Submitted by Dr Janet Boakes (CA 75)
RECOVERED MEMORIES OF SEXUAL ABUSE
In the past decade or so numbers of individuals have claimed that they suffered sexual abuse in childhood and have recovered memories of it only in adult life, sometimes decades after the event. Some have been told as adults that their psychological symptoms may be caused by a trauma of which they have no conscious memory. Originally reports of recovered memories linked the phenomenon to therapy and suggested that some of the memories had been inadvertently suggested by therapists. Techniques intended to help the process of memory recovery raise concerns that the memories recovered in this way are unreliable, they are the product of imagination and fantasy. People are not recovering memories but are describing events which did not take place1,2. Many scientific reports have warned of the dangers of reliance upon recovered memories following the use of such methods and all the major psychiatric and psychological bodies have issued guidance in this area3,4,5,6,7,8,9.
This is a new phenomenon. Until the first reports emerged in America in the late 1980s it was unknown apart from Freud's repudiated theory of sexual seduction more than a century ago. If the mind had the capacity to block out hideous events in the way proposed, it is remarkable that until two decades ago it had not been observed. It is worth noting that despite the large pool of people who are sexually abused, and the corresponding number of people who have the posited potential to repress and later recover memories, there is a striking absence of reliably corroborated cases of recovered memories in the literature.
"Recovered memories" stand or fall with the concept of repression. The notion that traumatic events can lie forgotten for decades until triggered by current circumstances is a widely believed-in phenomenon. There is, however, no body of evidence which demonstrates that traumatic events can be repressed. On the contrary, it appears that highly disturbing events are the ones least likely to be forgotten. Follow up studies of victims of a range of different trauma (war veterans, concentration camp survivors and those involved in major disasters)10,11,12,13,14 have not found an ability to forget. On the contrary many were troubled by recurring intrusive memories. Despite 60 years of research,15 efforts to study repression in the laboratory have failed to produce evidence in support. There are anecdotal clinical accounts of repression and memory recall, but almost none have been verified. Four prospective studies16,17,18,19 which purport to show evidence of repression are all methodologically flawed.20
Memory is known to be fallible, altered by the passage of time and subject to error and distortion.21,22 An extensive literature outlines its constructive and reconstructive nature rather than its reproductive nature. False memoriesthe apparent recollection of imaginary eventscan and do occur. There are accounts of experimental creation of false memories,23 held with complete conviction, challenging the belief that no one would make up such things.
Accounts of combat, both from the second world war and from more recent conflicts, notably the Vietnam war, refer to "psychogenic" amnesia, but the term describes a somewhat different phenomenon. Sufferers from wartime amnesia reported global amnesia, that is complete loss of all memory preceding or following the traumatic episode, and some could remember no personal information. Moreover these soldiers were fully aware of their memory loss. Such "psychogenic" amnesia was usually transient and memories were restored fairly quickly. This is entirely different from the "psychogenic" memory loss for specific incidents eg multiple rapes, while retaining intact a whole contemporary history of events. There is no reliable evidence to support such event specific amnesia.
As long ago as 1944, Sargant24 warned of the risks of uncritical belief in newly recovered memories which had to be distinguished from confabulation and fantasy. Many of those who described amnesia and subsequent memory recovery during the war had been treated with drug abreaction or with hypnosis, both now known to increase the conviction with which a story may be recalled while reducing its accuracy. This must cast doubts upon reports of wartime "psychogenic amnesia". Moreover, none of those with "amnesia" ever forgot that they were in the front line and thought they spent the war at home. Amongst Vietnam veterans amnesia was also quite uncommon.25
For a study to demonstrate the existence of repression it must show that: the alleged event occurred; it was of a kind unlikely to be forgotten in the normal way; its non-recollection cannot be explained by uncontroversial causes such as infantile amnesia (the period in infancy and early childhood from which memory is accepted as not possible) head injury, toxic states, or simple forgetting. No studies currently meet these criteria.20
RETROSPECTIVE CLINICAL STUDIES
A large body of retrospective clinical studies26, 27 finds that a significant proportion of patients who allege that they were abused report periods in their lives when they could not remember that the abuse had occurred, but these studies generally fail to meet the test above. There are inherent difficulties in asking subjects if they remember that they forgot. These studies have also been criticised for their methodological failings.28 Corroboration is generally either completely absent or is unreliable, often it is provided from the patient's reports and unverified by the experimenter. Corroboration is also noted to be less common in memories for sexual abuse when compared with other recovered memories29. In the absence of independent corroboration that the event actually occurred there is no scientific means of determining the veracity of a memory recovered from alleged total amnesia.
Whilst popular belief supports the ideas of repression and memory recovery the scientific evidence does not. The null hypothesis, that repression does not exist, (and therefore recovered memories cannot be relied upon) has not been falsified. Clinicians and investigators must be rigourous in seeking corroboration of all memories recovered years after the event. They must not be misled into thinking that current symptoms provide evidence of past trauma.
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2. Brandon, S, Boakes, J P, Green, R and Glaser, D (1998) "Recovered Memories of Childhood Sexual Abuse: implications for clinical practice", British Journal of Psychiatry, 172:296-307.
3. American Psychiatric Association (1993) Statement on Memories of sexual abuse. Washington DC, APA. reprinted in Moving Forward 6(2):8-9
4. American Medical Association (1994) Memories of childhood abuse. childhood sexual abuse. Report (5-A-94) Chicago. AMA.
5. American Psychological Association (1994) Statement on adult memories of childhood sexual abuse.
6. Australian Psychological Society (1994) Guidelines relating to the reporting of recovered memories. Sydney. APS Ltd.
7. British Psychological Society (1995) Recovered Memories. Leicester. BPS.
8. Canadian Psychiatric Association (1996) Position Statement. Adult Recovered memories of childhood sexual abuse. Toronto. CPA.
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