Repression, Dissociation, and Sex-Abuse Accusations
Richard A. Gardner, M.D.*
ABSTRACT: The concept of repression has been given a bad press
because it has been used by therapists to justify their induction of
sex-abuse delusions in non-abused patients. Denying the existence
of repression, however is not the best way to deal with these
therapists. Repression does exist, but must be put into
perspective with related phenomena including forgetting, suppression,
denial, dissociation, and depersonalization. The controversy over
the existence of repression is a distraction from the widespread problem
of recovered memory therapists who induce false memories of childhood
The Basic Issues in the Repression Debate
Among the many conflicts raging in the field of sex-abuse accusations
is the one centering on repression, especially regarding whether or not
it exists. But we are not dealing here simply with some kind of an
intellectual discussion on a theoretical issue. Rather, the debate
has become heated because of its relevance to the question of whether
certain sex-abuse accusations are true or false. This is
especially the case when an adult woman belatedly accuses her father
(and/or other relatives) of having sexually abused her in
childhood. Memories of such abuses are said to have been repressed
and then uncovered in treatment many years later. The accusing
woman, her therapist, and others claim that her failure to recall
anything at all about the abuses over many years was the result of
Critics of such claims say that there is no such thing as repression
or, even if there is, people subjected to abuses are not likely to
repress them, at least to the degree described by many of these
women. Supporters cite four studies to bolster their claim that
sexual abuse can be repressed or dissociated (Briere & Conte, 1989,
1993; Herman & Schatzow, 1987; Loftus, Polonsky, & Fullilove;
Williams, 1994). The best of these, by Williams (1994), suggests
that a significant percentage of adult women with verified medical
records of sexual abuse in childhood will not describe their abuses in
the course of interviews many years later. The supporters maintain
that these studies not only prove the existence of the repression
phenomenon, but also confirm that memories of sexual abuse can be
repressed for many years. Critics reply that none of these studies
assesses repression nor provides any credible scientific evidence to
support the assumptions of recovered memories.
My own position regarding this particular conflict is this: Concerns
about whether or not repression exists are irrelevant to the question of
whether there are people being induced by their therapists to believe
that they were sexually abused when they weren't. It matters not
whether 10% repressed or 99% repressed or any number in between.
The existence (or nonexistence) of repression does not preclude the
parallel track of false accusations being induced in suggestible women
by overzealous and even fanatical therapists. If what I have said
is valid, we are still left with the question of whether or not
repression exists. Accordingly, the question of whether repression
exists is still an important one, not simply for our understanding of
memories of sex abuse, but for other mental disorders in which the
repression theory is used.
One of the problems confronting those who are arguing about
repression is that those who believe it exists cannot point to any
specific part of the brain (at least at this stage of our knowledge) and
say, "That's where it's taking place." They have to rely
on patients' statements of their thoughts and feelings, much of which is
subjective. Such phenomena do not lend themselves well to
verification by traditional scientific methods. Accordingly, it is
very difficult for proponents of the regression theory to
"prove" that repression exists. Those who claim that it
does not exist also have difficulty providing "proof" because
it is just about impossible to prove that something does not exist,
i.e., one cannot prove a null hypothesis. We are left, then, with
appeals to "common sense" and what seems more or less likely.
I personally believe that there is such a phenomenon as
repression. It is the purpose of this article to not only describe
why I believe in its existence, but to put it into perspective with
other related phenomena, especially dissociation. There are some
who say that they do not believe in repression, but do believe in
dissociation. This may appear somewhat paradoxical because both
involve relegation of cognitive material out of conscious
awareness. Clearly, definition of terms is warranted. The
definitions presented here are derived from traditional concepts;
however, I have provided clarifications that should prove useful to
those involved in this debate.
Most would agree that we cannot keep in ongoing conscious awareness
all cognitive material. The vast majority of such material must be
stored. Not to do so would probably drive us insane as we would be
continually confronted with all the thoughts and memories of our
lives. In addition, it would make it difficult to select the
specific material that would be most important to focus on in a
particular situation, especially situations involving survival. To
say that long-term memory is stored in places like the hippocampus is
perfectly acceptable to most people today and does not evoke much
To say, however, that certain material is relegated to the
"unconscious" is likely to raise eyebrows in some circles and
even antagonism in others. Where material that is not in conscious
awareness is stored (and the name one gives to the Site[s] where it is
stored) is not particularly relevant to what I will be saying
here. (Of course, this issue is very relevant to such people as
neuropsychologists and those who are studying memory.) For my
purposes here, I am only stating that there must be sites (for lack of a
better term) where cognitive material that is not immediately available
to conscious awareness is stored. Nor does it matter to me whether
one calls such areas "the unconscious" or something
else. I will refer to these sites as storage areas.
