation of recovered memory and false memory. By
examining theories for understanding traumatic memories, we provide a
basis for examining empirical research in the field. Finally, we discuss from
a clinical perspective how one can integrate the current information about
recovered memories into care of one’s own patients.
HISTORICAL OBSERVATIONS OF TRAUMATIC EFFECTS
ON MEMORY
Over a century ago, Janet observed that instead of being routinely integrated
into narrative memory, trauma persists at a subconscious level. He stated that:
‘Forgetting the event which precipitated the emotion ...has frequently been
found to accompany intense emotional experiences in the form of continu-
ous and retrograde amnesia’ (as cited in van der Kolk et al., p. 285).5Forgetting
of war trauma is well known. Reports of combat trauma and associated
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Australasian Psychiatry Vol 13, No 3 September 2005
amnesia can be traced through war history. In the Amer-
ican Civil War, combat trauma syndromes were called
‘nostalgia’; in World War I, ‘shell shock’, and in World
War II, ‘traumatic war neurosis’. It was only in 1980 that
the present term, post-traumatic stress disorder (PTSD),
was coined by the third edition of the Diagnostic and Sta-
tistical Manual of Mental Disorders (DSM).6Regardless of
the name used to describe war trauma, amnesia has con-
sistently characterized many of the most severe cases.
Typifying the literature concerning combat amnesia are
reports from World War II. For example, Sargant and
Slater documented that 144 out of 1000 consecutive ad-
missions to a field hospital following the evacuation
from Dunkirk, France, were soldiers who had signifi-
cant amnesia for their trauma.7Those with the most
severe war stress were more likely to have amnesia
for combat than those with moderate stress. Similarly,
Henderson and Moore reported a 5% amnesia rate for
combat-related events in the first 200 of their war-related
cases admitted to a military hospital for psychiatric
reasons.8Grinker and Speigel also observed that some
combat veterans had total amnesia both for battlefield
events and events from their personal lives.9Interest-
ingly, Grinker and Speigel noted that the majority of
their patients made persistent attempts to recover these
lost experiences. Despite modern psychological inter-
ventions and debriefing, amnesia continues to be ev-
ident in war trauma. Solomon documented the case of
Yossi, a 21 year old platoon sergeant in an elite parachute
unit at the time the Yom Kippur War broke out.10
He fought with the commandos and then in the
‘Chinese form’ battle, notorious among Israeli soldiers
for its slaughter. He remembered little of the course of
the battle, but feelingly recounted a gruesome incident
in which the head of a soldier, still bearing its helmet,
came flying from an adjacent trench into his own ....
In the course of battle, 8 out of his 30 men were killed.
Except for himself and another platoon commander, all
the commanders in his company were killed; not a single
squad commander survived. Yossi’s position of respon-
sibility made the bloodshed even worse for him. As he
explained it, it was he who had to urge reluctant soldiers
to fight; then, when he tried to save the situation, his
request for permission to retreat was turned down.
Yossi was finally evacuated to a hospital in Israel, riddled
with shrapnel in his hands and legs. In addition, he suf-
fered from amnesia – remembering almost nothing, not
even how to read .... (pp. 197–198)
Solomon describes Yossi as experiencing ongoing severe
PTSD symptomatology, affective instability and depres-
sion. His memory loss persisted and he had to learn
to read again. She describes how in the subsequent
Lebanon war,
Yossi did not function from the very beginning ....
When they came under heavy Katushya bombardment,
he felt ‘on the verge of exploding’. Eventually, he was
saved by routine home leave, from which he refused to
return to duty.
For a month, he stayed at home just lying around, smok-
ing cigarettes, and drinking coffee. He did not bathe or
shave, talk to his wife, or look at the son who had been
born the year before .... Constantly enraged, he would
scratch the walls with his nails. He had terrible dreams in
which his Yom Kippur War experiences ‘all came back in
a huge onslaught.’ He was finally referred to an IDF men-
tal health clinic after he cursed and threatened to shoot
the army representative who had been sent to bring him
his military recall order. (pp. 198–199)
War trauma and resulting amnesia affects not only sol-
diers, but also civilians. For example, Nazi concentration
camp survivors provide many examples of individuals
who have amnesia for their experiences. Henry Krystal is
noted for writing about this ‘massive psychic trauma.’11
He illustrates how large areas of one’s traumatic past can
be blocked out in extraordinary ways with the following
vignette:
Recently, I had an opportunity to work with a ‘juvenile’
concentration camp survivor who ...brought himself to
confess to me that he had still, untouched by his analysis
or with me, a total amnesia for the events of 1942–45, al-
though by talking to fellow survivors, reading, and other
sources he has reconstructed the story which he still can-
not recall directly. (p. 852)
As Janet so intuitively observed so long ago, these am-
nesia experiences are accompanied by psychological
and/or physiological problems, which manifest despite
the lack of explicit memory for a traumatic event. Some-
times, this amnesia persists despite somatization and
even re-enactment of traumatic events.
One phenomenon that exists in cases of those with am-
nesia is known as the repetition–compulsion dynamic.
This occurs when trauma survivors do not explicitly re-
call their trauma, yet somehow re-enact the events. van
der Kolk described treating a Vietnam veteran:12
who had lit a cigarette at night and caused the death
of a friend by a Viet Cong sniper’s bullet in 1968. From
1969 to 1988, on the exact anniversary of the death,
to the hour and minute, he yearly committed ‘armed
robbery’ by putting a finger in his pocket and staging a
‘hold-up’, in order to provoke gunfire from the police.
The compulsive re-enactment ceased when he came to
understand its meaning. (p. 391)
CONTEMPORARY EXAMPLE OF
TRAUMATIC EFFECTS ON MEMORY
A patient of the first author illustrates an elaborate ex-
ample of repetition–compulsion:
A 27-year-old health worker with no history of psy-
chiatric treatment admitted herself to a hospital when
she began to feel suicidal. She acted disturbed, at times
walking around clutching a doll, behaviour that was
thought to exhibit severe borderline features. After a se-
ries of pseudoseizure-type ‘fits,’ she was transferred to a
neurology ward of another hospital. She caused concern
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Australasian Psychiatry Vol 13, No 3 September 2005
when she suddenly slammed her right arm into a wall
with such force that she fractured it. Afterwards, she pro-
vided no explanation. That evening, she was transferred
to another psychiatric unit, but she left the following
morning and jumped two storeys from a car park. She
sustained further fractures, yet had complete amnesia for
the jump.
It is important to emphasise that this woman previously
had been able to give a history of extensive physical,
sexual, and emotional abuse in an extremely disturbed
family in which an idealised brother had suicided. Whilst
there were gaps in her memory, she was fully aware of
having been made a ward of the State and of having had
multiple foster placements, the majority of which were
abusive.
Over the days following her jump, there was a progres-
sive recovery of memory for the events leading up to and
surrounding the jump. As she began to spontaneously
recover memories for her jump, she also experienced
intense flashbacks to elements of her childhood abuse,
of which she had not previously been conscious. She
became aware that her idealised dead brother had also
severely abused her. She recalled an occasion when she
was walking on a bush track and he approached her sexu-
ally. She resisted and he responded by throwing her over
a high embankment, resulting in her fracturing an arm –
her right. Equally traumatic for her was the associated
return of memories of this same brother sexually abus-
ing her in her bedroom, their mother opening the door,
looking in, and then closing it. She would experience as
an auditory hallucination the sound of her mother’s re-
ceding footsteps symbolising for her the totality of her
abandonment. Whereas previously she had rationalised
that her mother cared for her and had not intervened
because she did not know about the ongoing abuse, this
was no longer sustainable.
The event precipitating the unravelling of this pa-
tient’s psychic defences was a chance meeting with
one of her past foster mothers, who had been party
to her abuse and who had recently moved into her
neighbourhood.
For decades, clinicians have seen cases of memories be-
ing recovered after a period of forgetting. There is over a
century in which amnesias for all sorts of traumas, par-
ticularly those occurring on the battlefield, have been
documented. More recently, the diagnostic significance
of amnesia for trauma was well embedded in the 1980
DSM-III diagnostic criteria for PTSD.6Although count-
less cases of amnesia have been reported by early trauma
theorists and therapists such as Janet and even Freud, in
what was perhaps an interesting twist, the clinical phe-
nomenon became a polarized sociopolitical debate in
the modern era. The historical emergence of this debate
is described here.
