Experience and Memory
Jean Goodwin and Reina Attias
In this chapter we use clinical observations, and elements of trauma and attachment theory to propose a model for how body and memory problems arise simultaneously out of traumatic childhood events and develop together during later posttraumatic illness. Clinical observations from multiple contexts describe a population of patients who present both puzzling bodily symptoms and puzzling narratives of early childhood trauma. The clinical phenomenology of such cases has been described in the literature of "grand hysteria" (where generally the somatic symptoms bring the patient to treatment) and in more recent case studies of posttraumatic and dissociative disorders (in which a troubling trauma narrative brings the individual to treatment and somatic symptoms appear later, often during so-called abreactive crises, as traumatic memories are being reworked). Published case studies also point to temporal interconnections between exacerbation and amelioration of bodily and memory symptoms over the life history of a single individual ( Goodwin 1996).
Reconstruction of the moment of childhood trauma, using trauma, attachment and object-relations theories, also reveals a convergence of somatic and memory problems. Both at the moment of attack and at the moment of ineffective protest, the child's physical and emotional pain can produce cognitive confusion and dissociation (see Chapter 3). When the pain and terror are complicated by dissociation, additional bizarre bodily experiences and further disruption of memory and narration may occur.