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The Toronto group has been focusing on traumatic and depressive syndromes and on applying psychoanalytic knowledge toward the goal of an integrated understanding of the suffering person. To this end, we have been looking at what is available from brain imaging and, at the same time, at what is useful or problematic in current psychoanalytic dialogue.
Drs. Clare Pain and Ruth Lanius gave a presentation on trauma and dissociation theory and imaging. Early writers hypothesized thoughts and memories, preserved in the unconscious, as being “pushed away” but exerting pressure. While life is a continuum, the experience of continuity may be the exception rather than the rule. Animal responses to danger situations are different from human responses. In some individuals, dissociative phenomena in trauma may represent the outcome of structural states rather than defensive processes—that is, pathological and “normal” dissociation may be qualitatively distinct. The developmental stage of the traumatic occurrence(s)—especially with regard to verbalization—as well as present-day physiological state may have a bearing on the potential for “archeological” investigation of memories.
Dr. Lanius presented functional MRI investigations of the neural correlates of recalling traumatic memories. Her work—partly reported in et al., Biol. Psychiatry, 52 (15 Aug. 2002/no. 4): 305-311 and in et al., Biol. Psychiatry, 53 (1 Feb. 2003/no. 3): 204-210—focused on, among others, victims of mo-tor-vehicle accidents hearing prepared narrative scripts of their experiences while being scanned. In the clinical study of the acute posttraumatic state, a man who actively dealt with an accident demonstrated a richer activation pattern, which contrasted with that of his wife, who had frozen during the accident, and who had had a difficult early history. The results suggested that the diagnostic subcategories of hyperarousal and hypoarousal should be considered for future studies. PTSD subjects sh