WIDER CONTEXT: CONTROVERSY OF
THE MEMORY WARS
In what might be considered an incipient fireball, so-
ciety was attempting something that had never been
achieved before: progressively exposing to public gaze
traumas that had previously remained in quiet dark-
ness. By the 1960s, there was emerging awareness
of the human response to disaster. In 1962, Kempe
et al. described the ‘battered child’ syndrome.13 By
the 1970s, society was beginning to grapple with the
syndromes of Vietnam veterans, while at the same
time feminist writers and researchers were challeng-
ing decades-old rationalizations about child sexual
abuse as Oedipal phantasies and hysterical mendac-
ity. Adding to the fire, in the 1980s was Herman’s
book Father–Daughter Incest (1981) and Russell’s The
Secret Trauma: Incest in the Lives of Girls and Women
(1986), a large-scale epidemiological study on incest and
other childhood sexual abuse.14,15 Society’s confronta-
tion with the extent of child incest (Russell’s study sug-
gested 16% of American females had been incestuously
abused, one-quarter by their fathers) was to be joined
by others. There were confrontations about the extent
of abuses perpetuated in state and church institutions,
and about abuses more generally by clergy and health
care professionals. In the new technological era, the In-
ternet added a high-tech modus operandi for paedophile
networks.
To a large extent, the exposed abuses were perpetu-
ated against powerless, easily discredited, and prob-
ably the least protected individuals in our society:
children. Perhaps it was inevitable that forces previ-
ously operating below society’s subterfuge would erupt
in denial and combative self-protection. The False Mem-
ory Syndrome Foundation (FMSF) is one such outcrop-
ping that fuelled the social controversy with rhetoric
independent of a substratum of empirical research. The
researchers quickly joined the dialectic, however. The
hitherto uncontroversial area of cognitive laboratory re-
search concerning remembering and forgetting was sud-
denly on the frontline in a war zone.16 The memory
wars, which gathered momentum in the early 1990s in
North America, saw acrimonious divisions on the so-
cial front with law suits, TV documentaries, and the
picketing of therapists’offices. On the academic front,
there was the production of numerous discourses, some
polemical (e.g. Ofshe and Watters; Wakefield and Un-
derwager),17,18 some generated by memory researchers
(e.g. Erdelyi; Schacter et al.)16,19 and others by therapists
(e.g. Alpert; Courtois).20,21
STANCE OF PROFESSIONAL
ORGANIZATIONS
The polarizations, the proliferation of law suits involv-
ing questions of recovered memory and a climate of
anxiety in the 1990s saw professional mental health
organizations attempt to formulate position statements
regarding recovered memories. In trying to formulate
short statements based upon the extent literature, some
groups were deeply divided. For instance, in 1993,
the American Psychological Association formed a six-
member working group to analyse the evidence about re-
covered memory. The group consisted of three eminent
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psychotherapists with a principal focus on child sex-
ual abuse (Laura S. Brown, Christine Courtois and
Judith Alpert) and three eminent experimental psychol-
ogists involved with memory research (Elizabeth Loftus,
Stephen Ceci and Peter Ornstein). In 1996, unable to
reach consensus on many of the issues before them, the
three clinicians on one hand and the three memory re-
searchers on the other, had issued their conclusions in a
point–counterpoint exchange.22
The British Psychological Society exemplified a cau-
tious handling of issues. Their statement in 1995 read,
‘Forgetting of certain kinds of trauma is often reported,
although the nature of the mechanism or mechanisms
involved remains unclear,’ and, ‘While there is a great
deal of evidence for incorrect memories, there is cur-
rently much less evidence on the creation of false
memories’ (p. 173).23
A more comprehensive statement by the American Psy-
chiatric Association had been published in 1993. They
suggested that ‘children and adolescents who have been
abused cope with the trauma by using a variety of psy-
chological mechanisms, in some instances their coping
mechanisms result in a lack of conscious awareness of
the abuse for varying periods of time’ (p. 154).23
Echoing the stance of the American Psychiatric Associ-
ation, the position paper of the Royal Australian and
New Zealand College of Psychiatrists (RANZCP) on the
question of recovered memories of trauma was a docu-
ment less inherently conflicted than that of the British
and American psychological societies and associations.24
Adopted in 1996 and amended in 1998, the RANZCP
Clinical Memorandum emphasized the extent of physi-
cal and sexual abuse of children, the harmful nature of
such abuses, and that ‘memory of such abusive experi-
ences may be absent for considerable and varied periods
of life and may be recalled under any of a variety of
circumstance, including as a vicissitude of undergoing
psychiatric treatment for (at least initially) apparently
unrelated reasons.’ The document emphasized ‘that psy-
chiatrists, while supporting the clinical interests of the
patient, maintain a position of neutrality in the con-
sulting room – no matter what personal views they may
have formed. This is no different from the stance which
psychiatrists must take on many other matters raised by
patients.’
LEGAL ASPECTS
The legal aspects of memories for child abuse and recov-
ered versus false memory continue to be complex. De-
spite efforts to provide answers to the recovered memory
debate, the legal landscape reflects the scars of contro-
versy. McNally reported that as of 1998, 803 claims that
had arisen from recovered memories resulted in litiga-
tion in the USA.25 Not all of these were against alleged
perpetrators, however. The courts saw 139 malpractice
claims filed against therapists by their former patients re-
lating to allegations of ‘implanting’ false memories and
152 third-party malpractice suits were filed against ther-
apists on the grounds of claimed damage arising from
‘false allegations’. Clearly, the debate wages in the court-
room, but is recovered memory representative of most
child sexual abuse cases?
Simply put, no. By way of forming a perspective on the
relative magnitude of the number of legal child sexual
abuse cases based on recovered memory, van der Kolk
examined the Massachusetts Department of Social Ser-
vices records for a single year, 1993.26 These records con-
firmed sexual abuse in 2149 children. More than 200
men were jailed for sexual offences against children, and
another 278 were put on probation. In the law library,
van der Kolk could locate only five Massachusetts’ cases
over the previous 3 years where adults had taken an al-
leged abuser to court after recovering traumatic memo-
ries. This provides compelling evidence that only a small
minority of child sexual abuse cases that reach the courts
involve recovered memories. How valid are recovered
memories? The answer to this question is at the crux
of the recovered memory debate. However, in van der
Kolk’s research, of the five recovered memory cases he
identified, all produced convictions, with one of them
being James Porter, a notorious former Catholic priest
who was thought to have molested at least 155 children
and who currently remains incarcerated. Some of his ac-
cusers had suffered from years of amnesia of the abuse.
Why the controversy?
The heated memory controversy in the courts is seen
by some as being driven by a ‘sophisticated’ defence
that conjures up denial and disinformation.27 The
‘False Memory Defence’ uses such tactics as shifting
the blame to the plaintiff, shifting the blame to a third
party (the therapist) and selling the accused as the ‘real’
victim (see Whitfield for a review).27 This tactic, some-
times called the ‘looking good defence’, is a highly mo-
tivated source for fuelling the controversy in the courts.
Pope cautions against the pseudoscience of the court-
rooms and elaborates the ‘booming, buzzing confusion’
that is fraught with unclear terms, inferential errors and
ad hominem fallacies (p. 1160).28
CRITICAL SCIENTIFIC QUESTIONS
One positive outcome of the heated memory wars has
been a plethora of research about traumatic memory.
Many critical questions have been pursued. For exam-
ple, is it possible for someone to truly ‘forget’, repress,
dissociate or otherwise not have access to the mem-
ory of a significant past trauma? How can one be sure
that an individual has truly ‘forgotten’ an event rather
than simply not had occasion to think about it? Can
someone accurately remember that they previously for-
got something? If previously forgotten memories are re-
covered, are they as accurate as memories for trauma
that have never been forgotten? The next section ex-
amines evidence that will shed light on some of these
questions.
