Forgetting Trauma

How should we deal with trauma? As you know, the topic has broken out of the confines of the mental health profession and has  become a matter for public discussion. 

Many of the theorists tell us that we must remember the traumas we have suffered. The body keeps the score, one writer proposed, by which he meant that even if you forget a trauma your muscle memory will remember it.

As I have noted on occasion, this theory has everything in common with Freud’s original theory of conversion hysteria. After all, conversion hysteria refers to a neurosis where different bodily parts become the loci for trauma memory. A numb arm or a pain in the neck become signals of the existence of a repressed trauma.

Well over a century ago Freud recommended that his patients try to recall their repressed memories, the better to verbalize the problem. Truth telling will set you free.

Freud first claimed that his method worked. He soon discovered that it did not work. He eventually moved on to construct a different treatment model, one that also did not work, but that attracted more clients.

Anyway, Freud’s experience did not put the problem to rest. Recovered memory therapy is alive and well, and it continues to be based on the notion that recollecting traumas is the royal road to cure.

Now, the New York Times reports on a study conducted in Great Britain, and published in JAMA Psychiatry. 

The researchers discovered that people who had been traumatized and abused as children but who did not report it to psychiatrists did not show more distress than the general population.

The authors conclude that it was not the experience itself, but your way of processing the information that produces mental health problems.

The Times reports:

But the 173 subjects who did not report having been abused, despite court records that show that it occurred, had no more distress than the general population.

The findings suggest how people frame and interpret events in their early childhood powerfully shapes their mental health as adults, said Dr. Andrea Danese, a professor of child and adolescent psychiatry at King’s College London and one of the study’s joint authors.

“It goes back to almost the stoic message, that it’s what you make of the experience,” he said. “If you can change how you interpret the experience, if you feel more in control at present, then that is something that can improve mental health in the longer term.”

The authors concluded that forgetting the event was a good thing. If you did not think that the trauma was a meaningful experience, it was less likely to have damaged you:

But even considering these caveats, he said, it was notable that adults who had a documented history of having been abused but did not report it — because they had no memory of the events, interpreted them differently or chose not to share those memories with interviewers — seemed healthier.

“If the meaning you give to these experiences is not central to how you remember your childhood so you don’t feel like you need to report it, then you are more likely to have better mental health over time,” he said.

Be careful about the use of the concept of "meaning" here. It sounds constructive to say that victims who do not believe that it was a meaningful experience have better mental health, but that seems to suggest, to be more accurate, that they act as though the trauma had not happened, or else, that if it did happen, it happened to someone else.

One understands that many patients swear by the effectiveness of recovering memories. The research confirms a suspicion of my own, namely that recalling repressed memories is ineffective as treatment:

The new findings in JAMA Psychiatry suggest therapy that seeks to alleviate depression and anxiety by trying to unearth repressed memories is ineffective, said Dr. Danese, who works at the Institute of Psychiatry, Psychology & Neuroscience at King’s College.

Naturally, the psychiatrists do not want to damage their colleagues’ businesses. So they qualify their judgment, suggesting that it is best to manage the trauma. 

But he cautioned that the results of the study should not be interpreted as endorsing the avoidance of distressing memories, which could make them “scarier” in the long term. Instead, they point to the promise of therapies that seek to “reorganize” and moderate memories.

“It’s not about deleting the memory, but having the memory and being more in control of that so that the memory feels less scary,” he said.

For my part I agree with Dr. Elizabeth Loftus, who suggests that forgetting a trauma might just be the healthiest response. That is, to believe that the trauma did not happen to me, but happened to someone else:

Elizabeth Loftus, a psychologist at the University of California, Irvine, and a prominent skeptic of the reliability of memories of abuse, noted that the study stops short of another conclusion that could be supported by the data: Forgetting about abuse might be a healthy response.

“They could have said, people who don’t remember in some ways are better off, and maybe you don’t want to tamper with them,” she said. “They don’t say that, and that, to me, is of great interest.”

In the end this seems to correlate with recent studies of psychological resilience,  conducted by Columbia psychologist, George Bonanno. His is not the only study to suggest that most people who have been traumatized get over the experience, without having therapy. 

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