Talk:Recovered memory

Appropriateness of external links; pattern of introducing content

I would ask Citizens to look at the article, which deals with neurology and psychology, and then to look at the External Links page. Are the external links consistent with the scientific approach of the article, or are they a way to have CZ pointing to ritual abuse advocacy sites? How many of them are neurological?

Do also look at the article, which starts on general neurological aspects, but, without emphasis, focuses on repetitive child abuse.

There is unquestionably child abuse. Oddly, the existing article on the subject is not being edited, but new articles, on possibly controversial theories, keep getting introduced. What would a search engine see as the growing amount of CZ material focused on repetitive child abuse? Howard C. Berkowitz 03:22, 16 March 2009 (UTC)

None of the links are about ritual abuse. All are directly related to the topic. All of the articles are accurate as written. (reverted by user: It appears that you are following me around on Citizendium now, which feels like harassment.) Neil Brick 03:30, 16 March 2009 (UTC)

Harassment? Perhaps concern with CZ: Neutrality Policy, which is reasonably within my scope as both a Citizen and a member of the Editorial Council.

I certainly don't object to someone "following" my contributions. Howard C. Berkowitz 03:43, 16 March 2009 (UTC)

I was going to strike the comment, but you replied first. Will do so now. Neil Brick 03:46, 16 March 2009 (UTC)

Bibliography

I've done a swift PUbMed search and placed on the Bibliography page details of all recent reviews on this area that seemed relevant, as a start. Some of those I've worked into the Introduction. The main problem with this article is the apparent presumption that recovered memories are reliable; this is deeply disputed. Accordingly a) the fact that it is disputed must be stated unambiguously at the outset. To handle a complex literature in a controversial area neutrally, perhaps the best way is with an objective survey of peer-reviewed reviews in the academic literature - reviews are better for this than primary reports anecdotal reports or books as they are or should be balanced syntheses. It is especially important to give proportionate weight to the skeptical views that seem indeed to dominate in the academic literature. I'm not sure that mechanisms of memory are really relevant here; the issue is simply one of reliability; frankly, current theories of memory are not sophisticated enough to help here. On external links, again it is obvious that there must be an attempt to be objective about selecting links and not use only links that support one side of a controversy. Gareth Leng 11:52, 16 March 2009 (UTC)

Thank you, Gareth. Your improvements do help in the short term, but they also address part of what I see about the problem. Even though you have properly qualified the first sentence, the first sentence does not restate the article title, but generalizes it; this is a problem with the rest of the article. Would the title sentence "Neurological theories of recovered memory has been defined as the phenomenon of partially or fully losing part or a specific aspect of a memory, and then later recovering part or all of the memory into conscious awareness" work? That rephrasing into CZ style no longer makes sense.

Recovered memory is a redlink; the article should begin with a lede of neurological theories of recovered memories, and limit itself to that. Alternatively, setting this context would require an article truly about all views of recovered memory. It can't be a way to introduce the broader term as accepted, and then go off into some aspect. As with several related articles, the discussion here of a technical subject, or of a publication/survey related to it, operating under the assumption that the phenomenon is generally accepted. I also note that the "definition" is not sourced. I certainly don't insist on the lede sentence being sourced; it can be quite good for the first sentence to be a readable synthesis but the next few sentences need to be sourced references to sides in a controversial position.

While, as yet, we do not have a formal policy on orphaned articles, this certainly is one. Had there first been an article on recovered memory, with comments from both sides, then there would be a much stronger basis for this article. As you know, in other articles on controversial topics, I have worked them into a hierarchy to make them self-defining: first, for example, define a topic as generally as possible, using international law and other definitions, before getting into specific national discussions or case reports. Howard C. Berkowitz 14:02, 16 March 2009 (UTC)

Point taken. Suggest renaming this Recovered memory with redirect from False memory?Gareth Leng 14:39, 16 March 2009 (UTC)

