When a character in a film has amnesia, it is almost always due to brain damage caused by an accident or physical violence. This is also true somehow, but the real-life consequences are more serious.
- What is dissociative amnesia?
- How does dissociative amnesia differ from simple amnesia?
- What does dissociative amnesia affect?
- What are the four types of dissociative amnesia?
- What causes dissociative amnesia?
Dissociative Amnesia – Definition
We all go through hard times, but when memories are too painful to remember, a person can lose memories (amnesia) of the traumatic event. This memory loss is called dissociative amnesia.
Amnesia is the inability to remember recent or distant events entirely or partially.
A man who appears to have trouble recalling his memories, pexels.com
Dissociative amnesia is a dissociative disorder resulting from extreme psychological stress that involves memory gaps about an experienced trauma or adverse event.
A person with this dissociative disorder may:
Claim to have forgotten the trauma.
Feel agitated when others bring back to mind the traumatic memory.
Gradually remember the memory when emotionally ready to confront it again.
This disorder consists of memory gaps ranging from minutes to decades. However, sometimes lost information still seems to affect behavior even with memory loss.
A person who was almost killed by a shark, though having no memory of it, avoids going to the beach.
Dissociative amnesia is different from simple amnesia, which is caused by a medical condition like a stroke or a brain injury from an accident, a tumor, or a toxin. A person with dissociative memory loss frequently forgets about his own experiences (autobiographical memory), although this is typically reversible, and his cognitive functions remain intact. When a medical condition causes memory loss, it is usually permanent and makes it hard for the person to learn new things and store new memories. Memories of individual experiences are rarely lost.
This disorder typically affects memory and behavior, awareness, a sense of self, and emotional health. In some cases, this dissociative disorder can also compromise one's capacity to control one's voluntary movements.
Dissociative Amnesia – Symptoms
A depressed and emotional woman lying on the floor, pexels.com
Memory loss, the most common symptom of dissociative amnesia, is more complicated than ordinary forgetfulness. A person with dissociative amnesia may have no memory of a specific event or category (e.g., traumatic experience or a family member), personal experiences (e.g., childhood), or certain developed skills (e.g., how to ride a bike).
Amnesia may develop within hours up to weeks following a painful or stressful experience. People may appear disoriented, upset, or apathetic immediately following memory loss. Most people overlook memory lapses until they return or are shown proof.
Patients with dissociative amnesia are easily hypnotized and have high dissociative abilities. Other symptoms include increased emotional sensitivity, depression, drug abuse, and risky sexual behavior. These symptoms make it hard for them to get along with other people. People may also report feeling tired, weak, or having difficulty sleeping.
In DSM-5, dissociative amnesia symptoms are described as:
Having difficulty remembering crucial personal information that one would typically be able to remember.
Separation from one's own identity and feelings
Memory loss causes anxiety in daily life, career, academics, and relationships.
Not attributed to drug abuse, mental health disorders, or medical issues
Types of Dissociative Amnesia
The type of amnesia a person has affects how bad it is, what kind of memories they lose, and how it affects them.
There are four types of dissociative amnesia:
Localized dissociative amnesia
Selective dissociative amnesia
Generalized dissociative amnesia
Dissociative fugue
Localized Dissociative Amnesia
This amnesia, commonly seen among victims of abuse or war veterans, involves failure to remember events and other essential information during a particular period. This type is the most common form of the disorder. Typically, forgotten information centers on specific traumatic experiences. Localized amnesia might last from a few minutes to months or years, depending on how long the traumatic incident occurred.
A sexual abuse victim may forget what happened to her but can remember what else happened that day.
Selective Dissociative Amnesia
Selective amnesia occurs when a person remembers some details of a specific event or incidents within a specified period or stressful event. In other words, a person only remembers parts of what happened—most people with dissociative amnesia experience selective or localized amnesia.
A severely traumatized child may remember playing outside on the day of the traumatic incident but forget the details of the physical abuse.
Generalized Dissociative Amnesia
In generalized amnesia, a person forgets his identity and past personal memories. There are lapses in both semantic and procedural memory.
Semantic memory involves common knowledge about the world (e.g., knowing what a dog is or the capital states of the U.S.). Procedural memory is remembering how to do essential skills or routine habits (e.g., cooking or brushing teeth).
