Last week I wrote about doing work with sexual trauma survivors. Today I would like to talk about doing work with trauma survivors of all types. In particular, I will focus on the issue of memory work. One of the ways that people survive traumas is to dissociate. When they have dissociated, they often will have holes in their memory. These gaps can be specific to an incident such as having a car accident. One client remembered getting in the car to go to the grocery store and waking up in the hospital several days later. She had no memory of anything in between. The client was told that she had been in an accident, had been in the hospital for several days and she had had surgery. She would be ok, but she remembered nothing after getting into her car. She does not know where the accident occurred, what happened, or anything about the trip to the hospital. In her specific case, there may be memory loss resulting from a head injury, or it may be loss from the repression of the traumatic memory. If it is the latter, there is a very good chance that when she is strong enough to “carry” the memories, they will come back to her and she will “remember.”
The selective repression of memories that are scary or severely upsetting is an extreme form of a very common defense mechanism. According to Freudians, the first defense mechanism we develop is the one called repression. Repression is actually a form of selective editing. One does not really forget something, rather your unconscious protects you from something that it feels you cannot handle by causing you to “forget” it. It is not really forgotten it is repressed, blocked or covered up. It will stay covered up until your ego knows you are capable of remembering and thereby able to handle whatever the emotional content of the memory would be.
Another example that is very common of repressing or selective editing of memories is when a client comes in and says something such as: “I cannot remember my sixth grade year at all. I know I went through the sixth grade, but all I can remember is kindergarten through fifth grade, then I remember middle school.” It is not uncommon to find people who have significant gaps in their memories that are what we call horizontal barriers. It is as if a roadblock was placed over their memories for a certain period and they had to detour around that block of time. They remember everything before and everything after, but the period of time that needs to be repressed they have no “accessible” memories.
One other extreme example of repression is the example of someone suffering from Dissociative Identity Disorder, DID. (In the old days we called it multiple personality disorder.) In this case, the repression occurs in the form of vertical divisions or barriers, meaning that is that you will have a compartmentalized identity that has its own linear memory. A “part” or an identity will keep a particular history. They will remember the sequence of events that existed on the timeline of that part. If the “part” was present when they were in the sixth grade through high school, there will be linear memories of everything that happened to that part from the sixth grade through high school. What there will not be, at least accessible to that part, are memories of what happened to the other parts. The knowledge of these different parts is vertically compartmentalized and separated from each other.
DID is an artifact that is a survival skill for the client. It is obvious to the observer that in all actuality there are not separate people who live in and share one body. This is a heuristic construct that we use to discuss and explain the process of vertical repression. Each separate identity will have its own channel, its own accessible memory, as well as, its defined personality and skill sets. It will have a role to play in the drama that is the life of the client. Part of the healing process that happens in the therapy is the invitation for the vertical compartments to take down the barrier walls and allow the memories of each subset to be accessible and included in the memory life of the whole. This is very difficult and painful work, and it takes a lot of time, care and patience, not to mention skill.
A therapist who endeavors to do this memory work with trauma survivors needs to be very careful about the process they utilize to “recover” the memories. There is such a thing as the false-memory syndrome, which is an argument made by clients that a therapist unethically implanted false memories into them, which then led them to erroneously accuse people of things. These cases have gone to court and sometimes the therapist loses the case, ending up being responsible for major financial damages, sometimes losing their license to practice. These situations happen because the therapist did not follow the correct protocols in doing the memory work.
I believe that clients will not and cannot remember something until they can afford to remember it. By that, I mean if their ego strength is strong enough for them to remember and feel whatever the pain or horror is that they have repressed, if it has the capacity at this point to survive the knowing of what happened then they will be able to remember. Until they have gotten strong enough to do so, they will be unable remember. I have seen memories recovered under hypnosis, where the consciousness is blocked, then related either through having been taped in some fashion or by the therapist telling the client what they said under hypnosis. If the client is not strong enough to remember these events, it will not be a memory for them, but a recitation of a story that may just as well have happened to someone else. There is no sense of ownership or connectedness to the memories and the client does not feel as if they experienced the events.
