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Journal of Clinical and
Basic Psychosomatics Somatic symptom disorder etiology

the trauma. 13-15 Given this definition, “recovering” trauma to a lack of large clinical samples. We can determine
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memories is impossible since they were never encoded. prevalence rates for traumatic amnesia from population
Importantly, this definition of traumatic amnesia does not studies and unique prospective designs of documented
assume that separate memory systems, such as procedural trauma survivors, such as substantiated child sexual abuse
and emotional memory systems, have also failed. victims or car accident victims. Six studies have been
There is further confusion over the name dissociative identified that share a compellingly similar prevalence
amnesia because some research shows dissociation is a rate. Three of the six reported 19% of victims, and three
key determinant in PTSD etiology—PTSD’s intrusive reported 36% of victims have no memory of the trauma
remembering being the opposite of amnesia. In the event(s), immediately after a documented traumatic
descriptions of dissociation for people with PTSD, it is experience, and many of those have no memory of the
an appraisal of “numbness” during and after the trauma, trauma even months or years later. 22-28 The bimodal result
associated with the freeze response. Yet the research below seems to relate to the type of trauma; the three studies
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shows that dissociative amnesia is not caused by numbing/ that contacted child sexual abuse victims years later found
freezing, but instead by a very active response to the higher amnestic rates than the three studies that contacted
trauma: Fight or flight. The high cortisol generated to drive medical/health crisis trauma victims or general population
this high initial activity leads to memory blockade, and members about any kind of trauma and associated amnesia
that leads to amnesia, not numbing. Dissociative amnesia experienced. Young age and relationship to the perpetrator
falls in the DSM-5-TR category of dissociative disorders, (betrayal trauma) affect memory. 29,30
linked by the amnesia and separation of memory systems Traumatic amnesia is a more likely outcome of trauma
common in dissociative identity disorder—leading to exposure, yet is much less studied than PTSD. PTSD’s
its name dissociative amnesia. However, the definition prevalence rate is between 8% and 9%. Has there been
1,31
of dissociation—body separated from mind, or mind an assumption that what you can’t remember can’t hurt
separated from present reality—is not salient in the initial you? Sadly, the T-A-P theory indicates that what you
creation of the disorder. The single diagnostic criteria in can’t remember does just that—it hurts you. Because of
the DSM-5-TR for dissociative amnesia refers to amnesia the difficulty in substantiating trauma history with many
for (inability to recall) autobiographical events (declarative amnestic victims, if they seek any help at all, their symptoms
memory) that are usually traumatic in nature. There is can seem a mystery to themselves, their families, and their
no symptom referring to unreality, depersonalization, or health providers. In the worst-case scenario, they may be
numbing of emotion or sensation. To reduce confusion, labeled malingerers or hypochondriacs. In contrast, people
“traumatic amnesia” will be used in this review as a more with PTSD symptoms are more likely to be believed and
general condition that encompasses dissociative amnesia. treated. Van der Kolk sensitively describes how victims

It is helpful here also to briefly review the divergent use fragments of recollection, external corroboration, and
natures and anatomy of declarative and procedural memory fuzzy intuitions to confirm that they experienced trauma.
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systems. Due to various factors, one can be impeded during They piece together the meaning behind their mental or
encoding while the other remains intact. 16-21 Although physical dysfunction, having to trust emotional and body
partial impairment of recall for some aspects of trauma, memory only. That delicate process has led to dead ends for
and/or dissociation, and feelings of the “unreal” quality of some, reconstructed, potentially false memories for others,
trauma are fairly common in PTSD, PTSD sufferers are and denial for yet more (Alpert et al., Fredrickson,
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aware that they experienced a trauma, and can name it, as Freyd, and Herman for discussions of how traumatic
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well as many aspects of what happened to them – when, amnesia was often mischaracterized and mishandled as
where, and so on. In their comprehensive review, Bovin “repressed memory”). Traumatic amnesia complicates
and Marx concluded that memory for trauma is stable over the detection, diagnosis, and treatment of trauma-
the course of PTSD. In contrast, traumatic amnesia spares related symptoms. However, patient progress is possible
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victims from intrusive, upsetting declarative memories, when information retained by emotional and procedural
but preserves emotional and somatosensory memories. memory systems is included in clinical formulations, as
What at first appearance is a reprieve from the memory of somatic psychotherapists recommend.
a traumatic experience becomes an intrusive and painful
re-living of the trauma in the form of somatic complaints. 4. Peritraumatic perception
3. Prevalence Peritraumatic perception initiates divergent hypothalamus-
pituitary-adrenal (HPA) axis responses to trauma.
Since
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The DSM-5-TR struggles to present a reliable prevalence Foa first suggested that perception of an event’s potential
rate for dissociative amnesia, listing it at 1.2%, due again, threat might be more determinant of its impact on PTSD

Volume 3 Issue 1 (2025) 5 doi: 10.36922/jcbp.4254