There is a continuum regarding the depth and degree of implantation
of cognitive material in the memory storage areas. The range is
from material that is only superficially implanted and is easily
forgotten to material that is deeply embedded in storage area circuitry
so deeply embedded that it will always exist in the person's
brain. The comparison here is between writing with a stick in the
sand (writing that inevitably blows away) and writing deeply in cement.
In addition, there is a continuum from stored material with which the
individual is comfortable and that with which the individual is
extremely uncomfortable. Retrieval of material in the former
category does not produce significant anxiety, guilt, or
revulsion. In contrast, retrieval of material at the other end of
the continuum is likely to produce such reactions. Under such
circumstances there is a lack of receptivity for such information to be
given access to conscious awareness. In this article I will define
a series of mental mechanisms that relate to the phenomena of storage
and ease of retrieval. These phenomena also fall on a continuum,
roughly from that material which is readily and easily retrieved to that
which, although deeply embedded in the storage site, is very difficult
to retrieve especially because of significant degrees of guilt,
fear, and/or revulsion.
It would be an error for the reader to oversimplify my comments by
referring to them simply as "Freudian," with the implication
that they are passť and thereby not to be taken seriously.
Furthermore, that does me a disservice in that, although
psychoanalytically trained, I believe there are things Freud said that
are worthy of our serious consideration and other things that are best
forgotten, and all points in between. Those who dismiss Freud
entirely are throwing out the baby with the bath water.
There are different mechanisms that lie on the continuum related to
the relegation of conscious material into storage: forgetting,
suppression, denial, repression, dissociation, and
depersonalization. Roughly, these represent processes that involve
the most superficial degree of relegation to storage (forgetting) to the
most deep seated and dramatic example of that process
(depersonalization). These are not "pure" in that there
is some overlap. However, viewing these processes as being on a
continuum can he useful for understanding cognitive material that may
not be immediately accessible to conscious awareness.
All of us forget, and children more than adults. I speak on the phone
with my three-year-old granddaughter, Anna Lauren. This is the
||Hi, Anna Lauren. How are you?
||I'm fine, Grandpa.
||What did you do today?
||(after a pause) Mommie, what did I do today?
Children must be reminded to put on their coats and hats, take their
books and lunch, and remember not to lose their gloves. There is
no school worthy of the name that does not have a "lost and found
department," the primary purpose of which is to facilitate the
retrieval of the numerous articles that will inevitably be lost in any
school. It is a rare mother who has not been summoned to the
school to bring a forgotten book, homework assignment, or lunch.
A high-school student studies for a French test. She gets 23
out of 25 words right on her French vocabulary test. No one would
claim that this child has "a problem." We go to our 25th
anniversary alumni meeting. A typical interchange involves people
arguing about whether X event did or did not happen. They may even
do this somewhat humorously. Each may swear by everything that is
holy to him or her that his or her rendition is the accurate one.
But all agree that both cannot be right, so diametrically opposed are
their recollections. The interchanges, however, do result in a
gradual recovery (I hesitate to use that word) of memories that were not
previously recalled. This process is referred to as
accretion. It may very well be that such memories would never have
been recalled had the individuals not attended the meeting. They
were stored somewhere and not immediately available to conscious
awareness. Certain external cues, however, brought about retrieval
that might not have otherwise occurred. This, too, is all
normal. No one would say that these people have "a
But the storage system is also affected by motivation. Two boys
meet a girl and both ask for her telephone number. Boy A's
testosterone levels soared the very minute he set eyes on her and it is
highly likely that he will remember the telephone number. Boy B,
with a sexual inhibition problem, has a conflict. His testosterone
is mobilizing him to ask for her number. However, his adrenaline
levels (mobilizing him for flight), also become elevated and this
results in his forgetting the girl's telephone number. (The reader
will forgive me for my oversimplification here, but I do believe it
helps make the point.) I believe that in the second boy's
situation there were processes, not in direct conscious awareness (I am
trying to avoid the use of the word unconscious here), that were
operative in bringing about the memory failure. Perhaps in therapy
or in a discussion with a friend he would have been able to delineate
the psychological factors operative in his having forgotten the number.