I've tightened the text somewhat but am uncomfortable about the degree of speculation. I'm a neuroscientist, and this is a neuroscientist's distaste for neuropsychologists who use the words of neuroscience but don't dance the dance; not getting at you Neil at all - but for instance GABA - well half the cells in the brain use GABA, saying it's involved is like saying you need air to breathe. The opioid link is nearly all junked science. Gareth Leng 16:00, 16 March 2009 (UTC)

For the record, i agree with Gareth's suggested move and redirect and went ahead and did it. I hope this is OK. Chris Day 16:20, 16 March 2009 (UTC)

Context of "trauma"

"Trauma" is a very general term, and the usage here needs to do one of two things:

1. Narrow the definition to specific forms of psychological events, which are certainly things presented in therapy. "It is important to separate the role of the mental health professional as therapist from the role as an expert witness in court." [1]
2. General physical and psychological trauma from accidents, combat, etc. I'm active, for example, in the Trauma and Critical Care [2] online forum.

Without touching the issues of ritual abuse, there is obviously a huge knowledge base dealing with the second sort of trauma. The military has an immense interest in combat-related stress. Physical trauma medicine is multidisciplinary, and a survivor of multisystem trauma from an automobile accident is apt to get psychological evaluation, and treatment if necessary. While the methods are controversial — Critical Incident Stress Debriefing is now deprecated — emergency response workers also are monitored for psychological trauma.

So, given the amount of data on trauma of the second sort, which is noncontroversial, why are the examples predominantly related to child abuse? The second sentence of the first paragraph introduces the first case" "People sometimes report recovering long-forgotten memories of, for example, childhood sexual abuse." There is one mention of "Vietnam combat veterans with PTSD, and in patients with PTSD related to early childhood sexual and physical abuse. ", but all of the other trauma examples appear to be child and sex oriented. There are explicit mentions of child neurology but much more vague references to all populations.

This emphasis makes me about the article being a way to introduce content about patterns of child abuse, rather than seriously addressing the broader subject. Howard C. Berkowitz 16:23, 16 March 2009 (UTC)

Well, yes; but this is an interesting topic and one that needs to be handled properly. I'm not suggesting for a second that it's OK by me; I've just made a start with the first 3 sections and most importantly the bibliography. We could think about structure : subsequent headings might be Trauma; Post-traumatic stress disorder (with related text on effects on memory). Other headings? Laboratory studies on false memory; Suggestion; Legal cases; Media coverage?Gareth Leng 16:53, 16 March 2009 (UTC)

Gareth, you know that I like to approach subjects from a top-down standpoint. We certainly could use an article on trauma; I can speak fairly well to the scope of emergency/trauma medicine. Psychological trauma is a subset.

I can also come up with a fair bit of data on combat trauma and trauma in emergency service workers, as well as the still-difficult diagnosis and management. If, however, child abuse trauma is to be considered separately, let's identify it as such. Note that there is already an article, which definitely could use work, on child abuse. Again, a top-down approach might start with the well-documented areas of physical abuse and individual pedophilia, before leaping into ritual matters with much less documentation.

It's also an interesting question how this topic meets family-friendliness. When I was 7 or so, I saw an artist's reconstruction of an unidentified child, beaten to death, in a police request for information posted in a public place. I had nightmares for years. I had some rough personal experiences as a child, but there is a large difference in making family-friendly safety warnings available, and creating vivid imagery, even in words. Howard C. Berkowitz 17:35, 16 March 2009 (UTC)

Medicolegal

Looking at the Boakes and Porter quotes, I wonder if they really should be relegated to a footnote. Rather, perhaps their quotes, and possibly accepted testimony on recovered memory, might be the start of a section on medicolegal aspects of recovered memory. Howard C. Berkowitz 21:33, 16 March 2009 (UTC)

Yes fine in a section, but that would be too much for the lead?Gareth Leng 22:24, 16 March 2009 (UTC)

Agreed. What would you think of having a sentence in the lead that essentially says the area has much controversy, especially in the U.S., in balancing the rights of the accused against testimony that may either be imagined or a very bad experience? Such a sentence would then wikilink internally to the section, where the quotes could live. I'm open to suggestions about internationalizing the controversy; I simply don't know to what extent it's been an issue outside the U.S. Apparently, it is of note in Germany. Howard C. Berkowitz 22:32, 16 March 2009 (UTC)

Style issue

It really isn't CZ style to put four and five sources after a statement. If the sources say essentially the same thing, pick a good one, or, even better, quote a peer-reviewed meta-analysis or review.

