Psychological amnesia, true amnesia, dissociative amnesia

AmnesiaMemory loss. {{See also| amnesia}} can have a physical cause or be caused by a general medical condition, for example, head trauma or traumatic brainThe brain is a approximately a 1300-gram organ containing 100-billion neurons. It is the control center of the central nervous system. The mind and brain are not the same thing. (see mind) The mind emerges out of interactions between the brain and relationships during the earliest years of childhood. Different child-parent attachment relationships form differing physiological responses, patterns for interpersonal relationship and how an individual views the world. {{Rp|9}} (see attachment) injury (TBITraumatic brain injury (TBI) is "a traumatically induced structural injury and/or physiological disruption of brain function as a result of an external force".Mild TBI is known as mTBI. (Department of Veterans Affairs and Department of Defense (2009)) {{Rp|3}}), substance-induced amnesiaMemory loss. {{See also| amnesia}}, such as carbon monoxide poisoning or chronic alcohol consumption, or electroconvulsive therapy ^[1]:60-61 This page refers to amnesia as it relates to mental health, in particular trauma and dissociationDissociation is a compartmentalization of experience, where elements of a trauma are not integrated into a unified sense of the self. {{Rp|4-810, 127}}The lay persons idea of [[dissociation]], that which exists in the normal mind, is not what is referred to in this document. {{Rp|233-234}}. Amnesia is one of those words like "dissociation" that gets thrown around and used to mean all sorts of things, but this page will use correct terminology. There are basically two types of amnesia that are associated with the Trauma Stressor-Related Disorders and the Dissociative Disorders and that is "true amnesia," and "dissociative amnesia." ^{[2] [3]:153-172, 243-267}

"Dissociative amnesiaDissociative amnesia (DA) was previously called psychogenic amnesia is a form of temporary amnesia that presents often in traumatic situations; for example in car accidents or victim or witness of a violent crime. Dissociative Amnesia is described in the DSM as a disorder that causes significant distress or impairment in functioning, such as when a person cannot remember significant events that happened to them. " is not "amnesia", per say. It is a dissociative symptom resulting from Structural Dissociation of the personality and so it is seen in posttraumatic stress disorder, complex posttraumatic stress disorder, other specified dissociative disorder and dissociative identity disorder. Whether or not it exists in individuals with borderline personality disorder who have suffered structural dissociation is yet to be know. The differences in the ways "forgetfulness" is experienced by individuals within the range of Trauma Stressor-Related and Dissociative Disorders is important to understanding the disorders themselves. Anyone can forget where they put their car keys, especially if they are not paying attention or put them in a place they don't usually store the keys, and that is normal. Individuals needs to focus their conscious awareness on tasks or they tend to do them mindlessly. This is what highway hypnosis is. It's simply doing a repetitive task without paying attention to it. ^{[2] [3]:153-172, 243-267}

Dissociative amnesia is very different. It is the result of structural dissociation of the personality, and is an unhealthy state of being. ^[2] If you have this type of amnesia you are ill. In posttraumatic stress disorder and the complex form of posttraumatic stress disorder, it is experienced as many things, including avoidance, flashbacks, anxiety, severe startle response, headaches, forgetfulness, and angry outbursts. ^{[2] [3]:153-172, 243-267}

In borderline personality disorder (not all individuals with borderline personality disorder have suffered structural dissociation) the same symptoms can occur, but there is also a focus on relationship problems due to dissociative amnesia. This means the person with borderline personality disorder might "forget" important aspects of their current relationships and those forgotten items are replaced with ideas from childhood. The result is usually an overly emotional child-like state reacting from a bad experienced early in life. This is a very difficult form of dissociative amnesia to deal with. ^{[3]:153-172, 243-267}

