"Childhood Trauma Remembered" Pamphlet Available

ISTSS

Under the editorial direction of Matthew Friedman, MD, PhD. and Susan Roth, PhD., members of ISTSS and contributors outside the organization have prepared a 24-page document titled "Childhood Trauma Remembered: A Report on the Current Scientific Knowledge Base and its Applications." This paper provides scientific information about childhood trauma, psychotherapy with trauma survivors, and the latest scientific evidence about forgetting and remembering traumatic childhood events. It includes information about human memory and guidelines for applying this knowledge to clinical and forensic practice with trauma survivors. The pamphlet is clearly written in language accessible to educated lay readers as well as mental health professionals.

At this time, a subcommittee of the ISTSS Public Education Committee chaired by Laurie Anne Pearlman, PhD., is working on disseminating the information included in the pamphlet. Copies of the pamphlet will be mailed to ISTSS members and other interested parties in mid-May. A brief summary, prepared by Judith Herman, MD, follows.

The committee includes Brian Litzenberger, PhD. (project manager), Ted Bober, M.S.W., Berthold Gersons, MD, PhD., Elana Newman, PhD., and Camille Wortman, MSW. They are working with ISTSS board and staff members ad hoc. Plans are underway to disseminate the pamphlet in various formats to other professional organizations and the general public. The committee is determining the feasibility of a press conference or a media educational exchange in June. The information will be available on the ISTSS web site at http://www.ISTSS.org in mid-May.

MEMORIES OF CHILDHOOD TRAUMA

The following is a summary of Childhood Trauma Remembered (edited by Matthew Friedman, MD, PhD, and Susan Roth, PhD) written by Judy Herman, MD.

Many children, regrettably, experience serious psychological trauma. Children are commonly the victims of physical or sexual abuse; they may also witness violence directed against others. Much of the trauma that children suffer is kept secret and may not be disclosed until years later. Enduring psychological harm may result from traumatic experiences in childhood.

Many traumatized people, children and adults, have vivid and indelible memories of the traumatic event. Paradoxically, some traumatized people do not recall the event for a period of time but recover their memories later. This kind of amnesia has been documented after different kinds of trauma such as natural disaster, combat, and childhood abuse. It is not currently known why some people develop amnesia for traumatic events, nor is it understood how traumatic memories are forgotten or later recovered. These questions are currently the subject of intensive scientific research.

On the basis of documented cases, we know that it is possible for people to recall accurately memories of childhood trauma that they report having previously forgotten. Research findings to date suggest that recovered memories of childhood abuse are generally as accurate as never-forgotten memories. However, all memory is reconstructive and imperfect, and inaccurate memories can be as convincing as accurate ones. There is no established clinical or laboratory procedure for determining the accuracy of childhood memories.

Most memory recovery appears to be triggered in situations that include specific reminders of the original trauma. Psychotherapy does not play a direct part in most memory recovery; indeed, many people who have recovered traumatic childhood memories have never had any psychotherapy. Concerns have been raised, however, about the validity of the memories that arise during the course of psychotherapy. Though there is no evidence that memories recovered in psychotherapy are generally inaccurate, it is well known that some people are particularly vulnerable to suggestion, coercive persuasion, or social influence when reporting memories of past events. It is possible that therapists who fail to conform to accepted standards of practice might exert undue influence over the remembering process in some patients, resulting in a "recovered memory" of an event that never occurred.

Because childhood trauma often plays an important role in adult psychological problems, competent psychotherapists must be prepared to inquire about traumatic experiences in the assessment and treatment of patients. Professionals agree that undue influence is unlikely to occur in the treatment setting if standard principles of therapeutic impartiality and respect for patient self-determination are observed. Clinical practitioners must provide a confidential environment free of shame and intimidation, in which all sorts of distressing experiences can be freely discussed. In this environment, previously undisclosed childhood secrets may be revealed, and previously forgotten traumatic memories may also be recovered. Therapists should neither pressure patients to recover traumatic childhood memories nor suppress the process of recall.

Since there is no standard protocol for establishing the validity of recovered memory in individual cases, therapists must maintain tolerance for uncertainty as patients come to a new understanding of their past experiences. It is up to each patient to come to his or her own conclusions about the truth and accuracy of particular memories.

Similarly, therapists should encourage patients to consider their options carefully but should not instruct or pressure patients to take any particular course of action as a result of recalling childhood trauma. The choice to disclose remembered events, to confront accused perpetrators, or to seek legal redress rests with each individual.