If they say different things, then the differences need to brought out. For sheer readability, it is possible that a point that needs five references may need to be in a separate section or subarticle.

Numbers of references alone proves nothing. It would be, however, extremely informative to have impact metrics on the references. Impact metrics, I recognize, are evolving, with both citation and view measurements suggesting different things. Howard C. Berkowitz 02:37, 18 March 2009 (UTC)

IMO, it is sometimes good to have more than one source back up a controversial point. Being an encyclopedia, it also gives readers more resources on the topic. But I will keep your idea in mind and think about the style angle more.Neil Brick 03:16, 18 March 2009 (UTC)

Again purely speaking to style, pick the best source if there is no review, and then put the rest in bibliography/external links. We aren't trying to give readers "more resources" in the main article. That's the role of subpages. An encyclopedia is not a bibliography, but a place of synthesis and summarization. Right now, it's almost impossible to scan up and down between the text and the reference list, because the list of citations gets so long.

I have written articles with a great number of citations to primary document sources. Nevertheless, there was almost invariably enough differences betweenthe cited documents that each valid reference had a sentence about its point. Physically, that's much easier to understand than five footnotes in series. Howard C. Berkowitz 03:42, 18 March 2009 (UTC)

I just saw this and pretty much agreed with Howard's point here in a section below. There is one small paragraph that has up to 15 references. This is not helpful to a reader, IMO. As writers we know the material and should limit our cites to the most pertinent. As writers it is our responsibility to reduce the redundancy for the readers. More often than not, more is not better. Chris Day 16:16, 18 March 2009 (UTC)

Notes

On references, I think we need to distinguish between accepted points and disputed points. I think it is generally accepted that:

• a) some recovered memories are memories of real events and
• b) some are not,
• c) individual witness reports of recent traumatic events are unreliable,
• d) ordinary memories of long past events are unreliable, particularly in being often heavily embelished,
• e) false memories can be quite easily induced in some subjects by suggestion, especially with hypnosis,
• f) memories of traumatic events are sometimes suppressed by unknown mechanisms, and
• g) false memories seem absolutely real to the person remembering. I
• h)there is no way of telling which recovered memories are reliable and which are unreliable except by external evidence of the events.

What is disputed I think is

• A) exactly how reliable recovered memories are
• B) whether recovered memories are generally as reliable as ordinary memories,
• C) whether (and if so which) therapy techniques themselves are responsible for implanting false memories in some cases.

I'd welcome agreement/disagreement on this list, so we know where we are exactly. If we can construct a list of what is accepted and what is disputed, perhaps it might be helpful to but this in the article as a summary box?

I'm afraid I don't know what the following statements mean exactly, (so I guess that will be generally true for naive readers like me) "The base rates for memory commission errors are quite low, at least in professional trauma treatment. The base rates in adult misinformation studies run between zero and 5 percent for adults and between 3 - 5 percent for children"

Is there a primary source so I can try and understand this? The book referred to is clearly a strong text and I've added text from a review to explain it as a source (Bibliography), but don't have ready access to it.

Many professional organisations seem to have made formal statements and I'm trying to track these down on the web - I've added a list on the external links, though haven't found links for many yet. I think in trying to construct an objective overview of the topic these need to be given due weight in the article. Any help in tracking down web sources on these would be welcome.Gareth Leng 11:02, 18 March 2009 (UTC)

Gareth, The quote above is a synopsis of a section from the book. As to your statement above, I haven't seen any evidence that some recovered memories have been shown to be false. I also haven't seen any evidence that false memories can be induced easily and i am assuming you mean nontraumatic ones. And I also haven't seen any evidence that "individual witness reports of recent traumatic events are unreliable." But the rest of what you state seems possible. Neil Brick 02:19, 19 March 2009 (UTC)

I should say that I think these are things that seem to be generally accepted by professional organisations (see policy statements in extenal links) and by academic reviewers (see abstracts of review articles). There are in these, many examples of acknowlegement of "some true, some false". Here I'm asking for any examples of dissent from these "consensus" statements. On inducement of false memories see Loftus' work (as an early example) and for tramatic memories Porter's work, (both extensively covered in subsequent secondary sources and very highly cited). Unreliability of eyewitness reports has been very extensively studied in experimental conditions.