In other specified dissociative disorder, all the symptoms that have been listed in this paragraph apply, (avoidance, flashbacks, anxiety, severe startle response, headaches, forgetfulness, and angry outbursts, exchange of childhood memory"Memory is not a static thing, but an active set of processes." {{Rp|51}} "Our earliest experiences shape not only what we remember, but also how we remember and how we shape the narrative of our lives. Memory can be seen as the way the mind encodes elements of experience into various forms of representation. As a child develops, the mind begins to create a sense of continuity across time, linking past experiences with present perceptions and anticipations of the future." {{Rp|11}} and reactions with current day events) plus there is switchingFull dissociation is when an alter switches with the alter currently in executive control, resulting in amnesia for that alter. (see executive control) {{Rp|4-6}} In full dissociation, there is complete amnesia between dissociated states, which is a {{Rp|228}} criteria for a diagnosis of dissociative identity disorder in the DSM-5. {{See also| Dissociation}} of the one distinct state with the less than distinct states which can result in dissociative amnesia for the distinct state, and sometimes even for the less than distinct states. ^{[2] [3]:153-172, 243-267}Dissociative identity disorder is completely different from all the other disorders mentioned above. Two distinct states exist in this disorder, and what is experienced when two distinct states switch is "true amnesia." ^[2] This is due to the incredible phobia that exists between these states. Dissociative identity disorder is far more complicated than the other disorders listed here, and in addition to "true amnesia," the individual with dissociative identity disorder will also experience dissociative amnesia in all the ways that were described in the paragraph above (avoidance, flashbacks, anxiety, severe startle response, headaches, forgetfulness, and angry outbursts, exchange of childhood memory and reactions with current day events) for the other disorders that exist under the Structural Dissociation umbrella: posttraumatic stress disorder, complex version of posttraumatic stress disorder, borderline personality disorder where the individual was overwhelmed with unprocessed trauma events resulting in structural dissociation, other specified dissociative disorder and dissociative identity disorder. Again, true amnesia can only occur between two distinct states and so is only seen in dissociative identity disorder. ^{[4] [2] [3]:153-172, 243-267} The ability to recognize true amnesia from dissociative amnesia lies in the ability to tell a distinct state from a less than distinct state. See the following for more information: dissociative identity disorder, other specified dissociative disorder, Structural Dissociation. ^{[3]:153-172, 243-267}

True amnesia only exists in dissociative identity disorder

Amnesia is often reported that involves less than distinct states, but it's amnesia between distinct states that defines dissociative identity disorder, because for a correct diagnosis it's the distinct states that are sought out and not the amnesia itself. [2]:73-88 Individuals with posttraumatic stress disorder (PTSD), borderline personality disorder (BPD), and other specified dissociative disorder often report [amnesia, but what they experience is dissociative amnesia or amnesia of traumatic events both in past and present time, flashbacks and normal breaks of memory in daily life. [3]:1-130 Individuals with dissociative identity disorder cannot tell if they have amnesia between their distinct states, but trained observers can. The 2006 version of the theory of structural dissociation explained amnesia in dissociative identity disorder as a function of unnoticed passed time, [2]:91-94 but since then, Ellert Nijenhuis and Onno van der Hart have changed their stance to agree with what was mentioned at the start of this paragraph. Research in 2014 is settling in on the idea that only dissociative identity disorder has two or more distinct states. [5] [2]:8

Dissociative Fugue

A dissociative fugue, also known as psychogenic fugue or fugue statepsychogenic fugueA temporary loss of personal identity due to trauma, reclassified as dissociative amnesia within the DSM-5. Dissociative amnesia includes dissociative fugue as a subtype, since fugue is a rare disorder that always involves amnesia, but does not always include confused wandering or loss of personality identity. involves both travel and either loss of a identity (e.g., not knowing your name or where you live) or development of a new identity. There is always amnesia for the recent past, for example not knowing how or why the travel took place, ^[6]:232,431 the amnesia is generalized rather than selective amnesia. ^[6]:431 The DSM-5 states that a fugue can be noted within a dissociative amnesia diagnosis:

Dissociative Fugue is no longer in a separate category, and is now subsumed under the dissociative amnesia category. If an individual experienced fugue, it is noted here. ^[7]:156

Diagnostic manuals

Diagnostic manuals like the DSMPublished by the American Psychiatric Association as the standard classification of mental disorders used by US mental health professionals. It consists of diagnostic classification, the diagnostic criteria sets, and descriptive text. The DSM-II listed multiple personality disorder as a symptom of hysterical neurosis, dissociative type. The DSM-III (1980) moved Multiple Personality Disorder from a symptom to its own disorder. The DSM-IV changed the name to dissociative identity disorder (1994) and the DSM-5 (May 2013) updated the listing to current standards. {{Rp|384}} and ICD are not meant to be used to understand any mental disorderThe DSM-5 psychiatric manual defines this as "a syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. Mental disorders are usually associated with significant distress or disability in social, occupational, or other important activities. An expected or culturally approved response to a common stressor or loss, such as the death of a loved one, is not a mental disorder. Socially deviant behavior (e.g., political, religious, or sexual) and conflicts that are primarily between the individual and society are not mental disorders unless the deviance or conflict results from a dysfunction in the individual, as described above."{{Rp|20}}. Their intent is to give the minimum criteria needed to diagnose a disorder. The criteria listed here is paraphrased, as proper etiquette demands.

