Memory, Trauma & BPD

Introduction to Memory Issues in Borderline Personality Disorder

If you're short on time, here's an excellent quick & readable introduction to the topic of trauma and memory, by Hope E. Morrow, MA, MFT, CTS, BCETS, or this fabulous explanation of the various types of memory by C. George Boeree.

For a very helpful longer overview of how memory, brain chemistry and life experience interact in all of us, see the excellent article: Emotional Memory Management by Joe Carver, PhD.

Sigmund Freud's original psychological model of memory involved the "repression" of negative experiences or uncomfortable desires in order to maintain the functionality of the person's conscious identity, or ego, which could otherwise be seriously threatened. This repressed matter, however, does not entirely disappear, according to Freud: it inevitably expresses itself in the form of the psychological symptom.

Freud's original psychoanalytic method was based on his premise that these memories could be retrieved to the patient's conscious mind by engaging in stream-of-consciousness discussion with a trained analyst; thus Freud's famous "talking cure." It was postulated that the patient, via this process of memory retrieval in the presumably safe current environment of the analyst's office -- and with the aid of an analyst devoted to overcoming the patient's repression -- could subsequently learn to defuse the symptomatic re-occurrence of the original memories (Freud called the process abreaction).

The inability of some patients to achieve successful, healing abreaction was indeed what led to the first depictions of patients who might now be diagnosed with BPD or another dissociative or traumatic disorder (Freud's circle viewed these patients as standardly neurotic except in specific triggering situations which called forth quasi-psychotic behaviors -- thus they were seen to balance precariously on the psychical "borderline" between neurosis and psychosis. Other intriguing early labels included "hysterical neurotics" and "ambulatory schizophrenics").

Later theories of memory have rejected Freud's rather vaguely-defined notion of repression, and offer models of specific cognitive mechanisms, such as "minimization", "re-labeling" and "directed forgetting" that all combine to create the active forgetting of trauma.

Current, more physiologically-based memory models look at the development of (and damage to) neural pathways that govern and store human experience. Check out the brain scans offered by Drs Bruce Perry, a leading researcher in the field, and Ronnie Pollard in their pathbreaking 1977 monograph, Altered Brain Development following Global Neglect in Early Childhood.

In addition, some very provocative recent DNA-based research (enabled in part by the Human Genome Project) has concentrated on locating a specific inheritable genotype and endophenotypes that make some folks more vulnerable to developing this mechanism than others. Some folks appear to be inherently more vulnerable to encoding experience as traumatic than others, regardless of what the impact of the experience "objectively" should be.
This latest research certainly goes a long way towards explaining why some children in a given family will develop BPD or PTSD, and others will not -- a fundamental question that has puzzled researchers for many years.

Whether via repeated exposure or due to an inherited dispostion towards traumaticization, or both, some people dissociate when they are confronted with certain memories, that is, they psychologically turn off or mentally remove themself from the scene. Dissociation is, theorists speculate, the brain's way of coping with traumas or memories of trauma that pose an actual yet inescapable danger to the individual's safety. A repeated need to dissociate (as often observed in BPD) is now viewed by many researchers as a form of extended memory impairment that may reach beyond the specific traumatic memory itself. [for more, see the section below]

According to current leading trauma researchers such as Dr. Bessel van der Kolk and Dr. Judith Herman, repeated exposure to severe trauma overwhelms the brain systems responsible for integrating sensation, perception and emotion. As a result, memories for the various aspects of currently-experienced events become fragmented and inaccessible to one other, so that the memory is not stored as a retrievably complete whole. Dr. Eric Kandel is one of the researchers currently studying this issue.

