What is the cause of inability to recall key features of a traumatic event, also known as dissociative amnesia?

From the Guidelines

The inability to recall key features of trauma should be addressed through a phase-based treatment approach, starting with a stabilization phase to ensure the individual's safety and improve emotional regulation, as recommended by the Expert Consensus Treatment Guidelines for Complex PTSD in Adults 1. This approach is crucial in managing complex PTSD (cPTSD) in adults, which is characterized by core DSM-IV symptoms of PTSD, including reexperiencing, avoidance, and hyperarousal, along with self-regulation problems such as emotion regulation difficulties and disturbances in relational capacities. Some key points to consider in the treatment of cPTSD include:

• The importance of a stabilization phase (Phase I) in reducing self-regulation problems and improving emotional, social, and psychological competencies before proceeding to trauma-focused interventions 1
• The use of trauma-focused therapy, such as prolonged exposure, written autobiographical narratives, cognitive restructuring, and Eye Movement Desensitization and Reprocessing (EMDR) therapy, in the treatment of cPTSD, but only after the individual has achieved sufficient stability 1
• The need for patience and professional guidance in the recovery process, as memory recovery varies significantly between individuals and forcing recall can be retraumatizing. It is essential to note that the treatment of cPTSD should be tailored to the individual's specific needs and circumstances, and that a thorough assessment and diagnosis by a qualified mental health professional are necessary to determine the most effective treatment approach.

From the Research

Inability to Recall Key Features of Trauma

• The inability to recall key features of a traumatic event is a common phenomenon in individuals with post-traumatic stress disorder (PTSD) 2.
• This absence of memory or verbal recall can complicate cognitive-based treatment and make diagnosis and treatment planning more challenging 2.
• Research suggests that the absence of memory or verbal recall does not rule out measurable physiological bodily responses to the initial trauma or subsequent experiences 2.
• The use of multiple time- and context-specific simultaneous physiological measures and overt behavior can guide clinical effort and serve to objectively assess treatment outcome, even in the absence of memory or verbal recall 2.

Trauma Memories and Narratives

• Studies have shown that trauma narratives are often dominated by sensorial/perceptual and emotional details 3.
• The study of other narrative aspects, such as fragmentation, length, temporal context, and references to self, provides heterogeneous results 3.
• Cognitive theoretical models of PTSD suggest that trauma memories are distinct from other autobiographical memories and are characterized by certain features, such as fragmentation and disorganization 3.

Treatment Implications

• The inability to recall key features of a traumatic event does not necessarily preclude treatment with evidence-based therapies, such as trauma-focused psychotherapies 4, 5.
• Medications, such as sertraline and paroxetine, may also be effective in treating PTSD, even in the absence of memory or verbal recall 4, 5, 6.
• Predictors of treatment response, such as symptom severity, childhood sexual trauma, and time since index trauma, can inform treatment planning and improve outcomes 6.