The False Memory Syndrome: Science or Misogyny? Sanpra L. BLoom, MD iene foes A= aaa Be SS seers drome (FMS)” and “Recovered Memory, Thanpy CMT)" Aldoag hee ee sound quite official, FMS was made up by group representing or advocating for am- ieee eee a setae children, RMT is a form of “treatment” Sed unde Oy te Sos ES advocates. Despite this questionable author- Sa Sipe eee Sees pists to implant false memories of abuse (re- ee See ene ete eau ae es ee “Lawsuits against therapists for practicing ‘tecovered memory therapy are proliferating.” hharm to innocent patients who are misled by their greedy or troubled therapists co ac cuse innocent family members who then suffer irreparable harm. Lawsuits againse therapists for practicing “recovered memory therapy” ate proliferating. Some therapists are being picketed, their patients harassed, the privacy of their homes invaded. At- tempts are being made in several states co introduce legislation that would disallow any therapy that had nos been proven “safe and effective” by che standards similar to those used to est new drugs and thar would allow a patient’ relatives, even against the wishes of the patient, co sue the therapise for malpractice. The “false memory” defense is being utilized routinely in many cass in Which avieim is seeking justice chrough the courts, particulary in cases of sexual of- fenses. When asked to reimburse patients for therapy, insurers and managed care ce- viewers ae Frequently using the presumed existence of “false memory syndrome" as means of questioning and even refusing claims. ‘This makes for great press and persua- Page 4 (Pesma fer Warman ia sive propaganda but chere are significant ‘omissions fom virtually every discussion of this opic. As yer chee is no peer-reviewed, published study that supports the view chat “fale memory syndrome” exists. More trou- blingis cha there is no apparent way eo dis- tinguish between “recovered memory therapy” and any other form of therapy chat includes raking a good history from a pa- tient, There is no scientifically validated ‘evidence to support the proposition that it is possible to implant entite memories of traumatic events into anyone's mind. There is, however, an abundance of current and historical data that supports the existence of ether “false memory” of false reporting on the pare of perpetrators. And finaly, there has yee to bea balanced presentation about che vast body of theoretical and re- search data, deriving fom several diferent disciplines and spanning, over a hundred years of clinical experience tat indicates the significane differences between normal memory, normal forgetting, traumatic memory, and the intrusive r-experiencing of traumatic events. Amnesia for waumatie events has been described in vireually every survivor group for the last 200 years, The fact that there as not been such a balanced presentation tothe public, despite che ob- vious and overwhelming amount of data that contradicts most of what the false memory advocates offer as evidence, is what has convinced many chat this is more of a sociopolitical, chan a scientific, debate. In- deed, much of this debate has been con- ducted in the media with 2 one-sided, de Corted, and sensationalist bias, rather than in professional journals and in the court- room as icis used to provide accused perpe- trators with a defense The “filse memory” controversy is dis- tinguished by a linguistic dilemma, The same words—memory and remembering — are used co describe two entirely different brain activities, different neuroanatomical and neurophysiologcal bases, 2s well as en- tirely differen clinical presentations. When people experience intrusive flashbacks as visual, olfactory, affective, audieory, oF ki- esthetic sensations, although we erm this “traumatic memory.” it bears lee if any relationship to che normal process of re- membering. Remembering in our notmal terms is based on language while caumatic recall is nonlinguistic. Gradually as people begin to process hese incrusve images, they begin co form a narrative asa means of ex: plaining ther experience. Once such an ex- perience enters the narrative sphere ie may be open ro many of che distortions and changes related co “normal” memory pro- cessing the distorions so highlighted by he false memory advocates. In their recent book, Traumatic Sires, Van der Kolk, McFarlane, and Weisieh review the grow ing body of data indicating chat traumatic memory is relatively indelible even while being inexpressible in words. Much of the “As yer there is no peer-reviewed, published study that supports the view thar ‘false memory syndrome’ exists.” confusion in the popular and, sadly, pro- fessional literature is elated to unintentional ot deliberate attempts co perpetuate this confusion Inanartcle ina recen issue ofthe PTSD Research Quarterly, Metcalf and Jacobs samn- marized the differences becween the two important component systems of the memory, what they have termed the “cool” or cognitive system and the “hot” or emo- sional system. The “cool” hippocampal sy- «em record in an unemotional wa, with aa- cobiographieal dex and spatio-temporal context, events as they occur. The "hos" amygela system responds to unincegrared, fragmentary, Fear-provoking features of vents. Ici direct, quick, highly emocional, inflexibleand fragmentary. Hotayser recall of events is driven largely by fear and entails reliving with no artendane spatio-temporal context. In contrast, “cool” system memories are narrative, reolletve, and episodic, ack- ing the sense of reliving