On the quote, I'm afraid I'm going to have to remove it unless it's rephrased in a form I can make some sense of. Gareth Leng 22:35, 19 March 2009 (UTC)

intro too long

Seems far too detailed with too many references. It seems like a mini article in its own right. For example, hypnotism material should be in the body of the article. Chris Day 15:35, 18 March 2009 (UTC)

I just added a new heading titled Authenticity. Feel free to change the heading but lets keep all the content out of the intro. As an aside, the second to last paragraph in that section has far too many citations to be useful (at present this includes the citations in the twenties), we should be focusing on the best references. To a reader, too many references become bewildering an is not helpful. I would go through and weed out the redundant or weak ones but i do not have enough background information to begin the task. Chris Day 16:00, 18 March 2009 (UTC)

First attempt on unifying context

Fully understanding that not all trauma or recovered memories are suggested to be sexual, I created a preliminary article, medicalizing sexual offenses. In no way am I committed to that specific title, although the subject is important. It needs a parent topic of sexual offenses, as well as on sexual offenses against children, child abuse (which isn't always sexual), and criminalizing consensual sexual activities. I offer it in the goal of establishing context for a number of difficult articles.

In this case, there needs to be a parent topic of trauma, including purely emotional, physical (i.e., multisystem trauma medicine is an interdisciplinary centered around surgery but not limited to it), and interactions: if there is recovered memory and trauma, it certainly could apply to an accident victim just as much as to a crime victim.

The issues raised are relevant here, and in recovered memory, since the topics are at the intersection of law, health sciences, ethics and social sciences.

If some of these redlinks can be filled in, remembering family friendliness, and the articles (or Related Pages) be well-linked, it would be a start on taking individual studies and books and putting them into broader and — dare I say more encyclopedic' — contexts. Howard C. Berkowitz 16:08, 18 March 2009 (UTC)

Apropos "this is not specifically about sexual abuse"

Agreeing with your concern, Chris. In my experience with multisystem trauma medicine, it's certainly recognized that patients may have retrograde amnesia about the key events. Sometimes, there's some clinical importance to getting the best possible understanding of a forgotten memory of flying around in a tumbling car; recollections of the exact circumstances and mechanism complement examination and imaging in the treatment plan.

In other cases, especially when the retrograde amnesia is prolonged and interferes with activities of daily living, psychotherapists may well get involved in the rehabilitation.

I'll simply note that I have never heard the term "recovered memory" used in these context, or in stress prevention debriefings for emergency workers and combat veterans. Howard C. Berkowitz 16:46, 18 March 2009 (UTC)

So maybe the term is specific to sexual abuse? And a small circle of professionals at that? Or possibly a new upcoming term? It certainly "seems" to be a general term from my perspective of ignorance. Chris Day 17:10, 18 March 2009 (UTC)

Just to add, the references cited in this article seem to address recovered memories other than sexual abuse too, which is why I assumed it was a more general term. Chris Day 17:12, 18 March 2009 (UTC)

Without judging the merits, the term seemed to come into use in a legal context, associated with child abuse allegations. I've just glanced through several trauma medicine textbooks and it doesn't appear. My guess is that it's more legal and the applications of social science to law.

Gareth should have the definitive word here, but my impression is that the more general literature focuses on amnesia and the treatment of amnesias from traumatic, organic brain damage, chemical, and other etiologies. This article should certainly have amnesia and memory as parents. Howard C. Berkowitz 17:22, 18 March 2009 (UTC)

[undent]] Please note that I am in no way denying that children are abused. I question is why the article does not address traumatic amnesia secondary to combat, adult accidents, and experiences of rescuers. I question when the article addresses therapy, it seems to emphasize evidence-gathering rather than treatment.