It has been proposed that these gaps in memory storage and later recall may compel a person to confabulate, or make up conjectural memories to fill in the blanks of experiences they cannot remember clearly. Unfortunately, this is one of the least-researched areas of modern psychological research, and what research there is tends to concentrate on the role of confabulation in the areas of crime-witnessing or schizophrenic disorders, but it is very relevant to the study of BPD in particular. Whereas psychologists believe that everyone confabulates at one time or another, more severe distortions in memory -- the blatant "rewriting" of personal history -- are extremely common in Borderline pathology.
[For more, see the links on False Memories below. You could also take a gander at more recent topical studies such as:
The Cognitive Psychology of False Memories: A Special Issue of the Journal Cognitive Neuropsychology by Daniel Schachter, or
The Emotional Brain: The Mysterious Underpinnings of Emotional Life by Joseph LeDoux.]

In summary: according to current traumatic theories of memory, any peripheral environmental cue to the original trauma itself (no matter how remote) sets off a biochemical resonance, triggering the dissociative effect, which in turn prompts the creation of confabulations. Whether the original trauma was objectively traumatic or not is irrelevant -- the sufferer's brain perceived it as such. The process is lightning-quick and may not be perceived by the individual as a cognitive chain reaction to a biochemical unbalance, but as an automatic and natural response to perceived threat -- as appears to be the case for many sufferers of BPD.

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Dissociation and Memory Loss/Distortion

Dissociation and depersonalization are descriptive terms for a subjective experience, rather than a technical analysis of the biophysiology involved. As researcher Dr. Joan Turkis describes it, dissociation is "the disconnection from full awareness of self, time, and/or external circumstances. The essential feature of dissociative disorders is a disturbance or alteration in the normally integrative functions of identity, memory, or consciousness."

Dissociative symptoms can include the following feelings & perceptions:
erasure of a sense of "self", trouble controlling or feeling one's own body, trouble with speaking, trouble putting memories in the correct time frame, bad short- or long-term memory, extremely selective memory, time loss, somatoform syndromes, recurrent nightmares, visual disturbances, the compartmentalization of specific experiences, feeling "spaced out", out-of-body experiences.
Depersonalization describes the retrieval of memories of personal experiences without any emotional tone attached to them -- as though they had happened to someone else.

Theorists since Freud have speculated that this "out of body" experience is related to an innate cognitive coping mechanism for surviving early, intense abuse and/or neglect. However, despite persistent popular (and some cases even clinical) mythology, this abuse does not apparently always have to be sexual to provoke dissociation. Whatever its nature, the early trauma is presumed to have been damaging enough to the emotional stability of the young baby or child to instigate the unconscious dissociation process as an emergency survival technique.

Everyone experiences occasional dissociation to some degree (driving home from work for the thousandth time on the same route: when you arrive, you realize your brain was on "autopilot", thinking of something else the whole time; although you know the route exactly from memory, you can't recall specific details from this one journey. Another example is the sudden blinking awareness of the "real world" that startles you upon emerging from an engrossing film in the movie theater).

For those with BPD and related disorders, dissociation can take a more intense form, seemingly erasing entire episodes or even years of experience. [note: this phenomenon is distinct from the ego defense mechanism of "splitting", in which a loved one might be completely demonized at the drop of a hat.] Many folks with BPD report a pervasive sense of merely participating physically in interactions while their mind is elsewhere, most particularly when recalling or being reminded of traumatic past events. This reminder or "trigger" for the memories may well be an unconscious association known neither to the person with BPD nor to their loved ones. Seemingly innocuous comments, sights, smells or references can set off a period of dissociative absence (or rage) which is as frustrating as it is painful to all parties involved.

[The impulsive anger, or rage so closely connected with BPD appears to stem from this sort of "memory triggering" -- possibly limited in his/her early emotional development by the same traumatic abuse (and/or neurological malfunction) that originally caused the dissociative response, a person with BPD often possesses only a very restricted repertoire of expressions, most notably relying on depression and anger to express more subtle affects such as nervousness, reserve, a sense of inadequacy or ambivalence.]

