Transcription
Did you forget me? If so, you may be suffering from dissociation. No, I'm just kidding. If you forgot about me, probably you're mentally healthy.
Okay, Shanim, today we're going to discuss amnesia, the art and science of forgetting. My name is Sam Vakn. The author of Malignant Self-Love: Narcissism Revisited, and lest you forgot, I'm also a professor of psychology. I would like to propose a new taxonomy of dissociation, or dissociative disorders, or dissociative effects, effects, and so on. Dissociation is when you slice off, when you shut out something that you find unbearable, intolerable, overwhelming, or threatening.
Now, according to my new taxonomy, you could shut out yourself by divorcing yourself, by detaching from yourself. You no longer feel the threat, or the displeasure, or the ego destiny, or the fear. If you are not you, then of course you're not subject to these negative effects. So I call it internalized dissociation. But you could also shut out the world. You could also divorce the world. You could also let go of reality. The most extreme form is of course psychosis. But in less, in more normal people, we would have externalized dissociation. Examples of internalized dissociation are amnesia and depersonalization. Examples of external dissociation is an example is derealization.
Now go to the description. I have a video there which deals with depersonalization and derealization, going autopilot. And there's another video there which deals with structural dissociation, which is the overall arching framework currently in use by most practitioners, most scholars, when we deal with dissociation.
Today I want to focus on amnesia. Amnesia, as I said, is about forgetting. Amnesia is actually a form of numbing yourself. A form of avoiding triggers. A way to avoid triggers by not experiencing them. Amnesia, therefore, is the exact opposite of being there, of being present, of experiencing life unmediated in a direct manner. Amnesia is like a filter, and it is like a firewall. It is an interface between you and reality. When reality, internal or external, has become too much, amnesia signifies an integration failure. There's information coming from the environment. There are experiences you are going through, and yet you cannot integrate them. You cannot own them. You cannot make them part of who you are. And amnesia gives rise to dissociative fragments, and in very extreme cases, dissociative identities, for example, in dissociative identity disorder.
So amnesia is about isolating, encapsulating an internal or external, internal experience, for example, is memory. So encapsulating an internal or external experience, kind of cocooning them, placing them in styrofoam, and then isolating, isolating them from the rest of your personality, from other psychodynamic processes, from everything that's happening inside. It's as if there's you, and then there, there is, there are these isolated external or internal experiences floating somewhere, not part of you, not interacting with the rest of you.
Amnesia is, of course, like all other dissociative symptoms, or dissociative reactions, or defenses. Amnesia is about being overwhelmed. Amnesia occurs when you are overwhelmed by something. Again, you could be overwhelmed by internal psychodynamics. You could be overwhelmed by memories, by intolerable impulses, by choices or actions that you have taken which are dissonant. They create dissonance, cognitive dissonance, doxastic dissonance, dissonance regarding beliefs, axiological dissonance, dissonance regarding values. Whenever there's dissonance that cannot be resolved, sometimes people choose to forget about it, and amnesia sets in. It's a way to quell, and to reduce, and to mitigate intense negative adverse effects, emotions which threaten to drown you and take you apart, physical sensations, misperceptions, and misattributions of other people. For example, paranoid ideation.
The test of amnesia and other dissociative defenses is not in the precursors, is not in the triggers. We are all exposed to similar triggers. It seems that some people are more sensitive. They're more prone to dissociation. For example, we all sometimes entertain paranoid ideation. We all say, "Can we trust this person? Is there some kind of malignant or malicious or malevolent conspiracy against me? Are these people planning to undermine me and subvert me and so on?" We always misinterpret other people's motivations, their mentality, and so on. We always suspect that we were passed over for promotion because envious people conspired against us and so on. This is very common. But people who are sensitive to dissociation would find this kind of thinking, this kind of ideation, intolerable, overpowering, dominating, disabling, causing dysfunction. And in order to avoid this, they may simply forget it, forget about it, slice it off, shut it out. And this is amnesia.
Amnesia is therefore, in my work, and in the work of others, not everyone by the way agrees, but in my work, amnesia is an active defense against everything that I've just mentioned, against everything intolerable, everything burdensome, everything unbearable, everything terrifying, everything threatening, everything dissonant. It's a defense. It's an extreme form of detachment, repression, compartmentalization, denial, and therefore dissociation. In other words, in my work, amnesia includes all these elements, and all these ostensibly separate defense mechanisms are actually dissociative. I see no distinction and no difference between, for example, amnesia and detachment. Amnesia and repression. Amnesia and compartmentalization. I think repression, detachment, compartmentalization, and denial would be totally impossible without amnesia.