Suppression is a more active process than simple forgetting.
Forgetting often occurs without any willful intent to forget. In
contrast, in suppression, the individual may make a determined effort to
remove the material from conscious awareness. Girl jilts
boy. Boy is deeply pained. His consoling parents tell him:
"Try to forget about her. There are other fish in the
sea." He agrees that he is going to try to forget about
her. They suggest he watch television, play ball, or do something
else to try to distract himself. He agrees that that is a good
idea and watches a videotape of great interest to him. The parents
studiously avoid mentioning the girl's name in the hope that they will
thereby facilitate their son's forgetting process. The boy's
decision not to think about it is an active process and protects him
from psychological pain.
Another example of suppression would be the adult who wants to forget
about some embarrassing situation that occurred previously. The
mechanism lessens the likelihood that the material will become deeply
entrenched in the brain circuitry and, in some cases, blow away like the
name imprinted in the superficial layers of the sand. Whereas
suppression is a conscious deliberate process, repression (see below) is
a more automatic process less likely to be directed by the
individual's will. The aforementioned sexually inhibited boy who
forgot the girl's telephone number exhibited repression. He did
not consciously say to himself, "I want to forget her
number." Rather, he consciously said to himself, "I want
to remember her number." However, other forces within him,
not operating at conscious awareness, dictated otherwise.
An old Laurel and Hardy movie
is relevant here not only with regard to what it tells us about
forgetting, but techniques used in so-called "recovered memory
therapy." Oliver Hardy has fallen deeply and madly in love
with Georgette, the woman of his dreams. She will have no part of
him and he becomes despondent. The two men decide to join the
French Foreign Legion in the hope that service in the distant Sahara
Desert will help Oliver forget Georgette. So off they go to North
Africa. Intermittently, Stan asks Oliver, "Did you forget her
yet?" Oliver, justifiably irritated, implores Stan to please
stop reminding him of Georgette because his reminders are interfering
with the forgetting process. Stan (predictably) keeps asking
Oliver the same question and Oliver (predictably) responds with
increasingly zany fits. The forgetting process is further
complicated by the fact that Georgette turns out to be the wife of the
commanding officer of their unit! The vignette not only says
something about the forgetting process, but the techniques used by the
so-called recovered memory therapist.
Denial may be similar to suppression in that it often involves a
conscious decision: "I don't want to think about it" or
"I don't want to know about it." Denial, however, is a
much more powerful mechanism than suppression and is often automatically
(and unconsciously) used. Denial lies between suppression and
repression on the continuum. Denial is a much more powerful
mechanism and its ability to keep material out of conscious awareness is
far stronger than the mental mechanisms involved in suppression. A
foot soldier goes into battle denying the likelihood that he will be
killed. An indiscriminate lover has sex with a stranger, denying
the possibility of contracting a sexually transmitted disease.
People living in earthquake areas return to build their homes on the
same site, denying that it can happen again. The person with an
incurable disease denies the death sentences of a series of competent
doctors and believes the quack who tells him that he has the cure.
James Boswell attributed to Samuel Johnson the observation that
"Remarriage represents the triumph of hope over experience."
One can say that denial represents the triumph of hope over reality,
or the triumph of hope over the laws of probability. It is the
most powerful and widespread of the psychological defense
mechanisms. It has the power to entrench itself deeply into the
brain circuitry. Unlike suppression, it is most often an automatic
process, and not something that people most often deliberately do by
making a conscious decision. The boy who tries to forget about the
girl who jilted him is doing something constructive. People who
deny are often doing something self-destructive and do not wish to
recognize that they are acting injudiciously. Accordingly, the
denial mechanisms operate at unconscious levels to protect people from
the recognition that they are often being injudicious and even
foolish. An old anecdote that demonstrates this principle well: A
middle-aged single woman (well into middle age) spends a weekend at a
resort in the hope of meeting a husband. One day she notices a
newcomer sitting alone on the porch. It isn't long before she is
sitting next to him. The following conversation ensues:
||Are you new here?
||I just came up this morning.
||You know, I hope you don't mind my saying this, but you look
very pale. Is something wrong?
||No, I don't mind talking about it. You see, I just got out of
jail. I was in jail for a total of 25 years.
||That's terrible. What happened?
||Well, I got into a big fight with my wife and I ended up
murdering her. They gave me 10 years in jail.
||That's too bad. But that's only 10 years. What
||Well, soon after I got out, I got married again. And
then soon after that, I had a fight with my second wife and I
killed her too. So they gave me another 15 years, and I
just got out.
||(excitedly) Oh, so you're single!