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Australasian Psychiatry Vol 13, No 3 September 2005
Explicit
Procedural
Declarative
Implicit
Stem completion tasks
in cognitive
psychology
Bad habits
Things you know
you know. For example,
What is your
name?
Playing a piece of
music on the pi ano
Figure 1: The types of memory.
NATURE OF MEMORY AND THE EFFECTS
OF TRAUMA ON IT
Memory is active, selective and reconstructive.29 Since
the early work of Bartlett, psychologists have considered
memory to be largely constructive (or reconstructive),
and influenced by knowledge structures and schemas
(Bartlett, as cited in Hirt et al.).30 Memory is heav-
ily influenced by information processing, in particu-
lar, executive functioning, attention and experience. In
Freyd’s representational momentum work, she found
that the anticipation of future action and motion influ-
ence memory.31 For example, in recalling a static picture
where motion is implied (e.g. a basketball player in mid-
air), people recall the actor (basketball player) as farther
along the path of motion than what they actually saw.
It is also well-established in cognitive psychology that
memory is influenced by attention.
Memory can be thought of as a dichotomy between
declarative (knowledge) and procedural (skill) memory
(Figure 1). Complementary to this is the dichotomy of
implicit and explicit recall.
The vertical axis in Figure 1 represents the content of
memory. Declarative memory refers to the ability to con-
sciously recall facts (semantic memory) and the ability
to formulate a narrative of events (episodic memory).
Procedural memory refers to having behavioural or per-
formance knowledge (both skills and cognitive). The
horizontal axis represents how memory is accessed.
Explicit memory is knowledge that you consciously
recall and implicit memory is knowledge that is not con-
sciously recalled. Figure 1 provides examples of the inter-
section of these types of memory. These distinctions are
relevant for forgetting of trauma because such forgetting
may pertain to only declarative knowledge, while pro-
cedural knowledge is retained. Similarly, the forgetting
may be evidenced by a failure of explicit recall while
implicit recall is present.
AMNESIA AND FORGETTING
Freyd reviews several explanations for how forgetting
can occur in her review of motivated forgetting, interfer-
ence and inhibition.32 It is well established that passive
decay or erosion of memory can occur for short-term
memories, which require active effort to maintain in-
formation, so that there can be rapid ‘forgetting’ of new
information. Thus, information may be rapidly lost from
short-term memory before being committed to long-
term memory. If the information being rapidly lost is
seemingly important, such as information about a trau-
matic event, the result will be considered amnesia. If
only some declarative information is rapidly lost, while
at the same time some sensory or procedural informa-
tion is retained, the result may be amnesia for the event
accompanied with inexplicable and intrusive sensory
fragments along with the display of puzzling learned
behaviours.
MOTIVATED, INTERFERENCE AND
INTENTIONAL FORGETTING
If we remembered everything, we should on most occasions
be as ill off as if we remembered nothing. (William James
(1890), as cited in Freyd, 1998)[32]
Life would be unbearable if we were forced to always carry
unpleasant memories with us in our conscious awareness.[4]
William James eloquently intuits what cognitive psy-
chologists in the last century have empirically observed:
memory is necessarily selective.32 In 1923, Freud de-
scribed how ‘the ego defends itself against the instruc-
tural impulse by the mechanism of repression’ (p. 150).33
In 1948, Waldfogel reported that adults selectively for-
get unpleasant childhood events but not pleasant ones
and, more recently, Kihlstrom and Harackiewicz found
that negative memories tend to be recalled in a more
neutral or trivialized way.34,35
Forgetting can occur through interference. Proactive in-
terference occurs when existing knowledge interferes
with the creation of new memories, such as when one
has difficulty remembering a new phone number and
mistakenly dials the old phone number. Retroactive in-
terference occurs when one has difficulty recalling old
information because of new information, for example,
having difficulty remembering your old license plate
number once you have memorized your new license
plate number. We all experience interference when try-
ing to recall a friend’s new email address or phone num-
ber – the old number interferes with the new number.
Where one parked the car is also a common example –
we inhibit where we parked yesterday in order to remem-
ber where we parked today. This mechanism is likely in-
volved in some child abuse cases. The competing events
of happy times can interfere (adaptively) with the un-
happy experience of abuse.
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Intentional forgetting occurs when people try to forget
something. Cognitive psychologists have found that in
laboratory studies, when subjects are directed to forget
previously encoded material, they can successfully in-
hibit this recall with selective retrieval.36 Anderson et al.
have identified neural systems that may be involved in
the suppression of such unwanted memories.37
FORGETTING OF TRAUMA STIMULI
In two studies using a directed forgetting paradigm (a
laboratory task in which participants are presented with
items and told after each item or a list of items whether
to remember or forget the material), DePrince and Freyd
found that highly dissociative participants recalled fewer
charged words (e.g. ‘incest’) and more neutral words
than did participants with low Dissociative Experience
Scale scores for items they were instructed to remem-
ber when divided attention was required (item method:
DePrince and Freyd, 2001; list method: DePrince and
Freyd, 2004).3840 The high dissociators report signifi-
cantly more trauma history and significantly more be-
trayal trauma.39 Similar findings have been found with
children using pictures instead of words as stimuli. Chil-
dren who had trauma histories and who were highly
dissociative recognized fewer charged pictures relative to
non-traumatized children under divided attention con-
ditions; no group differences were found under selective
attention conditions.41
DISCOVERED MEMORIES
Schooler distinguishes discovered memories from reg-
ular memories by drawing attention to the concept of
a meta-awareness component to memory.42 In discov-
ered memories, it is the meta-awareness that is either
gained or regained and which changes the meaning of a
memory. This can occur either when individuals have an
experience without being explicitly aware of their inter-
pretation of that experience, or confuse the discovery of
(new) meta-awareness with the discovery of a memory
itself. An example of this would be learning as an adult
that intentionally hurting a child as punishment is abu-
sive. In coming to embrace this knowledge, one may re-
call being beaten as a child and suddenly ‘discover’ the
memory of being abused, whereas before the memory
was merely part of the fabric of just another childhood
experience. The ‘discovery’ increases the salience, mean-
ing and relevance of the particular memory or memories.
Sivers et al. relate this mechanism to the activation of
schema, and the reinterpretation of events as new infor-
mation is learned.43
STATE DEPENDENCY
Psychologists have shown experimentally that memory
improves when one is in the same state in which the
memory was encoded. This has been found in some re-
covered memory cases, where there has been notable
correspondence between the original abuse situations
and when memories were eventually recalled.43
RECOVERING MEMORIES
Memory recovery depends on the nature of the for-
getting.32,43 If forgetting is due to a complete absence
of encoding, then memory recovery is not possible
because the memory was never formed. However, if
some parts were encoded and others not, recovery
may involve weaving together fragments with a new
narrative. In contrast, if a memory was initially fully
formed but then later inhibited, eventual recovery may
result in a fairly complete memory suddenly being
available.
ACCURACY OF RECOVERED MEMORIES
Perhaps the greatest confusion created in the wake of
the memory wars is the conflation of memory accu-
racy with memory persistence. A memory, apparently,
is no more or less accurate if it is continuously recalled
or if it is forgotten and later recalled.32,44,45 Williams,
in investigating women who had been admitted to a
hospital emergency room for sexual assault, found their
memories 17 years later were no more or less accurate if
they were recovered or had been continuous.45 Although
there is some research to suggest that highly emotional
events may be more memorable than other events, there
is no clear evidence that traumatic memories, whether
recovered or continuous, are any more accurate than
other sorts of event memories.46
WHAT IS A FALSE MEMORY?
Before defining ‘false memory’, it is useful to under-
stand the historical origins of the term. False memory
did not originate in cognitive psychology, but rather
gained notoriety vis-a-vis a social movement in 1992:
the formation of False Memory Syndrome Foundation
(FMSF). This group formed in order to question the ve-
racity of child sexual abuse claims. Interestingly, FMSF
has primarily focused on contested recovered memories
of childhood abuse. The issue of amnesias occurring in
combat veterans, for example, never generated similar
discord.