Dissociation therefore underlies numerous defense mechanisms. And one could even generalize and say that dissociation is at the core of the very concept and process of defense mechanisms. Defense mechanisms are about dissociating us either from ourselves or from the external environment. And consequently, when we cause people, for example, patients in certain clinical settings, in my cold therapy, definitely it is based on retraumatization, when we cause people to relive, to reexperience trauma, it overwhelms them, and it requires a lot of work to integrate this new knowledge. And if we don't do this work, people instantly, instantly revert to amnesia. So in certain clinical settings, and not only in clinical settings, in life, when there is a reexperiencing or reliving or vivid reexperiencing of the trauma, retraumatization, people react again with amnesia. It's clearly a defense against not only trauma, but the memory of trauma, the traces of trauma, which are both in body and in mind. And so the intimate connection between trauma and amnesia is beyond doubt.
To overcome amnesia in clinical settings, otherwise in social interactions and so on, to overcome amnesia, we need to do a lot of integrative work, which is very reminiscent of shadow work. Indeed, in Jung's theories, complexes such as the shadow archetypes, which ostensibly are transmitted across generations, all these are actually dissociated artifacts. They're sliced away. They're shunned. They're buried. Like in the famous Edgar Allan Poe story, they are kind of buried. And so dissociation is a major, major element in the work of Carl Gustav Jung.
In clinical practice, dissociative amnesia is not considered a separate disorder, but some kind of symptom. It co-occurs as a component of other disorders. For example, post-traumatic stress disorder, dissociative identity disorder, even complex trauma in some cases. Dissociative symptoms such as amnesia are a part and parcel of the psychopathology of many types of mental illness. Psychosis, mood disorders, anxiety disorders, eating disorders, substance abuse disorders, acute stress disorder, post-traumatic stress disorder, somatic symptom disorder, borderline personality disorder, schizotypal personality disorder, the dissociative disorders, of course, and I would even add narcissistic personality disorder, which I regard as a form of dissociative identity disorder. In all these, dissociative amnesia plays a major role.
I would like to refer you to the Bible of dissociation. The title is Dissociation and the Dissociative Disorders: Past, Present, and Future, edited by Martin Dorahy and others, published by Taylor & Francis in 2023. I recommend that you also obtain, that's a second edition. I recommend that you also obtain the first edition because there are major differences. So in this book, we find dozens of articles on dissociation written by the most eminent experts on the topic. And I would like to refer to an article by Sylvia Solinski, where she discusses the connection, the nexus, or the causation between trauma and dissociation. And here's what she has to say: "Impaired memory for traumatic events has been widely documented in diverse populations, for example, combat veterans, Holocaust survivors, witnesses of violence or death, sexually abused or otherwise maltreated children." And she refers to work by Bruin, Dalenburg, and others.
"Trauma," she says, "may be defined as an inescapably stressful event or set of circumstances that overwhelm a person's existing coping mechanisms in an environment that fails to provide a buffer or to facilitate recovery." And she refers to the seminal work by Vanderhart and, of course, van der Kolk. "In childhood," says Solinski, "traumas comprise both acts of commission, for example, sexual abuse, and omission, for example, neglect, abandonment, attunement failures, where the absence or periodic withdrawal of certain resources creates a threat to the child's well-being and survival."
I would add to this overprotectiveness, instrumentalization, parentification, idolizing the child, pampering, and removing the child from reality and from peer feedback. Not allowing the child to separate and individuate and form boundaries. All these are forms, in my view, of abuse, traumatizing abuse, which leads to amnesia, memory gaps, problems of dissociation, which in their turn lead to solutions such as the formation of the false self. In both narcissism, narcissistic personality disorder, and in borderline personality disorder, the false self serves as a continuous, nondisjointed alternative to the dissociative true self. The false self is a narrative, and as a narrative, it maintains continuity and contiguity. The false self, therefore, is a compensatory mechanism. It compensates for the underlying dissociation in the true self. It has other compensatory functions which I will not dwell on in this lecture.
