Dissociative
Amnesia - formerly Psychogenic Amnesia, is a pervasive loss
of memory of significant personal information. This disorder is characterized
by a blocking out of critical personal information. Dissociative amnesia,
unlike other types of amnesia, does not result from other medical
trauma, such as a blow to the head. The predominant disturbance is
one or more episodes of inability to recall important personal information,
usually of a traumatic or stressful nature, that is too extensive
to be explained by ordinary forgetfulness.
The disturbance does not occur exclusively during the course of Dissociative
Identity Disorder, Dissociative Fugue, Post
Traumatic Stress Disorder, Acute
Stress Disorder, or Somatization
Disorder and is not due to the direct physiological effects of
a substance (e.g., a
drug of abuse, a medication) or a neurological or other general
medical condition (e.g., Amnestic Disorder due to a head trauma)
The symptoms cause clinically significant distress or impairment in
social, occupational, or other areas of functioning. Localised amnesia:
is present in a individual who has no memory of specific events that
took place, usually traumatic. The loss of memory is localised within
a specific window of time. For example, a survivor of a car wreck
who has no memory of the experience until two days later is experiencing
localised amnesia.
Dissociative amnesia
has several subtypes:
Selective Amnesia: happens when a person can recall
only small parts of events that took place in a defined period of
time. For example, and abuse victim may recall only some parts of
the series of events around his or her abuse.
Generalised Amnesia: is diagnosed when a person's
amnesia encompasses this entire life.
Continuous Amnesia: occurs when the individual has
no memory for events beginning from a certain point in the past continuing
up to the present.
Systematised Amnesia: is characterised by a loss
of memory for a specific category of
information. A person with this disorder might, for example, be missing
all memories about one specific family member.
Dissociative Fugue: is a rare disorder. An individual
with dissociative fugue suddenly and unexpectedly takes physical leave
of his surroundings and sets off on a journey of some kind. These
journeys can last hours, or even several days or months. Individuals
experiencing a dissociative fugue have traveled over thousands of
miles. An individual in a fugue state is unaware of or confused about
his identity, and in some cases will assume a new identity (although
this is the exception).Dissociative Fugue, formerly Psychogenic Fugue,-
is a sudden, unplanned excursion away from ones planned itinerary
accompanied by either memory loss or confusion about, loss of, or
assumption of a new identity.
Associated
Features:
Depression.
Anxiety
Disorders.
Post
Traumatic Stress Disorder.
Differential
Diagnosis:
Some disorders have similar symptoms. The clinician, therefore, in
his diagnostic attempt has to differentiate against the following
disorders which need to be ruled out to establish a precise diagnosis.
Dementia.
Head Trauma.
Substance Intoxication.
Early symptoms of neurological disorders (eg multiple sclerosis)
may resemble conversion symptoms.
Cause:
Dissociative
Amnesia:
Dissociative amnesia
appears to be caused by stress associated with traumatic experiences
endured or witnessed, physical or sexual abuse, rape, combat, natural
disasters; major life stresses, abandonment, death of a loved one,
financial troubles; or tremendous internal conflict, turmoil over
guilt-ridden impulses, apparently unresolvable interpersonal difficulties,
criminal behaviors. Additionally, some persons are believed to be
more predisposed to amnesia, eg, those who are easily hypnotized.
Dissociative
Fugue:
Causes are similar
to those of dissociative amnesia with some additional factors. Fugue
is often thought to be malingering,
because the fugue may remove the person from accountability for his
actions, may absolve him of certain responsibilities, or may reduce
his exposure to a hazard (such as a dangerous job assignment). Many
fugues appear to represent disguised wish fulfillment. The fugue may
remove the patient from an embarrassing situation or intolerable stress
or may be related to issues of rejection or separation and some fugues
appear to protect the person from suicidal or homicidal impulses.
Treatment:
The treatment for dissociative
amnesia is therapy aimed at helping the person restore lost memories
as soon as possible. If a person is not able to recall the memories,
hypnosis or a medication called Pentothal (thiopental) can sometimes
help to restore the memories. Psychotherapy can help an individual
deal with the trauma associated with the recalled memories.
Hypnosis is often
used in the treatment of dissociative fugue. Hypnosis can help the
client/patient recall his/her true identity and remember the events
of the past. Psychotherapy is helpful for the person who has traumatic,
past events to resolve.
Counseling
and Psychotherapy [ See
Therapy Section ]:
Hypnotherapy
[ See Hypnotherapy
Section]
Pharmacotherapy
[ See Psychopharmacology
Section ]
