Sunday, June 24, 2012

Waging Ghostly War on a National Level: Neuralinhibitions

“Neural Mechanisms in Dissociative Amnesia for Childhood Abuse: Relevance to the Current Controversy Surrounding the ‘False Memory Debate,’” a 1996 paper by Drs. J. Douglas Bremmer, John Krystal, Dennis Charney, and Steven Southwick, examined a number of studies that strongly indicated the presence of neurological conditions that affect the brain’s normal processes of encoding and retrieval under periods of high stress (or as some researchers refer to it, “high arousal”).* In turn, these events “modulate” or alter the usual ways in which the brain encodes and stores memory. After briefly citing the history of dissociation as a psychological/psychiatric construct, the authors propose that advancements in neuroscience offered new insights not just to the fact that dissociation occurs, but how it occurs. This would have not only a direct bearing on the issue of posttraumatic stress disorder (PTSD), but on the issue of childhood sexual abuse.

The authors stipulate early on that some childhood sexual abuse victims really cannot recall the abuse, although it’s often documented in police investigations and hospital records. The real disagreement was whether this is a case of simply forgetting or permanently disregarding a memory, or whether the memory still lies dormant in the brain: They write:
The fact that many individuals forget episodes of childhood abuse is well established. As many as 38% of trauma victims who experience abuse severe enough to result in a visit to a hospital emergency room had no memory of the event 20 or more years later....Some investigators have explained the loss of memory of abuse as secondary to ‘repression’ or dissociative amnesia. They maintain that memories of abuse may not be available to consciousness for many years, or perhaps even the individual’s lifetime....The opposite viewpoint holds that the loss of memories of abuse is a process of ‘normal forgetting.’...These authors argue that there is a popular misconception that forgotten memories exist somewhere in the brain and are only awaiting the proper stimulus or means to bring them to consciousness.
The authors then establish some points about how memory normally operates. They define memory retrieval as the process of taking a memory from storage in to conscious forethought. If you can easily recall the memory datum from storage to the forefront of your consciousness, the authors would call that “explicit memory.” This is what you exhibit when you play trivia, fill out an application, or reminisce with an old friend about the good times.

Some memories, however, don’t lend themselves to conscious recall, but are still quite evident. Researchers call these “implicit memories.” Oftentimes they “embed” themselves in skill sets. For example, if you’re chopping vegetables, you don’t really have to bring the memory of how to do that to the forefront of your conscious mind in order to get the job done. Implicit memory also occurs when emotions become associated with explicit memories of important events. If you watch interview shows, for example, then you well know that respondents who are reciting the particulars of an event will often exhibit strong emotion (e.g., they’ll break down and cry if the circumstances or consequences are horrific), even if the events that they are bringing to conscious memory happened fifty years in the past. In popular discourse, we call this “reliving the moment.” Bremmer et al would describe this as an association between an implicit memory (the horror, the shock, the betrayal, etc.) and an explicit memory (the sequence of actions).

The authors also address the issue of memory “integrity” or accuracy, and the ability of investigators or therapists to implant false memories into subjects. Reviewing studies analogous to “The War of the Ghosts” example and Lost in a Shopping Mall, they acknowledge that the findings “...led to the conclusion by some authors that misleading information ‘overwrites,’ or replaces, the original memory trace.”** On the other hand, they noted the belief among other researchers that “...if the subjects remember the original information [or perhaps never noticed it the first time around], they may make a guess based on the recall of the misleading information.

Between these two extremes (and I use the term loosely), Bremmer et al advance their own position, which is this: the studies, criticisms and arguments on both side are probably irrelevant to the issue of childhood sexual abuse. Why? Because this line of inquiry only examines normal memories under normal conditions and circumstances. Memories originating in moments of stress–especially stress at the level of trauma–are encoded, stored and processed differently from normal memory.

Figure 1. Diagram of a human brain

Figure 2. Another diagram of a human brain

Figure 3. Still yet another diagram of a human brain***

The authors explain that memories are initially located in the part of the brain known as the ‘hippocampus.’ After a period of time, say several weeks, the storage gets, well, sort of outsourced to other areas of the brain, quite often the various cortexes (or corticies). Some forms of memory have a tendency to cluster in a specific area. For example, visual memory could head for the occipital cortex, while tactile memories (which I seem to be experiencing a lot of, lately) could set up shop in the sensory cortex. Here, Bremmer et al suggest that the hippocampus serves as a node, of sorts, bringing together all these memories from their storage areas, located generally in the neocortex, during the time of explicit memory recall.