Certainly most Americans associate this 'Dr. Jeckyl/Mr. Hyde' phenomenon with Multiple Personality Disorder (now called Dissociative Identity Disorder), as depicted in many Hollywood films from Sybil to Fight Club, but we are less aware that the same mechanism plays a role in other personality disorders, too. Many researchers believe that BPD is a dissociative disorder lying somewhere on a spectrum between PTSD and Dissociative Identity Disorder.
For a clear overview of this perspective on dissociation and BPD, see: What is the difference between BPD and the spectrum of dissociative disorders? by Dr. Richard Moskovitz, author of Lost in the Mirror, an introduction to the disorder.

In fact, some researchers have questioned the actual existence of DID (Multiple Personality), speculating on "the possibility that both the history of abuse and PTSD symptoms may be seized upon as evidence of potential DID by therapists who seek to explain many of the puzzling features of BPD." Be that as it may, if one has lived intimately with someone suffering from BPD, it's not hard to understand this confusion among clinicians.

The results of a recent study of dissociative symtomatology in BPD patients, by Dr. Mary Zanarini, a BPD expert at McLean Hospital in Massachusetts, found that:

"Thirty-two percent of borderline patients had a low level of dissociation, 42% a moderate level, and 26% a high level similar to that reported by patients meeting criteria for posttraumatic stress disorder (PTSD) or dissociative disorders. [...] The results of this study suggest that the severity of dissociation experienced by borderline patients is more heterogeneous than previously reported. They also suggest that borderline patients have a wider range of dissociative experiences than are commonly recognized, including experiences of absorption and amnesia, as well as experiences of depersonalization."

During a dissociative episode, the brain is thought to switch into a biochemically-induced "high defense mode", during which the storage of new memories is effectively blocked. Yet not all memory is erased, which is quite confusing to those interacting with the individual during these times. Researchers propose that "these early encoding deficits [...] have a deleterious effect on the short-term memory system; they manifest as deficits in the ability to take in new information but not in the ability to conceptualize and manipulate previously encoded information".

See more links on Dissociative Disorders, Depersonalization Disorder and Dissociative Identity Disorder (Multiple Personality) for more information on these specific disorders as distinct diagnoses in conjunction with BPD.

Further reading:

The Spectrum of Dissociative Disorders: An Overview of Diagnosis and Treatment
by Joan A. Turkus, M.D.

Understanding Dissociative Disorders Through Dissociative Signs and Symptoms
by Cecilia Pearson, 1991

Childhood Trauma and Dissociation in Adulthood
Full-text article by Barbara Apgar, 1999

False memories in women with self-reported childhood sexual abuse: an empirical study
Bremner JD, Shobe KK, Kihlstrom JF., 2000
This test found that "Abused women with PTSD had a higher frequency of false recognition memory."

Dissociation: Culture, Mind, and Body
Fabulous detailed review of a book by David Spiegel, MD (Stanford University), discussing the mind-body connection in somatoform and dissociative disorders.

Dissociation and the Fragmentary Nature of Traumatic memories: Overview and Exploratory Study
by Bessel A. van der Kolk & Rita Fisler

Dissociation, affect dysregulation and somatization: the complex nature of adaptation to trauma
by Bessel van der Kolk, et al
Another great (academic) read by Dr. van der Kolk; lays out the dissociative side of PTSD and Complex PTSD.

The identification and characteristics of the partially dissociated states of patients with borderline personality disorder
Abstract of a study by Golynkina K, Ryle A., 1999

"Partial dissociation provoked by trauma and deprivation in childhood is seen to result in the persistence of separate self states. The characteristics of these and alternations between them are seen to account for the main features of the condition. The states identified [...] are classified into six groups, named abuser rage, victim rage, passive victim, ideal, coping and zombie."

Directed forgetting of emotional stimuli in borderline personality disorder
Abstract of a study by Korfine, Lauren; Hooley, Jill M., 2000

Cognitive and Physiological Aspects of Attention to Personally Relevant Negative Information in Depression
Full-text online dissertation by Greg Jeremy Siegle 1999

Autobiographical memory and parasuicide in borderline personality disorder
by Startup M, Heard H, Swales M, Jones B, Williams JM, Jones RS., June 2001
Abstract of a study which suggests that the inability to remember autobiographical specifics is directly tied in to an innate protective mechanism reducing the chance of parasuicidal behavior.