Solinski says, "At the moment of trauma, the victim is rendered helpless by overwhelming force. When it is force of nature, we speak of disasters. When the force is perpetrated by people, we speak of crimes, abuse, and atrocities. For some, traumatic experience is tantamount to an encounter with a radically unimaginable which alters the attitudinal and belief structure of the individual." Jordan Peterson uses the word evil. So does Scott Peck. His scholars claim that narcissism, for example, is the personification of evil, and coming in contact with the narcissist, or having a relationship with the narcissist, is actually the experiencing of the outer darkness of the prince of darkness. So in that case, it would be a traumatic experience, and the radically unimaginable underlying experience would be that of evil.
Solinski says, "For others, particularly survivors of child abuse, trauma results in entrenched self-beliefs and internalized dire expectations. Hence, for many individuals, a particularly destructive effect of trauma is that it confirms what is expected rather than presenting a devastating incongruity." And she refers to work, very important work by Bramberg, who came up with his own framework of self-states. And this framework of self-states informs my work in the intracychic model. And Herman, the famous Judith Herman, and her idea of complex trauma, continues to discuss forgetting. How abuse is remembered, she says, can vary. Partial forgetting is consistent with considerable variation in the degree of reported amnesia. This includes total forgetting, forgetting some basic knowledge that the abuse happened, forgetting some but not all of the abusive incidents, forgetting some salient facts and episodes, and remembering physical but not sexual or emotional abuse. Confusion and doubt regarding memories and their meaning are common, even when childhood abuse has been documented. Davis and Davidson Frolley in 1994 note that, "Chronic doubts about what did and did not happen, along with a persistent inability to trust one's perceptions of reality, are perhaps the most permanent and ultimately damaging long-term effects of childhood sexual abuse."
We can therefore, and now Saknin, I'm interjecting. We can therefore consider dissociation, and especially amnesia, as a form of self-gaslighting. It is an attempt to impair one's reality testing because reality is unacceptable, unpalatable, unbearable, and intolerable. It's a rejection of reality by creating an alternative reality of absence, of nothingness. It's as if it's more survivable to live in a void than to face what has happened. So this is exactly what the child does, the traumatized and abused child. This kind of child chooses absence, internal absence, by turning off the true self, and instead compensates by creating a deity, a divinity, a narrative that somehow continues the child by other means. It's an amnesiac act on the one hand, dissociative in its nature, and an attempt to leverage creativity, or what is called psychoticism, in order to survive.
I continue with Solinski. "This is demonstrated," she says, "by the phenomenon of underestimating prior knowledge of an experience. What Scholl called the 'forgot it all along' effect, where individuals believe that they have forgotten the abuse at a time at which they were in fact aware of it. For example, they may have forgotten they talked about it to someone until they discover or rediscovered the abuse. This discovery may be attributable to changes in their meta-awareness." In other words, their ability to reflect on their experiences. So this meta-awareness of the abuse, which enables them to reinterpret it as abuse, is missing. Factors contributing to past amnesia for abuse include young age at onset, greater severity of abuse, abuse by a perpetrator known to and trusted by the child, and family dynamics that foster little, especially maternal, support and cultivate secrecy. This is known as pseudo-mutual family. I have a video dedicated to pseudo-mutuality and pseudo-hostility in families.
One of the most eminent and prominent authorities on dissociation, a man who has created the trauma model of personality disorders and a trauma model of mental illness, and a man whose work has informed my work very, very substantially, is Colin Ross. Colin Ross says this in the aforementioned book: "There are four meanings of the word dissociation, referring to four different but to some degree overlapping phenomena. First, there is a general systems meaning of dissociation. The opposite of association, a disconnection or lack of interaction between two variables. There are dissociation constants in physical chemistry, for instance. Second, dissociation is a technical term in experimental cognitive psychology. In cognitive psychology, dissociation is often a normal property of cognitive functioning. For example, countless studies have demonstrated the dissociation between procedural and declarative memory." Cohen and Eizenberg, I'm sorry, in the '90s, for example. "Such dissociation is normal in that it does not entail any special operations or exceptional properties of the mind. Third meaning of dissociation is as a phenomenological term in clinical psychology and psychiatry that has been operationalized by various measures. In this sense, dissociation is what is measured by the items on questionnaires and structured interviews assessing dissociative experiences and symptoms. For example, the Dissociative Experiences Scale (DES), developed by Bernstein and Putnam in 1986, and the Dissociative Disorders Interview Schedule (DDIS), developed by Colin Ross himself in 1997. And the fourth meaning of dissociation is as an intracychic defense mechanism. Confusion arises when these different meanings of the word dissociation have not been specified."
