Thinking - about priorities in responding to trauma memories in psychotherapy

By: Tom Cloyd - 3 min. read; reviewed: 2024-08-13:1520 Pacific Time (USA))

After 45 years of research, discussion, and intense clinical work, trauma memories are still a “loaded” subject, in more ways than one. Not long after the 1980 publication of the APA’s Diagnostic and statistical manual of mental disorders (third edition) - the “DSM-III” - there was a burst of research on psychological trauma, because for the first time there were two formal trauma-related diagnoses: PTSD (Posttraumatic Stress Disorder) and MPD (Multiple Personality Disorder). At the same time, there was an intense pushback from the general public and from conservatives in both psychology and psychiatry.

The “False Memory Syndrome Foundation” (FMSF) was launched by parents of a psychology professor who claimed abuse by these parents.¹ The Foundation attracted considerable attention, and was joined by prominent members of academic psychology. At the same time the legitimacy of its core claim - that most if not all purported abuse memories were in fact false reports - was actively disputed by a wide range of psychotherapy professionals and academic researchers.²

The denial-response to the legitimization of trauma-related psychopathology, diagnoses, research, and treatment brought about by the publication of the DSM-III is an appropriate topic for another article. I personally know of several members of my profession who quit after being harassed by lawyers associated with the now-defunct FMSF. I will further state that there is simply no doubt that the strong majority of trauma memories that can be checked invariably prove to be true, and that ongoing attempts to discredit those who report memories of trauma are incredibly injurious, illegitimate, and worthy of the strongest possible legal pushback.

Following are some significant excerpts, edited for brevity, concerning priorities for dealing with trauma memories in psychotherapy, from a book³ by one of the true giants in developing effective treatments for trauma and dissociative disorders:

“Psychotherapy is much more competent and capable as a means of addressing human suffering than it is as a method for the discovery of historical truth. It would be nice to be able to be clear about whether or not the events patients discuss in therapy have actually occurred, and if they occurred, whether or not they are presented accurately, and if there are inaccuracies, whether or not there is rhyme and reason that determines the nature of the inaccuracies.

“If there is mental content that causes distress, it is more therapeutic to process it, even if there are uncertainties about its historical accuracy. Most psychotherapies, even those unrelated to trauma, work with narratives of uncertain/undocumented veracity. Any approach that advocates determining the truth of what a patient says before what the patient says is dealt with in the therapy is a priori dubious….Those who hold this stance focus their insistence on proof of abuse/neglect allegations, but rarely afford such scrutiny to other statements that might be of even greater importance for understanding the patient….When the criteria for according or withholding…credibility vary with the subject under consideration, something far from dispassionate objectivity is governing the evaluative process.

“…Some recovered memories of trauma can be documented, some can be disconfirmed, and…most…remain neither confirmed nor disconfirmed…[In a range of studies,] 95% of dissociative children and adolescents were found to have documentable abuse….Finding that some memories put forward are accurate does not allow the inference that other memories put forward are accurate as well. Likewise, finding that some memories put forward are inaccurate does not a priori invalidate any other memories that the patient might present.

“Further, …memories of trauma are not invariable in form….Both memories that first enter awareness as fragmentary scenarios or sensory impressions and memories that first enter awareness as complete recollections of complex events [can] prove to be accurate.”

Notes ^{^}

 

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