Hi,

I am going to make a general comment of what I have found to be quite helpful regarding those "fuzzy memories" or a feeling that "something traumatic" may have happened but they have no memories of it.

When a client tells me that they feel as though some kind of abuse or trauma has occurred to them, but they have no memories of it, we talk about their reasons for feeling this way - often this is related to some kind of symptoms they are experiencing.

What I try to do is take a neutral, supportive stance, and talk to them about the range of possibilities that this may indicate.

I explain that I do not know what happened to them - that only they can know that and the answers are inside and if something occurred to them that they may eventually remember it, or they may never remember it.

I also explain that sometimes we have symptoms of trauma that we feel are out of proportion to what it is that we do remember so that we start to wonder or assume that something more may have occurred.

I talk about "little t" traumas (experiences of day in day out emotional neglect, isolation, and abandoment - getting teased on the playground, parents not emotionally present) and "big T" traumas (the kind that most people would recognize immediately as being traumatic - cataclysmic natural disasters, sexual assaults, child abuse, severe motor vehicle accidents, etc...).

What I often find is that people who have trauma symptomatology but remember predominantly "little t" traumas rather than the "big t's" tend to feel like their feelings are unwarranted, or out of proportion to the situation.

However , what I find - and what I explain to clients - is that often those "little t" traumas are as traumatic and as likely to produce some kinds of trauma symptomatology as the "big T" traumas - it is not the case that big T traumas are more traumatic, it is just that they are more easily recognized as being traumas that would create a response.

I also will often ask if they know if they had any invasive medical procedures in early childhood, as sometimes these can create trauma symptomatology consistent with that seen with child sexual abuse - after all a toddler who is having invasive or painful procedures done does not necessarily comprehend the intention behind these procedures so much that something that is being done to their body that they do not want, but they have no choice. This has especially been the case historically, when medical staff and parents were less aware of the risk of trauma with young children or even older children, if they were not adequately prepared for it and supported during it.

Often it is the case that the symptoms that are being experienced and leading to a suspicion of sexual abuse may possibly be explained by one of the above scenarios.

Again, I am very careful here - it is a bit like walking a tightrope because I don't want them to feel they are being dismissed, nor do I want them to be fearful and afraid and be looking for something that might be there or might not, and their emotional life and the therapy process get tied up in remembering or not remembering.

I am very clear with clients that it may very well be that there is a history of sexual abuse, but it may also be that there are other factors that explain this and I may work with them on the symptoms and experiences that trigger these symptoms and, when applicable, process those with an open mind and neutral stance of "we know that these symptoms and feelings are troubling and we are not sure where they are coming from - but they need to be healed."

Sometimes people will go on to remember additional traumas they had not been aware of, and sometimes they will obtain greater insight regarding the connection of known experiences to their current difficulties. And, sometimes they may never know what had caused the symptoms, but at the same time are able to transform them.

Now if someone were to tell me "I know that I was sexually abused, but I do not have specific memories" I may or may not have the discussion above. People can and do recover a "memory" or "knowing" or verbal description of an incident before they have specific visual memories of it, as the different aspects of the trauma are stored in differnet areas of the brain.

However, when it is that vague sense of "I think maybe this happened but I am not sure" I find that having a variety of explanations for why they may feel that way - that includes the possibility of sexual abuse but does not assume it - can be extremely helpful in allowing people to validate their own emotional experience without getting caught up in the trying to figure it out -which in my experience can stall therapy and can create a great deal of upset and feel crazymaking because they can't decide what is real and what isn't, and don't want to be "making it up" and yet know that that their body and/or psyche are telling them that something happened.

My apologies for a very long winded response! I have dealt with this kind of situation often and this is the best approach I have found for it so far, as it allows for and accepts the possibility, and often provides a feeling of relief on the part of the client in being able to work on the symptoms while setting aside the struggle to know and remember.

It may of course not be appropriate for any one specific client but is one of the "tools" I keep in my clinical bag to use when it may fit for a given situation.

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Carol Ann Rowland, MSW, RSW