The next step on the continuum is repression. This mechanism is
more automatic than denial and more likely to be triggered by
unconscious processes that may be more complex. In denial the
dangers are well circumscribed and easily defined, e.g., death by
incurable disease, a highly probable future earthquake, and lifelong
spinsterhood. In repression, as is true for denial, there is
relegation of data to storage out of conscious awareness. Whereas
in denial the material being avoided is well circumscribed and generally
external, in repression the danger is internal, i.e., stored material,
which, if brought into conscious awareness would cause psychological
pain. Such relegation to storage often relates to the guilt,
shame, embarrassment, self-loathing, etc. that individuals would
experience if they were to recognize that such impulses existed within
themselves. The wife beater represses memories of all the
unconscionable things he did in the course of his rage outbursts.
I have enough experiences with these individuals to say that they are
not all simply lying when they deny the extent of their depravity
(although lying is certainly operative). Many of them genuinely do
not recall many of the more odious things they do.
Slips of the tongue often provide good examples of the repression
mechanism. Many years ago a mother described to me extremely harsh
punitive measures for disciplining her children. These included
beating them with a strap, punishing them with meals consisting only of
bread and water, and locking them in closets. After describing
these in great detail, the mother said to me: "Don't get me wrong,
Doctor. I love my killdren, I mean my children."
It was obvious to me that this woman could not allow herself to
appreciate the extent of her murderous rage toward her own
children. This would have evoked enormous guilt. Her
hostility revealed itself however, with her slip. Sigmund Freud
would have called this "return of the repressed." I am
in full agreement with him on this point and this vignette is an
excellent example of the phenomenon.
Another example: I recall well seeing on television a TV interview of
Richard Nixon on the White House steps. He was asked about his
reactions to Jack Ruby's murder of Lee Harvey Oswald, soon after Oswald
had murdered John F. Kennedy. Nixon's statement (and I swear I
remember it this way): "Two rights don't make a wrong; I mean two
wrongs don't make a right."
Dreams provide a good example of the process of repression.
Freud erred when he considered the primary purpose of dreams to be wish
fulfillment. Certainly, there are dreams that do provide wish
fulfillment and overtly sexual dreams (not necessarily the so-called
symbolic ones with phallic and vaginal symbols) are good examples of
this. Freud did not, however, describe the more important and
common function of dreams, namely, an alerting mechanism designed to
bring to the dreamer's attention dangers that he or she might not have
consciously been aware of. Because of guilt and shame, the data
were relegated out of conscious awareness, but press for expression
because the information is of vital importance to the individual,
possibly even of survival value. For example, a middle-aged woman,
still single (I'm not talking here about the woman described previously
at the resort), tells me that she's met a new man and she's "deeply
in love." By the time of the session she's already had three
dates and they're talking about marriage. She describes herself as
"walking on a cloud." In the course of our discussion
she tells me that the man had been married twice previously. (I
know that this vignette has an uncanny similarity to the story above
about the woman at the resort, but believe me, it has nothing to do with
it.) I asked her what she knew about his two previous marriages
and the reasons. for the divorces. Her answer: "I never asked
him about that. I don't believe that's any of my
business." In response, I told her that I thought it was very
much her business and that it was also my business.
She disagreed with me and the session ended.
That night she had a dream in which a man, who looked uncannily
similar to her new boyfriend, was married to another woman, a woman whom
she could not recognize. In the dream the woman was very upset
because her husband was cheating on her. It was not simply a case
of an occasional one night stand. Rather, it was a situation of
compulsive infidelity. In the next session, she presented the
dream and, with some difficulty, came to appreciate that the dream
reflected deep concerns on her part about her new boyfriend's potential
for marital infidelity. She agreed with me, then, that it was
her business to find out about the causes of his previous divorces.
In the following session she told me that she had indeed confronted
her boyfriend and learned what she had feared, namely, that his previous
marriages broke up because of his infidelities. We both agreed
that, although he had never said anything specific about his
philandering, she must have been picking up certain messages from him
that suggested danger for her marriage. She did, then, describe
how he boasted about his sexual conquests and sexy women with whom he
had gone to bed. The dream and our ensuing discussions helped her
appreciate that there was a high likelihood that such behavior would be
repeated in this new marriage, so deeply were such patterns embedded in
his brain circuitry.
