Transcript

Science and Medicine

Shankar Vedantam and Harrison Pope
Washington Post Staff Writer and Psychiatry Professor, Harvard Medical School
Monday, February 26, 2007; 12:00 PM

Washington Post staff writer Shankar Vedantam and Harrison Pope, a psychiatry professor at Harvard, was online Monday, Feb. 26 at Noon ET to discuss a new study that uses historic literature and art to examine if repressed memory is a cultural syndrome.

Read more about the study: Was Repressed Memory a 19th-Century Creation? (Post, Feb. 26)

Shankar, who writes the Department of Human Behavior columns, will also field questions about recent stories.

The transcript follows.

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Shankar Vedantam: Welcome to this online chat to discuss today's science page story about repressed memories. We are joined today by Dr Harrison Pope, the Harvard psychiatrist who recently completed a very intriguing study that argued that the phenomenon of repressed memories, which is also known as trauma-induced amnesia, is a "culture bound syndrome" -- a disorder that was largely nonexistent before the year 1800. Pope and his colleagues argue in a paper they published in Psychological Medicine that the idea people can suffer traumatic memories, forget about them completely, and then recover them at some point in the future is the product of 19th century western culture, rather than a basic property of the brain. The advent of Hollywood may have accelerated this motif, according to Pope and his colleagues. One of the implications of the study, according to Rich McNally, an expert who studies culture and trauma at Harvard, is that doctors should focus on treating patients for depression or post traumatic stress -- the symptoms with which they arrive in doctors' clinics -- rather than trying to unearth hidden memories as a way to unlock depression and other disorders. There are lots of interesting dimensions to the study -- among others, if you can think of a pre-1900 literary reference to trauma-induced amnesia in any language, you could win a challenge posed by Dr Pope's lab and win $1000.

I would also be happy to take any questions on my Department of Human Behavior column. Today's piece explored why so many performers seem to do so poorly when they are asked to make acceptance speeches at the Oscars. If you know what you would say to the world if someone thrust a mike in your face and gave you a few seconds, let us know. At the end of our discussion on the repressed memory article, we will post your Oscar acceptance speeches. Keep it brief, and please please please avoid endless lists of thank yous!

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Shankar Vedantam: Dr Pope, I would like to start off the conversation with a couple of questions. The study has a very unusual methodology -- searching for literary references to trauma-induced amnesia as a way to study whether the disorder has always been with us -- as opposed to being a "culture bound syndrome" that surfaced sometime in the 19th century. Tell us a little about what prompted your literary approach, and give us some sense of how widely you searched for references to people who suffered a traumatic event, forgot about it, and then recovered the memory.

Harrison Pope: Dear Shankar,

My apologies for slow speed because I am a hunt-and-peck typist! In reply to your question, I've pasted in some material from the text of our original paper that describes briefly 1) what prompted our approach; and 2) some indication of the breadth of our search:

1) In an initial survey (Pope, 1997) of fictional and nonfictional works prior to 1800, we could not find any cases of dissociative amnesia. Indeed, one of the first that we could identify was Dr. Manette, in Charles Dickens' A Tale of Two Cities (Dickens, 1859), who displays amnesia for much of the trauma of his incarceration in the Bastille. Similarly, Emily Dickinson (1862) speculates that a traumatic event might breed amnesia because it is too painful to remember, as quoted in your article in this morning's Post.

We were struck that dissociative amnesia appeared so commonly in modern works, but seemed absent prior to 1800. Natural human psychological phenomena, such as delusions, hallucinations, depression, anxiety, and dementia, appear in written works throughout the ages-in the Bible, in Greek tragedy, in Shakespeare, and in the literature of other cultures around the world. Therefore, we reasoned that if dissociative amnesia were also a natural phenomenon-an innate capacity of the brain-then it, too, should appear in written works throughout history. In other words, our ancestors would inevitably have witnessed dissociative amnesia for traumatic events in themselves or others, and then portrayed this phenomenon in nonfictional works or in fictional characters. Accordingly, we initiated a greatly expanded search, using Internet and print advertising, for cases of dissociative amnesia appearing in any written work prior to 1800.