In the period that followed, a successful press campaign
saw the phrase ‘false memory syndrome’ gain promi-
nence in the media despite an absence of empirical ev-
idence or validity for the concept. As false memory was
adapted into everyday language, it was rapidly adopted
by cognitive psychologists as well. The term replaced for-
merly used cognitive terms such as memory errors and
intrusions.47 Today, false memory in cognitive psychol-
ogy often refers to errors in details for learning and re-
call tasks (e.g. recalling the word sandal instead of foot or
needle instead of thread and eye). Thirteen years after the
formation of FMSF, there is still no empirical evidence
of an actual syndrome.
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Australasian Psychiatry Vol 13, No 3 September 2005
False memory remains an active social movement. In
common usage, the reference to false memory encap-
sulates a broad range of meanings, from simple lexical
errors and mis-recalled information, to fabricated mem-
ories. Media publicity of false memory focuses on sen-
sationalized and unusual cases, while the empirical evi-
dence for false memories is often based on simple lexical
manipulations in the laboratory.47
HETEROGENEITY OF TRAUMAS
AND AMNESIA
van der Kolk noted in 1996 that amnesias for traumatic
experiences, with delayed recall for all or parts of the
trauma, have been documented in the literature after
natural disasters and accidents, war-related traumas, kid-
napping, torture and concentration camp experiences,
physical and sexual abuse and committing murder.48 A
general population study showed that virtually all cat-
egories of severe traumas produced victims with amne-
sia.49,50 Elliott and Briere found that a history of ‘com-
plete’ memory loss was most common among victims
of child sexual abuse (20%), and a substantially higher
proportion of victims had significant amnesia for par-
ticular details of their traumas.49 Of the 505 who com-
pleted the survey, 72% reported some form of trauma
and, of these, 32% reported delayed recall of the event.
This phenomenon was most common among those who
observed the murder or suicide of a family member, sex-
ual abuse survivors and combat veterans. The severity of
the trauma was predictive of memory status while the
most commonly reported trigger for recall of the trauma
was some form of media presentation such as a TV show
or movie (54%), whereas psychotherapy was the least
commonly reported trigger (14%).
ROLE OF BETRAYAL
Writing in 1996, van der Kolk stated, ‘For reasons that
are not at all clear [compared with other traumas], child-
hood sexual abuse seems to result in the highest degree
of total amnesia prior to memory retrieval’ (p. 285).48
Freyd embarked on a line of research that became for-
malized as betrayal trauma theory.32,51 This theory ex-
amines the way the relationship between the abuser
(who is also an attachment figure) and the victim will
impact on how childhood sexual abuse is remembered.52
Ongoing childhood sexual abuse is frequently incestu-
ous or the perpetrator is a trusted adult well known to
the family. Betrayal trauma theory suggests psychogenic
amnesia as an adaptive response that functions not so
much to reduce immediate suffering, but to promote
long-term survival by not rupturing attachment to a fig-
ure vital to development. If the betrayer is a primary care-
giver, it is particularly important that the child complies
in order to maintain attachment. For a child to withdraw
from a caregiver upon whom he/she is dependent would
further threaten his/her life, both physically and men-
tally. Thus, the trauma of child abuse necessitates that
knowledge about the abuse be blocked from those men-
tal mechanisms that control attachment and related be-
haviours. The information that gets blocked may be par-
tial (for instance, blocking emotional responses only),
but for many partial blocking will lead to a more pro-
found amnesia.
In a prospective community study, Williams found that
among a sample of 129 adult women whose childhood
histories of sexual abuse were documented by medical
and social service records, 38% failed to recall these
events at a follow-up interview 17 years later.53 In fact,
Williams’ study is one of numerous studies of varying
methodology that have found that a significant propor-
tion of adults who report a trauma history also describe
a period of time when they did not recall the experience,
with the rates of reported forgetting in the case of child
sexual abuse ranging from approximately 12 to 77% de-
pending on the study. Included within this range, Loftus
et al. reported 19% of subjects experiencing total amne-
sia before memory retrieval.45,54,55 Freyd reported find-
ing, from re-analyses of a number of relevant datasets,
that incestuous abuse was more likely to be forgotten
than non-incestuous abuse.32 These datasets included
the prospective sample assessed by Williams and ret-
rospective samples assessed by Cameron and Feldman-
Summer and Pope.45,52,56,57
When viewed from an interpersonal and attachment
perspective, the ambivalence toward one’s caregiver/
abuser and the traumatic memories that underpin this,
lead not unnaturally to the phenomena of accuser/
recanter as in child sexual abuse accommodation syn-
drome (pp. 51–54).32 Kluft points out in his natural-
istic study of the memories of 19 patients with dis-
sociative identity disorder (DID), that some patients
recanted and rescinded multiple times.3Recantation
is not unexpected in child sexual abuse cases, and
may result from denial. In fact, recantations themselves
are often rescinded.32 There is no fundamental rea-
son to disbelieve a recovered memory and then to be-
lieve a subsequent recantation. Recantation is not ev-
idence that a recovered memory is false, nor does it
serve as corroboration for the veracity of a recovered
memory.
CASE EXAMPLE: LAURA
In response to the recovered memory controversy, a
growing number of cases have published in meticulous
detail individuals’ experiences in which early trauma is
well documented but is followed by a period of docu-
mented amnesia for the traumas, followed by the re-
covery of memories of the traumas. One such example
is provided by Duggal and Stroufe.58 They report the
case of a young woman who happened to be a subject
in a prospective longitudinal study from early child-
hood. Background information concerning the family
had been obtained before any report of sexual abuse.
Four and a half years into the study, child protection
officers and police were called in following the child
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Australasian Psychiatry Vol 13, No 3 September 2005
(‘Laura’) reporting sexual abuse. (Her parents were di-
vorced and she was in joint custody.) It was noted by
her mother at the time that Laura would cry, tantrum,
and have nightmares when she went to stay with her fa-
ther. Around the time Laura reached third grade, it was
documented that she had told a friend that she had been
sexually abused, a case-note that was to constitute the
last childhood record of memory for trauma.
At age 16, in response to direct questions regarding past
sexual abuse, Laura indicated that she had never been
sexually abused. A similar response at the 17 year as-
sessment was obtained. At 18 years, 10 months Laura
discussed her memory of abuse openly in a structured
interview administered by a research assistant who was
blind to Laura’s previous history. Laura indicated that in
the previous few months she had memories about being
sexually abused as a child by her father. The memo-
ries had returned progressively over a 1–2 week period,
culminating in explicit memories of her father sexu-
ally abusing her. At one point, Laura went to a friend’s
house where she thought she heard her father’s voice.
She noted, ‘I totally went into shock all over again, just
like screaming “get him away from me” ’ (p. 315).
Laura’s father never denied that she’d been sexually
abused. A child therapist who saw Laura initially after
the involvement of Child Protection had met her fa-
ther at various times. Her father stated that if Laura had
experienced sexual abuse, it had been perpetuated by
somebody else, adding the qualification that if he had
done it, it would have occurred while he was on drugs
and he had no memory of it.
ISSUE OF CORROBORATION
The clinical account of Laura is representative of corrob-
orated cases of recovered memory. Despite these cases,
some writers continue to deny the validity of recov-
ered memories. To counter such arguments, Professor
Ross Cheit launched the Recovered Memory Project in
August 1997. This project takes the form of a website
(www.RecoveredMemory.org) that contains a growing
archive of corroborated cases of recovered memory of
child sexual abuse. At the time of this writing, it in-
cludes 96 cases. One of the more famous cases on Cheit’s
archive is that of Marilyn Van Derber, Miss America
1958. Her recovered memories were corroborated by her
sister, Gwen Mitchel, who had continuous memory of
similar abuse and who long thought she was the only
one in the family sexually abused by her father. Van
Derber experienced amnesia for the abuse until she re-
covered the memories at age 24.
Traumatized dissociative individuals are perhaps the
most likely to experience amnesia for traumatic events.