DSM-5 was last updated May 2013	ICD-10 was last update 1994
An individual is unable to recall autobiographic memory associated with a traumatic event. Usually the individual is unconsciously selective in their recall of traumaThe most fundamental effect of trauma is dissociation, so we define trauma as the event(s) that cause dissociation. {{Rp|75}} The original trauma in those with dissociative identity disorder was failure of secure attachment with a primary attachment figure in early childhood. {{Rp|83}}.	"The main feature is loss of memory, usually of important recent events, that is not due to organic mental disorder, and is too great to be explained by ordinary forgetfulness or fatigue. Dissociative amnesia is usually centered on traumatic events, such as accidents or unexpected bereavements, and is usually partial and selective.
An individual must feel distress by the inability to recall events.	Complete and generalized amnesia is rare, and is usually part of a fugue. If this is the case, the disorder should be classified as such. The diagnosis should not be made in the presence of organic brain disorders, intoxication, or excessive fatigue.
The cause is not physiological, nor is it dissociative identity disorder.	Dissociative amnesia can not be diagnosed if it is caused by alcohol (or another psychoactive"A psychoactive drug or substance affects mental processes, e.g. cognition or affect. " This includes both legal and illegal substances or drugs, but does not necessarily mean only those which produce dependence.The ICD diagnostic manual uses the term psychoactive substance use disorders to defined being clinically relevant use (for example intoxication, harmful use, the cause of a psychotic disorder). Examples include alcohol, cannabis and stimulants. {{Rp|53-54}} substance-induced amnesic disorder), it also cannot be diagnosed if the person meets the diagnosis of amnesia not otherwise specified, anterograde or retrograde amnesia"Loss of memory for events preceding the onset of amnesia." {{Rp|30}}, or nonalcoholic organic amnesic syndrome, or for postictal amnesia in epilepsy.
Dissociative fuguepsychogenic fugueA temporary loss of personal identity due to trauma, reclassified as dissociative amnesia within the DSM-5. Dissociative amnesia includes dissociative fugue as a subtype, since fugue is a rare disorder that always involves amnesia, but does not always include confused wandering or loss of personality identity. is a specifier in dissociative amnesia.	In the ICD dissociative fuguepsychogenic fugueA temporary loss of personal identity due to trauma, reclassified as dissociative amnesia within the DSM-5. Dissociative amnesia includes dissociative fugue as a subtype, since fugue is a rare disorder that always involves amnesia, but does not always include confused wandering or loss of personality identity. Dissociative amnesia (DA) was previously called psychogenic amnesia is a form of temporary amnesia that presents often in traumatic situations; for example in car accidents or victim or witness of a violent crime. Dissociative Amnesia is described in the DSM as a disorder that causes significant distress or impairment in functioning, such as when a person cannot remember significant events that happened to them. is a separate diagnosis, rather than included in dissociative amnesia.

^{[7]:156 [8]}

References

1. ^ Sadock, Benjamin James (2008) (coauthors: Sadock, Virginia Alcott). . Lippincott Williams & Wilkins..
2. ^ a b c d e f g h i j Vanderhart, Onno (2006) (coauthors: Nijenhuis, Ellert; Steele, Kathy). . New York:Norton. 13: 978-0393704013.
3. ^ a b c d e f g h Lanius, Ulrich (2014) (coauthors: Sandra L. Paulsen, Frank M. Corrigan). . New York:Springer Publishing Company. 10: 0826106315.
4. ^ Nijenhuis, Ellert. TEN REASONS FOR CONCEIVING AND CLASSIFYING POSTTRAUMATIC STRESS DISORDER AS A DISSOCIATIVE DISORDER. Psichiatria e Psicoterapia, volume 33, issue 1.
5. ^ Dorahy, Martin; van der Hart, Onno (2014). DSM-5’s PTSD with Dissociative Symptoms: Challenges and Future Directions. Journal of Trauma and Dissociation. (doi:10.1080/152906)
6. ^ a b Dell, Paul F. (ed) (2009) (coauthors: O'Neil, John A.). . New York: Routledge..
7. ^ a b APA, (2013). [ /books?vid=0890425566 Diagnostic and Statistical Manual of Mental Disorders-5]. APA.
8. ^ World Health Organisation, (2010). ICD-10 Classification of Mental and Behavioural Reaction to severe stress, and adjustment disorders.