And now turning to part 2 of your question above:

We placed a notice offering a $1000 award to the first person who could produce an example of dissociative amnesia for a traumatic event, in any work of fiction or nonfiction, in any language, prior to 1800 (see full text at www.biopsychlab.com). For our notice, we used the term "repressed memory," a term essentially synonymous with dissociative amnesia (Pope, 1997), and probably more recognizable to lay readers. We took care to indicate that "repressed memory," like "dissociative amnesia," represented the inability to recall a traumatic event, as opposed to ordinary forgetfulness for an event, or merely trying not to think about the event. We posted our notice on numerous Internet web sites and discussion groups, and placed a similar display advertisement in the Chronicle of Higher Education (March 31, 2006; page A52)-a publication with 83,000 paid subscribers (see http://chronicle.com/about-help.dir/adv/disadinfo.htm). We also posed our question on "Google Answers," a service where hundreds of experts, many with sophisticated Internet searching skills, will attempt to answer any question (See full text and responses at: http://answers.google.com/answers/threadview?id=443814)-though we were limited by Google's policy to a $200 maximum award in this instance. We also translated our advertisement into French and German (full texts available at www.biopsychlab.com) and placed it on French and German web sites, again offering $1000 US to the first person who could provide a case meeting our criteria. Although we performed more than 20 of the web postings ourselves, our notice spawned discussion threads on numerous other web sites as well; some of these are shown in Table 1, but there are likely others of which we are unaware. Finally, we subscribed to two private e-mail groups specifically focused on trauma and memory (Table 1) and placed our notice there as well.

H. G. Pope, Jr., M.D.

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Shankar Vedantam: I would like to ask Dr Pope one other general question before we get down to detailed questions from readers. Could you give us a quick history of the recent controversy over repressed memory? What is the general consensus in the field today about the validity of such memories?

Harrison Pope: Let me begin by carefully defining the terms here. When I use the terms "dissociative amnesia" or "repressed memory," here and in response to other questions, I am using them synonymously, and I am referring to the theory that an otherwise lucid individual could experience a severe traumatic event and then be unable to remember that event for a prolonged period, and then recover this previously inaccessible memory at a later date.

That said, the hypothesis of "repressed memory" has been one of the most highly controversial topics in modern psychiatry, with some writers suggesting that it is common, afflicting as many as 20-30% of trauma victims (especially victims of traumas such as childhood sexual abuse), and others claiming that it is nothing but a myth, or just a piece of "folklore." So there are strong opinions on both sides of this debate!

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Albany, N.Y.: How do we know if the notion of repressed memories really exists. It could simply be the product of people who are very reluctant to talk about unpleasant experiences. After all, we are talking about mentally ill people to begin with who suffer from this, so how can we confirm that the claims of repressed memories are real.

Harrison Pope: See my definition of the term "repressed memory" in answer to Shankar's question above. We are not using the term "repressed memory" to describe mere forgetting, or denial, or reluctance, but rather the actual INABILITY to remember a specific traumatic event.

H. G. Pope, Jr., M.D.

Shankar Vedantam: Rich McNally suggested something intriguing when I interviewed him. At least some victims of trauma do not feel what happened to them was traumatic as the experience took place. This does not speak to cases involving violence or violent sex abuse, but it may involve certain kinds of child sex abuse that only seemed confusing when the person was a child. It is only years later, when the person thinks about the memory that the full *meaning* of the experience becomes clear -- and the person experiences the memory as a traumatic event. So McNally argues that while the trauma may seem to have been long forgotten and then remembered, it is really that it is being discovered for the first time as the adult grapples with the meaning and implications of the event. Questions and comments about this?

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Colorado Springs, Colo.: The rise of predestination, and the accompanying sense of powerlessness, presented by Calvinist doctrine -- the rise of mindless jobs in congested cities that comes with the Industrial Revolution and the resulting sense of hopelessness in man's condition -- and finally, a rise in universal literacy that would allow new voices to talk about their condition -- would account for the appearance of these experiences in the culture and ultimately, the literature of a Euro-centric population. There were many new things under the sun during this period. A new kind of pain was often one of them.

Harrison Pope: See my previous answer to question #9 from this chat, which raises issues similar to yours.

H. G. Pope, Jr., M.D.

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Southern Maryland: How does one go about getting treatment to see if there are repressed memories? I have many symptoms of child sexual abuse but don't recall any instances of it. I come from a large family -- lots of aunts, uncles, cousins, and 2 sets of grandparents who we visited at least once a week, so it's entirely possible. How do you uncover these repressed memories -- hypnosis, long-term psychotherapy, or what?

Harrison Pope: Actually, our paper questions whether "repressed memories" represent a naturally occurring human psychological phenomenon in the first place. Therefore, we would suggest that it may be hazardous to assume that you have "repressed memories" that you don't yet know about. However, as mentioned in my answer to an earlier question in this chat, our paper does not really discuss issues of psychiatric treatments, so we're getting beyond the specific scientific issues discussed in the paper if we try to discuss treatment questions.