When examining the literature for corroborative evi-
dence of abuse in patients with DID or dissociative dis-
order not otherwise specified (DDNOS), it often can be
found. Kluft reviewed six studies involving collectively
125 patients with DID/DDNOS. Confirmation of abuse
was obtained for 115 of the patients (92%).3In the only
published Australian series with DID patients (n =62,
plus 10 with incomplete data), corroborating evidence
was available for 29%.59 Although this was not a foren-
sic investigation (and many patients were not seen in
circumstances that afforded ongoing follow up), there
was little to distinguish patients whose abuse was cor-
roborated, for example, by an admission from an abuser,
police records etc. from those where such material was
not available at the time. Although evidence of corrob-
oration in the literature helps to establish the validity
of reports, in the case of individual patients in therapy,
corroboration does not always occur. Some patients may
choose to seek medical records, school records, search
through childhood diaries or talk to acquaintances who
knew them as children. These resources are not always
accessible, however, and not every patient may possess
the wherewithal to seek this information. Clinically, it
is the duty of therapists to support patients, even if it
means supporting the acceptance that they may never
know what happened with absolute certainty.60 This
raises the question: what is the responsibility of the ther-
apist?
RESPONSIBILITY OF THE THERAPIST
One important responsibility is competency and train-
ing. Briere stated in 1992, in addressing the eruption of
the memory wars, the opinion that ‘although part of the
outcry regarding incompetent therapists who “implant”
false memories of abuse is undoubtedly specious, it is
also true that some very bad “therapy” in this area is be-
ing done by individuals with insufficient training, expe-
rience, and/or psychological stability’ (p. 292).61 Knapp
and Van de Creek make the point that lack of train-
ing among therapists leads to impoverished treatment
quality, for example, the psychotherapist who ‘helped’
Stephen Cook recover untrue memories of abuse by the
respected Cardinal Bernadin.23 Lindsay and Read sug-
gested from equally anecdotal reports that negligence in
respect of dealing with recovered memories came from
untrained and unlicensed professionals.62
Undoubtedly, it is vital that therapists carefully as-
sess patients’ needs and ascertain whether treatment is
within their area of expertise and competency. Thera-
pists should know the constantly evolving theory and
research about memory, suggestibility and child sexual
abuse.60 Further, it is critical that an individualistic ap-
proach is taken, because symptoms, assessments and cir-
cumstances vary widely from patient to patient. Pope
and Brown elaborate that the therapist would do well
to keep an open mind, and support ambiguity, particu-
larly where recovered memories are concerned.60 Addi-
tionally, therapists need to be sensitive to the changing
needs of patients. For example, an individual seeking
treatment for an eating disorder may realize that sexual
abuse was the catalyst for the behaviour. A therapist un-
trained in sexual abuse (regardless of whether the mem-
ory was continuous or recently recovered) would need to
230
Australasian Psychiatry Vol 13, No 3 September 2005
consider whether transferring care to another clinician
is appropriate without deserting a patient, or whether
consultation would enable the therapist to meet the pa-
tient’s needs.
Equally important to competency, is the awareness of
power balance between patient and therapist.60 Thera-
pists who collaborate with patients will be far more likely
to empower and support them. Coercion and suggestion
in treatment with a sexually abused patient should be
avoided. Rather, these individuals benefit from receiv-
ing support for their adult autonomy and as experts on
themselves. It is the therapist as expert, authority or all-
knowing who runs the risk of overpowering a patient
and influencing him/her with his or her own biases and
preconceived notions. Berliner and Briere proposed that
therapists’ beliefs and practices can ‘create the condi-
tions under which vulnerable patients may come to be-
lieve, falsely, that they had been abused in childhood’
(p. 11).63
CONNECTIONS
Issues concerning patients’ memories and how they are
dealt with by health professionals probably have more
relevance to the paradigm of respect and patient auton-
omy than any other. A therapist could perhaps be de-
fined in part as a trained professional with whom one
shares memories and the thoughts and feelings that go
with them. The therapist should not have a ‘power over’
dynamic in which one ‘acts on’ the patient.64 Some
might consider the therapist a custodian of pieces of
another’s life, providing a space in which a hurt or de-
prived person can learn to trust in order to share and
sort out his/her past experiences.
A therapist who fails to exercise ambiguity with respect
to a patient’s memories, recently recovered or not, can
do harm. Goals, whether they be theoretically based in
connection as in feminist theory, reconceptualization,
as in acceptance and commitment therapy or otherwise,
should provide support, safety, ongoing assessment and
consistency.65
It is imperative that the therapist not actively pursue
memory recovery. In one respect, it would disempower
the patient by overemphasizing the need for remember-
ing rather than focusing on one’s internal states and
experiences. By emphasizing a need for details or cor-
roboration, it can create the dynamic of therapist as
judge, needing evidence, with concern for the patient’s
well-being at the wayside. It is far better, as Pope and
Brown suggest, to model the acceptance of doubt, am-
biguity and uncertainty, and de-emphasize the content
(or need for content) for a particular memory.60 After
all, it is likely the patient’s confusion or distress brought
him/her to therapy, not a specific memory alone, or a de-
sire to recover an elusive memory. Therefore, the mem-
ories in themselves should not be pursued in therapy.
There is substantial research to show that women who
have been sexually abused often do not disclose the
abuse, even to a therapist.66,67 Therefore, the therapist
should ask about the experiences in a non-suggestive,
unbiased way (see Pope and Brown, for discussion,
pp. 156–159).60 A therapist may never be totally sure
of the historical accuracy of some particular account;
the emphasis should be on authenticity rather than on
forensic discovery.64
Although the crux of the memory wars was about allega-
tions for child abuse and memories for that abuse, inde-
pendent of any therapy, the flames were at least in part
fanned by incompetent therapists.23,62 A few therapists
practising something along the lines of what Pendergrast
and others referred to as ‘recovered memory therapy’,
provided substance to the ‘false memory’ defence.68 Be-
cause of this, it is worth noting that the competent ther-
apist will not ethically use suggestion and imagination
to influence patients, and will not urge patients to take
pre-emptive legal action against presumed abusers. The
competent therapist will not induce patients into other
actions that have more to do with the therapists’ identi-
fications, projections or self-promotion needs than their
patient’s welfare. The therapist is principally not a so-
cial advocate, abuse crusader, biographer, researcher or
forensic investigator.
Therapy is not particularly about the therapist. When
therapists fail to provide a therapeutic frame that is safe
and does not involve coercion or feeling of obligation in
fulfilling a therapist’s agenda regarding one’s memories,
it is highly likely that multiple other boundary prob-
lems will be emerging that will further undermine the
therapy. This is not to imply that the therapist should
ever forget their humanity, rigidly enforce some nar-
row notion of therapeutic neutrality, or fail to consult
common sense and the hard-won lessons of clinical ex-
perience. Every patient and situation is in some ways
unique. A wide appreciation of the spectrum of bound-
ary issues and the differences between boundary vio-
lations that damage/exploit the patient, and carefully
justified boundary crossings made to support and em-
power the patient, is a fundamental requirement.
The competent trauma therapist is a collaborator who
forms a therapeutic alliance. He/she might provide bal-
anced and factual information on the nature of trauma
and remembering, and demonstrate appropriate toler-
ance for ambiguity and uncertainty. Therapy is not man-
ualized but rather focused on, and developed at, the
individual level. It does not proceed ‘from rule to rule,
but rather from concern to concern, from question to
question, and from hypothesis to hypothesis ...[and]
must emerge from the therapists’ efforts to explore the
concerns, and to aid the patient in becoming an active
participant in making sense of what is being recalled,
and in deciding how, when, and at what speed to take
the next steps in therapy and in life’ (p. 148).60
CONCLUSIONS
During a controversial period that reached its zenith
in the mid-1990s, in which there were numerous
allegations regarding the excesses of so-called ‘recovered
231
Australasian Psychiatry Vol 13, No 3 September 2005
memory therapists’, it was actually difficult to find any
therapists who defined themselves principally as prac-
tising ‘recovered memory therapy’. McNally observed in
2003, ‘As far as I can tell, no one practicing psychother-
apy today endorses this term as descriptive of what they
do’ (p. 3).25 It was also hard to find many writers in
the field of trauma and memory who placed particu-
lar emphasis on the entity of ‘repression’. Perhaps it
was because the term repression uncomfortably strad-
dles many meanings such as denial, suppression, spac-
ing out, traumatic amnesia, resistance and unawareness.