This type of amnesia is rare, yet it has serious consequences, such as forgetting family and friends. At the acute onset of generalized amnesia, a person may experience disorientation, which can be life-threatening.
A disoriented person who has forgotten how to operate the stove is more likely to start a fire or get hurt.
Dissociative Fugue
A person with dissociative fugue not only forgets who he is, but he may also suddenly change careers or wander away from home, taking on a new identity. This dissociative amnesia type is the most extreme and can take a few hours to years. Dissociative fugues, like their quick onset, can also cease suddenly.
A businessman in grave financial distress suddenly abandons everything and flees his home. Months later, he is discovered working as a clerk in another city. He has no recall of how he got there.
Dissociative Amnesia – Causes
Many factors are linked to this disorder, and models have been proposed to explain the intricate relationships that result in dissociative amnesia.
Depiction of physical violence, pexels.com
Trauma and Stress
Dissociative amnesia has been linked to trauma, which two models describe as a result of memory retrieval issues.
In the first model, retrieval deficits occur due to a negative impact on the prefrontal cortex (a part of the brain involved in memory retrieval and executive function) caused by mental stress and other predisposing factors.
Executive functioning consists of mental skills relating to self-awareness, emotion and behavior control, and planning and remembering information.
Executive functioning also involves blocking out unwanted memories, which can get in the way of other cognitive functions, like recalling other personal memories.
In the second model, stress hormones cause the frontal and temporal lobes of the brain to work out of sync when retrieving memories. High levels of stress hormones can make it harder to store, organize, and recall personal memories. The frontal and temporal lobes are involved with consciousness, emotions, and visual memory.
Social and Cognitive Factors
Sociocognitive models suggest that this disorder is tied to culture; cases should have been recorded in literature if it were a psychological condition. Even if people back then understood psychology differently, they would have described it in a way modern readers would recognize. Others believe dissociation-related cognitive deficits explain dissociative amnesia's cognitive problems.
The social-cognitive view holds that the inability to retrieve information in dissociative amnesia might be entirely attributable to mild impairment in executive function and willful memory suppression.
Gene-environment interactions can also change stress hormones and brain function, increasing the risk of trauma-related dissociative amnesia. Other causes include mild traumatic brain injuries, which reduce the capacity of the brain to retrieve memories of personal experiences, becoming a predisposing factor to dissociative amnesia.
Dissociative Amnesia – Treatment
Because most patients recover independently, treatment options for dissociative amnesia are limited, but common strategies include hypnosis, sedatives, psychotherapy, and a supportive environment.
Hypnosis can help people with amnesia deal with their symptoms and make them less severe. Clinicians help patients deal with traumatic memories by having them remember what happened. Clinicians do this by asking the patient to remember things that happened before the amnesia symptoms started and then guiding him up to the time of trauma.
Doctors also use sedatives like barbiturates (truth serums) and benzodiazepines. Barbiturates work by getting people to let go of their fears, making them feel safe and calm when asked to talk about their memories. These drugs are given through an IV, and then a patient is interviewed to help them process their memories.
With hypnosis and sedatives, it's easy to make up false memories or cause a lot of anxiety, so doctors need to be careful when treating patients. Doctors also ask for consent before starting the treatment since these methods may not always produce accurate memories.
Providing a supportive environment helps assure patients that doctors care about their well-being. It is critical not to add to the patient's anxiety.
Psychotherapy is used to treat people even after their amnesia has gone away. Psychotherapy aims to help people move forward by assisting them in understanding the trauma, which can lead to healing and help them avoid future traumas.
Dissociative Amnesia - Key takeaways
Dissociative amnesia is memory loss of events or information resulting from traumatic or extremely stressful situations.
Dissociative amnesia symptoms include memory loss (most common), emotional hypersensitivity, depression, drug abuse and other self-destructive behaviors.
The four types of dissociative amnesia include localized (complete memory loss of a specific traumatic period), selective (incomplete memory of what happened), generalized (memory loss of identity and personal experiences) and dissociative fugue (most extreme type involving wandering from home), of which most patients are most often diagnosed with localized or selective amnesia.
Stress and trauma are usually attributed to dissociative amnesia. Other causes include cultural connections, gene-environment interactions and mild traumatic brain injuries.
Treatment for dissociative amnesia typically involves recalling of the traumatic memories and walking it through with the patient, preventing anxiety, using sedatives for relaxation, supportive environment and psychotherapy.
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