in the present. ‘Under normal conditions, these rw systems work in parallel and are integrated as a whole. LeDoux has studied the function- ing ofthe amygdala and its ole in memory and it is apparenc that once fear is condi- tioned, ic is viewally indelible, although parts ofthe “coo!” system can suppress fear responding by thealey Gs) 199%"Amnesia for traumatic events has been described in vinu- ally every survivor group for the last 200 years.” These two systems respond quite dtfer- ently costes. Inia, as stress increases, the “cool” hippocampal system becomes enhanced, but a caumatic levels of sressit bbecomes dysfunctional, probably due to effecs of cortisol. Meanwhile the “hat” sy tem becomes increasingly responsive sess increases and, ac craumatie levels of sess, becomes hyper-responsive. As a result, at traumatic level of stress, che individual wil focus exclusively on fear-evoing features of the experience and the memories ofthis event willbe fragmentary, lack a spatio-emporal context and be asociated with high levels of emotional arousal, particularly fer. These fragments of memory wil probably be accu- tate co the extent of the focus on the fear provoking simul but wil lace any kind of narrative formato context in time and space. The October, 1995 issue ofthe Journal of Traumatic Sees (obtainable through the ISTSS offices 847-480-9028) was devoted to the acest research on traumatic memory, all of which provides suppore for this de scription of memory functioning and of clinical presencacions. In one study by Van der Kolk and Fisler, all subjects, regardless of age at which the teauma occurred, re ported that chee initial memory was notin the form of a narrative, but was instead a somatosensory or emotional flashback ex- Petience. In their report ofa brain imaging scudy, these authors suggest chat che notion of "speechless terror" which is pac ofthe trauma response is not merely a popular metaphor, but an experience tha is based ‘on altered brain function atthe moment of the trauma. Ina general population survey of traumatic experiences by Ellioce and Briere, 30% of females and 1496 of males reported a history of sexual abuse and 42% ofthese described some peri of time when they were amnestic fr the abuse, with 20% of sexual abuse victims describing a period of time wien they were completely amnes- tic forthe abuse. Interestingly, only 8% of the entire sample wer in psychologieal eat ment and reatment stars was not predic- tive of recall status—individuals recovering abuse memories were no more likely to be in psychotherapy than their cohorts wich selFreported continuous memory. Linda Williams reporced on hee study originating almost 20 years ago in which she followed children wh had documented sexual abuse Of those who eemembered reported that there was a time when chey did not remember chat che sexual abuse had happened eo them. The implications of this work for ereat- ment are enormous. Our growing under- standing ofthe mechanics of memory helps us develop a theoretical framework for why psychotherapy works. Healing appacently necesiats the creation of a verbal and re- lacional narrative as away of healing from trauma and integrating traumatic memory fragments so that they no longer areas likely to produce che oublesome intrusive symp- ‘om typical of trauma syndromes. Bt once this narrative processhas been engaged, e- aly is subject o alteration and distortion. The sociopolitical implications ofthis “debate” must also be taken seriously by crery dlncian, paricalry given the present socioeconomic climate whichis 50 hostile abuse, 16% Co the practice of psychotherapy and often so seemingly invested in maintaining an a mosphere of violence towards women and abuse simultaneously elevates the malevo- lenc intene of therapist while perpetuating the steeorype of hysterical, naive, easily ed ‘misguided female patients and successfully masking the very real malicious intent of perpetrators. Violent perpetration against ‘women and children in these “enlightened” “The cteation of the "False Memory Syndrome” has provided sexual offenders with an excellent defense times can only thrive in an atmosphere of lies, deceitand confusion. Beware of science used in the service of misogyny; beware of hose who seek to silence the voice of the Dr. Bloom is Executive Director, The Sanctu- «ary Friends Hospital, Philadelphia, PA; and. a member ofthe Board of Directors, Interna sional Society for Traumatic Seress Studies children. The creation of the “False Memory Syn- drome” has provided sexual offenders wich an excellent defense which puts che victim at ase ous disadvantage unless she has wieneses to the events, which i not likely in the ease of childhood sexual abuse. The ques- tion has ver to be raised why memories of sexual assault shouldbe any es reliable chan memories of Witnessing a shooting, bank robbery, oracarac- cident. In atacking the therapist—not the par sient—the adopted by the false memory advocates are similar to anti-aborsion strategies which ateack the physician—not the ‘woman seeking the bor tion. The characterization of Svengalian therapists implanting suggestions of religion. ana Poona + Reduced regi PCa nship between psychoanalysis, culture, ‘Member bonofits includ + Low lability and malpractice insurance rates + Sponsorenie of you For information: Tre Auencan Acaoeuy oF Pevewaanysis 47 East 19th Strat cre: (212) 475-7900 Un DCU hh is and psychiatry ‘oT me Auer ACADEMY oF ration fees at Academy meetings * New York, NY 10009-1223 aw: (212) 475-8101 Page 15