Certainly in war-related PTSD, the gold standard of treatment is cognitive behavioral therapy, possibly with pharmacologic adjuncts. There are other, more experimental, psychodynamic methods such as EMDR and EFT. In none of these is recovery of the memory the goal, but the management of feelings triggered from things that remind the patient, even indirectly, of the trauma.

What is this article really about? Perhaps traumatic amnesia needs to be in its own article, and the references that only discuss traumatic amnesia need to go there. There are articles on stress disorders and their treatment. Are recovered memory techniques primarily forensic or therapeutic? I can't tell. The sources seem to focus on what was recovered, not what the recovery did or did not do for the patient.

If it is therapeutic, why is this article not clearly linked to other articles on stress disorders, or even merged into them? If it is forensic, why not make it clear? There do seem to be quite a few articles on topics related to cult and ritual abuse, and I cannot help but think this article is here to reinforce them.

Again, there is general discussion, but the preponderance of the examples are from children, and, of those, sexual abuse. The examples include both cases where the abuse was, and was not, validated. Do note that I am in no way denying the existence of traumatic injury.

Many of the examples below only mention the amnesia, a subset mentions recovery by undefined means

• Porter: childhood animal attack
• Brandon: childhood sexual abuse
• Kihlstrom: childhood sexual attack
• Widom: "childhood victimization"
• Williams: child sexual abuse
• Chu: childhood abuse
• Duggal: childhood sexual trauma
• The Recovered Memory Project: "traumatic childhood abuse are said to have been corroborated." (not in title)
• Van: childhood trauma
• Corwin: child sexual abuse
• Sheflin and Brown: "CSA" removed twice as apparent essay, not peer-reviewed scientific paper
• Freyd: childhood abuse

No, I don't think it is my job to develop "recovered memory" with respect to other areas of trauma, as my knowledge of trauma medicine and military stress disorders doesn't reveal it being used. I'd like to see a strong case made that recovered memory has a significant role outside the prosecution of child abuse. This article doesn't tell me anything else. Howard C. Berkowitz 21:53, 19 March 2009 (UTC)

Section on neurological basis

The difficulty with this section is a) that it puts excessive weight on a few rather old papers and b) it's about PTSD rather than recovered memory. There's no doubt that acute stress affects memory processes, and there are reports of long term structural changes that are generally in line with many other findings. Bremner has several more recent reviews, van der Kalb also. My suggestion is to start an article on PTSD and move the current text there and then update and broaden the coverage? I'll get back on the points aboveGareth Leng 17:27, 18 March 2009 (UTC)

Apropos PTSD, I definitely can mention that both in the U.S. military and civilian disaster preparedness, there is much emphasis that not all stress disorders are PTSD; see Posttraumatic stress disorder/Related Articles. There are recognized acute stress syndromes, and at least three MeSH-recognized PSTD types. Recognition of all is very critical, especially the earliest signs of PTSD, where interventions may be most useful. In like manner, while it's controversial (one technique, Critical Incident Stress Debriefing was found harmful for some people), there are proactive methods of dealing with emergency service workers and soldiers who have just gone through a sitution likely to be traumatic. In fire services, for example, it appears there must be time soon after for team discussion and mutual support, in casualty situations and especially when they've lost some of their own. Howard C. Berkowitz 17:39, 18 March 2009 (UTC)

Editorializing (I think) in a footnote!

Footnote #27 begins, "Consider this, skeptics of recovered memory...." Do my eyes (and brain) deceive me, but isn't that a clear exhortation to "skeptics" to straighten up and fly right? Or am I misreading something innocent? Hayford Peirce 22:44, 18 March 2009 (UTC)

Well, the link reports temporarily available, and looks like it might be paid content. That seems to be the title of the article, however, and rather strongly makes the point that appearing in a journal doesn't mean it was peer-reviewed. Journals certainly have editorials.