Brain Researchers From UCLA, Johns Hopkins Discover Role of Key Protein in Converting Short-term Memories Into Lifelong Ones
May 2001

Emotion Regulation and Memory: The Cognitive Costs of Keeping One's Cool
by Jane M. Richards and James J. Gross 2000

About Multiple Personality Disorder and Dissociation
by A.J. Mahari, a woman diagnosed with both BPD and DID.

The Significant Other's Guide to Dissociative Identity Disorder (Multiple Personality Disorder)
by Jeff Vineburg
This has got to be one of the more compelling accounts I've read. Much of it applies to SOs of BPs, too.
You can also join the Significant Others of DIDs email support group. To join, email the moderator at: snuffy

The Effects of DID on Children of Trauma Survivors
By Esther Giller, 1995
Great article detailing the parenting challenges of someone suffering from a dissociative disorder, and its effects on the children.

FIVE CONFLICTING VIEWS ABOUT MPD AND DID
Great compilation from the website of a person with DID.

DISSOCIATION: NATURE'S TINCTURE OF NUMBING AND FORGETTING
by David L. Calof

International Society for the Treatment of Dissociative Disorders: Treatment Guidelines
And visit the Society's Home Site: ISSD

Dissociation As a Mediator of Child Abuse Across Generations.
Abstract of a study by Egeland B, Susman-Stillman A., Nov. 1996
"Mothers who were abused and are abusing their children were rated higher on idealization, inconsistency, and escapism in their description of their childhood and they scored higher on the Dissociative Experience Scale compared to mothers who broke the cycle. Mothers who were abused and abused their children recalled the care they received as children in a fragmented and disconnected fashion whereas those who broke the cycle integrated their abusive experience into a more coherent view of self."

For more, please check out: Dissociative Disorders, Depersonalization Disorder and Dissociative Identity Disorder (Multiple Personality)

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Physiological Correlates to Traumatic Memory Loss

There is a growing body of research that seeks to define the exact physiological correlates to dissociative episodes.

Memory Mechanisms in Posttraumatic Stress Disorder
by Barry Layton, Ph.D. and Robert Krikorian, Ph.D., August 2002

On the Veracity and Variability of Traumatic Memory
by Jacobs, W. J., Laurance, H. E., Thomas, et al 1996
"We specify conditions under which a memory for a traumatic event has a high, medium, or low probability of accurately reflecting the target event. In addition, we specify circumstances under which a second party may have a large, medium, or minimal influence on the content of traumatic memory."
Excellent introduction to the topic.

The Phelps Lab, Department of Psychology, NYU
This research group focuses on

"understanding how memory works in our lives and how this is represented in the brain, with a particular emphasis on emotion. Through our research we try to integrate what we know about human behavior with animal models of the neural basis of learning and memory. By combining traditional cognitive techniques with brain studies, we hope to get a better understanding of emotion's influence on human learning and memory from the behavioral and neuroanatomical perspectives."

Click on "Selected Papers" to read a host of relevant studies.

The Body Keeps The Score
"Memory and the evolving psychobiology of post traumatic stress"
by Bessel van der Kolk, a leading trauma researcher, Harvard University Trauma Center.
Some bits are very technical, but overall it's very good. van der Kolk has published scores of articles on the neurology of traumatic stress.

Development of the Cerebral Cortex: Stress and Brain Development
by Paul J. Lombroso, M.D. and Robert Sapolsky, Ph.D, 1998
Excellent summary of the physiological damages of long-term stress on brain development (including the hippocampus/memory storage).

