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.People who areunable to remember anything, including who they are, are said to suffer fromgeneralized amnesia.Generalized amnesia may be lifelong or may extend from aperiod in the more recent past, such as 6 months or a year previously.The Woman Who Lost Her MemorySeveral years ago a woman in her early 50s brought her daughter to one of ourclinics because of the girl s refusal to attend school and other severely disruptivebehavior.The father, who refused to come to the session, was quarrelsome, a heavydrinker, and, on occasion, abusive.The girl s brother, now in his mid-20s, lived athome and was a burden on the family.Several times a week a major battle erupted,complete with shouting, pushing, and shoving, as each member of the familyblamed the others for all their problems.The mother, a strong woman, was clearlythe peacemaker responsible for holding the family together.Approximately every 6months, usually after a family battle, the mother totally lost her memory and thefamily had her admitted to the hospital.After a few days away from the turmoil, themother regained her memory and went home, only to repeat the cycle in the comingmonths.Although we did not treat this family (they lived too far away), the situationresolved itself when the children moved away and the stress decreased. Durand 5-58Far more common than general amnesia is localized, or selective amnesia, afailure to recall specific events, usually traumatic, that occur during a specific period.Dissociative amnesia is common during war (Cardeña & Gleaves, 2003; Loewenstein,1991; Spiegel & Cardeña, 1991).Sackeim and Devanand (1991) describe theinteresting case of a woman whose father had deserted her when she was young.Shehad also been forced to have an abortion at the age of 14.Years later, she came fortreatment for frequent headaches.In therapy she reported early events (e.g., theabortion) rather matter of factly; but under hypnosis she would relive, with intenseemotion, the early abortion and remember that subsequently she was raped by theabortionist.She also had images of her father attending a funeral for her aunt, one ofthe few times she ever saw him.Upon awakening from the hypnotic state she had nomemory of emotionally reexperiencing these events, and she wondered why she hadbeen crying.In this casethe woman did not have amnesia for the events themselves butrather for her intense emotional reactions to the events.Absence of the subjectiveexperience of emotion that is often present in depersonalization disorder andconfirmed by brain-imaging studies (Phillips et al., 2001) becomes prominent here.Inmost cases of dissociative amnesia, the forgetting is selective for traumatic events ormemories rather than generalized.depersonalization disorder Dissociative disorder in which feelings ofdepersonalization are so severe they dominate the client s life and prevent normalfunctioning.dissociative amnesia Dissociative disorder featuring the inability to recall personalinformation, usually of a stressful or traumatic nature.generalized amnesia Condition in which the person loses memory of all personalinformation, including his or her own identity. Durand 5-59localized amnesia Memory loss limited to specific times and events, particularlytraumatic events.Also known as selective amnesia.Dissociative FugueA related disorder is referred to as dissociative fugue, with fugue literally meaning flight (fugitive is from the same root).In these curious cases, memory loss revolvesaround a specific incident an unexpected trip (or trips).Mostly, individuals just takeoff and later find themselves in a new place, unable to remember why or how they gotthere.Usually they have left behind an intolerable situation.During these trips aperson sometimes assumes a new identity or at least becomes confused about the oldidentity.Consider the case of the misbehaving sheriff.The Misbehaving SheriffAktar and Brenner (1979) describe a 46-year-old sheriff who reported at least threeepisodes of dissociative fugue.On each occasion he found himself as far as 200miles from his home.When he came to he immediately called his wife, but he wasnever able to completely recall what he did while he was away, sometimes forseveral days.During treatment the sheriff remembered who he was during thesetrips.Despite his occupation, he became the outlaw type he had always secretlyadmired.He adopted an alias, drank heavily, mingled with a rough crowd, and wentto brothels and wild parties.Dissociative amnesia and fugue states seldom appear before adolescence andusually occur in adulthood.It is rare for these states to appear for the first time afteran individual reaches the age of 50 (Sackeim & Devanand, 1991).However, oncethey do appear, they may continue well into old age. Durand 5-60Disorder Criteria SummaryDissociative AmnesiaFeatures of dissociative amnesia include:" One or more episodes of inability to recall important personal information,usually of a traumatic or stressful nature, that is too extensive to be explained asordinary forgetfulness" Episodes are not related to a medical condition, psychological effects of asubstance (e.g., a drug of abuse), or a separate psychological disorder" Inability to recall causes clinically significant distress or impairment infunctioningSource: Based on DSM-IV-TR.Used with permission from the Diagnostic andStatistical Manual of Mental Disorders, Fourth Edition, Text Revision.Copyright2000.American Psychiatric Association.[UNF.p
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