Occasionally, when dealing with current politicomilitary matters, I may on rare occasion quote a reputable editorial commentator who appears to be confirming a primary document, but that is an extremely rare need. Some other references may also be opinion pieces; their validity as sources really needs close examination if there is scientific content. Howard C. Berkowitz 23:04, 18 March 2009 (UTC)

I think the medical people here ought to look at this footnote and decide if it's worthy of inclusion. Hayford Peirce 23:33, 18 March 2009 (UTC)

First, it may be moot. Clicking on the note gives "informaworldTM is currently experiencing some technical difficulties, which we are working to fix. We apologise for this downtime and hope to restore access to the site as soon as possible." It appears to be a publisher site, so if it's paid content, there would have to be an awfully good argument to have it at all.

Second, look at it in context "and in some cases recovered memories of traumatic childhood abuse are said to have been corroborated.[27]"  ??? "said to have been corroborated" ??? what kind of assurance does that give?

On hunting around for the text, it's by a political science professor. Here's a secondary quote from [3]

ETHICS & BEHAVIOR, 8(2). 141-160 Lawrence Erlbaum Associates, Inc. Consider This, Skeptics of Recovered Memory - Ross E. Cheit - Department of Political Science - Brown University - Some self-proclaimed skeptics of recovered memory claim that traumatic childhood events simply cannot be forgotten at the time only to be remembered later in life. This claim has been made repeatedly by the Advisory Board members of a prominent advocacy group for parents accused of sexual abuse, the so-called False Memory Syndrome Foundation. The research project described in this article identifies and documents the growing number of cases that have been ignored or distorted by such skeptics. To date, this project has documented 35 cases in which recovered memories of traumatic childhood events were corroborated by clear and convincing evidence. This article concludes with some observations about the politics of the false memory movement, particularly the tendency to conceal or omit evidence of corroboration. Several instances of this vanishing facts syndrome are documented and analyzed.

Maybe it's a personal prejudice, but as soon as I see an author say "so-called", I stop reading as an assessment of his or her ability to write. If the citation above is accurate, it's a political statement. What is it doing in an article supposedly about science?' I'd pull it out, and check to see if any other of the sources are political opinion and yank them.

Just out of interest, I went to the journal site [4], and found it has both peer-reviewed and "essay" content. The next, #28, does look like a true research paper, but I'm just looking at the first page on Questia. Maybe more source checking is in order here; essays and editorials from scientific journals need to be clearly identified.

If someone wants to do an article about the politics of this matter, it might belong there. Otherwise, Howard C. Berkowitz 00:24, 19 March 2009 (UTC)

Okie, so why *don't* you pull it out? Hayford Peirce 01:34, 19 March 2009 (UTC)

Happy to do so; just be around for the expected complaints. Howard C. Berkowitz 02:12, 19 March 2009 (UTC)

I'll be your back. Not as a Constable -- this is just an author's editing, as per the way a Wiki is supposed to work. Hayford Peirce 02:20, 19 March 2009 (UTC)

It appears to have been reverted, with some additional argumentative text.

I'm not sure if this can be solved without E-I-C intervention. Nevertheless, I'm about to take a bold step for readability: wherever there are multiple consecutive citations, I'm going to move them to a bibliography subpage. They won't be lost, and I will even keep them in groups. Right now, however, there are so many citations that it's impractical to go through and find any "essays." Howard C. Berkowitz 02:53, 19 March 2009 (UTC)

(undent) I moved the reference to another more appropriate section, using a different idea from the article. This is not a revert. It was in a peer reviewed journal. Neil Brick 03:32, 19 March 2009 (UTC)

Just having looked at the bibliography, there seems to be confusion about the purpose of that subpage. It's fairly unreadable, first because of unneeded indentation, and second because it's a mass of abstracts, not "annotated in a user friendly manner" as called for by the page. I will put things in a separate section. Howard C. Berkowitz 02:56, 19 March 2009 (UTC)

If I understand correctly Gareth was/is using it as a storage zone for papers he found in a pubmed/medline search. Chris Day 03:02, 19 March 2009 (UTC)

Well, nothing is lost. I reformatted the first, but then just gave up and moved inline cites. Nevertheless, they are in a separate section. Howard C. Berkowitz 03:06, 19 March 2009 (UTC)

(undent) Neil, can you state, with certainty, that the article was peer-reviewed, which is not at all the same as an essay or editorial in a journal that contains peer-reviewed articles? It seems unlikely; the article is by a political scientist but in a psychological journal, and has language rarely found in objective scientific papers. If the article itself is not peer reviewed, and it indeed is described as a "commentary", it has to meet a much, much higher bar. I still recommend it be removed. Howard C. Berkowitz 04:18, 19 March 2009 (UTC)

It was published in a peer reviewed journal.

