Traumatic Narrative & Memory

Cumulative developmental trauma (emotional pain experienced in response to breached expectation from ontogenetically social motivational need fulfillment) and both early and later experienced trauma disrupts memory processing and sometimes produces post-traumatic stress disordered (PTSD) symptom expression in the genetically predisposed individual with genetically predisposed vulnerability for later developing the condition. Individuals who go onto to develop PTSD symptom expression typically seek trauma avoidance coping mechanisms due to the perceived intensity of emotional pain experienced with trauma retrieval. Despite the relief with trauma avoidance, the cup runs over so to say (i.e. a response threshold or response constraint is exceeded) and produces symptoms of sleep disturbance, nightmares, abreactions (reexperiencing uncontrollable painful sensory flashbacks of the trauma as if it were happening in the present), diffuse anxiety (reminiscent of constrained fear), and depression (reminiscent of the sense of loss of integrity in response to the trauma), and unintentional identification with the trauma. Freud called the warehouse and storage for avoided memory, the unconscious, and the process mediating its storage, repression. Recent neuroscience research suggests that this memory gets trapped in brain structures relating to encoding and storage and is awaiting retrieval. However, adaptive coping mechanisms of avoidance restrict neural components of the traumatic memory and get trapped within brain structures associated with storage. In order to facilitate symptom relief, the trauma survivor will need to retrieve the trauma and all the personally meaningful emotion and cognition associated with the trauma to facilitate the extinction of chronic traumatic physiological arousal associated with the trapped PTSD memory.

Freud

Early in the twentieth century Sigmund Freud developed his psychoanalytic methodology for treating traumatic neurosis. He noted that “external excitations (also called traumas) undoubtedly provoke a very extensive disturbance in the workings of energy of the organism and will set in motion every kind of protective measure” directing the patient to seek defense and avoidance of reexperiencing the trauma’s enormity (Freud, 1922, p. 34). As time elapses, continual excitations from within due to internal binding and containment become “timeless (in quality) not arranged chronologically nor can time be applied to them.” (Freud, 1922, p. 32). Accordingly this formed the essence of his theory of the unconscious.

Freud indicated that prior to therapy the patient’s knowledge of the traumatic event is incomplete and expressed in a “highly summary form” as an incomplete trauma narrative (Breuer & Freud, 1893; Freud, 1922). The joint use of psychoanalytic free association and hypnotherapy encouraged patients to disengage defense mechanisms and attentional processes. These mechanisms had originally inhibited the spontaneous flow of episodic recall of traumatic events and the negative affect that had been attached to the trauma (Freud, 1904, 1920, 1922). He advised the practitioner to not only encourage patient trauma disclosure but also to reexperience his/her traumatic-related forgotten life during the therapy session (Freud, 1922). Accordingly, verbal disclosure transformed trauma-related action and symptom expression into words. He envisioned treatment goals as making “conscious everything that is pathologically unconscious?fill(ing) up all the gaps in the patient’s memory to remove his (or her) amnesias (for the traumatic event)” (Freud, 1917, p. 282-). This would become evident in the later development of a complete trauma description and narrative. Despite its lack of empirical testing, psychoanalytic therapy has been reported to be clinically effective though inconsistent in its effectiveness due to variability in clinical skill and practice.

Freud conceptualized that the repression of trauma memory for which there was later amnesia laid the foundation for the future development of the unconscious (Freud, 1920). In describing amnesia in this way Freud attributed unconscious processes to repression.

References

Breuer J. & Freud S. (1893). Studies on Hysteria (1893-1895). In: The standard edition of the complete psychological works of Sigmund Freud, Vol. 2-Reprinted in 1955 and translated by J. Strachey, pp. 1-18, London, Great Britain: The Hogarth Press Limited.

Freud S (1904). Freud’s psycho-analytic procedure. In: The standard edition of the complete psychological works of Sigmund Freud, Vol. 7. Reprinted in 1953 and translated by J. Strachey, pp. 249-70, London, Great Britain: The Hogarth Press Limited.

Freud S (1920). Preliminary hypotheses and technique of interpretation. In: A general introduction to psycho-analysis: a course of twenty-eight lectures delivered at the University of Vienna. Reprinted in 1935 and translated by J. Riviere, pp. 90-101, New York, New York: Liveright Publishing Corporation.

Freud S (1920). Fixation upon traumas: The unconscious. In: A general introduction to psycho-analysis: a course of twenty-eight lectures delivered at the University of Vienna. Reprinted in 1935 and translated by J. Riviere, pp. 242-252, New York, New York: Liveright Publishing Corporation.

Freud S (1922). Beyond the pleasure principle. Translated by CJ Hubback. London, Great Briton: The International Psycho-analytic Press.

Freud S (1917). Fixation to traumas-The unconscious. In: Introductory lectures on psychoanalysis-A Liveright paperback. Reprinted in 1963 and then 1977 and translated by James Strachey, pp. 273-85, New York: Norton.