H. G. Pope, Jr., M.D.

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St. Paul, Minn.: My question regards your search in the literature for signs of repressed memory, and the trauma that may precipitate it. Since you already state--and I'm in full agreement with this--that repressed memory may be a culture-bound syndrome, I'm wondering why you don't apply the same criteria to "trauma." In other words, trauma, especially psychic or psychological trauma, is also culture bound to a certain extent. Certainly, in many societies, a "curse" can produce trauma--hence the king in "Shakuntala" could have been suffering from the trauma of being cursed, thereby losing his memory. More contemporary examples of psychic trauma based on indigenous religious beliefs about "curses" would be Haitian Vodou, European "mal'occhio," etc. And the "curse" goes back to biblical times, beginning "in the beginning" with Gen 3:14-15, 17. Maybe we need to redefine our notion of "trauma." Thank you.

Harrison Pope: You raise an important point that is hard to fully answer in real time with my hunt-and-peck typing. Below, I've pasted some text from our published paper that partially addresses your point:

A variant of the above hypothesis asserts that dissociative amnesia is indeed present in writings prior to 1800, but hard to recognize, because our ancestors interpreted and described psychological phenomena differently from ourselves. For example, people in earlier centuries might have witnessed dissociative amnesia, but portrayed it as demonic possession or some other supernatural event, or described it in language entirely different from what we would use today. Certainly language and interpretation may vary-but dissociative amnesia is a graphic and striking phenomenon; if an otherwise lucid individual spontaneously develops complete amnesia for a serious traumatic event, such as being raped or witnessing the death of loved ones, then a description of such a case would surely be recognizable, even through a dense veil of cultural interpretation. In other words, historical literature would include not just oblique religious or supernatural references to dissociative amnesia, or cases that merely showed certain features of it; one would also find clearly recognizable cases. Similarly, one would find not just modern commentaries that see hints or suggestions of dissociative amnesia in historical works; one would be able to distinguish clear-cut cases in the historical works themselves.

Even if we grant that different people have defined trauma differently (certainly a fair point), I would still suggest that if "repressed memory" were a natural human psychological phenomenon, we would not just find examples of things that might arguably be traumas, such as a forgotten curse, but also lots of cases of common, ordinary, concrete, indisputable traumas, such as people who were raped, or saw their families killed -- and then were unable to remember the event. The absence of these latter, simple cases leads me to question whether "repressed memory" is actually a natural phenomenon.

Nevertheless, your point is important. If possible, read our entire paper for a more detailed discussion of these issues.

H. G. Pope Jr, M.D.

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Patients' Diversity Is Often Discounted (June 26, 2005)

Social Network's Healing Power Is Borne Out in Poorer Nations (June 27, 2005)

Racial Disparities Found in Pinpointing Mental Illness (June 28, 2005)

Shankar Vedantam: Readers may be interested in taking a look at a series of articles I wrote in 2005 that explored many dimensions of the role of culture in psychiatric diagnosis, treatment and outcome.

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bc in dc: Gentlemen- I find it interesting that the idea of repressed memory sprang up in the 19th century, as did the rise in popularity of spritism, parapsychology, mediums, seances, etc. Coincidence? Comments? Thanks, bc

Harrison Pope: The question of why this all may have arisen in the early 19th century is a fascinating question, but beyond the scope of our published paper. We offered a few line of conjecture in our paper about this question, though, as follows:

...we know that 19th-century Europeans developed an evolving notion of the unconscious, arising against the cultural background of Romanticism. Very likely, this Weltanschauung fostered the speculation that the mind could protect itself by relegating horrors to the unconscious-in Dickinson's phrase, like "one within a swoon." (As quoted in the Washington Post article this morning).

But unlike the swoon, another Victorian symptom that soon became obsolete, dissociative amnesia (or alternatively, "repressed memory") perhaps prospered because of its theoretical interest to writers such as Freud and Janet, its convenience as a dramatic device (especially with the advent of film), and more recently, its appeal to trauma theorists, both popular and scientific. Like the diagnosis of fugue, which flourished briefly in the favorable cultural climate of the late 19th century, dissociative amnesia may have survived in our culture because it has occupied a persistently fertile niche.

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Shankar Vedantam: Dr Pope, I have heard from some readers who feel that your study devalues their experiences. They say they have indeed recovered memories of traumatic sexual abuse -- memories that are causing them great suffering. As a clinician, what would you say if such patients came into your clinic? Do you feel the study devalues their experience and suffering? What would you advise patients to do with such memories?

