Lacunar amnesia is categorized as a type of dissociative amnesia. Amnesia is an impairment of the memory, usually caused by physical damage to specific areas of the brain or by psychological factors, such as situations that are so painful they are only retained in the subconscious mind (also known as repression). Dissociative amnesia is considered a mental illness and is characterized by disruptions in memory, awareness, perception, and identity.
Lacunar amnesia (Lacunar is based on the meaning of lacuna, which means gap) is a type of dissociative amnesia where the loss of memory is associated with a specific isolated experience acting as a defense mechanism for a traumatic event that has occurred. An example of a traumatic event that could cause lacunar amnesia is physical violence against one’s person, a wartime event, a car accident, or a natural disaster. The memory will be repressed into the subconscious and the victim will not remember anything about the incident.
What separates lacunar amnesia from other dissociative forms of amnesia is when the memory loss is only related to the one specific traumatic event which is removed from the conscious mind. For example, if a person suffers a car accident, they may remember what happened during that day leading up to the accident and waking up in the hospital after the accident, but they will have no memory whatsoever of the accident itself or why they are in the hospital.
Suffering or witnessing a traumatic event is the one singular cause of lacunar amnesia.
The singular symptom associated with all cases of lacunar amnesia is the inability to recall any part of a traumatic event experienced or witnessed by the victim. This one symptom separates lacunar amnesia from other forms of dissociative amnesia, making it easier to identify.
It’s important to be able to distinguish lacunar amnesia from other types of dissociative amnesia to pinpoint the particular symptoms that characterize this condition. For example, in Fugue State, a person who experiences an extremely stressful event may not only forget about the event, but they are likely to travel away from home and even form a new identity to cope with the trauma. Lacunar amnesia does not trigger the flight response but is notable because the person suffering from it will repress the memory of a traumatic event to the point they believe it never happened.
Suppressed memories should be treated as soon as possible as they can be harmful if the person suffering from lacunar amnesia suddenly remembers part of the repressed memory through possible actions or a nightmare. When this happens, the victim could dissociate further. Memory repression, particularly in adolescents, can lead to maladaptive behaviors and aggression. Therefore, it is important to seek treatment for this condition.
Lacunar amnesia is unlike general amnesia, which usually involves memory loss from a physical ailment such as brain trauma or disease. Lacunar amnesia is neuropsychological, which means it is not caused by a physical trauma, but rather a psychological trauma. If an incident causes too much emotional suffering and a person cannot deal with it, the brain will remove memories of the event.
While dissociative lacunar amnesia is not common (only about 1%-2% of the population suffers from it), rates of this disorder can increase after wartime or a natural disaster or any such incident which involves a large number of people.
A controversial, but all too common, example of lacunar amnesia is a condition referred to as repressed memories. There have been cases when adults seem to “suddenly” remember incidents from their childhoods, such as sexual abuse, that happened to them as a child. This is controversial because there is no way to actually prove that any abuse occurred or if the patient is fabricating the memory, which has been found in some circumstances. There were several cases in the 1980s of repressed memories and accusations of child abuse where the alleged victims recanted their stories a decade later, admitting the incidents likely did not occur. The topic of repressed memories being admissible in court is still very controversial as some professionals believe memories can be “planted,” and the actual incidents of abuse never occurred at all.
It is more likely that children, more so than adults, are able to repress memories as their identity is still forming during the early years of childhood and they are more able to disengage from traumatic events. Children who learn to use this defense mechanism believe the trauma that is happening to them is actually happening to someone other than themselves.
