psychiatric disorders
Dissociative Amnesia
Treatment of Dissociative Amnesia
To recover memory, a supportive environment and sometimes hypnosis or a medication-induced semihypnotic state Psychotherapy to deal with issues associated with recovered memories of traumatic or stressful events If memory of only a very short time period is lost, supportive treatment of dissociative amnesia is usually adequate, especially if patients have no apparent need to recover the memory of some painful event. Treatment of more severe memory loss begins with creation of a safe and supportive environment. This measure alone frequently leads to gradual recovery of missing memories. When a supportive environment does not result in improvement or when the need to recover memories is urgent, questioning patients while they are under Hypnotherapy or, rarely, in a medication-induced (barbiturate or benzodiazepine) semihypnotic state can be successful. These strategies must be done gently because the traumatic circumstances that stimulated memory loss are likely to be recalled and to be very upsetting. The questioner must carefully phrase questions so as not to suggest the existence of an event and risk creating a false memory. Patients who were abused, especially during childhood, are likely to expect therapists to exploit or abuse them and to impose uncomfortable memories rather than help them recall real memories (traumatic transference). The accuracy of memories recovered with such strategies can be determined only by external corroboration. However, regardless of the degree of historical accuracy, filling in the gap as much as possible is often therapeutically useful in restoring continuity to the patient’s identity and sense of self and in creating a cohesive life narrative. Once the amnesia is lifted, treatment helps with the following: Giving meaning to the underlying trauma or conflict Resolving problems associated with the amnestic episode Enabling patients to move on with their life If patients have experienced dissociative fugue, psychotherapy, sometimes combined with hypnosis or medication-facilitated interviews, may be used to try to restore memory; these efforts are not always successful. Regardless, psychotherapy maybe useful for patients to explore how they handle the types of situations, conflicts, and emotions that precipitated the fugue and thus develop better responses to those events and help prevent fugue from recurring. 