Biological factors of PTSD: neurotransmitters and neuromodulators
by Birmes P, Senard JM, Escande M, Schmitt L., 2002

Glucocorticoids and cognitive function: from physiology to pathophysiology
"Memory and the evolving psychobiology of post traumatic stress"
by Jameison K, Dinan TG., 2001

Episodic Memory: from Mind to Brain
by Endel Tulving, 2002

A neurobiological perspective on emotionally influenced, long-term memory
by L. Cahill, 1999

Beta-adrenergic activation and memory for emotional events
by Cahill L, Prins B, Weber M, McGaugh JL., 1994

The prisoners of despair: right hemisphere deficiency and suicide
Review of research by I. Weinberg, 2000
(You may have to register to read; it's free)

"It is suggested that due to functional insufficiency of the right hemisphere the suicidal person demonstrates a compensatory shift to left hemisphere functioning. This shift manifests itself in reversed asymmetry of neurotransmitters, tendency to dissociation, alienated and negative perception of the body, lower sensitivity to pain, disintegration of self-representation, cognitive constriction, overly general nature of personal memories, difficulties in affect regulation as well as such personality traits as low openness to experience and personal constriction."

Functional neuroanatomical correlates of the effects of stress on memory
Abstract of research by Bremner JD, Krystal JH, Southwick SM, Charney DS., 1995

Decoding traumatic memory patterns at the cellular level
by Thomas R. McClaskey, D.C., C.H.T., B.C.E.T.S., 1998
Nice clear introduction to this neurobiological concept.

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"Revictimization" and Borderline Memory

Why do folks with BPD seem to only remember the negative and forget the positive?

Explaining the forgetting and recovery of abuse and trauma memories: possible mechanisms
Epstein MA, Bottoms BL., 2002
"Rates of forgetting were similar among victims who experienced sexual abuse, physical abuse, and multiple types of traumas. Victims of other types of childhood traumas (e.g., car accidents) reported less forgetting than victims of childhood sexual abuse or multiple types of trauma. Most victims' characterizations of their forgetting experiences were not indicative of repression in the classic Freudian sense but instead suggested other more common mechanisms, such as directed forgetting and relabeling."

Posttraumatic Stress Disorder and trauma memory - a psychobiological perspective
by Wessa M, Flor H., 2002

"We postulate that posttraumatic stress disorder is maintained by learnt cortical and subcortical plastic changes. Specifically, we assume that classical conditioning leads to an intense emotional memory of the trauma that is mainly implicit and related to plastic changes in subcortical structures such as the amygdala. At the same time an insufficient explicit trauma memory is formed that manifests itself in insufficient cortical processing of trauma content. This dissociation of implicit and explicit memory prevents the extinction of the emotional response to the trauma and perpetuates the disorder. First empirical results based on this model confirm the main hypotheses."

As the Pendulum Swings: The Etiology of PTSD, Complex PTSD, and Revictimization
by Anne M. Dietrich, M.A., CT
Excellent article exploring the history of the term and asking whether "Complex PTSD" (BPD) may have a genetic component.

The Compulsion to Repeat the Trauma: Re-enactment, Revictimization, and Masochism
Excellent full-text article by Bessel A. van der Kolk, examining Freud's old notion of "repetition compulsion" and why people with Borderline and other personality disorders seem to seek out re-enactments of their original traumatic experiences (such as abusive romantic relationships).

Memories of Fear: How the Brain Stores and Retrieves Physiologic States, Feelings, Behaviors and Thoughts from Traumatic Events
by Bruce D. Perry, M.D., Ph.D., 1999
Perry is another of the leading U.S. researchers in trauma theory.

Memory performance among women with parental abuse histories: Enhanced directed forgetting or directed remembering?
Abstract of a study by Cloitre, Marylene; Cancienne, James, et al, 1996, suggesting that:
"The enhanced selective memory in the abused group was the result of better recall for "remember" and not poorer recall for "forget" information, indicating that abused individuals have an enhanced ability to sustain attention to designated "remember" information."