Central to the discussion here is the area of the brain known as the ‘amygdala,’ which the authors characterize as “an important mediator of emotional memory.” As an example, they mention the startle response–that thing you do when someone sneaks up behind you and says “Boo!” In their words, this represents, “...a primitive reflex that is part of the animal’s response to threat.” Organisms that suffer lesions or other physical damage to that part of the brain can completely stifle the startle response. The authors thus contend, “The amygdala integrates information that is necessary for the proper execution of the stress response, including (internal) emotion and information from the external environment.”

Part of the brain’s stress response includes the substantial release of neuropeptides and neurotransmitters. A number of studies compellingly show that these biochemicals “richly innervate,” or highly stimulate, the hippocampus and the cortexes involved with memory encoding, storage and retrieval. An abundance of these chemicals can enhance some forms of memory, but only at certain levels. For example, epinephrine boosts the avoidance response, which is brought about because of unpleasant emotional memories. Researchers in one experiment shocked labs rats as they crossed a specific threshold in a maze. That made them really skittish about crossing another threshold. When scientists removed the adrenal medulla, the place where epinephrine is typically stored, they could shock the rats all they wanted. The rodents would still not exhibit fear from the memory, or more importantly, avoid another threshold.

Adrenocorticotropic hormone (ACTH) and glucocorticoids can both enhance memory, but only at low levels. A lot of either or both has the opposite effect. The authors also cite studies that show a definite correlation between high stress and physical damage to two specific regions within the hippocampus. Other studies suggest that the flood of glucocorticoids produced during the stress response damage the hippocampus.

Because of the pivotal role of the hippocampus in memory, abnormalities within it could explain why some people have access to traumatic memories, and others don’t. In 1995, Bremmer et al participated in a study in which they compared the hippocampal region of twenty-six Vietnam vets suffering from PTSD to a control group of twenty-two individuals who had never suffered from posttraumatic stress.**** The hippocampuses of the veteran subjects were, on average, 8% smaller in comparison to the rest of their brains compared to the control group. Among those same vets, they found “Lower IQ scores in combat veterans with PTSD than in comparison subjects.”

That makes for some interesting questions. For example, one could guess that damage to the hippocampus would make it more difficult to store memories of learned tasks initially, and coordinate what memory is there. Could this mean that people with lower IQs have a greater risk for PTSD because they have a relatively smaller hippocampus? Could it be that the stress response actually created the PTSD by damaging that area of the brain in the first place?

Bremmer et al imply these questions, but provide no answers for them. They do point out, however, that people who suffer from PTSD have greater difficulty in learning and in explicit memory recall during their lives. They also exhibit other behaviors that directly tie into the issue of childhood sexual abuse.

*This paper appeared in the American Journal of Psychiatry, vol. 153, n. 7 (July 1996 Festschrift Supplement). The affiliated institutions: Yale University, School of Medicine; the Division of Clinical Neurosciences, National Center for Posttraumatic Stress Disorder; and the Psychiatry Services of the West Haven, CT Veterans Administration.

**In one study, for example, children who watched an episode of The Six Million Dollar Man, in which the title character became so weak that he couldn’t lift a can of paint, remember him lifting the paint can three weeks later. Like the “War of the Ghosts” stories, the memory adapted to personal or cultural expectations during the recall process. In another study cited here, respondents witnessed a film in which researchers staged an automobile accident. Many of the subjects recalled seeing broken glass, when there was none. In this case, the researchers deliberately misled the subjects by using such words as “smash” as opposed to “collided,” or “made contact with,” and so on.

***I could not find a single diagram that shows all of the areas of the brain discussed here, but I thought between several images that should give a better idea of where these areas are located.

****Bremmer, J. Douglas, Penny Randall, Tammy Scott, Richard Bronen, John Seibyl, Steven Southwick, Richard Delaney, Gregory McCarthy, Dennis Charney and Robert Innis. 1995. ”MRI-Based Measurement of Hippocampal Volume in Patients with Combat-Related Posttraumatic Stress Disorder.” American Journal of Psychiatry, vol. 152, n.7 (July).