Dissociation, on the other hand, has been intensely ob-
served, operationalized and measured. It is embedded in
the diagnostic criteria of a range of DSM-IV disorders,
including the dissociative disorders, PTSD, acute stress
disorder and borderline personality disorder.69
It has been a long time since psychiatry and psychology
have witnessed a more acrimonious dispute than that
which focused on the phenomena of recovered memo-
ries of childhood sexual abuse. This dialectic is typified
in the DSM-IV definition of PTSD.69 Two of the princi-
pal symptom clusters relate to persistent re-experiencing
phenomena such as intrusive recollections and distress-
ing dreams and to persistent avoidance of trauma-related
stimuli (e.g. detachment, avoidance of thoughts or re-
minders). The parallel paradox is that traumatic mem-
ories are both the least forgettable and the most forget-
table of all memories.32
A decade beyond the memory controversies, our world
has vastly changed. In 1980, the most authoritative and
comprehensive textbook of psychiatry in the world cited
a 1955 reference that incidence rates of incest were ap-
proximately one case per million.70 This cultural denial
was radically transformed in the last two tumultuous
decades as the phenomenon of child sexual abuse gained
exposure and notoriety. We now are left to ponder a
world that has widespread paedophiliac abuses of chil-
dren by clergy capturing the public’s attention. We’ve
seen senior and ceremonial figures such as the Cardi-
nal of Boston and the Governor-General of Australia
forced to resign their positions because of how they
handled past allegations of child abuse in their precincts
and we have witnessed how police operations worldwide
have netted many thousands of individuals (including
in 2004 over 2000 in Australia) using the Internet to buy
or distribute pictures of children being sexually abused.
As these atrocities come to light, we can be more pre-
pared as clinicians to be competent in their treatment.
We can target awareness and prevention programmes.
As we learn to accept and heal the past, we can hope-
fully look to a quiescent future in our field.
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... Freud originally claimed that "the ultimate cause of hysteria was always the seduction of the child by the adult", but in the wake of evidence of abuse occurring in influential families that would implicate his own father, Freud developed the seduction theory which postulated that the memories were not real, but fantasy (van der Kolk, 2014, p.181). However, for over a century amnesias for all sorts of traumas, particularly those occurring in combat, have been documented as well as by early trauma theorists and therapists such as Janet and Freud (Middleton, De Marni Cromer, & Freyd, 2005). ...
... Historically the debate about recovered memory is closely tied to the legitimacy of DDs. Trauma Model theorists consider that dissociative individuals are perhaps the most likely to experience amnesia for traumatic events (Middleton, De Marni Cromer, & Freyd, 2005). Historically Fantasy Model theorists have widely regarded these 'recovered memories' as being false (because imagined) recollections, but their recent statement that the Fantasy Model "leaves open the possibility that certain recovered memories are genuine and as accurate as continuous memories, it posits that others may be inaccurate and stem from fantasy, suggestive influences, or both" indicates their position has softened considerably in recent years (Lynn et al., 2014, p. 904). ...
... The view that traumatic memory can be lost and recovered is supported by professional organisations around the world. The Australian and New Zealand College of Psychiatrists (RANZCP) emphasised over a decade ago the extent of physical and sexual abuse of children, the harmful nature of such abuses and that 'memory of such abusive experiences may be absent for considerable and varied periods of life and may be recalled under any of a variety of circumstance' (Middleton et al., 2005). ...
Thesis
The aim of this thesis is to examine the prevalence of dissociation and Dissociative Disorders (DDs), and the role of trauma and parent-child dynamics as etiological factors, to assess the validity and plausibility of the Trauma Model and Fantasy Model of dissociation. Its meta-analysis found 11% of college students (N = 2,148) meet the criteria for a DD following assessment by a structured clinical interview; 17% (N = 4,061) had clinical levels of dissociation on the Dissociative Experiences Scale (DES); students were experiencing dissociative symptoms 17% (N = 26,821) of the time; and DES scores were highest in countries that were comparatively unsafe. Using a short version of the Multidimensional Inventory of Dissociation (MID-60) at least 8% of participants at an Australian university (N = 313) had clinical levels of dissociation, and participants reported experiencing dissociative symptoms 13% of the time. In females 51% of MID-60 scores were predicted by secure attachment, the number of sexual abuse episodes, the number of different types of sexual abuse and physical abuse, and being choked. In males 53% of MID scores were predicted by the number of sexual abuse episodes, a father who was not kind and caring, and parents who preventing independence by organizing and problem solving on the child’s behalf. Fantasy factors, including therapist suggestion, hypnosis and organic amnesia could not account for these findings. The second study (N = 309) compared three university groups (normal, elevated, and clinical levels of dissociation) and a group of inpatients and outpatients diagnosed with a DD. This found DDs, and levels of dissociation consistent with a DD, occur in individuals that report a childhood history of interpersonal trauma (particularly sexual abuse and life threatening trauma) alongside negative interpersonal dynamics between themselves and their parents, including an insecure and fearful attachment style. Odds ratios for a DD diagnosis in iii females include an insecure attachment style (72 : 1), negative parent-child dynamics (21 : 1), the mother’s role in, or response to, maltreatment being negative (45 : 1), any sexual abuse (16 : 1), being choked (28 : 1), choking or smothering and sexual abuse (106 : 1). There were strong similarities in antecedents reported by the university group with clinical levels of dissociation and the group of patients diagnosed with a DD and both groups had the highest rates of corroboration for abuse claims. The findings of this study provide strong support for the Trauma Model.
... Middleton and Butler (1997) provided an overview of the long history of recovered traumatic memory and urged a balanced, cautious approach which avoids dichotomous conceptualization of memory as real or false. In a reflective paper about the era, Middleton et al. (2005) wrote that, during this controversial period, it was difficult to find any therapist who defined themselves as practicing "recovered memory therapy," and while there undoubtedly examples of malpractice, most therapists were practicing responsibly. ...
Article
The Australian history of the false memory (FM) movement has similarities to that of the UK and America, but also important differences that are rarely described in the literature. This article, through an examination of cross-discipline professional literature, media reports, and the personal observations of the second author, describes the history of the FM Movement in Australia and outlines similarities and differences between Australia, the UK and America. All three countries experienced the establishment of false memory syndrome (FMS) societies and a backlash against those reporting or treating child sexual abuse (CSA). However, in Australia the backlash was notably smaller and led to a different trajectory for those reporting CSA, particularly institutional abuse. The authors propose that this is due to differences in the media and legal systems; the later timing of the backlash in Australia; and a more muted reporting of satanic ritual abuse (SRA), which avoided the extreme disbelief and backlash that occurred in other countries.
... Spanos developed his theory at the height of the so-called memory wars that contested the veracity of recovered memories of sexual abuse. No empirical evidence of a false memory syndrome was ever found (Middleton et al., 2005), and the landmark Lost in the Mall study that is held up as evidence of the syndrome "failed to convincingly implant memories of getting lost in any of the study participants" and the study's author Elizabeth Loftus herself admitted the results could not be applied beyond the study participants (Crook & McEwen, 2019, p. 12). The fantasy model evolved over the years, and its proponents now accept the possibility that certain recovered memories may be as genuine and accurate as continuous memories . ...
Article
This Australian study explores a person’s self-reported exposure to childhood abuse to identify the characteristics that are predictive of clinical levels of dissociation in adulthood. The final sample comprised 303 participants, including 26 inpatients and outpatients (24 females and two males) receiving treatment for a dissociative disorder (DD), and 277 university participants, including 220 controls (186 females, 34 males), 31 with elevated levels of dissociation consistent with a DD or posttraumatic stress disorder (27 females and four males), and 26 with clinical levels of dissociation (20 females and six males). The findings demonstrate clinical levels of dissociation and DDs occur in individuals reporting a history of childhood abuse, particularly sexual abuse and experiences that are potentially life-threatening to a child, such as choking, smothering, and physical injury that breaks bones or teeth, or that compromise the child’s survival needs, including threats of abandonment and deprivation of basic needs. Females who disclosed being sexual abused in addition to being choked or smothered had a 106-fold risk of clinical levels of dissociation. As expected, self-reported amnesia was prevalent in the dissociative groups. Yet, even in the control group, one-third of those disclosing sexual abuse reported an unclear memory of it. Strong similarities in abuse experiences were found between the clinical sample and those in the university sample with clinical levels of dissociation (which is unlikely to have previously been diagnosed). The dissociative groups reported higher rates of corroboration of their abusive experiences. The findings support the traumatic etiology of dissociation.
