Dissociative amnesia: symptoms, causes and treatment

This type of dissociative disorder is linked to traumatic and highly stressful experiences.

Dissociative amnesia is included in dissociative disorders.. It involves not being able to remember relevant personal information, such as an event or one's own identity. It usually appears as a consequence of experiencing a highly traumatic or stressful event.

There are five different types of dissociative amnesia, depending on its manifestation. In this article we will know the characteristics of this disorder, its symptoms, causes and possible treatments.

What is dissociative amnesia?

Dissociative amnesia is a type of dissociative disorder that appears as such in the DSM (Diagnostic Manual of Mental Disorders). Only one episode of amnesia is necessary to diagnose it (although more may occur).

Dissociative disorders encompass a series of psychological disturbances that involve a disconnection or rupture in the processes of memory, identity, perception and/or consciousness.. That is, they involve a lack of continuity in any (or between some) of these aspects or processes of the person.

Symptoms

The main symptom of dissociative amnesia is A significant impairment in the ability to recall important personal information.. One or more episodes may occur, although only one is necessary to diagnose dissociative amnesia.

Usually the information that is forgotten is of a traumatic or stressful nature. This inability to remember is too extensive to be explained by ordinary or "normal" forgetting. The symptoms cause significant discomfort in the person or interfere with the person's life and functioning.

In addition, in order to make the diagnosis, this alteration that occurs in the ability to remember, does not occur exclusively within another mental disorder, such as an identity disorder.such as dissociative identity disorder, dissociative fugues, post-traumatic stress disorder (PTSD), somatization disorder, etc.

Amnesia is also not produced by the direct effects of a psychoactive substance (drug) or a drug, nor is it explained by a medical or neurological disease.

Features

The information that is "lost" or forgotten in dissociative amnesia is usually part of the person's conscious awareness, i.e. it is his or her autobiographical memory that is affected. However, even if the person cannot access such information, it may still influence behavior.

For example, consider a woman with dissociative amnesia who has been raped in an elevator, and who cannot get back into an elevator even though she is unable to remember the event.

The 12-month prevalence of dissociative amnesia is around 1.8%; it is more frequent in women (2.6%) compared to men (1%).

Causes

Dissociative disorders generally originate as a reaction to an extremely stressful or traumatic situation (a trauma); they arise as a defense mechanism for the person (albeit maladaptive), to "protect" him/her from memories that are too traumatic or difficult to process.

They are reactive responses to external situations, but taken to the extreme and dysfunctional.Thus, when these responses become disorders, they logically become maladaptive responses.

Thus, dissociative amnesia is usually caused by highly traumatic usually occurs due to highly traumatic situations that the person lives through and is unable to process in a functional way. These traumatic or stressful experiences may be suffered directly (e.g. sexual abuse) or may simply be witnessed.

Types

Dissociative amnesia can be of five types: localized, selective, generalized, systemized and continuous.

1. Localized amnesia

Localized amnesia involves not being able to remember a specific event or a specific period of time. They are specific gaps in memory, and are related to trauma or stressors.. In this case the amnesia may last for hours, days or longer. Generally the forgotten period ranges from minutes to decades, but the characteristic here is that the period is clearly delimited.

2. Selective amnesia

This second type of dissociative amnesia involves the entails forgetting only certain events (or specific parts of them) during (or specific parts of them) during a certain period of time. It may appear together with the previous one.

3. Generalized amnesia

Here the memory impairment is much greater, and patients may lead to forget their own identity and history. patients may lead to forgetting their own identity and life history.. Some of them even cannot access learned skills, and even lose the information they have about the world. Its onset is sudden.

It is less frequent than the previous ones, and more common among war veterans, sexually assaulted people and people who have lived through extreme stress or conflict.

4. Systemized amnesia

In this case the person forgets information of a specific category or nature, e.g. information about the sound surrounding an event, about a specific person, visual elements, smells, etc.for example, information about the sound surrounding an event, about a specific person, visual elements, smells, etc.

5. Continuous amnesia

In continuous dissociative amnesia, people forget information from a specific point in time to the present (encompassing the present). (encompassing the present). That is, there is retrograde (past) and anterograde (present) amnesia.

In this case, most patients are aware (or partly aware) of their memory gaps.

Treatment

The treatment of dissociative amnesia includes psychotherapy and some types of drugs (antidepressants, anxiolytics), the latter being complementary to psychological intervention (ideally, they should be used in this way to facilitate psychotherapeutic work, so that the patient is calmer and can access it).

The psychological therapy will have as one of its objectives that the person can process and understand what he/she lived through, so it will have to work on the event and the psychological sequels it is producing.For this reason, work should be done on the event and the psychological sequelae it is producing.

People with dissociative amnesia may appear confused and distressed; others, on the other hand, may be indifferent. It will be essential to work from empathy and flexibility.

Bibliographical references:

• American Psychiatric Association -APA- (2014). DSM-5. Diagnostic and statistical manual of mental disorders. Madrid: Panamericana.
• Belloch, A.; Sandín, B. and Ramos, F. (2010). Manual de Psicopatología. Volume I and II. Madrid: McGraw-Hill.
• Caballo (2002). Manual for the cognitive-behavioral treatment of psychological disorders. Vol. 1 and 2. Siglo XXI (Chapters 1-8, 16-18).