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Wednesday, June 13, 2012

Waging Ghostly War on a National Level: A Study in Dissociation

Experimental psychology has much to offer the current debate about childhood abuse.  However, laboratory scientists, with their enormous cognitive authority to define reality for the rest of the population, must be especially conservative when arguing that laboratory results generalize to contested memories of abuse.  Researchers must make an effort to untangle the appropriate from inappropriate application of research results to this debate.--Dr. Jennifer Freyd, “Science in the Memory Debate” (Ethics and Behavior, vol. 8, no. 2, 1998).
In the above paper, Dr. Freyd indicated that one of the main problems in “The Memory Debate” is the dismissal of scientific methodology and logic in favor of passion, bias, and Scientificism.

‘Scientificism’ is a word I made up many years ago, and have never used it until now.  It came to me when, after listening to a pro-atheist show on my favorite radio station, but as a, by now, veteran blogger I kept noticing the same thing.  Often people invoke science as the reason for why they believe some things are true, but not others (e.g., evolution vs. intelligent design).  But in conversing with them, or reading what they write, you will find that their understanding of scientific knowledge, principles, methods and even ethics are shockingly limited.
In other words, their belief in science does not come about because of a knowledge of scientific protocols or methodology, or because of what it can actually tell us (or what it can’t, for that matter).  Their beliefs tend to be substantially paralogical, or extrarational; or in short, articles of faith.  Thus, it’s not very different in that regards to any other religion: hence, Scientificism.

Dr. Freyd contended that the research carried out by the likes of Drs. Charles Brainerd, Valerie Reyna, and Elizabeth Loftus are important, and can have some bearing on the discussion.  At the same time, she cautioned that this work is hardly definitive when discussing the role trauma plays in memory encoding, memory retention and memory availability.  Because of their extensive PR efforts, the FMS has managed to position such research as Lost in a Shopping Mall at the center of the contested memory debate.  It should occupy a space more to the periphery.

Worse, public perception of False Memory Syndrome has often depended more upon the reputation of the scientists supporting it than on the actual science necessary to establish it.  If people are unaware of scientific methodology, or if they’re not confident of their scientific knowledge, they could very well put their faith in the scientist that seems more authoritative.  The public decision is thus not subject to logic or reason as it is a belief, or an expectation of what scientists should do or be.

This, in turn, has the possibility of misleading the public.  As Dr. Freyd wrote:
Because the stakes in a contested memory dispute are so great at the individual and societal level, there is often a tremendous struggle for the authority to define reality....To argue a position about the scientific status of memory (or to claim a scientist or science supports one’s own viewpoint) may give a kind of authority and legitimacy that is then used to attempt to win the underlying dispute about a particular abuse allegation....

The state of the science is often not presented clearly or accurately.  Currently, known facts about memory are often misrepresented, results are often generalized inappropriately, and conceptual issues are often tangled.  For instance, there is no research to date documenting a ‘false memory syndrome’ (FMS) despite the widespread promulgation of this term. [emphasis original].
As with faith, many of the findings about FMS become prone to generalization, and then over-generalization. As Dr. Freyd pointed out, one has to question what forgetting or interjecting words in a list–something that constitutes a brief, passing moment in the subject’s life with little if any consequence–has to do with the delayed recall of a memory of something that affected them greatly, most likely over far longer periods of time. 

Dr. Freyd then goes on to cite a number of studies that clarify issues of memory accuracy and memory “persistence.”  From our “War of the Ghosts” example, we can clearly see that memory normally includes accurate and inaccurate information.  On a commonsense level, we often find that when reviewing a shared experience, the parties involved often disagree about the minor points of the event; and sometimes they disagree on a major point. 

What really throws us a curve is the thought that memories might not be available.  It’s not that we have forgotten (or if you’re into psychobabble, ‘repressed') the event.  It’s just that we don’t have access to the memory on a continuous basis.  Dr Freyd calls the degree to which we have access to these memories ‘persistence.’  Other researchers refer to this phenomenon as ‘implicit memory.’