Harrison Pope: Important question! As readers will see if they read our original scientific paper, we are not questioning that there are many people who genuinely and honestly feel that they have recovered repressed memories. Certainly such people deserve therapy from a careful and sympathetic person, and their experiences should certainly not be dismissed or devalued in any way. But this issue is somewhat tangential to the purely scientific and historical question raised in our published paper; our paper does not discuss therapy or make any specific recommendations about therapy. Readers interested in pursuing this question should take a look at the actual published paper.

H. G. Pope, Jr., M.D.

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Laurel: We haven't heard as much about it recently, but between 10-20 years ago repressed memory was widely cited among alleged victims of child sexual abuse and other practices related to satanic cults. I'm recalling, perhaps incorrectly, that the McMartin preschool trial was based on the idea that the prosecution had "recovered" memories from the pupils, but at the trial it turned out their methods had actually planted the ideas.

Sensationalistic accusations of satanic practice were similarly "recovered" by religiously-motivated investigators. Then the story dropped out of sight for lack of substance. Was there anything there, or is this another case where "man bites dog" is news; "oops, man didn't bite the dog after all" isn't.

Harrison Pope: Yes, as a matter of fact we have also published a paper showing that scientific papers on "repressed memory" peaked in the 1990's and then fell off sharply -- in agreement with your thoughts below. You can get a pdf of this paper if interested from us if you go to our website at:

www.biopsychlab.com

and then send us your address through the "contact us" link.

H. G. Pope, Jr., M.D.

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Washington, D.C.: Because these researchers could find no examples of repressed memory in literary works before the 19th century, they argue that this psychiatric disorder is a creation of Western culture sometime in the 19th century. But cannot another explanation be that some human beings have only recently developed the ability to recover repressed memories, an ability that most human beings will have hundreds or thousands of years from now?

Richard Bucke ("Cosmic Consciousness") argues that the human mind has evolved over the centuries and is still evolving. For example, human beings have only recently developed a sense of color. The ancient Greeks knew only three colors, and there is no word for any color at all in the primitive Indo-European speech. The blazing blue of the oriental sky is not mentioned even once in Homer or in the Bible. But today we can recognize not only the seven basic colors, but literally thousands of different shades and gradations of them. Other recently acquired faculties are the sense of fragrance and the musical sense.

Could it be that we are evolving as a race toward greater mental agility and that the ability to recover repressed memories is one step in that evolution?

Harrison Pope: Hello-

We have considered your question in our published paper, and I have pasted the relevant paragraphs for our paper below:

The remaining two hypotheses in Figure 1 postulate that dissociative amnesia existed only after 1800. The first of these hypotheses maintains that dissociative amnesia is a genuine, naturally occurring phenomenon, but simply did not afflict people until the last 200 years. For example, it might be argued by analogy that conditions such as bulimia nervosa, were rarely, if ever, seen two centuries ago (Pope et al., 1985). But bulimia nervosa is not a valid analogy, because it represents a voluntary (albeit pathological) behavior-namely, binge eating and "purging"-whereas dissociative amnesia is hypothesized to be an involuntary phenomenon that occurs spontaneously in the brain. Psychiatric disorders characterized by voluntary behaviors, such as compulsions, drug abuse, or paraphilias, may vary widely in prevalence across different cultures and different periods of history, because voluntary behaviors are modulated by cultural influences. By contrast, phenomena caused by innate brain processes, such as psychosis, depression, anxiety, or dementia, occur in all cultures across history (albeit with varying frequency, depending on biological and psychosocial modulators). Dissociative amnesia falls in this latter category. In other words, if the brain were inherently capable of spontaneously developing amnesia for a traumatic event, then the brains of individuals in classical Greece, or 18th-century England, or Tang Dynasty China, would possess the same capability as the brains of modern individuals.

A variant of this hypothesis asserts that modern individuals have somehow learned to exercise their innate ability to develop dissociative amnesia, whereas our ancestors did not learn this skill. But this argument also falters upon reflection. For example, it is widely maintained today that children develop dissociative amnesia for experiences of sexual abuse (Brown et al., 1999; van der Kolk, 1994; Freyd, 1996), even though no one has "taught" them how to do this. Therefore, children throughout the ages would also have been able to develop dissociative amnesia without prior teaching, and hence this phenomenon would have found its way into written works centuries earlier-unless our brains somehow metamorphosed after 1800.