... A number of organizations have published position statements on recovered memories, which include these excerpts (see also Dalenberg, 2006;Middleton et al., 2005): ...
Article
Full-text available
This is the first of three articles on recovered memories of child sexual abuse. The controversy regarding recovered memories of sexual abuse is perennial and numerous clinical studies document the phenomenon. Study designs are variable and a number of methodological issues are explored. The recovery of memory is independent of the veracity of memory and there is consensus among a range of professional organizations that recovered memories are a valid entity. The second and third articles examine various approaches to elucidating the nature of memory and how it is affected by traumatic events.
... The view that traumatic memory can be lost and recovered is supported by professional organisations around the world. The Australian and New Zealand College of Psychiatrists (RANZCP) emphasised over a decade ago the extent of physical and sexual abuse of children, the harmful nature of such abuses and that 'memory of such abusive experiences may be absent for considerable and varied periods of life and may be recalled under any of a variety of circumstance' (Middleton et al., 2005). ...
Chapter
Dissociative disorders are characterised by the disruption and discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control and behaviour. In depersonalisation/derealisation disorder, the person’s perception of the self and surroundings is altered and they may feel detached from their body or may perceive the world as being unreal. Dissociative amnesia is defined by inability to recall important personal experiences of a traumatic or highly stressful nature. The person with dissociative identity disorder (DID) has two or more distinct personalities, each with unique memories, behaviour patterns and relationships, whereas in subclinical DID the personality states intrude on the person’s thoughts, feelings and actions, but are not developed enough to take full control of the individual. Dissociative disorders are related to childhood abuse, neglect, insecure attachment to the primary caregiver, and exposure to traumatic and stressful events. The aetiology of dissociative disorders continues to be debated, though over time, given the increased data available on familial and institutional child abuse, allied with intriguing neuro-physiological findings, most experts see trauma as a major factor. The trauma model suggests that dissociation becomes a reflex coping strategy when the options of fighting or fleeing are not possible, as is frequently the case in young children, living with inescapable repetitive trauma. The fantasy model suggests that fantasy-prone and suggestible individuals, often with genuine histories of abuse, have poor sleep and this combination of factors results in two false beliefs — first, in ‘recovered’ memories of (more) childhood abuse, and second, that they have a dissociative disorder, when in reality the symptoms and stories of dissociation and trauma are borrowed from the media or other people. The fantasy model has been demonstrated to lack robust empirical support. It is not uncommon for people with histories of a trauma to experience an extended period of time in which they cannot recall it; that all types of memory are open to distortion and recovered memories of trauma are found to be as accurate as continuous memories of trauma. Furthermore, differences in brain activity can be witnessed between alters, yet no differences are seen in people role-playing DID. In the safe, supportive context of therapy, patients are encouraged to learn new strategies for coping with emotions, so as to gain better control over tendencies to rely on dissociation. The common feature of somatic symptom and related disorders is the excessive focus on physical symptoms. The nature of the concern, however, varies by disorder. Somatic symptom disorder is defined by excessive thought, distress and behaviour related to somatic symptoms or health concerns. Illness anxiety disorder is defined by fears of a serious disease when no more than mild somatic symptoms are present. Conversion disorder is characterised by sensory and motor dysfunctions that are incompatible with recognised neurological or medical conditions. Somatic symptom and related disorders may arise suddenly in stressful situations. Factitious disorder can be distinguished from the other somatic symptom disorders as the person compulsively seeks unnecessary medical attention, not because they believe they are unwell, but in a conscious or subconscious attempt to garner care, concern and support from medical staff. A growing body of research confirms that adverse experiences in childhood are closely linked to a range of illnesses and medical conditions, including those associated with somatic symptom and conversion disorder. Neurobiological models suggest that some people may have a propensity towards hyperactivity in those regions of the brain involved in evaluating the unpleasantness of somatic sensations, including the anterior cingulate and the anterior insula. Cognitive–behavioural models focus on attention to and interpretation of somatic symptoms as a way of understanding why some people experience such intense anxiety about their health. Psychodynamic theories of conversion disorder have focused on the idea that psychological stress following a traumatic or stressful experience converts to a physical impairment, yet most people are unaware of the subconscious motivation for their symptoms. Cognitive–behavioural therapy is the most evidenced-based approach for reducing the physical symptoms of somatic symptom and conversion disorder, as well as reducing anxiety in people with illness anxiety disorder.
... High betrayal trauma has been linked with dissociation Goldsmith, Freyd, & DePrince, 2012;, which may be related to betrayal blindness. Betrayal blindness is unawareness of the abuse that may develop as a mechanism of protecting the needed relationship with the perpetrator (DePrince Middleton, Cromer, & Freyd, 2005). Whereas empowered individuals are likely to either confront the wrongdoer or withdraw from the relationship when betrayed, victims who trust and/or depend on the perpetrator for physical and/or emotional needs may become psychologically "blind" to the abuse to preserve the needed relationship with the perpetrator (e.g., Freyd, 1996). ...
Article
Full-text available
Though hallucinations traditionally have been conceptualized as a central feature of psychosis, some hallucinations may be dissociative, with dissociation potentially contributing to hallucinations. Childhood trauma has been linked with dissociation and hallucinations. Betrayal trauma theory distinguishes abusive experiences based on closeness to the perpetrator. In the current study, we examined the indirect effect of dissociation on the relationship between high betrayal child sexual abuse (perpetrated by a close other) and hallucinations. Participants (N = 192) from a northwestern university in the United States completed self-report measures online assessing history of high betrayal child sexual abuse and current dissociation and hallucinations. Bootstrapping analyses indicated a significant indirect effect of high betrayal child sexual abuse on hallucinations through dissociation, 95% Confidence Interval (.16, .66). Through betrayal trauma theory, this study provides a non-pathologizing framework for understanding how dissociation and hallucinations may develop as natural reactions to the harm inherent in child sexual abuse perpetrated by a close other. These findings have clinical implications for relational models of healing for trauma survivors who are distressed by dissociation and hallucinations.
... But it became apparent that where individuals initially recovered memories of past sexual traumas, therapy was not the usual precipitant and the degree to which memories can be truly completely created appears to have been inflated (Brewin & Andrews, 2016). Those whose trauma involved betrayal seemed more likely than others to experience amnesia for their childhood trauma (Freyd, 1996;Middleton, De Marni Cromer, & Freyd, 2005). Elliott and Briere (1995) reported that a history of "complete" memory loss was most common among victims of child sexual abuse (20%), while a substantially higher proportion of such victims had significant amnesia for particular details of their traumas. ...
Article
This study aimed to assess the effect of an emotional memory management programme on executive functions and difficulties in emotional regulation in adolescents. A semi‐experimental (pretest–post‐test design with a control group) research design was used in this study. The population of this study consisted of all adolescent boys in Bushehr, southern Iran, who were studying during 2015. Initially, the eighth grade was randomly selected using the availability sampling method and considering the sample homogeneity principle. Two classes were then randomly allocated to experimental (n = 17) and control (n = 17) groups. Data were collected using the Difficulties in Emotion Regulation Scale, the Stroop test, the Wisconsin card sorting test and the continuous performance test. Multivariate analysis of covariance was used for data analysis. The results showed that our preliminary study was influential on the different domains of difficulties in emotional regulation (impulse control difficulties, non‐acceptance of emotional responses and lack of emotional clarity), cognitive flexibility, cognitive inhibition and cognitive impulsivity. This preliminary study showed reduced difficulty in emotional regulation and improved adolescents' cognitive flexibility, inhibition and impulsivity.
