Memory, Suggestibility, and Dissociative Disorders

  • Concussion and Memory Assessment:
    • Speaker self-assessed for concussion after a fall (serial sevens, memory checks, Glasgow Coma Scale 1515).
    • Stressed importance of EMT pupillary response checks, noting initial pain delay due to adrenaline.
  • Memory and Self-Identity Formation:
    • Memory is vital for learning and identity; autobiographical memory develops around ages 33 to 3.53.5.
    • "Childhood amnesia" occurs before this due to a shift in memory storage systems involving words and abstract thought.
  • Suggestibility and False Memories:
    • Individuals are highly suggestible regarding early memories, often remembering being told about events (source information error).
    • Hypnosis can create elaborate false memories (e.g., Bridey Murphy case, traced to forgotten stories).
  • Dissociative Disorders as a Protective Mechanism:
    • Theory: Dissociative disorders are self-hypnosis, where trauma leads children (due to neuroplasticity) to "escape inside," creating psychological compartments to wall off experiences (like a ship's compartments).
  • Types of Dissociative Disorders:
    • Dissociative Amnesia: Most common; extensive memory loss not due to physical factors (e.g., brain injury, electroconvulsive therapy or ECT). Psychologically driven, often without emotional turmoil.
    • Subtypes: Localized (specific time), Selective (aspects within a time), Generalized (long periods, identity loss, retrograde), Continuous (rare, anterograde-like, psychologically driven).
    • Treatment: Address psychological factors; changing environment can be more effective than trying to change the person.
    • Dissociative Identity Disorder (DID): Formerly MPD; complete dissociation into distinct personalities (alters) with varying mutual awareness.
    • Depersonalization/Derealization Disorder:
    • Depersonalization: Feeling detached from oneself.
    • Derealization: World seems unreal or wrong (e.g., people appear like robots).
    • Linked to emotional uncoupling from memory content; delusions can make sense of these experiences. Removing delusions without addressing anxiety is detrimental.
    • Dissociative Fugue: Severe dissociative amnesia where individuals forget identity/past and physically flee, often establishing new lives. Remits spontaneously, lasting days to years.
    • Preceded by depression; an unconscious escape from overwhelming stressors. Multiple episodes possible.
    • Prevention: Recognize warning signs (emotional shifts, stress) and intervene by addressing stressors (e.g., work-life balance) as a medical condition.