Memory functionality in those with Dissociative Identity Disorder (DID) is probably one of the most controversial part of the diagnosis. According to the DSM-IV-TR, in order to meet the diagnostic criteria for DID, a person must experience:
Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness.
(American Psychological Association, 2000).
The wording for this criteria mean that it is up to the diagnosing professional what is to be considered “extensive”.
In our experience this has meant that a majority of our childhood cannot be remembered. There are occasional snippets, but much of our childhood and teen years, up until the age of 16 are predominantly made up of family stories and certificates. We get glimpses or snatches of our past, but much of it is a blur of pictures, smells or just is “lost”. It’s a very odd feeling to have little knowledge of your own history. What memories we do have of these years are lumped in the ages 7-9, this is not so much because these were the ages where we have clarity in our memory; but rather because the two alters who were most present in our younger years are this age. Because they have little concept of time, everything happened to them and they are 7 and 8, so it must have happened to the body when it was 7 and 8.
This has confused many people assessing our mental health as we are able to mention lots of things that happened in those years. What they often neglect to ask is about the school we were attending at the time, or whether we wore a school uniform to place the experience into a context. So our 8 year old will say that “experience X” happened when we were 8. But she also knows that we wore a school uniform at the time, meaning that it must have occurred after the body turned 13 as this was when we had to wear uniforms for school.
This concept raises the specter of False Memory Syndrome (FMS) and inaccuracies with recovered memories. If we can’t remember most of our past, how can we be sure that any abuse we talk about happened?
In What is DID? I mentioned the opinion that DID is on the Post Traumatic Stress Disorder (PTSD) continuum. Note that the major aspects of PTSD are re-experiencing the event and avoidance of the stimuli; with amnesia considered one possible way to avoid the stimuli. According to Leskin, Kaloupek, and Keane (as cited in Gleaves & Williams, 2005), there is a struggle between re-experiencing and avoidance. But it does show that it is possible to experience amnesia for traumatic events – for example in documented events such as the Holocaust (van der Hart & Brom, 1999).
An important distinction in this amnesia is that while the autobiographical memory might be affected by the trauma; the feelings, habits and sensory memories will remain (Gleaves & Williams, 2005). Again, to bring this to our experience, one of our triggers is the smell of rubber. We would avoid the smell of rubber without any realisation as to why. We knew something bad had happened in a school playground, and it was only when more of the autobiographical memory was accessed that we realised that we linked the smell of the rubber to the tractor tyres that we were on. So from this event our sensory memory remained intact, but the autobiographical memory was partially lost.
So if DID is further along the PTSD spectrum, surely this would mean that the memory issues surrounding events would be more advanced. Whether this advancement would also impact on the sensory memory is not clear – again in our case, we have some sensory triggers which we cannot tie to any event. So it would seem as if there are more gaps in autobiographical memories as the trauma covers more events over a long period of time.
So is this recovered memory accurate? Studies cited in Gleaves & Williams (2005), state that the central themes of recovered memories are no more or less accurate than continuous memories of abuse. In the instance that is described above, one of the perpetrators was jailed two years ago for historical sexual abuse to other girls – so women independent of us reported this man as being an child abuser while he was in his early to mid teens. We could have all imagined it, but the chances of this same man being nominated as a random target by women with no contact with each other would be fairly long odds.
The other controversy associated with FMS is that DID is an iatrogenic occurance cause by over zealous therapists. In some respects this controversy has had the benefit of causing a growing number of studies which look at the DID diagnosis from a variety of viewpoints. Gleaves & Williams (2005), accept that poor therapy techniques can cause someone with DID to deteriorate, but this is not iatrogenesis. It indicates that there needs to be training for the therapists in the areas of healing from trauma.
I’ll expand on some of these ideas later in another posting on DID and time loss and co-consciousness.
American Psychological Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR (4th ed.). Washington: Author.
Gleaves, D., & Williams, T. (2005). Critical questions: Trauma, memory, and dissociation. Psychiatric Annals, 35(8), 648-654. Retrieved January 11, 2009, from Health Source: Nursing/Academic Edition database.
van der Hart, O., & Brom, D. (1999). When the victim forgets: Trauma-induced amnesia and its assessment in Holocaust Survivors. In A. Shalev, R. Yehuda, & A. McFarlane (Eds.), International handbook of human response to trauma (pp. 233-248). New York: Plenum Press. Retrieved January 13, 2009 from http://www.onnovdhart.nl/articles/Whenthevictimforgets280405.pdf