Note that I have only briefly touched on the idea that our brains could have somehow evolved to be able to be able to repress memories currently -- but I would argue that the burden of proof would rest on those who would propose this hypothesis.

H. G. Pope, Jr., M.D.

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Cambridge, Mass.: I have to admit I don't fully understand the point of this study, since pegging dissociative amnesia as a culture-bound syndrome does not exclude its origin in brain functioning. Careful investigation of which factor in this phenomena is the culture-bound factor might reveal that it is actually the presence of people in positions of authority who give credence to the claims of dissociative amnesia sufferers that has been extant in any substantial way only since the mid-19th century. In addition, considering the widespread historical belief in some sort of spirit possession, the possibility that amnesiac sufferers themselves did not believe--could not tolerate believing--their own recollections (rather than doubting their own sanity) cannot be discounted. As an individual so plagued, to be able to accept such a memory would require a culture that has acknowledges both the original traumatic event and its later recall.

Harrison Pope: You raise several important points in the space of your question. See my earlier answer to the person who asked about curses, earlier in this chat, for some text that partially addresses one of the points that you raise. You also raise a more general point about the vast differences between cultural perceptions today as opposed to centuries earlier, which might influence how a "repressed memory" might be perceived (i.e., spirit possession). Here is a paragraph from our paper that partially addresses that point:

A similar argument begins with the observation that motorcars and subatomic particles were not described before 1800, because they had not been conceived. By analogy, the argument continues, individuals before 1800 had simply not conceived of dissociative amnesia, because they did not conceive memory in the manner that we do today. Indeed, as Young (1995) has shown, the boundaries of the concept of memory have greatly evolved in the last two centuries. Therefore, dissociative amnesia might have existed, yet gone unnoticed, in earlier times. But this argument is not plausible, because one need not conceive of dissociative amnesia to describe it. As illustrated in the works cited above, our ancestors were certainly capable of describing traumatic events, and also capable of describing individuals with amnesia. Therefore, they would surely have been capable of describing an individual who developed amnesia for a specific traumatic event, if they saw such a case-even if they did not understand what they were seeing. In other words, whatever their cultural concepts of memory and trauma, their descriptions of amnestic individuals would still be identifiable. By analogy, writers before 1800 also had very different concepts of delusions and hallucinations-yet descriptions of these symptoms are nevertheless readily identifiable throughout texts prior to 1800. If dissociative amnesia existed, why would it not be identifiable in numerous texts as well?

You may want to read the original paper in its entirety, rather than these fragments, to follow our discussion more systematically.

Finally, you point out -- correctly, I believe -- that a culture-bound syndrome can of course still have its origins in brain functioning. We also address that point to some degree in the paper in our discussion of "pseudoneurological" symptoms -- but I'll have to refer you to the paper on that one, because I can't type fast enough to do justice to your question here!

H. G. Pope, Jr., M.D.

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Washington, D.C.: Sometimes science reporting is subject to complaints that it has misinterpreted the science or mislead the public in its interpretation. One recent example was the Sam Roberts story in the NYT on more women living without a husband. Many other examples exist through time. First, what do you do as a reporter to try to avoid these problems? Do you think these kinds of problems can be avoided or do you think it is something you can only try to minimize? One recent commentary on this issue ends with the advice for news organizations to "sharpen their efforts to report scientific studies accurately". Do you have something more specific to offer?

Shankar Vedantam: Thanks for the question. It's hard to argue with the statement that reporters should be accurate, or that improvement is always possible. But that said, both the business of science and the business of journalism inherently involve judgment and perception, and both of those are obviously influenced by people's personal backgrounds. I think good reporters and editors consciously seek out people with diverse points of view, as one way to be fair. While the issue of political bias gets a lot of attention on the blogosphere, I can't say I myself have ever heard conversations in the newsroom where someone decides to go after a politician because of an ideological difference. Rather, I would argue the most pervasive biases of reporters are largely the product of the biases of the mediums in which they work. Cable television, for example, finds it difficult to do in depth stories because the medium requires speed. It loves an Anna Nicole Smith story or a story about a presidential impeachment following a sex scandal because those stories are a lot easier to do -- and often more popular -- than in depth investigations such as the Post's recent coverage of the "other Walter Reed." I would say journalism in general prefers simple stories to complex stories -- a bias with far greater impact than naked ideological bias. As a reader, I always tell myself to bring an informed skepticism to what I read -- not knee jerk cynicism, but a willingness to subject what I read or hear about to critical thinking.

