Unconscious relational traumatic memory and its relevance to ‘everyday’ clinical psychiatry

Abstract

Objective:

The aim of this paper is to demonstrate the relevance of the concept of unconscious relational traumatic memory to ‘everyday’ clinical psychiatry.

Method:

One clinical vignette and concepts from the Conversational Model of Psychotherapy are used to consider the potential relevance of this type of memory.

Conclusions:

The influence of modern classification systems and the dominance of the paradigm of ‘biological psychiatry’ over the last 30 years have together led to an emphasis on diagnosis and treatment by symptom cluster. This perspective may overlook both the patient’s current psycho-social context and their personal history. An understanding of unconscious relational traumatic memory may assist in both the conceptualisation and the treatment of many patients, particularly those adults who have been abused in childhood, where the link between the early experiences and the late manifestations are frequently lost.

Keywords

child abuse conversational model of psychotherapy patient history psychosocial issues trauma traumatic memory unconscious memory

Get full access to this article

View all access options for this article.

References

Ellenberger

. The discovery of the unconscious. New York: Basic Books, 1970.

Shorter

. A history of psychiatry. New York: Wiley, 1997.

American Psychiatric Association (APA). Diagnostic and statistical manual of mental disorders. 3d ed. Washington, DC: APA, 1980.

Rosenham

. On being sane in insane places. Science 1973; 179: 250–258.

Kendell

Cooper

Gourlay

. Diagnostic criteria of American and British psychiatrists. Arch Gen Psychiatry 1971; 25: 123–130.

World Health Organisation (WHO). The international statistical classification of diseases and related health problems, tenth revision. Geneva: WHO, 1992.

Linford

Arden

. Brain-based therapy and the ‘pax medica’. Psychother Austr 2009; 15: 16–23.

Parker

. How should mood disorders be modelled? Austr NZ J Psychiat 2008; 42: 841–850.

Zimmerman

Ruggero

Chelminski

. Psychiatric diagnoses in patients previously over-diagnosed with bipolar disorder. J Clin Psychiatry 2010; 71: 26–31.

10.

Starcevic

. Anxiety disorders no more? Australas Psychiatry 2008; 16: 317–321.

11.

McHugh

. Striving for coherence: Psychiatry’s efforts over classification. J Am Med Ass 2005; 293: 2526–2528.

12.

Read

. Does schizophrenia exist? Reliability and validity. In: Read

Mosher

Bentall

(eds) Models of madness. New York: Routledge, 2004, pp. 43–56.

13.

Anand

Malhi

. From manual to bible: The questionable hegemony of DSM-IV. Austr NZ J Psychiatry 2011; 45: 348–350.

14.

Horwitz

Wakefield

. The loss of sadness. New York: Oxford University Press, 2007.

15.

Gelinas

. The persisting negative effects of incest. Psychiatry 1983; 46: 312–332.

16.

Ellenson

. Predicting a history of incest: A predictive syndrome. Social Casework 1985; 66: 525–532.

17.

Felitti

Anda

Nordenberg

. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) study. Am J Preventative Med 1998; 14: 245–258.

18.

Herman

. Trauma and recovery. New York: Basic Books, 1992.

19.

Schore

. Affect regulation and the origin of the self. New Jersey: Lawrence Erlbaum, 1994.

20.

Schore

. The experience-dependent maturation of a regulatory system in the orbital prefrontal cortex and the origin of developmental psychopathology. Develop Psychopathol 1996; 8: 59–87.

21.

Schore

. Affect regulation and the repair of the self. New York: Norton, 2003.

22.

Meares

. The conversational model: An outline. Am J Psychother 2004; 58: 51–66.

23.

Meares

. The metaphor of play. 3rd ed. East Sussex: Routledge, 2005.

24.

Segal

. Introduction to the work of Melanie Klein. London: Hogarth Press and Institute of Psychoanalysis, 1978.

25.

Meares

. Amplification and forms of relatedness. In: Meares

Nolan

(eds) The self in conversation, Volume 1. Sydney: ANZAP Books, 2002; 222–236.

26.

Bargh

Chartrand

. The unbearable automaticity of being. Am Psychologist 1999; 54: 462–479.