Truth lies in the eye of the beholder
CMAJ 1997;156:1265
The article "The repressed memory controversy: Is there middle ground?" (CMAJ 1996;155:647-53 [abstract / résumé]), by Dr. P. Susan Penfold, was a thoughtful consideration of the subject. I was disturbed, though, by the tone of the letters by Dr. Paula Tyroler and Adriaan J. Mak (CMAJ 1997;156:344-5). Their positions are clear -- they do not believe that memories can be forgotten (repressed) and then remembered. How can we not repress memories? We cannot possibly remember everything that happened to us, although all the events are likely stored somewhere in our brains. What we choose, unconsciously, to forget and to remember is largely out of our control.
As a practising general-practice psychotherapist with several years' experience with abuse survivors, I am only too aware of how fickle memory is. Even people who have experienced the same event in childhood remember it differently, simply because they are 2 individuals with different views and models of the world. The "truth" lies in the eye of the beholder and often changes with time.
I have certainly had patients whose fantasy-prone personalities have enabled them to embellish memories, not out of malice, but to provide understanding of their anxiety-ridden lives. It is this group that is especially prone to the plethora of lay therapists who use guided imagery and hypnosis to ferret out "repressed" memories. I agree with Tyroler that there is probably no way to distinguish between true memories and pseudomemories. However, to the patient the memory is true; it is a part of his or her experience. As therapists we need to help the patient heal that memory and thus himself or herself. A serious problem arises when we take the memories that are told to us by patients in a therapeutic setting and bring them into the external world as "truth." I do not believe it is necessary, or indeed advisable, to encourage patients to "confront the perpetrator" as a method of healing.
Mak is concerned about the people over 60 years of age who "tell the world these accusations are false," and so am I. It is equally painful to be wrongfully accused as is to be wrongfully treated by an abuser. However, it is surely equally possible that these accused have "repressed" their memories, or that they remember events differently, or that they simply deny them. Who would not deny such a heinous act?
There is much to be learned, and it does not serve us well to take the polarized views of Tyroler and Mak any more seriously than the views of those who believe that every memory really happened.
Edward Leyton, MD
Kingston, Ont.
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