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Adelphi, Md.: Since Dr. Pope is on the board of False Memory Syndrome Foundation and FMSF is a leading exponent of denying recovered memories of early sexual abuse, shouldn't his association with such a controversial and one-sided group have been mentioned in the article? FMSF is not considered a scientifically unbiased organization.

Harrison Pope: I am a member of the scientific advisory board of the FMSF, but I receive no compensation from them, and I have no role in the activities of the FMSF, nor do they have any role or jurisdiction over the scientific papers that I publish.

H. G. Pope, Jr., M.D.

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Washington, D.C.: Your views please on medical/psychiatric "fads". Some years ago the 'fad' was eating disorders, childhood abuse, repressed memories, etc. It appears many are diagnosed and treated for the disorder du joour. And then, in two years, you hear nothing about the disorder that was, briefly, on every plate. Repressed memory is one such. Thank You, Bob

Harrison Pope: See my response to an earlier chat question where I describe a previous paper that we wrote about the rise and subsequent sharp fall in scientific publications about "repressed memory."

H. G. Pope, Jr., M.D.

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Washington, D.C.: I suffered for years from severe respiratory infections which led to numerous bouts of bronchitis. I could remember back to the age of 2 1/2 when my mother was pregnant with my younger brother, so I was certain that there was nothing related to some long ago event. After being thoroughly tested by one of Washington's top doctors, no physical cause was determined. I had never heard of repressed memories or dissociation or any such terms, yet within weeks of having a flashback to a childhood trauma, I have not had a single recurrence of such problems in nine years. How do the researchers explain this?

Shankar Vedantam: I am not sure whether it is entirely fair to ask researchers to explain every case such as this. Dr Pope and others are advancing a theory; it seems to make sense to me to subject their theory and method to critical inquiry, but I am not sure they have a responsibility to explain every case. Besides, they are not arguing that people cannot have repressed memories; merely that such phenomena may be influenced by cultural context. That does not make the experience feel less "real" to people. Finally, I would say that if you have been helped by your recollection of this event, more power to you! I don't think you need science to validate your personal experience ...

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Bowie: Most of the alleged incidents of repressed memory that I've heard involve childhood sexual abuse, usually by family members. I trace my own recollection of it (as a news story, I have no personal involvement) almost exactly to the time our society started involving law enforcement in family life to an extent previously not used. Before then, what went on at home stayed there and people didn't discuss it openly for fear of dishonoring the family. Was there a similar cultural change about the relationship among family members that occurred about 1800 that would have caused the issue to suddenly appear from nowhere?

Harrison Pope: Others have raised this question with us. Indeed there may well have been cultural changes, but it seems implausible that that could explain the absence of ANY apparent descriptions of "repressed memory" prior to 1800. Child sexual abuse and rape both go back to the beginning of written works, including the Bible -- so one would surely expect to find at least some earlier references to "repressed memory" in spite of cultural shifts.

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Arlington, Va.: Perhaps there wasn't a framework of understanding or linguistic structure prior to 1800 to process what might have been repressed memories. Have you looked at reference to traumatic dreams or nightmares, either sleeping or waking, that could be references to repressed memories? Also, taboos have always been strong social controllers through time. People might not have been inclined to write about, for example, mental images of child sexual contact with adults, especially parents (Oedipus aside). Child sexual abuse victims today are marked by attachment, loyalty,and confusion regarding their abusers and/or shamed silence. Wouldn't this have been the same in the past?

Dr. Pope, it seems you have approached this study with the assumption that repressed memories are a social construct, and that you require proof to the contrary. Especially with literary study, it is easy to read into works of deceased authors just about anything the analyst wishes to construe. To carry forward from this that, if there are no literary references to repressed memories prior to 1800, then the whole phenomenon must be "created." (What I find disturbing about this assumption is that it echoes what often happens in dysfunctional families when a child discloses abuse: "Honey, PROVE to me that your daddy messed with you!") Using your reasoning, one might conclude that the idea of a round Earth is a social construct, because early writings portrayed it as flat.

Harrison Pope: I have partially addressed your questions in my responses to the person who asked about curses and also a subsequent person from Cambridge (I think) earlier in the chat. But for a full response to your very reasonable questions, try to read our actual paper if you can. (I'm too slow a typist do do full justice to your question in real time here!)

