On the last track, we discussed difficulties in determining whether or not a client has fabricated a memory as well as the client abandonment ethical dilemma.
On this track, we will examine the various sides of the argument regarding the ethical use of repressed memories.
Ethics - 4 Considerations in the Ethical Use of Repressed Memories
#1 Defining Repression
Repression is defined as "A defense mechanism, derived from psychodynamic theory, in which the individual unconsciously pushes out of the consciousness certain memories, ideas, or desires that are unacceptable or cause a high level of anxiety. Once these ideas or desires are contained in the unconscious, they cannot be recalled directly.
However, they may emerge in one's behavior in disguised forms, and their effects are sometimes seen in slips of the tongue or dreams. Because repression is, by definition, a mechanism of the unconscious, it should not be confused with the conscious act of suppression. Ask yourself this ethical question: is your sexually abused client repressing or suppressing?
#2 The Case for Memory Repression
It is common to consciously suppress unpleasant experiences. Many psychologists believe that unconscious repression of traumatic experiences such as sexual abuse or rape is a defense mechanism which backfires. The unpleasant experience is forgotten but not forgiven. It lurks beneath consciousness and allegedly causes a myriad of psychological and physical problems from bulimia to insomnia to suicide.
#3 The Case Against Memory Repression
However, the theory of unconsciously repressing the memory of traumatic experiences is controversial. Here is the ethical dilemma. There is little scientific evidence to support either the notion that traumatic experiences are typically unconsciously repressed or that unconscious memories of traumatic events are significant causal factors in physical or mental illness.
Most people do not forget traumatic experiences unless they are rendered unconscious at the time of the experience. No one has identified a single case where a specific traumatic experience in childhood was repressed and the repressed memory of the event, rather than the event itself, caused a specific psychiatric or physical disorder in adulthood.
To make the ethics issues even murkier, the strength of the scientific evidence for repression depends on exactly how the term is defined. When defined narrowly as intentional suppression of an experience, there is little reason to doubt that it exists. But when we talk about a repression mechanism that operates unconsciously and defensively to block out traumatic experiences, the ethical picture becomes considerably murkier.
Evidence concerning memory for real-life traumas in children and adults indicates that these events--such as kidnappings, the sniper killing at an elementary school, or the collapse of a skywalk--are generally well remembered....complete amnesia for these terrifying episodes is virtually nonexistent.
#4 Multiple or Repeated Sexual Abuse
Psychologist Lenore Terr, a defender of repressed memory therapy, argues that repression occurs for repeated or multiple traumas, such as a repeatedly sexually abused child. However, Schacter refutes repressed memory and notes that "hundreds of studies have shown that repetition of information leads to improved memory, not loss of memory, for that information." He also notes that people who have experienced repeated traumas in war, even children, generally remember their experiences. A person who suffers a great trauma often finds that she cannot get the event out of her mind or dreams.
To the contrary Terr's theory is that the child becomes practiced at repression to banish the awful events from awareness, and forgetting might aid in the child's survival. Terr's dissociative theory, however, is based on speculation rather than scientific evidence. Thus if your therapy is based upon a witch hunt so to speak for repressed memories, you might keep in the back of your mind that ethically repression is a controversial clinical area.
Most therapists accept as fact that it is quite common to consciously repress unpleasant experiences, even sexual abuse, and to spontaneously remember such events long afterward. However, most of the ethical controversy centers around recovered memories during repressed memory therapy (RMT). Critics of RMT maintain that many therapists are not helping patients recover repressed memories, but are suggesting and planting false memories of alien abduction, sexual abuse, and satanic rituals.
If you are thinking of conducting a formal or informal study regarding client's repressed memories you might keep in mind the Ethics and Standards of Practice, which states "Therapists must provide explanations to clients prior to assessment about the nature and purposes of assessment and the specific uses of results."
On this track we have discussed the difference between unconscious repression and conscious suppression. In addition we have discussed the controversy regarding the ethical use of unconsciously repressed memories and the role the therapist might play in actually creating those memories by suggesting and planting false memories of sexual abuse.
On the next track, we will examine the persuasive impact of group therapy on a person considering sexual abuse.
What is the ethical dilemma in utilizing repressed memories as the basis of your sexual abuse therapy?
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