All Is Not Forgotten(38)

I began working with Sean a few months before Jenny’s rape. It was toward the end of winter. Sean never wore a coat. He said he was always hot. Yet when he came through my door the first time we met, he was shivering. I remember this with exceptional clarity.

Sean had come to me out of desperation. As you already know, Sean had lost his right arm in a bomb explosion in Iraq. His comrade died beside him. He was given the treatment, and he now had almost no memory of the event. He suffered from severe depression and anxiety, which were exacerbated by his underlying anxiety condition. He did not have the traditional PTSD pathology that most people have been made aware of through movies and magazine articles—the overreacting to stimuli reminiscent of combat. Do you recall how I explained to you the brain’s filing system? How emotional responses to events cause the brain to categorize memories? Simply put, the extreme emotional experience of combat causes the memories from that event to be filed in the metal cabinet—with neon lights and alarm bells. It’s the brain’s way of telling you, Do not forget that when these things happen, you could die! And so any stimuli that enter the brain that remotely resemble combat trigger the fight-or-flight chemical response, the flood of cortisol and adrenaline that make you react, or overreact. And when you are placed in a constant state of chemical panic, your “nerves fray.” That’s the colloquial expression. Your body is physically altered—heart pounds faster to get blood to muscles, pupils dilate to focus attention, sugar is produced for immediate energy consumption. It is physical stress. We need not get more complicated than that.

The course of therapy is not a walk in the park, but it has a methodology and a path involving desensitization—in a sense, refiling the memory. Every time we recall a memory, it is altered and then returned to storage in the altered state. This is called reconsolidation. Soldiers are exposed to combat stimuli in a setting that is safe and comfortable. Over time, they can make their brains take down the neon lights and alarm bells and recognize the difference between a balloon popping and sniper fire. The patient’s brain actually begins to recall the memory in a different way that does not associate the facts of the memory with pain or fear.

This was not possible for Sean, because he was not dealing with a response to a filed factual memory. He was dealing with a physical and emotional response that had no “remembered” facts. I have had clients who believe in reincarnation. They tell me that they feel things that they should not feel, given the course of their lives. They tell me the only explanation is that they experienced things in their prior lives that left these feelings in place.

I will not go further afield to comment on my views of the supernatural. I have developed a tolerance for the views of others so that I do not inadvertently disparage them. It takes tremendous effort. However, I think these clients serve as a fine comparison to what Sean and Jenny experienced. Powerful feelings that do not have a file. Why am I so afraid of the water? Why do I gag when I smell grass? Why did I feel déjà vu when I went to New York City for the first time? These are some of the questions from my clients. Of course, I usually get to the answer without resorting to the absurd, but we do not need to concern ourselves with that.

Sean had different questions: Why do I want to pound my fist into the wall when I’m holding my son? Why do I want to throw my wife across the room when she touches me? Why do I feel like screaming all the time, for no reason and at no one? The triggers were benign and held no resemblance to anything he would have seen on his mission. He called them ghosts—the feelings that roamed inside him, looking for a place to rest.

And Jenny: Why do I feel like my skin is crawling? Like I want to peel it off my body? Why do I keep rubbing my scar where he carved my skin with that stick? Why is my stomach always burning with acid? Like Sean, her body was producing chemicals in reaction to an emotional response that had no particular trigger, and certainly no trigger that resembled her attack.

There is a world of controversy around memory recovery. Some researchers (and I use that term loosely because the people who have inserted themselves in this arena range from celebrated neuroscientists to convicted sex offenders) claim that memories cannot be recovered and that any so-called recovered memories are necessarily false. Indeed, I am sure you have heard about cases of emotionally damaged adults receiving treatment from therapists and suddenly “remembering” that they were molested by a parent or a teacher or a coach. There is even an organization dedicated to stopping memory-recovery therapy.

There are just as many researchers on the other side, and they, too, have compelling stories about successfully recovered memories that are later verified by confessions or physical evidence.

I have read every research study, news article, anecdotal story, and legal brief that has been made public over the years, and I am comfortable with my conclusions. There are two issues: The first is that memories are stored. The second is that stored memories must be retrieved to be “remembered.” Both processes involve brain hardware and brain chemicals. Memories can be stored and subsequently lost or erased. Memories can also be saved but misfiled and therefore difficult to retrieve. Both these events are forms of “forgetting.” I believed, and still do believe, that the treatment given to Sean and Jenny and now countless other trauma victims does not “erase” every memory from the trauma. Some are saved but misfiled, and are therefore capable of being found and retrieved. And remembered.