Many years ago, I had a friend who could not remember his sixth grade year at all. He went to a hypnotist and “recovered” his memories under hypnosis. A tape was made and I was allowed to listen to the tape. On the tape my friend told the story of being a twelve year old boy who lived in a tent with his mother and young sister during the depression. His mother worked in the fields of California as a migrant worker. The boy was assigned to stay in the tent and take care of his three year old sister. It was a horrible year with grinding discomfort and poverty. At some point during the year rats came in while he and his young sister were sleeping and bit his sister, disfiguring her enough that she was put in the hospital. His mother lost her job and the children were put in an orphanage because the mother could not take care of them. This situation lasted for almost a year until extended family in Arkansas took all three of them in and they were back together as a family. My friend remembers none of this. He hears the story told in his own voice in extreme detail, but feels as if it is a movie, or a story he has read. It is not his story. Yet the information in the story makes a lot of sense in terms of the history of his life. He does not challenge that it really happened that way or that it affected him in his life. He simply says, “I don’t remember it.” And he doesn’t! If I were working with him in therapy as a client, I would work to get his ego strong enough to enable him to “remember” and take ownership of these events by experiencing the emotions that are associated with them. At the time that the tape was made he was not emotionally strong enough to feel those feelings, so he continued to block them through the defense of repression.
As a therapist, I invite my clients to remember their past. I work on their sense of capacity and their sense of safety. I teach them something that is called a fractionated abreaction. I do not want them to re-experience the trauma in its entirety. I want them to experience just enough to be in touch with their fears and feelings to know what they are, then to come back to the present and process what they know and remember. I do not want them to be re-abused by re-experiencing the entire scope of the event and replaying it in their minds. That is not necessary, and could be considered abusive.
In order to do this, I work with them to find a code word that will break through their “remembering” and call them back to the present. When they spontaneously go “back” and begin to remember and re-experience the horror of the trauma, I use the word to ground them and return them to the present. Then we talk about what they felt and what they remembered. These memories are owned by them because they actually had feelings about them. They are not just a recitation of the facts from hypnotized data mining of memories.
I never suggest memories and I never say specific things such as, “Let’s go back to the time when you were ten and your grandfather abused you.” I say things such as, “I want you to spend a little time drifting. Just quietly let your mind roam back in time to any place you know you need to go, to remember whatever you need to remember for us to talk about today.” Wherever they go and whatever they remember is entirely their own artifact and not one suggested by me. I am often surprised by what they choose, but always follow their lead. When or if they resist at some point in the “remembering,” I invite them to stop. They can only go at their own speed. These memories are extremely protected and resistant to recovery. They only way to get them out is for the client to safely have the power to visit them and experience them as the ego of the client heals and gets stronger.
The therapist does not guide it, direct it or control it. If you learn how to facilitate the conversation and empower the client, you can help them and protect yourself from the issues of the false memory syndrome. Memory work is an important part of the healing process for the damaged client. Your job is to create a safe, grounded environment that will facilitate the client’s ability to go back and remember. Your job is not to be the director of the play, or a fellow actor. As a therapist your job is to help the client recover whatever they need in order to live their lives today, in a way that is not dysfunctional and toxic. You have to be able to go with them wherever they need to go, but you must not send them or take them there. Believe in the process and trust the strength of the client.
You can’t remember it until you can afford to! If memories start to flood into consciousness it will be because your ego is now strong enough to deal with the feelings those memories will trigger. You will be strong enough to handle them, however upsetting and painful they may be. They cannot and will not come until you have the ability to process them and heal from them. This is a painful but safe experience, you will not be destroyed by your memories, you will ne made stronger because now, you will “know” what you need to know.