I myself had a dream, about a patient, that serves as an excellent
example of the dreams value as an alerting mechanism. Many years
ago a man of 25 requested treatment for homosexual difficulties.
He considered his homosexuality to be psychogenic and hoped that therapy
would help him achieve a heterosexual life pattern. This treatment
took place in the mid-1960s at a time when a psychotherapeutic
(psychoanalytic) approach to homosexuality was accepted practice.
Today, I would be far less receptive to trying to "cure" this
The patient was born and raised in New England and had attended a
prestigious boarding school and Ivy League college. His father had
died when he was three and he had absolutely no recollection of
him. He was raised with his mother and three older sisters, all of
whom doted over him. His mother often undressed in front of him,
even into the teen period. He first began having homosexual
experiences in high school, but did describe some successful
heterosexual experiences as well. However, his homosexual
experiences were much more gratifying to him.
In his early twenties he married in the hope that this might bring
about a heterosexual orientation. He had not told his wife about
his homosexuality at the time of the marriage. After about a year
she became aware of his activities and at first hoped that she might be
able to salvage the marriage. When I saw him, she had decided upon
divorce and he went into therapy, hoping that he could avoid future
similar consequences of his homosexuality. At the time he entered
treatment, he was also in difficulty in the firm where he worked.
He was employed by an investment banking firm, and it was becoming
increasingly clear to him that he was being passed over for promotions
because of suspicions of his homosexual lifestyle.
During the first two months of treatment, the patient appeared to be
involving himself well in therapy. He was a mild mannered man who
was quite polite and formal. His relationships, however, were
invariably tempestuous, especially his homosexual relationships,
especially because of jealous rivalry. In association with the
stresses of these relationships, he would often drink heavily and
sometimes become quite depressed.
Consciously, I did not consider the patient to be significantly
different from other patients I was seeing with regard to any particular
thoughts and/or emotional reactions that I might be having about
them. One night, however, after about two months of treatment, I
had a dream in which the patient was pursuing me with a knife in an
attempt to murder me. Although I fled in terror, he was gaining on
me. The pursuit seemed endless. Finally, I awakened just at
the point where he was about to stab me. When I awakened, it was
with a sigh of relief when I appreciated that it was only a dream.
I was in analytic training at the time and so I began to think seriously
about what the possible meaning(s) of the dream could be. I had to
consider the most obvious explanation, namely, that my dream was a
reflection of unconscious homosexual desires that I presumably harbored
toward my patient (his putting a knife=penis into me). Because I
have never had any particular inclinations in this directions, I found
it difficult to accept this as a possible explanation. However, I
also had to accept reluctantly the latent homosexual explanation because
of the way unconscious processes operate. I was also taught in
analytic training that when a therapist has a dream about a patient, it
invariably indicates inappropriate countertransferential
reactions. I was not too comfortable with this unflattering
explanation either. I could not recall having had any dreams
previously about my patients (nor have I had any since), but I did, on
occasion, exhibit what I had to accept were inappropriate
countertransferential reactions. Accordingly, I was left with the
feeling that the dream was important but without any particular
explanation for its meaning. (At that time, I was not appreciative
of the alerting value of dreams.)
About two weeks after the dream, the patient entered the session in
an agitated state. Although I do not have verbatim notes on the
interchange that ensued during that session, the following is
essentially what took place:
||(quite tense) I'm very upset. I can't take it any longer. I
can't continue this way.
||This is very difficult to talk about.
||I suspect it will be, but I know you appreciate that it's
important for you to discuss those things here that you are
hesitant to speak about.
||Yes, I know I have to tell you but it's difficult.
||I can't stand it any longer. I've got to tell you.
I'm in love with you. And I've been in love with you since
the first session. I can't stand it any longer.