Okay. So let's go to a source, an authoritative source of disambiguation. The American Psychological Association dictionary, which, by the way, is available online. How does it define amnesia? "Partial or complete loss of memory, either temporary or permanent. It may be due to physiological factors such as injury or disease (organic amnesia) or to substance abuse (drug-induced amnesia) or to psychological factors such as a traumatic experience (and this is known as dissociative amnesia)." And so on. "A disturbance, amnesia is a disturbance according to the dictionary. Amnesia is a disturbance in memory marked by inability to learn new information." And this is called anterograde amnesia. And there's amnesia that is marked by inability to recall previously learned information or past events. And this is known as retrograde amnesia. When severe enough to interfere markedly with social or occupational functioning, or to represent a significant decline from a previous level of functioning, the memory loss is known as amnestic disorder." We'll come to amnestic disorder in a minute.
I would like to read to you the definition of dissociative amnesia. "Dissociative amnesia is a dissociative disorder characterized by failure to recall important information about one's personal experiences, usually of trauma or a traumatic or stressful nature. And this failure is too extensive to be explained by normal forgetfulness. Recovery of memory often occurs spontaneously within a few hours and is usually connected with removal from the traumatic circumstances with which the amnesia has been associated." This used to be called, by the way, psychogenic amnesia.
Okay. We distinguish dissociative amnesia from functional amnesia. Functional amnesia is a loss of memory for events that one has personally experienced and that occurs in the absence of any identifiable neurological pathology. Functional amnesia is thought to arise as a defense against anxiety and distress, or as a way of escaping from specific situations. It is often used as a synonym of psychogenic amnesia and dissociative amnesia, but wrongly so.
So what is an amnestic disorder? The dictionary defines it this way: "In the fourth edition text revision of the Diagnostic and Statistical Manual (DSM), it is a disturbance in memory marked by inability to learn new information (anterograde amnesia) or to recall previously learned information or past events (retrograde amnesia), and that is severe enough to interfere markedly with social or occupational functioning or level of functioning. A distinction should be made between amnestic disorder due to a general medical condition, substance-induced persisting amnestic disorder, and amnestic disorder not otherwise specified. The first of these, due to a general medical condition, can be caused by a variety of conditions such as head injury, anoxia (lack of oxygen), herpes simplex and syphilis, and posterior cerebral artery stroke, resulting in lesions in specific brain regions, including the medial temporal lobe and the diencephalon. And there are connections with various cortical areas as well. It may be transient, lasting from several hours or more, up to a month. Some of this is known as transient global amnesia, or it may be chronic, lasting more than one month." In the DSM-5 and DSM text revision, edition 5 text revision, these have been subsumed into the category major neurocognitive disorder, and it is no longer considered a distinct entity.
Okay. Amnestic syndrome, amnestic disorder is mentioned, of course, in the DSM. But what we want to focus on is dissociative amnesia. Now, the DSM F44.00 defines dissociative amnesia as "an inability to recall important autobiographical information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting." And then it adds, "most often of localized or selective amnesia for a specific event or events, or generalized amnesia for identity and history." And so this definition is somewhat problematic because it confuses information, or the retrieval of information, with lived memory. And so it much better suits, much better applies to an amnestic episode, or even dissociative fugue, than to the kind of amnesia that we are talking about in borderline personality disorder and narcissistic personality disorder, where the amnesia there, the dissociative defense, leads to identity diffusion and identity disturbance. The amnesia there is actually an active element, not a passive defense, but a psychodynamic. And the amnesia is ongoing. It's a background operation in these mental illnesses. As I mentioned, narcissism, borderline, it's a mental process, background process that constantly slices off, shuts out, reframes, regenerates narratives, engenders fantasies. And so the dissociation in borderline personalities, or in narcissism, is wrongly described as a one-off. You know, there's a bad memory, we forget about it, we move on. That's not the case. It is intimately involved in the day-to-day functioning of the borderline narcissist, and it engenders and fosters and generates additional artifacts, additional clinical features and symptoms. That's why this definition in the DSM is partly wrong because it ignores this dynamic aspect, because the lived memory, as it is reorganized by the dissociative underlying organizing principle, the dissociative hermeneutic explanatory principle, is totally ignored in the DSM. And so the ICD-11, unfortunately, in this particular case, usually doesn't do it, but in this particular case, followed the example of the DSM-5 and conflates. The ICD-11, published in 2022, also conflates dissociative crisis like dissociative fugue and dissociative amnesia. The description is copied from the DSM-5 almost verbatim. And consequently, both diagnostic manuals are very deficient and very partial when we attempt to somehow cope or describe or capture the dissociative undercurrents and processes in personality disorders and other compounded mental illnesses. There's a major gap there which needs to be addressed.
