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Glenn Yank, MD is a Psychiatrist located in Tennessee.


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Question:
I had surgery scheduled for May 19 and made plans to be at the hospital on Wednesday the 19th, although the day was actually Monday the 19th. I told my husband the previous week, “I have surgery next Wednesday,” and in my mind I was absolutely sure of the day. My husband took off work and everything. When we arrived on Wednesday, we learned we were two days late, that the hospital had been unable to reach me on Monday, and that I would have to reschedule my surgery. Then and only then did I realize that I hadn’t even had a reason to believe my surgery should be scheduled for Wednesday. I hadn’t really looked at a calendar although it felt like I had. I hadn’t really heard anyone from the doctor’s office tell me Wednesday, although it felt like I had. I made the leap toward a conclusion that I accepted as if I had come to it by way of logical sequencing when really it was based solely on a feeling. There are many other recent examples in my life of this type of mistake. I’ve had dissociation for about 20 years and haven’t experienced anything like this before. I am at a place in therapy where more and more earlier (younger) alters are spending more time forward, so I think this has to do with the alters crossing communications. It doesn’t seem like forgetfulness, because there was nothing to remember in the first place. I’m making up things in my mind that haven’t occurred but it seems so real that I think it has occurred. Is this possibly due to some kind of early senility or is it a type of thought process that occurs with dissociation? If so, will it get better as the dissociation gets better or is it permanent/progressive? – Chrissy & Company

Answer:

I am quite certain that you are not experiencing any form of senility or dementia. The memory impairments found in those disorders are quite different from what you experienced. Dementing disorders show memory loss, particularly of short term memory, with an inability to remember details accurately, but not a consistent mis-remembering that you describe. People who are demented will sometimes make up details, usually vague ones, to hide their deficits, but because they cannot remember, they don’t remember what they have made up. Thus, they will not tell stories consistently to themselves or others.

What you seem to have done is to replace one memory with an alternate version, which you then remembered consistently. This is not primarily a disorder of memory, because you were able to remember “Wednesday” consistently in your talks with your husband and others.

You are correct in wondering if this is a process that can occur with dissociation. The research literature indicates that there appear to be correlations between the capacities for dissociation, imagination, suggestibility, and hypnosis. There are several implications of these correlations, one of which is that people with a powerful capacity to dissociate may also have the ability to believe ideas that are suggested to them by others, or even by themselves. Negative consequences of this are the beliefs of survivors that what their abusers said about them was true, and the so-called “false memory syndrome,” in which people come to believe (even if only for a while) what others have suggested or what they expect others to want them to believe. Positive consequences of the association of dissociation and imagination/suggestibility are the abilities of some survivors to make excellent use of imagery and other “hypnotic” techniques in their therapy.

In your case, it is possible that some part of you had a fear of surgery. Many abuse survivors have intense fears of surgery and medical procedures for a variety of reasons, including that certain aspects of the procedures may be triggers for dissociation or may re-enact aspects of their abuse, and also because they may have histories of negative interactions with doctors as children. I have known several patients who were taken to doctors as children, and the doctors completely missed the evidence of abuse and subjected the patients to further painful and intrusive examinations. Based on these kinds of reasons for wanting to avoid surgery, a person could invent a belief that the surgery was on a different day than it was actually scheduled for, and then come to believe this to be true.

Let me be clear that this is only conjecture on my part, and I believe no one could assert that this is what happened to you without interviewing you and getting a lot more history. I am just stating that this kind of scenario does happen to people who have dissociative disorders, and is far more consistent with what you report than any kind of dementing disorder.

If I am correct, and what you describe is related to dissociation, it should diminish as your dissociative symptoms become less intense and less automatic. These phenomena are neither permanent nor progressive. Practice grounding techniques, write down important things, and continue in your therapy.

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Disclaimer: The information contained here is not intended nor implied to be a substitute for professional advice relative to your specific medical or mental health condition or question. ALWAYS seek the advice of your physician or other health provider for any questions you may have regarding your medical or mental health condition. Information provided here DOES NOT constitute a doctor-patient relationship between you and the column author.

© Copyright 2003-2005. All rights reserved. Contact: ShrinkTime Last edited: 06/7/03.