Recovered Trauma Memories and Hypnosis
Not too long, I came across a request on a professional listserv for a therapist experienced in hypnosis to help someone recover "possible" childhood memories of abuse. This request contained some very serious misunderstandings about abuse memories and hypnosis; as a consequence, I thought it was worth writing about the topic in greater depth.
Perhaps the place to start is addressing what we actually know about how memory works. Up until about 20-30 years ago, many scientists believed our brains kept perfect record of what happens to us. Recent research has suggested this view isn't accurate. Memory is actually extremely fallible and prone to distortion. Moreover, when we recall something, it's not like pulling a file out of a cabinet as we used to believe. Instead, memory appears to be a reconstructive process-we take bits of remembered information and recreate what happened in our minds. For these reasons, our memories of a particular event may change over time.
Laboratory studies have provided evidence of how someone can be influenced to believe something happened to them that didn't. Researchers have been able to suggest events to people that they denied initially, but began to believe weeks later. These experiences include getting lost in a shopping mall as a child, spilling a punch bowl on the bride at a wedding, an animal attack, medical procedure, and many others. Not everyone is suggestible, but up to a quarter of people will integrate the suggested memory into their own, forgetting where it came from, and coming up with a lot more detail to flesh it out over time.
What about hypnosis? Although not trained in it myself, I believe hypnosis can be a useful clinical tool, and there's some support for the use of hypnosis in helping people with chronic pain, smoking cessation, and other stress-related problems. But the scientific data suggest that the use of hypnosis in recovering memories is very problematic.
Contrary to the popular notion of hypnosis as a tool to uncover "hidden" memories locked away within the recesses of the brain, there's no evidence hypnosis improves our ability to remember things that happened to us compared to non-hypnotic or regular recall. Not only is hypnosis no better than regular recall, data suggest that recall during hypnosis can actually result in the creation of more false memories than recall while not under hypnosis. Furthermore, people who recall memories under hypnosis are more likely to believe in the accuracy of these memories, regardless of whether they are true or not. It is for these reasons that many professionals working with individuals who may have been abused as children strongly caution against the use of hypnosis as a tool to try to recover possible unremembered trauma. The American Medical Association took a stand warning against accuracy of memories recovered through hypnosis in 1985. You can read the statement here.
In sum, we can influence some people into believing things that never happened without hypnosis, but hypnosis makes it easier and more believable.
These misunderstandings about memory and hypnosis contributed to a particular destructive period in psychotherapy. In the 1980-1990's, there was an epidemic of cases with well-meaning therapists, often through hypnosis, "recovering" memories of childhood sexual abuse that never happened. Families were ripped apart and lawsuits were filed. This included a wave of reports of what was called "satanic ritual abuse." The FBI investigated thousands of reports of abuse reportedly perpetrated by satanic cults and was unable to find any corroborating evidence for it. You can read the FBI report here.
Please don't misunderstand me: I am not saying people don't recover memories of childhood abuse later in life. In my own practice, I have had people come to see me after recalling childhood abuse they had previously forgotten. We certainly can forget events, particularly very difficult events and things we don't understand at the time. And I am very happy to work with individuals who have recalled previously forgotten memories. However, I do not and will not seek out unremembered abuse. The risk of creating the memory of something that never actually happened is too great.
A study by a group of U.S. and international researchers lead by Dr. Gerarts looked at three groups of people with childhood sexual abuse memories: 1.) those who had always remembered their abuse; 2.) those who spontaneously recovered memories outside of therapy; 3.) and those who had recovered memories during therapy. The researchers interviewed other people in the participants' lives who could corroborate the abuse. Researchers were able to corroborate stories in many cases for people who reported always remembering the abuse (45%) and people who recovered memories outside of therapy (37%). For people, who recovered abuse memories in therapy, researchers were unable to corroborate a single case.
Just because the researchers were unable to corroborate any cases of abuse when memories were recovered in therapy doesn't mean that they were all false. After all, researchers were able to corroborate less than half of abuse memories for people who had always recalled the abuse. However, the finding is extremely disturbing, as it suggests memories of abuse recovered in therapy are less likely to have actually happened than those spontaneously recovered.
It might be understandable for psychotherapists to be searching for abuse memories if remembrance of trauma was absolutely necessary for improved mental health. However, there is no compelling evidence that unremembered abuse causes mental health problems. I suspect this misunderstanding is a holdover from Freud's belief that many problems are related to repressed material in the unconscious. When people actively avoid painful thoughts, memories, and feelings, this can cause a lot of problems. This can be worked on in treatment. Searching for unremembered abuse in order to explain current difficulties is simply irresponsible on the part of the therapist.
Gold standard treatments for post-traumatic stress disorder such as Prolonged Exposure and Cognitive Processing Therapy deal with intrusive trauma memories, not hidden ones. There is no empirical evidence that someone needs to remember a previously forgotten traumatic experience to live a healthy and fulfilling life. Problems come when survivors avoid things that remind them of the trauma.
For these reasons, I caution people from looking for trauma memories with a therapist. Using hypnosis to recover memories is especially dangerous. You might find them, but there is no guarantee they are real-no matter how real they seem.