There has been much public controversy surrounding the reporting in psychotherapy of previously inaccessible 'memories' of sexual abuse. The debate on the validity of recovered memory quickly became an either/or argument: memories of childhood trauma must be either fictions created on an analyst's couch or real events so horrible the mind hid them away.
A review of the literature surrounding recovered memory by British writer Mary Target offers another perspective based on psychological research into memory.
In her essay for the International Journal of Psycho-Analysis, extending earlier work with Dr Peter Fonagy, Dr. Target explains that there are two types of memory, which interact. Procedural memory, built up from earliest infancy, carries knowledge about what to expect from the world and how to deal with it: knowledge that is very hard to verbalize but is shown in behavior. Autobiographical knowledge, established around 3-4 years of age, has been portrayed in the recovered memory debate as giving either a mental videotape that can be stored and replayed at will, or a wholly fictional imagining of past events (suggested by the therapist). In fact, personal memories are narratives based on a mixture of real events, the current mental state and wishes of the person, and probably the non-conscious influences of procedural memory.
Using commentary on six books, ranging from accounts of recovered memory to scientific works on memory and analysis, Target has synthesized current thinking. The result is a solid overview of the issues and a prescription for an appropriate analytic approach to the problem of memory.
Target argues that much of the debate on recovered memory is based on misunderstanding the aims of psychoanalytic treatment-in some cases by therapists themselves. Writers on both sides of the debate assume that therapy should find out what happened in the patient's past. Target focuses on the questions of what kinds of truths analysts and psychotherapist are in fact trained to uncover, and how their techniques can best serve the patient. Target argues that this requires a fuller understanding of the different kinds of memory.
Target explains that the most common model of memory, which now seems to be erroneous, includes the following assumptions:
- All experience is stored in episodic memory (memory as videotape).
- Experience of abuse is often repressed (forgotten because it is painful or shameful).
- Repression is particularly likely if the abuse is in infancy, or is repeated.
- True memories of abuse have distinctive characteristics.
- Repression can be lifted by analysis, revealing quite accurate memories of early abuse.
- Retrieving these memories should be therapeutic for the patient.
Although research has cast doubt on the 'common-sense' view of memory, it has produced two concepts that promise greater understanding of early childhood trauma:
- Dissociation, a disconnection between mental processes-such as thoughts,
feelings, meanings, sometimes the sense of identity-that are usually integrated.
- Procedural, or implicit, memory-the kind of memory that shows how to do
something-versus autobiographical, or episodic, memory which recalls the who,
what, where and when of an event.
These two concepts, according to Target, can help analysts understand and manage
signs of trauma, without exacerbating the problem or stimulating a false memory.
Dissociation is familiar to clinicians, but should be understood by the proponents of 'false memory syndrome' as a possibly more relevant explanation of recovered memory than repression, their usual bugbear. This is not to say that dissociation necessarily indicates trauma, and certainly not that memories coupled with dissociative symptoms are historically true. There is a real risk of false memories, but the clinical phenomena of dissociation may help us, more than the idea of repression, to understand some cases of apparent forgetting of known trauma.
Psychoanalysis offers an ideal-probably unique-way to understand and treat responses that are based on procedural memories of trauma. Through intensive attention to ways of relating, characteristic patterns can emerge, and over time be transformed. In cases of abuse within the first few years of life, these patterns may show the constant anticipation of trauma which cannot be remembered, only re-enacted, because it happened while implicit memories were being laid down but before autobiographical memory could be encoded. The patient's way of behaving tells a story even when the events could not be remembered, and reconstructing detailed stories from the past-though a natural part of the process-ought not be the aim of analysis. These stories may have enormous impact precisely because they illustrate major patterns of thinking and feeling about the self and others, outside awareness. However, the events will have been distorted by the child's limited understanding, by internal or external pressures over the years and by recreation during remembering-a process akin to the game of telephone. In contrast to unreliable memories of early events, what the analyst can directly know, and modify, is the pattern of relating and expectation, the legacy of whatever events may have occurred.
Does an open mind about the validity of memories add to any past abuse the patient suffered? Target argues that the analyst can respect the meaningfulness, psychic truth, of autobiographical memories, without judging their historical truth. Indeed, if the analyst 'validates' the historical truth of a particular recovered memory, then he or she may limit the effectiveness of the psychoanalytic process. It is not the analyst's job to decide whether events remembered are factually true, but to work with the patient's constantly changing psychic reality. This was what Freud discovered and psychoanalysts have been trained to practice.
Cognitive research may now have thrown light on why Freud's method works so well in addressing early experience-it gives us a way into implicit memory, laid down long before the autobiographical stories. The patient or therapist may turn this current reality into new autobiographical memories, which help to give a sense of continuity and meaning to someone's life, but might not actually be true. The psychological truth of the new memories (as with dreams) comes from the underlying themes, outside awareness and drawing on a different memory system, which continue to shape the patient's emotional life, and which a long-term, intensive therapy can help to change.
### Copies of the full review, The Recovered Memories Controversy (International Journal of Psychoanalysis, 79: 1015-1028) are available from the American Psychoanalytic Association by calling Dottie Jeffries at 312-938-1969. The text is also available on-line at www.ijpa.org. For more information, please contact Dottie Jeffries or Leon Hoffman, M.D., chair, Public Information Committee at 212-249-1163 or 73542.334@compuserve.com.
Mary Target may be reached at mary.target@ucl.ac.uk.