While I'm talking to you about my problems, I keep thinking
about how much I love you.
||You know, the word love can mean many things. It
would be helpful to us if you could tell me the exact kinds of
thoughts and feeling you've been having when you say that you
||That's even harder.
||I can appreciate that; however, if we're to fully understand
what's happening, it's important that you try to tell me.
||If you really want to know, I want to have sex with you.
||Even there, having sex with someone is a statement that covers
a lot of ground. I'd like you to try to be more specific
about the particular kinds of thoughts and feelings you're
having when you say that you want to have sex with me.
||(hesitantly) Well, I just wouldn't want to start having sex
right away. I'd want there to be some overtures on your
part, some advances by you.
||I'm starting to get the picture. Now what specifically
would you want me to say and do.
||Well, I just wouldn't want you to simply ask me. I'd
want you to plead.
||What would you want me to say specifically?
||I'd want you to beg me. I'd want you to get down on your
knees and beg me to have sex with you. (Patient now
becoming agitated.) I'd want you to be extremely
frustrated, to be very horny. I'd want you to be on the
floor kissing my feet, begging me over and over again to have
sex with you.
||Well, I wouldn't just have sex with you then. I'd want
you to beg more. I'd want you to kiss my feet. I'd
want you to promise to do anything at all to get me to have sex
with you. You'd be on the floor crying and pleading.
But I still wouldn't gratify you. I'd let you
squirm. I'd let you plead. (Patient now becoming
||Finally, when I felt you had enough punishment, I'd make you
get undressed and then I'd make you lie down on the ground on
your belly. Then I'd fuck you in the asshole and reduce
you to my level. I'd humiliate you and gratify you at the
||Is that the end of the fantasy or is there more?
||Oh, there's more; I just wouldn't stop at that. First,
I'd call your wife. I know you're married; you have that
ring on your finger. And I saw those pictures on your
desk; I assume those are your kids. Anyway, what I'd do
then would be to call your wife. I'd tell her that you're
a fag. And I'd tell her that you have sex with your
||What do you think would happen then?
||Then she'd divorce you. What woman would want to live
with a fag?
||Yeah, I wouldn't stop there. I'd call the people who are
in charge at the Columbia Medical School, the dean or whoever it
is. I'd tell him that they have someone on the faculty who
fucks his patients. I'd also tell them you're gay.
And I'd tell them that you had sex with me. Then they'd
kick you off the faculty.
||Yeah, one more thing. I'd call the medical society and
tell them what you really are, a fag, a gay doctor who fucks his
patients. And they'd take away your license.
||No, that's it.
||You know, you started this session by telling me that you
'~love" me. Is this your concept of love?
||Well, maybe it's not love, but it's the way I feel.
Maybe it's the way I feel because I know that you don't love me
the way I love you.
||Here you tell me that you love me and then you tell me how you
want to humiliate me, expose me as a doctor who has sex with
patients. Then you tell me that you would like to have my
wife divorce me and then I'd be kicked off the faculty at the
medical school and then lose my medical license. It sounds
to me like you want to destroy me. It doesn't sound very
much like love to me. It sounds to me like the opposite,
In the ensuing discussion, the patient was too upset to be able to
gain any insight into what was going on. His treatment did not
last much longer. He left about two weeks later, claiming that I
really did not have very much affection for him. If I genuinely
wanted to show my affection, I would have sex with him.
Although the vignette demonstrates well an important psychodynamic
mechanism operative in some patients with male homosexuality, namely,
the use of love as a reaction formation to hate, it is not presented
here for that purpose. Rather, the vignette is presented as an
example of an alerting dream. It is reasonable to speculate that
at the time of the dream I was already receiving subtle signals of the
patient's hostility. I was not aware of these consciously and may
have been threatened by them. This resulted in my repressing these
thoughts and feelings. However, it was important for me to
ultimately appreciate the implications of the patient's hostility,
especially because the implementation of his wishes would have been
catastrophic for me. Accordingly, my pent-up thoughts and feelings
finally erupted into conscious awareness via the alerting dream.
This dream, like many dreams, served as a compromise between full
repression without any conscious awareness of the repressed material and
full conscious appreciation. The symbolic portrayal allowed for
release of the repressed material and, at the same time, lessened the
unpleasant emotions (such as shame, guilt, and fear) that I would have
experienced had this material been allowed to enter conscious awareness
without any disguise.
Had the man continued in therapy, I would have used the dream to help
me make decisions regarding hospitalization. The dream suggested
that this was indeed a dangerous man. Of course, one would not and
should not use one's own dream as an important criterion for deciding
whether or not to hospitalize a patient. The clinical behavior
must be paramount; however, the dream should not be ignored
either. As I hope the reader agrees, the dream can be a powerful
source of information about dimly sensed but not overtly recognized
It is my hope that these vignettes demonstrate well the repression
mechanism. It is a powerful force. I believe that there
probably are some women who do indeed repress memories of sexual
abuse. In some cases it was repressed because it was a painful,
embarrassing, and humiliating experience that would only produce
personal denigration if recalled. For others, there may have been
enjoyment of the experience and recognition of such pleasure would be
too guilt-evoking to allow such memories into conscious awareness.