Back to the book Dissociation and the Dissociative Disorders: Past, Present, and Future, chapter 17, "The Perceptual Theory of Dissociation" by Donald Beer. I would like to quote a few excerpts. Beer says, "This explanation posits that there are different memory systems: conscious and non-conscious, and different retrieval processes: conscious memory retrieval and automatic non-conscious search. There is a distinction between narrative and procedural memory, and between explicit and implicit memory retrieval. Narrative memories with their explicit retrieval are available to conscious recall. But procedural memories with their implicit retrieval are not. Memory for relived, reexperienced trauma seems to be different from both types of memory." Bruin in 2003 draws a similar distinction, positing a situationally accessible memory system. "Perhaps," says Beer, "there is a different dichotomy among memory systems that is reflected by narrative, procedural, and so on. One that includes one memory that preserves an event as an ongoing first-person experience, and two, memory that is non-immediate, psychologically distant, and accompanied by a conviction that the experience is over, even if emotionally distressing."
"Reliving an amnesic trauma is a different order of experience since it evokes overwhelming, intense, and painful emotion, displaces present time perception. So it seems to be happening in the moment, proceeds in what appears to be the identical sequence, and subsequently cannot be remembered." In other words, when I'm interjecting here, when we reexperience trauma, very often we relive it. It's as if we're there. We are back in that moment. Everything is happening to us again. We can't remove ourselves from the scene. But once the retraumatization episode is over, we again slice it off. We again shut it out. We again kind of delete it. We use dissociation and amnesia to forget about it.
Beer continues, "I propose that relived memories have been filed as ongoing or unfinished. Successful treatment allows that experience to be stored as the second, non-immediate type of memory. A memory of experience that is known to be over. The individual can then remember without being thrown into the experience. The person can remember and know that the trauma is in the past. In other words, that the person is safe."
"In short," says Beer, "a trauma is amnestic because it cannot be integrated into the person's existence as constituted or self-system. Using Sullivanian language, these traumatic experiences remain 'not me.' Using more phenomenological language, these traumatic experiences are excluded by the 'miu' world structure or existence as constituted. The experiences outside the limits of the person's reality. An amnestic disorder, therefore, would imply a self-system that excludes distressing, probably traumatic events, commensurate with its existence as constituted."
Again, we must not forget the major conceptual contribution of Sigmund Freud. And prior to Freud, Jean-Martin Charcot. Freud got it wrong partially, of course. We no longer teach Freud, or even to some extent Charcot. But some of the concepts we are using habitually, automatically, in psychology today, definitely in cognitive psychology, in clinical psychology, emanate from Freud. For example, it was Charcot and Freud who associated strongly trauma and dissociation. They made this connection. Freud may have identified the wrong types of trauma, but he popularized the idea that trauma results very often in dissociation, and that these memories that are buried and repressed should be brought back to consciousness, brought back to the surface, generating what he called "up reaction." That's all Freudian. And yet, it is an integral part of what we teach today in universities. I should know, I'm a teacher. So it would behoove us to have a look at the past.
Amnesia, as Freud called it, amnesia. Freud regarded amnesia as a limited gap in memory. He found that events that led to the constitution of what he called hysterical symptoms are shut out of memory. He noticed this. He was not the first to notice this. He actually went to Paris. He studied under the likes of Charcot and Janet, and so on. So he borrowed a lot, and I'm being charitable, from their work. He connected amnesia with hysterical symptoms. Sometimes he uses the word amnesia in lieu of hysterical symptoms. He regarded it as the main hysterical symptom. Conversion symptoms aside, I'm talking about the mind, not the body. Amnesia is determined by the fact that events are not at the disposal of memory. And they are not at the disposal of memory in Freud's work because of emotions, because of affective reasons, because they arouse unpleasure. They are unbearable. They are repressed from memory in order to avoid this feeling of unpleasantness, discomfort, fear, threat, and so on. And this is definitely Freud's major contribution to the study of dissociation, and it stands valid today as it has been when he proposed it. All amnesia, in conjunction with neurotic symptoms, are caused by what he called repression. Freud connected, therefore, the same way I do, dissociation and amnesia, especially with repression. Repression led to amnesia in his work. In my work, amnesia is the overriding umbrella, and repression is one type of amnesia.
