Dissociative Amnesia (300.12

There are three phases to the individual psychotherapy used in the treatment of dissociative

identity disorder. In phase one, there is the establishment of safety, reduction in symptoms,

and stabilization. Phase two involves confronting and working through the traumatic

memories. Phase three involves integration and rehabilitation. Besides the preferred

treatment of individual psychotherapy, patients can participate in family systems therapy,

cognitive therapy, clinical hypnosis, and creative arts therapy. It does not respond to

medications unless there is coexisting anxiety and depression.

DISSOCIATIVE AMNESIA (300.12)

Dissociative amnesia or DA is one of the three specified dissociative disorders seen in DSM-V.

There is a transient loss of recall memory in this disorder that can occur over a few seconds or a

few years. This is almost always secondary to psychological trauma. It involves memory loss

that is beyond that seen with typical forgetfulness. The patient may forget key details of what

happened before or during a traumatic event but will remember other details.

This usually arises out of childhood traumatic events but can be difficult to actually diagnose. In

older individuals, it can stem from war trauma or stressful situations that involve extremes of

emotions that the individual cannot cope with. There are brain abnormalities in the right

temporo-frontal cortical area in individuals who have dissociative amnesia.

The main criteria of dissociative amnesia, according to the DSM-V, include the following:

• Inability to recall autobiographical memories about a traumatic event

• Distress caused by the inability to remember the event

• There is no physiological cause of the lack of memory

• The disorder is not secondary to dissociative identity disorder

• There is no substance use or abuse involved

Having suppressed memories can be harmful to the patient and sometimes requires treatment.

The partial memory recall can lead to flashbacks and nightmares. It is often a comorbid state

with PTSD and can lead to self-destructive or self-harming behaviors or aggression against

others. Dissociative fugue is not a separate disorder in the DSM-V but is a subtype of

dissociative amnesia. In dissociative fugue, the patient often leaves their home and assumes a

new identity far from where they used to live. Daily life can trigger the person to dissociate

more.

The condition of DA can affect a person’s work-life, where they may fail to remember key

aspects of their job. Relationships can suffer and families can be stressed by the depressed and

confused state of the family member who has lost their memories. Friends and family can play

an important role in helping the individual recover lost memories. Cues and storytelling with

the help of a therapies can help recover memories without furthering dissociation. Relaxation

can help as well. Some will improve with mindfulness therapy.

The object of any treatment for dissociative amnesia is to reintegrate the memories and relieve

the patient of fragmentation. The disorder is difficult to treat and most commonly

spontaneously resolves however, it can take many years for this to occur. Treatment can, on

the other hand, reduce the underlying symptoms, helping the patient decrease depressive and

suicidal symptoms. The comorbidity of PTSD can be treated with therapy. The major treatment

involves psychotherapy, which includes dream analysis and memory training in order to

retrieve hidden memories. Cognitive-based therapies are the most effective at reducing the

symptoms and improving memory recall.

Dissociative fugue is fascinating to many people and is a subtype of dissociative amnesia in the

DSM-V. These are people who change their identity and move to a new location after a

traumatic event or accident. Once they are discovered and identified, they undergo a slow or

spontaneous recovery, in which they gradually recover their lost memories and resume their

regular daily activities.