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Lukijalle Oppimisen, opiskelun ja opetuksen tutkimuskeskus Ounas perus�tettiin marraskuussa 2005 Lapin yliopiston kasvatustieteiden tie�dekuntaan vastaamaan lappilaista kasvatusta ja koulutusta koskeviin uhkiin, jotka liittyvät mm. koulujen lakkauttamiseen ja väestön syrjäytymiseen. Ounas tähtääkin lappilaisen tulevaisuu�den uskon ja lappilaisen identiteetin vahvistamiseen uusimman kasvatukseen liittyvän tutkimustiedon avulla. Ounaksella on ollut selvä sosiaalinen tilaus, ja sen piirissä toimii tällä hetkellä yli 50 opettajaa tai tutkijaa. Ounas on järjestänyt viime vuosina useita, kaikille avoimia, teemasymposiumeja. Yhden teemasymposiumin aiheena olivat narratiiviset tutkimusmenetelmät kasvatustieteissä. Kyseinen teemasymposium toimi lähtökohtana myös tälle teok�selle. Narratiivisten tutkimusmenetelmien käyttö on lisääntynyt merkittävästi käyttäytymis- ja yhteiskuntatieteissä viimeisen vuo�sikymmenen aikana. Yhtenä esimerkkinä tästä on kansallinen Kertonet -verkosto, jonka edustajat kokoontuvat säännöllisesti. Väitöskirjoja tai pro gradu -tutkielmia ohjanneet ovat huoman�neet, että useat opiskelijat ovat hyvin kiinostuneita kertomusten käytöstä ja niiden analysoinnista. Tämä artikkelikirja onkin tar�koitettu erityisesti graduntekijöille ja jatko-opiskelijoille. Toisaal�ta uskomme, että teoksesta on hyötyä myös opinnäytetyön ohjaajille ja tutkijoille. Erityisen kiinnostavaa narratiivisuudessa on sen moninaisuus: ei ole yhtä ainoaa oikeaa tapaa soveltaa narratiivista lähestymista�paa. Yksi tämän kirjan tavoitteista onkin juuri tämän moninaisuu�den tavoittaminen. Siksi olemme pyytäneet kirjoittajiksi kahdeksan asiantuntijaa, jotka edustavat kasvatustieteen lisäksi sosiologista, psykologista ja kielen tutkimuksen näkökulmaa. Kaikki kirjassa julkaistavat artikkelit kävivät läpi sisäisen arviointikierroksen. Kolme ensimmäistä artikkelia liittyvät teemoiltaan oppimi�seen ja opetukseen. Taina Rantalan artikkelin fokus on siinä, mil�laisia tarinoita kuvat välittävät ja kertovat koulusta. Hän tuo esille oppimisen iloon tai sen puuttumiseen liittyviä tarinoita. Jo�kaisessa tarinassa on oltava päämäärä. Lisäksi hän lähestyy kuvan ja tarinan välistä yhteyttä järjestyksen ja valintojen näkökulmista. Soili Paanasen artikkeli tarkastelee saksalaisen elämäkertatutki- muksen juuria ja sen teoreettisia ja metodologisia taustaoletuksia sekä elämäkerrallis-narratiivista haastattelua ja sen analysoinnin vaiheita. Lopuksi hän yhdistää elämäkertametodologian oppimi�sen tutkimukseen. Raimo Kaasila soveltaa artikkelissaan narratii�visia lähestymistapoja tutkiessaan luokanopettajaopiskelijoiden matemaattisia elämäkertoja ja heidän identiteettinsä kehittymistä opettajankoulutuksen aikana. Hän esittelee kahta toisiaan täyden�tävää tapaa soveltaa narratiivista analyysiä: ensimmäisessä pää�huomio kohdentuu kertomuksen sisältöön, toisessa sen muotoon. Ulla-Maija Salon artikkelissa tulee esille sosiologinen näkö�kulma. Hän tarkastelee, minkälaisiin asioihin voidaan kiinnittää huomiota analysoitaessa keskustelua, arkipuhetta ja kertomuksia. Hän esittelee keskustelunanalyysin lähtökohtia ja kertomusten asettumista keskusteluun. Lopuksi Salo pohtii kertomusten per�formatiivisuutta ja Goffmanin puheenanalyysiin liittyviä ideoita. Merja Laitisen ja Tuula Uusitalon artikkeli käsittelee narratiivista lähestymistapaa psykologisesta näkökulmasta, päähuomion ollessa traumaattisten elämäntapahtumien tutkimuksessa. He rajaavat tar�kastelunsa sellaisiin psyykkisesti traumatisoiviin tapahtumiin, joi�hin liittyy väkivaltaa, kuolema tai niiden uhka. Seija Tuovila käsittelee kielen osuutta maailman hahmotuk�sessa, kielentutkijan mahdollisuuksia määritellä tunnesanojen semanttisia merkityksiä. Samalla hän kertoo väitöstutkimukses�taan, jossa hän tarkastelee suomen kielen tunnesanaston merki�tysulottuvuuksia ja yksittäisen tunnesanan merkitystä. Kirjan lopuksi Matti Laitinen esittelee menetelmän, jonka avulla voidaan kuvata yrityksissä ja muissa organisaatioissa tapahtuvia muutok�sia. Menetelmässä korostuu se, että tutkittavan muutosprosessin kohdehenkilöt osallistuvat tutkimuksen tekoon kertomalla tapah�tumista ja kommentoimalla tutkijan tekemiä kuvauksia. Kirja si�sältää myös sivun pituiset elämäkertatiedot seuraavista keskeisistä narratiivitutkijoista: Peter Alheit, Jeromy Bruner, Barbara Czar�niawska, Grimmin veljekset, Paul Ricoeur ja Jeja-Pekka Roos. Ne ovat teoksen toimittajien ja artikkelien kirjoittajien kokoamia. Rovaniemellä 15.9.2008 Raimo Kaasila, Raimo Rajala & Kari E. Nurmi
Article
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Conceptual and methodological approaches from cognitive science have increasingly been applied to research examining the relation between trauma, dissociation and basic cognitive functioning. The current study replicates and extends recent research that examined performance in a directed forgetting task using PTSD and trauma history as the grouping variables (McNally, Metzger, Lasko, Clancy, & Pitman, 1998) to college students who were classified as high or low dissociators based on their performance on the Dissociative Experiences Scale (DES: Bernstein & Putnam, 1986). High and low DES participants' performance was examined under two atlcntional contexts: a selective attention condition and two new divided attention conditions (based on DcPrincc & Freyd, 1999). Differences between the groups were revealed when a divided attention version of the task was employed. Consistent with DcPrince and Freyd (1999), when divided attention was required, high DES participants recalled fewer trauma and more neutral words than did low DES participants, who showed the opposite pattern.
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In this highly readable text, the author details the findings of an exhaustive series of studies of Isreali combat veterans, documenting the effects of combat stress reaction on mental and physical health, social interaction, and military effectiveness. In addition to providing mental health professionals, trauma victims, and military personnel with an unparalleled source of information, the work's exploration of the cultural, social, and political processes affecting recovery from combat stress reaction offers a unique perspective of contemporary Isreali culture.
Chapter
In the past two decades, as the result of feminist consciousness-raising, sexual abuse of children has been recognized in North America and Western Europe as a serious social problem. The testimony of victims, first in consciousness-raising groups, then in public speakouts, and finally in formal survey research, has documented the high prevalence of sexual exploitation of children. The best available data, drawn from large-scale surveys of nonclinical populations, indicate that the risk of victimization may be as high as 1 in 10 for boys (Finkelhor, 1979), and greater than 1 in 3 for girls (Russell, 1984). Whether the child victim is male or female, the perpetrator is usually male. Most perpetrators are not strangers but are well known to their child victims; often they are in a position of trust or authority that affords them access and power.
Article
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.
Chapter
The diagnostic criteria of the DSM-III-R ([APA] 1987), which have already been discussed in various parts of this book, represent a spirit of compromise to reduce our criteria to the lowest common denominator. By limiting our criteria to the descriptive ones exclusively, we created a simple enough picture, so that we communicate about certain conspicuous essentials common to virtually all posttraumatic states. These criteria reflect the essential, but not all, points made by the leading contributors in this field. The most explicit statement which summarized the psychoanalytic experiences, as well as his own, was the work of (1941). Among Kardiner’s classic findings were: (1) a fixation on the trauma altering the perception of the whole world, (2) a typical dream life, (3) a contraction of the general level of functioning, (4) increased irritability, and (5) a proclivity to aggressive action.