In an earlier post, I quoted Drs. Kenneth Pope and Laura Brown, saying:
It continues to be unclear if the protocol of any research purporting to validate the FMS diagnosis in large numbers of persons used any criterion other than the decision-rule that all recovered memories of abuse are inherently false.  Statements by some FMSF proponents have seemed to characterize recovered memories of trauma as objectively false per se.  FMSF Scientific and Professional Advisory Board member Harrison Pope and his colleague James Hudson….emphasized that ’[t]raumatic experiences are memorable’…; asserted that there has never been a confirmed case of ’noncontrived amnesia among neurologically intact individuals over the age of 6 who experienced events sufficiently traumatic that no one would be expected to simply forget them’…; and asserted that trauma survivors in scientifically valid studies unanimously remembered the events….’:  Founding FMSF Scientific and Professional Advisory Board members Hollida Wakefield and Ralph Underwager…wrote, 'People who undergo severe trauma remember it….' Martin Gardner…asserted that ’[b]etter-trained, older psychiatrists do not believe that childhood memories of trauma can be repressed for any length of time, except in rare cases of actual brain damage….And there is abundant evidence that totally false memories are easily aroused in the mind of a suggestible patient….’  FMSF…itself published the claim: ‘Psychiatrists advising the Foundation members seem to be unanimous in the belief that memories of such atrocities cannot be repressed.  Horrible incidents of childhood are remembered…..’”
The experts cited in this passage hammered home the notion that we cannot forget traumatic events, unless there is some appreciable neurological damage. Taken extremely literally, that seems to be true.  I cannot deny these sentiments, anymore than I can deny being a practicing homo sapiens, matriculating in college, or participating in thespian events in wicked New York City.

So, despite their accuracy, these statements are quite misleading. 

The term ‘recovered memory’ is also misleading, and this often has led the public to confuse what’s involved.  The memory was never lost, according to the mainstream researchers in this field.  Rather, they’re implicit.  Or in other words, they're not available for substantial periods of one’s life.  In terms of accuracy, they are as true or false as any other type of memory.  What causes us to become aware of the implicit memory (i.e., when implicit memory becomes explicit, or at the forefront of our conscious thinking) might be events, situations or stimuli that we might not expect to encounter.

Yet a number of studies compellingly show that people do have latent memory awareness of traumatic events.  Dr. Freyd mentions a number here, and I will too in a future post.  For now, I’ll state that it does happen.  Later, I’ll review a number of studies that show us, to some degree, why it happens.

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Tuesday, June 05, 2012

Waging Ghostly War on a National Level: I Recant

My thanks to our friend Ray for the link and the suggestion.
4.  If the experiment is assumed for heuristic reasons to demonstrate that an older family member can extensively rewrite a younger relative’s memory in regard to a trauma at which the older relative was present, why have FMS proponents presented this research as applying to the dynamics of therapy…but not to the dynamics of families, particularly those in which parents or other relatives may be exerting pressure on an adult to retract reports of delayed recall?–Dr. Kenneth Pope and Dr. Laura Brown, Recovered Memories of Abuse.
The Lost in a Shopping Mall study based the validity of perceived experience on the recollections of family members. The researchers obviously realized that family members can have just as much or far more influence over our thoughts and actions than therapists. Our families often shape our political and spiritual beliefs. Even if we disregard them later, we do so only after compelling cognitive dissonance leads us to think something else.

Then too, as children, and later as adults, our families offer us various forms of support, from financial to emotional. Getting cut off from one’s family would be, in and of itself, traumatic for most of us. Even if the separation is temporary and not due to malice (e.g., moving to another city for career reasons), it still serves as a stressor.

If, as the Lost in a Shopping Mall study contends, family members can induce false memories, then it would stand to reason that the accused could still overwrite the accuser's belief--a prospect that FMS proponents do not appear to address. Drs. Pope and Brown consequently consider this a possible explanation for some former claimants to recant their chargers.

Most people who have experienced delayed recall of childhood sexual abuse will tell you that the experience can have a devastating effect on family life. Both accused parents and claimants frequently complain about the separation from their loved ones, the divisions between factions, the mistrust, the animosity and so forth. In a essay dated 10 September 2010, recanter Meredith Maran characterized the ordeal as "The Lie that Tore My Family Apart." In her 2010 autobiography, My Lie: A Story of True False Memory, she related how the accusation estranged her from her father for eight years. She talked about her desire for "redemption" (her word) from her father when he came down with Alzheimer’s.

In deference to family peace, or in effort to repair relations torn asunder, one would have to see the pressures weighing on incest claimants to recant their stories. One would also have to consider this pressure a possible factor in the accused coming forward to corroborate stories of abuse, especially if the statute of limitations makes prosecution impossible, and the accuser agreed beforehand to not seek civil damages. That’s not to say that either the recanter or confessor are lying or relaying inaccurate information. The problem is that we don’t have strong evidence that memory itself played a role in these actions, as opposed to the need for reconciliation.