I do believe, however, that such repression is relatively uncommon and
does not approach the traditional one-third figure frequently floating
about these days. But even if I am incorrect here and it is indeed
true that the one-third (or even greater) figure of repressed memories
of sexual abuse is valid, this does not preclude the parallel track of
suggestible and/or gullible women being programmed to believe that they
were sexually abused in childhood when there was no good reason to
believe that they were.
At the time of abuse, especially when it is severely traumatic, a small
percentage of children will dissociate. This is a phenomenon which
is most often seen in situations of severe trauma, such as military
combat, earthquakes, tornadoes, floods, rape, and attempted murder.
There is a massive flooding of stimuli into the brain circuitry. The
unity of consciousness is disrupted. There is a disintegration of
consciousness and certain segments of the personality may operate
autonomously. Continuity and consistency of thoughts are
disconnected from one another. Identity confusion and identity
alteration may occur. There is a loss of sense of the passage of
time. The person may experience perceptual distortions, illusions,
or feelings that the surrounding world is strange or unreal
(derealization). Sometimes there is complete amnesia for the event
(psychogenic or dissociative amnesia) or the individual enters into an
altered state of consciousness in the context of which complex behaviors
are exhibited that are unknown to the patient (psychogenic or dissociative
fugue). Dissociation is well compared to the overloaded computer
that stops functioning because it cannot deal with the massive amount of
information being poured in. This phenomenon may be associated with
psychic numbing, which also serves to protect the individual from full
appreciation of the trauma.
In chronic abuse this pattern may become deeply entrenched to the point
where the process becomes automatic: each time the person is abused, he or
she automatically dissociates and thereby protects himself or herself from
the pain of the experience. The result may be (in a small percentage
of cases) no conscious recall of the traumatic events.
Such dissociative episodes may then occur in situations in which the
person is reminded of the abuse by cues that are similar to those that
existed at the time of the original abuse. For example, a Vietnam
veteran walks past a movie house with advertisements showing battle scenes
from the movie playing therein. These, because of their similarities
to the battlefield conditions in Vietnam, trigger a dissociative reaction
in which his brain is flooded with flashbacks of the combat situation as
well as the disorganization of thinking typical of dissociation.
Under such circumstances, there are likely to be other manifestations of
dissociation in which the person may be amnesic for certain time blocks
during which events that transpired are totally obliterated from the
person's memory, but have been clearly observed by others. This is
not simply a matter of forgetting certain events, which all people do, but
there is total obliteration of memory of such events and confusion when
confronted by observers of the person's involvement in such events.
People who have not been traumatized and/or abused are not likely to
manifest or experience bona fide dissociative phenomena. Overzealous
examiners often frivolously apply the concept of dissociation to even the
most transient episodes of inattentiveness and "spacing
out." This may be done in circumstances when there was
absolutely no evidence for bona fide dissociation at the time of the
original alleged abuse.
An article on the subject of dissociative states would not be complete
without some mention of the so-called Multiple Personality Disorder, a
diagnosis which is very much in vogue at this time. Although DSM-IV
(American Psychiatric Association, 1994) lists Dissociative Identity
Disorder (Multiple Personality Disorder), I have not yet personally seen
such a case and am extremely dubious about its existence, although I
cannot be certain that it does not exist. As mentioned, one cannot
prove a null hypothesis. I can, however, express my skepticism.
Many years ago, while serving as a psychiatrist in the military
service, I interviewed in jail a man who had murdered another soldier in
the course of a fight. Specifically, he had fired 23 rounds to the
head and chest of this man. When I saw him he was clearly in an
altered state of consciousness and this is basically what he had to say to
||I don't remember killing him. I have absolutely no memory
of killing him. They say I killed him. ... I must have
because the bullets match my gun, which they found in the
bushes. I don't remember throwing it in the bushes, but it
must have been my gun because my fingerprints were on it. ...
I do not think this man was lying. He was clearly in an
altered state of consciousness and I do believe he was suffering with
psychogenic amnesia. The information was dissociated because he did
not want to view himself as the murderer that he actually was.