H. G. Pope, Jr., M.D.

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Seattle, Wash.: As an historian, I found myself intrigued by your study. After reading the article, however, I'm quite skeptical of the approach. A plausible case can be made that what you're describing is simply a genre effect: the increasing tendency of European authors after the 18th century to describe their inner feelings and emotions, as part of a more general trend toward emphasizing the autonomy of the individual. In particular, as scholars like Frances Yates have demonstrated, the idea of what "memory" was and how to go about training it has changed radically in the modern period.

The point is that it seems likely that the organic phenomenon of repressed memory was not "invented" in the 19th century, but rather our way of conceptualizing it. The referents of nearly every disease we recognize today changed during the 1700s. There is rarely a one-to-one correspondence between them old and new nosologies. To single out repressed memory as in "invention" is in my view a significant distortion. You could just as well say that plague is an invention (there are still hot debates over whether the Black Death was in fact caused by Yersinia pestis).

The anthropologist Claude Levi Straus points out in one of his works that ocean mariners in the medieval period were able to see a number of stars with the naked eye that we today can't detect without telescopes: and yet, there they are. It's only our way of seeing that's changed. What effort did you make to work through epistemological problems of this kind?

Harrison Pope: See my answer, in response to a question earlier in this chat, where I have posted a paragraph from our published paper addressing your main issue, namely that our ancestors conceived of memory very differently from ourselves -- together with our response to this issue.

HGP

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Bowie, Md.: Did either of these experts take into account the particular zeitgeist of the culture of an era in terms of beliefs and the words used to refer to such beliefs in their search of the literature? It is hard to believe that there were no traumatic experiences that were consciously or unconsciously blocked before the 19th century.

Shankar Vedantam: Yes, the team of researchers did look quite broadly at this. Basically, they were looking for characters in literary works before 1800 who experienced a trauma, completely forgot about it, and later remembered the event. All those conditions need to be met. If you think you can come up with an example that would disprove their theory, you can try to win their $1000 challenge. Please visit www.biopsychlab.com and click on "repression challenge" for more details, as well as very specific post 1800 examples ...

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College Park, Md.: Are the doctors aware of the writings and work of Dr. Richard Kloft or Ellert Nijenhuis, PhD who have researched and worked with individuals who truly suffer from DID because they survived chronic physical and sexual abuse by fragmenting the memories into different aspects of the conscious self, thus allowing them to endure what otherwise would have been unbearable? Have either of the gentlemen read Dr. Nijenhuis' book on structural dissociation?

Harrison Pope: Our paper is looking specifically about "repressed memory" for a specific traumatic event, NOT dissociative identity disorder, where different personalities are said to have amnesia for each other. We were careful to restrict our question only to repressed memory of a specific traumatic event.

HGP

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Washington, D.C.: Dr. Pope, A less-charged question on False Memory Syndrome: having a passing familiarity with some of the work on FMS, I'm wondering if/how your study supports or weakens that concept. If repressed memory - even if real in some cases - is itself a "creation," or a cultural/social rather than physical condition, does that support the case that memory, including false memories, can be created?

Harrison Pope: If someone claims to have recovered a "repressed memory," our study does NOT imply that that memory is necessarily false. Another possibility, for example, is that the memory is absolutely true, but that the individual has, in effect, forgotten that they were capable of remembering it at an earlier time.

HGP

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Washington, D.C.: The Salem Witch Trials certainly qualify as repressed memories in the 17th century. The children first showed physical signs, then they recalled witchcraft practiced on them by others, then they actually saw the images of people who they believed were harming them in the present. In fact, they may have been experiencing psychological pain in the present of repressed memories that were resurfacing. Eventually, adults began to manipulate the children and more than 150 people were incarcerated for witchcraft in the summer of 1692. Someone however had harmed the children, and they first repressed the memory and then experienced great distress when they memories began to re-emerge. Whom should I call to receive my $1000 due?

Harrison Pope: See our posted "repressed memory challenge," which specifically mentions why the witch trial example does not meet our criteria.

HGP

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Adelphi, Md.: Since this article supports one side of a much debated issue involving not only the legitimacy of some recovered memories, but the major cause being serious childhood sexual trauma, shouldn't Dr. Pope's membership on the Board of the False Memory Syndrome Foundation have been included in the article. A cursory reading of the FMSF literature will show how political this issue really is.

Harrison Pope: See my previous answer to a very similar question earlier in the chat.

HGP

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Springfield, Va.: Could "repressing memories" (or rather, forgetting bad things) just be our brains way of coping and letting us live productive lives without being bogged down by early childhood trauma? Personally, I know I have forgotten about some crazy events in my teens years (mom throwing knives), that friends have later reminded me about. I like to think I forgot about them so I wouldn't be held back by an abusive childhood.