In Maran’s case, that reconciliation came about at the onset of her father’s illness. Although she repeatedly referred to false memories in her interviews and in My Lie, she gives us conflicting information as to whether her original accusations stemmed from memory, or from a tenuous belief originating in the troubling aspects of the relationship to her father, her ideological leanings, her research and work, or a combination of all of the above.

In a Salon interview posted 20 September 2010, Maran explained the genesis of her initial accusations. A journalist, she had covered a number of stories, during the late-1980s, of unquestionable childhood sexual abuse. She described her relationship to her father as "contentious" for many years. This led her to believe that she, like the subjects of her articles, had to have been molested as well:
In the years leading up to that mass panic, I was working as a feminist journalist, writing exposés of child sexual abuse, trying to convince the world that incest was more than a one-in-a-million occurrence. In the process, I convinced myself that my father had molested me. After five years of incest nightmares and incest workshops and incest therapy, I accused my father, estranging myself and my sons from him for the next eight years....

It really was a gradual thing. I don’t think there ever was a time when I would have bet a hot fudge sundae on it. I remember telling my brother, 'I think, maybe, this happened.' And, of course, the statement of accusation is all it takes to put the wheels in motion. Either legally or in your family. One thing I’ve learned is the relevance of the phrase 'the perfect storm.' Not only for me, but for a lot of women I know who made these false accusations, it was very much a social phenomenon. Metaphorically, everything we were saying was true. But there was a confusion between a metaphor and a fact. And it was a highly relevant difference.
Some proponents of FMS have characterized statements made by comedienne-turned-farmer Roseanne, during a February 2011 broadcast of The Oprah Winfrey Show, as a recantation. In 1991, her then-husband, fellow comedian Tom Arnold, candidly told her of his own childhood sexual abuse, an experience he never dissociated. This triggered memories of her own sexual abuse. Inspired by the recent disclosure of incest made by former beauty queen Marilyn van Derber, she decided to go public with her allegations in an interview with People magazine.

Initially, Roseanne’s specific comments seem to imply that she experienced an actual memory that was false:
I think it's the worst thing I've ever done," she says. "It's the biggest mistake that I've ever made....

I think what happened was that--well, I know what happened was that I was in a very unhappy relationship...I was prescribed numerous psychiatric drugs. Incredible mixtures of psychiatric drugs to deal with the fact that I had, and still in some ways, have and always will have some mental illness. And the drugs and the combination of drugs that I was given, which were some strong, strong drugs, I totally lost touch with reality in a big, big way.
The public disclosure of the memory not only estranged Roseanne from her parents, but also from her siblings, including her then-business manager Geraldine Barr (in the audience during the show’s taping), all of whom sought therapy to deal with the situation. She regretted publicizing the allegation before completing her own therapy, and for characterizing it as incest not only because of the stigma attached to her father, but because of what seems to be genuine remorse for spreading that stigma to her entire family.  As she stated, "What I learned was that hurt people hurt people and that you have to heal your own hurt so you stop hurting other people."

During the interview, she also talked about the opportunity to speak to her father shortly before his death in 2001. As she tells the story, one senses how important it was for her, on a personal level, to reconnect with her father, ruing, "Had my father lived a little bit longer and had he had the right therapist and people around him, I think we would have had resolution."

Roseanne obviously backed down on the allegation. But unlike Maran, she’s quite clear that what she experienced was an actual memory of events that had an empirical basis, not a belief or a metaphor. More to the point, even during this interview she maintained that the memories are quite clear, and she has no reason to distrust them:
I want to say that nobody accuses their parents of abusing them without justification to do that....I didn't just make it up. A lot of things were true and abusive and horrible things that happened to me that my father did....I say in the book [Roseannearchy: Dispatches from the Nut Farm] I was mistaken to use the word incest, But I really can’t think of another word, and when I do, I’ll use it.
Drs Pope and Brown’s fourth question about False Memory Research posits that the use of recanted allegations as scientific evidence supporting the claim is highly problematic. In the case of both Roseanne and Maran, we can see the familial pressures on both women, the hardships they endured in the aftermath of the allegation, their true love and affection for the accused parent, and their need to connect with same parent, especially when he is close to death. In this context, we cannot confidently assess (1) whether the initial allegation stemmed from memory as opposed to belief; (2) whether new memories or beliefs merely surfaced to replace the old ones; and (3) whether the recantation stemmed from a realization of false memory, or from other motivations designed to protect and maintain the family--not to mention the accuser’s place within it.

To read earlier posts in this series, click here.

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