I believe that adult women who are raped might, under certain
circumstances, dissociate. But this is rare. It is probable
that some children dissociate in the course of sexual encounters with
adults but this is also rare. Overzealous evaluators, however, are
interpreting every distraction and every mild example of "spacing
out" as a manifestation of dissociation. This is most commonly
seen in situations where the child has not been sexually abused and the
dissociation phenomenon is being brought in to give medical credibility to
the evaluator's belief that the child was abused, a belief which has
absolutely no basis in reality.
Dissociation, then, can be considered a stronger form of
repression. Repression probably does not use up as much brain energy
or as much brain-cell circuitry. When dissociation is occurring, the
brain is really buzzing. Therefore, it should be differentiated from
repression and placed further along the continuum of mental mechanisms
that induce storage of cognitive material.
Depersonalization is commonly seen in association with
dissociation. Again, it is primarily confined to situations in which
the individual is subjected to extremely severe trauma.
Depersonalization is best viewed as a phenomenon in which the mind appears
to have split away from the body. It is as if the person's mental
apparatus hovers above the body and observes it. This is an adaptive
mechanism in life-threatening situations that helps protect the individual
from full appreciation of the impact of what is going on. Sometimes
the individual feels that his or her body is dead, like a zombie or a
mummy. This is often referred to as derealization and is also seen
in association with dissociation. When, however, the mind appears to
be looking down upon the dead (derealized) body, the term
depersonalization is warranted. People on the brink of death, while
being tended to by emergency caretakers, may look upon what is going on,
as if from above, in a dispassionate, but nevertheless interested
way. Again, it is important to note that depersonalization only
occurs in situations of severe trauma. On occasion, a woman, in the
course of being raped, will depersonalize.
Some children, while being abused, will depersonalize the whole event
by making believe (usually consciously at first) that they are someone
else. The child may believe that the abuse is occurring to someone
else or that he or she is invisible and observing the abuse from
above. This lessens psychic pain. The child may feel like he
or she is living in a dream state. Such children may also have
experiences in which they believe they are someone else. In
contrast, children who have not been abused are not likely to describe
depersonalization phenomena. The only one exception to this would be
psychotic children, especially older ones, for whom the depersonalization
phenomenon may be part of a schizophrenic process.
Repression has been given a bad press because it has been resorted to
by overzealous, incompetent, and fanatic therapists who use the
"repressed memory" theory to justify their induction of
sex-abuse delusions in their gullible patients. They have borrowed a
psychological mechanism in the service of giving medical (psychiatric)
credibility to their programming maneuvers.
Denying the existence of repression is not the best way to deal with
these therapists. First, it is very difficult to "prove"
that something does not exist. Second, even if one were to be able
to prove that repression does not exist, overzealous therapists would
merely focus on other justifications for their maneuvers. Disputes
over what percentage of sexually abused women forget (repress) their
memories of abuse are irrelevant to the question of whether gullible
and/or suggestible women are being programmed to believe they were abused
when they weren't. Accordingly, the repressed memory arguments are
in the wrong arena. Whatever the degree of repression and forgetting
there is in the track of those who were abused, there is a parallel track
of those who are being convinced that they were abused when they were
not. The repression controversy is a distraction from this
phenomenon and thereby does not serve well the goal of those who are
trying to bring attention to the national scandal of the induction of
false sex-abuse accusations in gullible and suggestible people.
American Psychiatric Association
(1994). Diagnostic and Statistical Manual of Mental Disorders-IV
Washington, DC: Author.
Briere, J., & Conte, J. (1989, August). Amnesia in adults
molested as children: Testing theories of repression. Paper presented
at the 97th Annual Convention of the American Psychological Association,
New Orleans, IA.
Briere, J., & Conte, J. (1993). Self-reported amnesia for abuse in
adults molested as children. Journal of Traumatic
Stress, 6(1), 21-31.
Herman, J. L., & Schatzow, E. (1987). Recovery and verification of
memories of childhood sexual trauma. Psychoanalytic Psychology,
Loftus, E. F., Polonsky, S., & Fullilove, M. T. (1994). Memories of
childhood sexual abuse: Remembering and repressing. Psychology of Women
Quarterly, 18, 67-84.
Williams, L. M. (1994). Recall of childhood trauma: A prospective study
of women's memories of child sexual abuse. Journal of Consulting and Clinical
Psychology, 62(6), 1167-1176.