Q: If a 3-year-old girl is brutally raped by a pathetic piece of trash masquerading as a human being, and that child later has no conscious recollection of the event, does she still run the risk of having emotional problems as she goes through her life, and if so, what signs and symptoms of post-traumatic stress disorder should the adults in her life look for? And, for that matter, can a person have PTSD from an event from which they have no conscious recollection? — D.H., Henderson
A: I have spent the past two columns constructing an overview of human memory, setting the stage for an answer to this question.
I make my living on the presupposition that engaging and examining one’s past in the company of a skilled listener/practitioner is a good thing. That is, it yields generally positive results. Classic psychoanalytic theory is hinged on the practice. But if we look at the current state of research regarding human memory, it behooves us to adopt a cautionary view of memory — its accuracy, veracity and reliability — including those memories “recovered” through the use of therapeutic techniques such as hypnosis or the literal interpretation of dreams.
But your question turns this inquiry around. What about a 3-year-old who is sexually abused, a fact established by witnesses, medical and forensic evidence, and perhaps ultimately the confession of the perpetrator, but the victim is left with no recollection whatsoever? So, now, those people charged to love and care for the victim must themselves be responsible to manage and integrate the knowledge of this terrible event, and to be prepared to help the child do the same.
So many factors weigh in. Let’s say the child doesn’t remember. I would invite the parents into a cautionary welcome of this as a blessing. There is zero a priori need for this child to remember, any more than my firstborn needs to remember me holding him down at age 14 months, him screaming, while the phlebotomist-from-hell spent several minutes digging around in my boy’s arm with a needle. (He’s lucky. Wish I could forget.)
I’m saying a denied, altered or repressed memory is not necessarily a bad thing. It is not true that all things unremembered necessarily cause or predict unhappiness or psychological unwellness. And even if there is clear evidence of unwellness — depression, hysteria, psychosis, phobias, sexual dysfunction, self-destructive behavior, etc. — there are treatment models that do not require remembering to be successful.
Likewise, the recovery of a denied, altered or repressed memory is not necessarily a good thing. I’ve worked with combat veterans enough times to know that rejecting memory is sometimes the merciful alternative to going crazy. But apart from this extreme case, I promise you that recovering a memory in no way predicts or guarantees that a patient will improve.
Insight does not equal wellness. Write it down.
And, of course, this entire argument is based on the presumption that we can know Trauma A causes Symptom B. It might or might not, and it’s not always a simple thing to know the difference. The lives of some childhood sex abuse victims are literally and permanently ruined. They complete suicide. They spend their lives in state-managed behavior health care. They are driven to the brink of sanity and beyond. Some victims, however, astonish us by facing and integrating this history without severe symptoms — no depression, no bad dreams, no flashbacks, no impedance of normal and satisfying sexual courtship in quality relationships.
When patients fret and perseverate about the possibility of repressed memories, I invite them to trust their unconscious. If and when we need to know, if and when we’re strong enough to embrace a deeper, more complete reality — maybe that’s exactly when we remember the thing that needs remembering. I freely admit I’m personally attracted to this idea intuitively more than I am advancing it as proven fact. But I’m in good company (see C.G. Jung.)
And maybe we never need to remember. Really.
So, we’ll wrap this up next week by describing the resources and readiness parents need as they help their child include historical trauma in a personal legacy — whether or not that trauma is ever recalled in historical, conscious memory.
Steven Kalas is a behavioral health consultant and counselor at Clear View Counseling Wellness Center in Las Vegas and the author of “Human Matters: Wise and Witty Counsel on Relationships, Parenting, Grief and Doing the Right Thing” (Stephens Press). His columns appear on Tuesdays and Sundays. Questions or comments can be e-mailed to firstname.lastname@example.org.