Dissociative amnesia: symptoms, causes and treatment

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

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

• Related article: "The different types of amnesia (and their characteristics)"

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 appear).

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

Symptoms

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

Information that is forgotten is usually traumatic or stressful in nature. This inability to remember is too broad to be explained by ordinary or "normal" forgetting. The symptoms cause a significant discomfort in the person or interfere with the life and functioning of this.

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

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

• You may be interested: "Types of memory: how does the human brain store memories?"

Characteristics

The information that is "lost" or forgotten in dissociative amnesia is generally part of the person's conscious consciousness, that is, it is their autobiographical memory that is affected. However, even if the person cannot access such information, it can still influence behavior.

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

The 12-month prevalence of dissociative amnesia is around 1.8%; it is more common 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 (although maladaptive), to "protect" them from memories that are too traumatic or difficult to process.

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

In this way, dissociative amnesia usually caused by highly traumatic situations that the person lives and is unable to process functionally. These traumatic or stressful experiences can be experienced directly (eg sexual abuse) or can simply be witnessed.

• You may be interested: "What is trauma and how does it influence our lives?"

Types

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

1. Localized amnesia

Localized amnesia means 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 can last for hours, days, or longer. Generally the forgotten period goes from minutes to decade, but the characteristic here is that the period is clearly delimited.

2. Selective amnesia

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

3. Generalized amnesia

Here the memory impairment is much greater, and patients can lead to forgetting their own identity and life history. Some of them cannot even access the 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, people who have been sexually assaulted, and people who have experienced extreme stress or conflict.

4. Systematized amnesia

In this case the person forgets information of a specific category or nature, for example information about the sound that surrounds 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). That is, there is a retrograde (past) and anterograde (present) amnesia.

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

Treatment

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

Psychological therapy will have as one of its objectives that the person can process and understand what they experiencedTherefore, work must be done on the event and the psychological consequences that 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.

Bibliographic 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 of Psychopathology. Volume I and II. Madrid: McGraw-Hill.
• Horse (2002). Manual for the cognitive-behavioral treatment of psychological disorders. Vol. 1 and 2. Madrid. 21st century (Chapters 1-8, 16-18).