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Tuesday, June 2, 2009

Treatment Tuesday - Dissociative Amnesia

This week’s assessment is courtesy of Debra, the winner of the Seekerville give-away from May 5th (obviously I’m running behind a bit b/c of my move cross-country).

Debra’s heroine, Gretchen*, lives in Glasgow, Scotland, in 1837. She was involved in a violent incident as a child in which she defended and saved her grandmother by killing a man with a pitchfork. She is taken away from her grandmother and put in an institution. Later she is raised as a companion to a young, wealthy woman. Gretchen is intelligent, feisty, bold, and very untrusting. She doesn’t want to remember her past.

The book starts with her acting like a madwoman. She has been in another attack and had to fight for her life to get away (although the reader isn’t privy to this). Local police find her running in the streets out of her head, so they bring her to an asylum, unconscious. When she stirs, she lashes out at p
eople before passing out again. After a rough dream, she wakes up in the morning with no memory whatsoever.

Debra is concerned about portraying Gretchen realistically. Even while she has no memory of her past, is it possible for her to have the presence of mind to find the hero attractive? To have her personality still come through?

* Names have been changed to protect the fictional.

Great questions, Debra! Hopefully I can shed some light for you.

You mentioned that you had done some online research into post-traumatic stress disorder, which I did a post on here. However, the type of amnesia you have described above is unlikely to be the result of PTSD, as usually that type is more pin-pointed toward the traumatic event (which does fit your scenario), but not towards her entire life (which doesn’t fit).

Photo by Jill Greenseth

The best diagnosis for Gretchen is Dissociative Amnesia. The main feature of this amnesia is an “inability to recall important personal information, usually of a traumatic or stressful nature, that is too extensive to be explained by normal forgetfulness” (DSM IV-TR, p. 520). This is reversible, which is important, because Gretchen will remember her past by the end of the book. Dissociative amnesia is most likely reported as a gap or series of gaps in recall for aspects of an individual’s life history.

Less commonly, an individual has a florid episode with sudden onset (which is what Gretchen has). Of the five types of amnesia associated with dissociation, the type of amnesia she has is generalized, which is a failure to recall a person’s entire life. The Diagnostic and Statistical Manual (DSM) therapists use actually says that people with this “rare disorder usually present to the police, emergency rooms, or to general hospital consultation-liaison services” (DSM IV-TR, p. 520). So kudos for you, since you already have this happening in your book.

So, about whether her personality would still shine through…the DSM didn’t have a lot to say about that, which can be a good thing, as it leaves the door open to however you want to portray it. I look at it as more compartmentalized. She’s lost her past, not everything that makes her who she is. You mentioned in the sample chapters I read (due to Debra’s winning the Seekerville contest) that Gretchen wanted prayer when she was feeling anxious. This remembering of an aspect of her life is possible. Her personality could still shine through, too, as long as you are conscious to give her some new aspects to it (i.e., she’s bound to be anxious about not remembering, depressed, even, and may even regress in her maturity level due to this).

A few other common symptoms people reported who have this disorder are trance states, providing approximate inaccurate answers to questions (like 2 + 2 = 5), aggressive impulses (which you’ve already shown), self-mutilation, and suicidal impulses/acts (perhaps from desperation? being overwhelmed? Anything could go here.).

Two other symptoms require a bit more explanation, which I’ll do so in case you want to include these in your manuscript. The first is analgesia, which is the ability to feel pain while still conscious. The second is depersonalization, which is a feeling of detachment or estrangement from one’s self, like the person is living in a dream or movie (i.e., being an outside observer of their own mental process, body or body parts).

One thing that might be of help for Gretchen’s backstory is that people who have already had one episode of amnesia are predisposed to having amnesia for subsequent traumatic circumstances. So, if after killing the guy with a pitchfork she disclose that she had amnesia following that event, it makes the case that much stronger for her having the dissociative amnesia after the second attack. Also, keep the recall of her dissociated memories gradual, as that’s more realistic than WHAM! “Oh, now I remember everything!” (Although that can happen.)

So here's a bit more for you to work with as you're revising what promises to be a great novel! I enjoyed reading what you sent so much.

This service is for fictional characters only, so any resemblance to real life examples is entirely coincidental. Any other fictional character assessment questions can be directed to

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Debra E Marvin said...

Thanks Jeannie,
as you and your blog readers can see, my character really needed some time on your couch. The hero of the story is waiting in the other room, as he's got some major personal baggage too!

I am so pleased that the basis of this story is not so far off that I needed to rewrite the entire plot.

You offer a great service here and I want to thank Seekerville and you for the opportunity. It's always interesting to get into our characters'heads and . . . oops I guess that means you're really getting into the author's head.

Strange creatures, aye?

This WIP has popped around the contest circuit with various responses (ye olde conflicting suggestions) but never has anyone said it wasn't an interesting concept. You've given me the encouragement to trudge on.
Okay, back to the asylum . . .

Katie said...

great stuff per your usual Jeannie!!!!

Krista Phillips said...

Wow! This is the first time I've read your "therapy" session and I'm blown away!!!!! WELL done!

Jessica said...

Sounds like a cool plot, Debra! Great breakdown Jeannie. You explain things in a very easy to understand way.

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Both comments and questions are welcome. I hope you enjoyed your time on the couch today.