Research has been conducted by Neuroscientist Brendan Depue to find out what happens to the brain when someone witnesses or suffers a traumatic event. His research included showing a group of volunteers an unpleasant picture, such as a car crash; the volunteers were shown the photo and subsequently told not to think about the image. Depue’s findings demonstrated that the volunteers’ brains were not as active when asked to deliberately not think about the picture. Depue’s findings also indicated that when the subjects’ brains slowed down, it appeared as if those areas of the brain that processed the picture were shutting down. Since the brain activity declined, it appeared that the subjects weren’t trying to think of something else in lieu of the picture, but their brains were actually taking part in suppressing memories of the unpleasant picture. Depue concluded that the brain may actually take part in suppressing traumatic events and removing them to the subconscious mind. While this is not proof that the brain reacts in this manner when a traumatic event occurs, the results merit further research in understanding how lacunar amnesia affects the brain.
Whether or not the brain is active in blocking memories that are too painful to remain in the conscious mind, or whether this condition is part of the fight or flight response that is typical of any kind of traumatic event, it’s important to be able to identify symptoms of lacunar amnesia so the victim can begin efforts to recover and resolve the memory.
Memory loss of a specific event due to lacunar amnesia is recoverable and memory of the event is not lost forever, unlike other types of amnesia due to a physical ailment where the memory may not return.
The main goal of treatment for a person with lacunar amnesia is to help the patient recover their lost memory of the traumatic event. Additional goals of treatment of lacunar amnesia should include teaching the patient new coping mechanisms, dealing with the traumatic event that caused the lacunar amnesia, helping the victim improve relationships with those around them, and getting their lives back to normal functioning as soon as possible.
Recovery could also occur on its own either when the victim is reminded of the event or another trigger such as a similar event or a nightmare. If this does occur, treatment should immediately follow to help the patient understand and cope with the trauma that caused the lacunar amnesia in the first place.
While recovery could occur on its own either during therapy or possibly due to another trigger, there are many alternative treatment options for those who don’t recover their memories on their own.
Talk therapy with a professional psychotherapist is the typical treatment for dissociative types of amnesia such as lacunar. Psychotherapy is typically effective in dealing with the traumatic event once the memory is recovered and is an important part of ongoing treatment as well. Psychotherapy could also include family therapy.
Meditation therapy enables people to relax, become more aware of their thoughts and feelings and better handle difficulties in their lives.
Cognitive Behavioral Therapy involves self-talk and removing negative thoughts and replacing them with positive thoughts.
This is a form of therapy that treats people with recurring flashbacks, nightmares and other symptoms associated with Post Traumatic Stress Disorder (PTSD).
Art and music exploration therapy is used to encourage patients to explore their thoughts and feelings in a safe and creative environment.
Hypnosis in a clinical environment uses focused concentration and relaxation to achieve a state of consciousness that allows people to access memories that may be hidden in their unconscious. This could be used to try to uncover repressed memories from a traumatic event.
Computers and visual imagery are used to train the memory and make it stronger to possibly uncover memories from a traumatic event.
These therapies are typically effective, particularly if the patient has a support system and a normal functioning life situation. Medication, however, is not effective in treating lacunar dissociative amnesia but it can treat any associated anxiety or depression related to this condition.
Preventative measures can be taken if lacunar amnesia has not set in. These measures involve understanding consequences of the traumatic event that occurred in the first place and the feelings associated with the event.
People who experience trauma, such as emotional abuse during childhood or adults who experience traumatic events such as natural disasters, kidnapping, automobile accidents and the like, are all susceptible to lacunar amnesia. The key to prevention is seeking treatment early, before lacunar amnesia sets in.
If abuse during childhood is caught early enough and treated, lacunar amnesia may not present itself as the underlying trauma that would have caused amnesia could be resolved, or at the very least, addressed and therapy administered. Adults are more aware of the psychological after effects of a traumatic event and should seek treatment immediately following the event to resolve any consequences that may appear in the future, such as lacunar amnesia.
Lacunar amnesia can be treated and even prevented if a traumatic event has occurred and the victim or those close to the victim recognize the person needs help to resolve any feelings that may result from the event. Repressing the event could result in anxiety, depression and a whole host of psychological disorders typically associated with trauma.