What Is Dissociative Amnesia?
The main symptom of dissociative amnesia is memory loss. This is more severe than normal forgetfulness. This memory loss is often associated with a stressful or traumatic event. The person cannot remember important information about his life. An episode of amnesia usually occurs suddenly and may last minutes to hours, or months to years.
In dissociative fugue, the person may forget almost all his personal information. He may not remember his name, personal information, and friends. He may even travel or wander in confusion to a different place and adopt a new identity.
Dissociative amnesia belongs to a group of mental illnesses called “dissociative disorders.” In dissociative disorders, there is a breakdown of mental functions, such as memory, awareness, perception and/or identity.
The symptoms in dissociative disorders can be so severe that they make the person unable to function normally. This affects his relationships and work.
Dissociative amnesia affects around 1% of men and 2.6% of women in the general population.
Symptoms of Dissociative Amnesia
The main symptom of dissociative amnesia is a sudden inability to remember personal information or experiences. These individuals may be unaware of their memory problems. They may appear confused and even suffer from anxiety or depression. Most cases of dissociative amnesia are short-lived. Recovery happens suddenly on its own. It can be because of a trigger in that person’s surroundings, or due to therapy.
There are three main types of dissociative amnesia:
- Localized amnesia: This is the most common form of dissociative amnesia. There is a failure to recall events during a certain period such as during childhood, or anything about a coworker or friend. Often there is an association with a specific trauma. For example, a victim of a crime may remember everything that happened during a day except being robbed at gunpoint.
- Generalized amnesia: Here the memory loss affects one’s identity, and the person cannot recognize his family, friends or co-workers at the job. Generalized amnesia has an acute onset. It may be more common among sexual assault victims, combat veterans, and individuals undergoing extreme emotional conflict or stress.
- Dissociative fugue: In this, the person has generalized amnesia. He may even travel to a different location and adopt a new identity. They cannot recognize family members, friends, or coworkers. They may not also have knowledge about their personal identity. They cannot account for such a lack of knowledge.
The other dissociative amnesias are:
- Selective amnesia: The individual can remember some parts of a traumatic event but not other parts. Some individuals can have both localized and selective amnesias.
- Systematized amnesia: The individual forgets information in a specific category, such as all information about a particular person or about their family.
- Continuous amnesia: The individual forgets each new event as it occurs.
Dissociative amnesia is associated with extreme stress, usually because of traumatic events—abuse, accidents, disasters, or war—which the person has witnessed or experienced. Mild traumatic brain injury may precede dissociative amnesia. One suspects a genetic link because it is more common in those with close relatives who have suffered from similar conditions.
DSM-5 lists the following diagnostic criteria for dissociative amnesia:
- An inability to recall important autobiographical information, usually of a traumatic or stressful nature, more severe than normal forgetfulness.
- It causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- It is not because of alcohol or substance abuse, or to a medication or a medical condition (e.g., partial complex seizures, transient global amnesia, following closed head injury/traumatic brain injury, other neurological conditions).
- It is not better explained by dissociative identity disorder, posttraumatic stress disorder, acute stress disorder, somatic symptom disorder, or major or mild neurocognitive disorder.
Treatment of Dissociative Amnesia
Patients can experience spontaneous recovery. This happens when they are removed from the stressful or threatening situation and feel safe. It could also happen when exposed to personal cues from their past.
There are no proven pharmacological treatments available. If the patient also has anxiety or depression, anti-anxiety and antidepressant medications will be useful.
The psychotherapy of dissociative amnesia involves accessing the dissociated memories. Then one works through the emotionally loaded aspects of these memories and supporting the patient through integrating these memories into consciousness.
- Cognitive-behavioral therapy: This focuses on changing harmful thinking patterns, feelings, and behaviors.
- Family therapy: This educates the family about the disorder and its causes. It also helps family members recognize the symptoms of a recurrence.
- Clinical hypnosis: Hypnosis can enable patients to reorient temporally. Therefore they achieve access to otherwise unavailable memories. This uses intense relaxation, concentration, and focused attention to achieve an altered state of consciousness (awareness). It allows people to explore thoughts, feelings, and memories they may have hidden from their conscious minds.
- Screen Technique: This helps make the traumatic memories more bearable by placing them in a broader perspective. Here the trauma victims can also identify adaptive aspects of their response to the trauma. This technique allows for the recollection of traumatic events without triggering an uncontrolled reliving of the trauma. The screen technique provides a “controlled dissociation” between the psychological and physiological aspects of memory retrieval. Individuals can be put into self-hypnosis and instructed to get their body into a state of floating comfort and safety. They can do this by imagining that they are somewhere safe and comfortable: “Imagine that you are floating in a bath, a lake, a hot tub, or just floating in space.” We remind them that no matter what they see on the screen their bodies are safe and comfortable: “Do the work on your imaginary screen, not in your body.” In this way, you can avoid the physiological reactions to working through traumatic memories, facilitating the psychotherapeutic work.