Shankar Vedantam: Sure, this is the argument made by proponents, and it is something that has wide support in literary narratives after the year 1800. It is hard to question the idea that people forget about things that happened to them; however, how do we know such forgetfulness is because the brain suppresses traumatic events? The brain sure seems to forget a lot of other stuff as well ... I think we are exploring the difference here between personal experience and a scientific theory. One important difference is that scientific theories make falsifiable hypotheses. If you can find a literary example of dissociative amnesia from before the year 1800, that would falsify Dr Pope's hypothesis.

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New York, N.Y.: As opposed to repressed memory, there is accurate memory when even many many year before, after a traumatic event, people remember every detail around that event. Like the person who suddenly saw a spouse drop dead. The survivor remembers even what jam they ate for breakfast, about the time that the trauma took place.

Shankar Vedantam: Thanks for the comment. I don't think anyone would argue with the idea that highly emotional events seem to produce more vivid memories. As you say, this is the opposite of trauma-related amnesia suggests -- that events that are highly emotional are forgotten.

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New York, N.Y.: It seems that this study is based entirely on history and literature. Is there any neurological basis for the belief that "repressed memories" do not actually occur?

Harrison Pope: A fair question, but scientifically, I would suggest that the burden of proof is to show that they DO occur. More generally, there is much literature about neurological mechanisms, but we have restricted our question in our study to the simple black-and-white question of whether "repressed memory" a naturally occurring observable phenomenon, regardless of what may be going on neurologically beneath the surface.

HGP

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Laurel, Md.: Many people's view of the morality of lying comes from the Ninth Commandment, usually the one from Exodus 20:16, rendered in the King James version as "Thou shalt not bear false witness against thy neighbor." Although some people consider this a blanket prohibition against lying, there is a key phrase at the end "... against they neighbor."

Note the possible outs this allows, one is not prohibited from:

...lying about yourself

... saying nice things about another that are not true

... uttering falsehoods that aren't against another person

Things like "I got invited to a major league tryout once but hurt my arm," "That's a lovely sweater you're wearing," or "I saved 25 cents a gallon on gas in Pennsylvania last week" do not fall under the commandment language. And I suspect this is most people's view of the morality of lying when applied to their own speaking.

However, they feel somewhat wronged when OTHERS tell such lies TO THEM.

washingtonpost.com: Almost Everyone Lies, Often Seeing It as a Kindness (Feb. 19)

Shankar Vedantam: Here's a question unrelated to the trauma article about a column I wrote last Monday connected to the Libby perjury trial. Good points all, except that I don't think the courts have such a limited view of lying. When you put up your hand and take an oath, there does not seem to be an exception for harmless lies as opposed to harmful ones!

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Arlington, Va.: Dr. Pope, what do you see are the contemporary implications of your study?

Harrison Pope: See our paper for full details. Perhaps the most important implication is our suggestion that the American Psychiatric Association's Diagnostic and Statistical Manual (DSM) should reclassify dissociative amnesia as a conversion disorder. Dissociative amnesia is already classified as a conversion disorder in the International Classification of Diseases (ICD) -- so this would simply bring the DSM into congruence with the ICD.

HGP

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Arlington, Va.: An absolutely fascinating article and topic--thank you! As a cultural historian with an ethnological orientation, though, I have to agree with those who see this matter as far more complex than a hasty reading of the news reports would allow. Specifically, just because a psychological (or psychophysical) phenomenon is rooted in culture does not necessarily make it unreal; on the contrary, some would question whether there are ANY complex human emotional responses that are not decisively shaped by culture.

In other words, repressed memory may be a rare, but universally available, brain mechanism which only a very few cultures have enabled to come into effect--one such culture being our own. I am eager to know if you know of other studies completed or underway that take cultural history into account as this one did. Thank you.

Shankar Vedantam: I think this question has been addressed earlier. Besides Dr Pope's paper, I would also recommend the links to the series of articles I wrote in 2005 that explored the views of psychiatric experts who argue that all psychiatric disorders (and non psychiatric disorders for that matter) are influenced in one way or another by culture. Nowhere in my series of articles or in Dr Pope's paper does anyone make the argument that syndromes that are influenced by culture are not "real."

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Shankar Vedantam: Thanks so much to everyone who participated in the online chat today. And thanks especially to Dr Pope for taking an hour of his time to field questions. It's a very intriguing subject and gives us all lots to think about.

Have a good day everyone.

Shankar

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