Anyhow, Freud said that the contents that are subject to amnesia are all sexual or aggressive in nature, and they're intimately connected to sexual or aggressive instinctual strivings, urges, drives, impulses. Today, we know this is only partly true. But still, he is right to a large extent. Someone experiences sexual abuse as a child. If someone wants to externalize aggression, and it is forbidden to do so, to be aggressive towards your father or your mother or your boss is socially frowned upon and may carry consequences, may have adverse consequences. So whenever there's this problem of the ego having to suppress the id, in Freud's work, the reality principle having to prevail over the need to act impulsively, whenever this happens, according to Freud, there would be some kind of dissociation, some kind of amnesia. We would forget this conflict, relegated to the recesses of the mind, inaccessible to memory.
There was a suggestion in early psychoanalysis to connect the gap of memory, the huge gap of memory, which is known as infantile amnesia, the fact that we cannot remember anything before age two or three. To connect this with sexual or aggressive instinctual forces. We cannot explain infantile amnesia. There's no inferiority of infantile mental functioning. It's true that the brain is only half-developed, takes another 20 years to develop fully, but the critical faculties of memory are there already. So neurology or neurobiology cannot explain infantile amnesia. And Freud and other psychoanalysts stepped into the bridge and suggested that the child is actively repressing memories which the child finds terrifying, which challenge the child's nascent and emerging self, a self that has a pronounced social aspect. So when the child has an urge or an impulse to act aggressively or sexually that is socially frowned upon, it endangers the process of self-formation, and the child represses and forgets about these experiences. Amnesia. It's a kind, if you wish, of hysterical amnesia, infantile amnesia. It's a repression of content, exactly the same way hysterics do experience amnesia in Freud's early work. The large, large portions of infantile amnesia connected in psychoanalysis with sexual and aggressive impulses, sexual aggressive nature. There's a debate if this kind of amnesia is derivative or primary. So later in life, we again experience amnesia, and again, it has to do with emotions and affects which we find unacceptable, unpalatable parts of ourselves that we reject. In this sense, by the way, projection is a form of amnesia, all defense mechanisms, as I said at the beginning of my lecture. But this kind of amnesia is clearly derivative. It's a kind of continuation of infantile amnesia. The content that has been subjected to amnesia becomes directly connected to the contents represented by childhood amnesia. So we have primary amnesia in childhood, and then it becomes kind of a habituated, kind of, "Wow, great solution," and I'm going to use it again. When you're an adult, and then you have primary amnesia that gives rise to imitations of itself, known as derivative or secondary amnesia later in life.
Freud believed that psychoanalysis is a great way to overcome amnesia and bring forgotten material to the surface, into consciousness. There's a task of removing amnesia, which is at the core of psychoanalysis. Freud himself said that "only that procedure which sets as its goal the greatest possible elimination of infantile amnesia deserves to be called correctly conducted analysis." And here we come back full circle to today's thinking, most updated thinking about dissociation, which basically retained these conceptual contours and demarcations and boundaries proposed by Freud.
Amnesia is an integral part of daily life. We forget. There is a memory decay. We forget about 50% of everything we've experienced, everything we've read, everything we've watched. We forget about 50% within an hour or so. Forget about 90% within 24 hours. Amnesia is at work all the time. And it's a healthy process because otherwise we will be overwhelmed by information. It is when amnesia is applied to experiences which should have been retained, because retaining them would be instructive, would foster growth and development, avoidance of threats, and so on. When amnesia interferes and represses, eliminates this kind of access to these kinds of emotions that we talk about, we are talking about pathological amnesia.
So the narcissist and the borderline experience amnesia which is derivative, but which is not helpful, which is dysfunctional, which causes the narcissist and the borderline to develop defenses which lead to even further dysfunction. The narcissist, for example, confabulates in a desperate attempt to bridge memory gaps, yawning memory gaps. The borderline acts out or assumes another self-state. It's all a last-ditch effort to somehow survive amnesia that is encroaching and threatens to consume the individual. Black hole amnesia, I call it. And it is a pitiable, a pitiable state of affairs. And ultimately, the narcissist and the borderline lose this battle. Their identity never coalesces, never makes sense to them. They experience absence as a viable alternative to the chaos and mayhem that their so-called identity affords. And then finally, they retreat there, never to be found again. They disappear internally in a sucking sound, the equivalent of implosion. Having tried explosion relentlessly, but having failed, they decide to consume themselves, and they disappear inside. At that point, their amnesia is total.