Directed forgetting of trauma cues in adult survivors of childhood sexual abuse with and without posttraumatic stress disorder
by McNally RJ, Metzger LJ, Lasko NB, Clancy SA, Pitman RK., 1998
"Relative to the other groups, the PTSD group did not exhibit recall deficits for trauma-related to-be-remembered words, nor did they recall fewer trauma-related to-be-forgotten words than other words. Instead, they exhibited recall deficits for positive and neutral words they were supposed to remember."

Implicit and explicit memory for trauma-related information in PTSD
by McNally RJ., 1997
This study points out that "directed forgetting research suggests that adult survivors of childhood sexual abuse who have PTSD exhibit memory deficits only for neutral and positive material, not for material related to their abuse."

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Childhood Sexual Abuse, Traumatic Amnesia, and the "Recovered Memory" Debates

Dr. Jim Hopper's excellent collection and review of the most recent literature/research on traumatic memory and amnesia
Highly recommended for a good introduction to the issues & most recent research on the so-called "False Memory Syndrome."

Memories of abuse in borderline patients: true or false?
Dr. Joel Paris, 1995 (must purchase article for a fee)

"This review will examine issues related to the validity of memories of child abuse in patients with borderline personality disorder (BPD). Evidence will be examined suggesting that borderline patients have a distorted perception of interpersonal events."

Uncovering Memories of Alleged Sexual Abuse: The Therapists Who Do It
by Hollida Wakefield & Ralph Underwager
For the curious, this is an article written by two of the best-known names in the publicization of the "False Memory Syndrome", a condition not recognized by the DSM-IV.
The basic premise of the False Memory Syndrome Foundation is that traumatic memory can rarely be repressed, and therefore the majority of cases of recovered memories of childhood abuse are fictitious creations "planted" in the client's head by an unscrupulous therapist seeking to exploit a child's "natural" resentment against parental caretakers. The debate has died down somewhat since the early 1990's, but for the record, here are the views of this group.

Editorial: False Memory Syndrome vs. Lying Perpetrator Syndrome: The Big Lie
by Patience Mason, The Post-Traumatic Gazette
Great, readable response to the many scientific and social problems with the "False Memory Syndrome."

Dealing with the problem of "false memory" in clinic and court
By John G. Watkins, Ph. D.

Hypnotizability, Cognitive Processing and Electrocortical Activity in PTSD
by Etzel Cardena, 1998

Neural Correlates of Memories of Childhood Sexual Abuse in Women With and Without Posttraumatic Stress Disorder
by J. Douglas Bremner, M.D., Meena Narayan, M.D., et al, 1999

Betrayal Trauma : The Logic of Forgetting Childhood Abuse
by Jennifer J. Freyd
Dr. Freyd is not only an academic psychologist, she is a survivor of childhood abuse whose parents founded a high-profile but very controversial national organization (False Memory Syndrome Foundation) to fight what they saw as her "false allegations." From the book: "The more the victim is dependent on the perpetrator, the more power the perpetrator has over the victim in a trusted and intimate relationship,the more the crime is one of betrayal. This betrayal by a trusted caregiver is the core factor in determining amnesia for a trauma." Read a detailed review of the book.

Memories of Childhood Abuse: Dissociation, Amnesia, and Corroboration
Full-text study by James A. Chu, M.D., Lisa M. Frey, Psy.D., Barbara L. Ganzel, Ed.M., M.A., and Julia A. Matthews, Ph.D., M.D., 1999

"A substantial proportion of participants with all types of abuse reported partial or complete amnesia for abuse memories. For physical and sexual abuse, early age at onset was correlated with greater levels of amnesia. Participants who reported recovering memories of abuse generally recalled these experiences while at home, alone, or with family or friends. Although some participants were in treatment at the time, very few were in therapy sessions during their first memory recovery. Suggestion was generally denied as a factor in memory recovery. A majority of participants were able to find strong corroboration of their recovered memories."

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This Page Last Updated: June 25, 2003

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