PAIS International Peer Reviewed Journals List

http://www.csa.com/factsheets/supplements/paispeer.php

Ethics & Behavior. (1050-8422) http://www.leaonline.com/loi/eb

Their peer review process:

http://www.tandf.co.uk/journals/journal.asp?issn=1050-8422&linktype=44

The burden of proof is for you to prove that a peer reviewed journal does not have peer reviewed articles. Neil Brick 04:31, 19 March 2009 (UTC)

May I remind you that, in the discussion that led to the Cold Storage of Extreme Abuse Survey, the Editor-In-Chief made exactly the point that appearance in appearance in a peer-reviewed journal does not mean that an individual article was itself peer-reviewed? Quoting from the link you gave, which is not their peer review process but their Instructions to Authors, "Perspectives are occasional essays describing challenging dilemmas in ethics and behavior." Many journals containing peer reviewed articles contain just such opinion papers, which are interesting from the perspective of the editors, but are emphatically not peer-reviewed. The New England Journal Medicine has some of the toughest peer review, but it periodically prints anecdotal Letters to the Editor that may be hysterically funny, but certainly not authoritative ("Thigh Trimmer Tenosynovitis", "A Case of Extreme Hypernatremia in a Young Woman of Mediterranean Origins" (i.e., Lot's Wife), and the detailed surgical report of removing a pediatric group's office manager's tie from the paper shredder come to mind.)

I can, of course, communicate with the journal. If they deny it was peer reviewed, what might that do to credibility of other citations? Howard C. Berkowitz 22:57, 19 March 2009 (UTC)

For what it's worth, the author lists it on his CV as "refereed" - see http://research.brown.edu/pdf/10061.pdf Shamira Gelbman 23:05, 19 March 2009 (UTC)

And "refereed" is synonymous with peer reviewed. Neil Brick 02:06, 20 March 2009 (UTC)

[undent] The editor journal confirmed it went through peer review. I'd be interested to see an impact analysis; I don't think I have access to a database of such.

I was wrong in suspecting it by the title, but I maintain there is no "burden of proof" to establish a paper is peer-reviewed. The E-I-C has stated that appearing in a journal that contains peer-reviewed articles does not guarantee that a given article is peer-reviewed; it is a legitimate question to ask when dealing with controversial material. Impact is still a legitimate issue for any source, including both the quality of journal and how many external papers cite the article. Not all CZ sources need be peer-reviewed, but when they are not, some indication of validity is relevant. A news item from the Washington Post or Christian Science Monitor tends to be a bit more trustworthy than Weekly World News.Howard C. Berkowitz 01:28, 20 March 2009 (UTC)

Thank you for confirming this with the publisher. Neil Brick 02:41, 20 March 2009 (UTC)

Scope of what U.S. District Courts do.

I thought I changed this sentence before, but, for the record, I just changed:

"A decision in U.S. District Court accepted repressed memories as valid."

to

"A U.S. District Court accepted repressed memories as admissible evidence in a specific case."

In the Federal court system, the District court is the lowest level; it is not an appeals court. While District court decisions may indeed be accepted all the way up to the Supreme Court, or the SCOTUS may decline to review a Circuit Court of Appeals acceptance of a decision and the District level becomes an established precedent for stare decisis, the sentence I changed was confusing at best.

The "Court" accepting can refer to the judge permitting evidence into a jury trial, with the jury decision opposed to that piece of evidence. If it was not a jury trial, and the judge cited that piece of evidence as supporting a decision, a much stronger level of acceptance exists. There is insufficient information in the article to evaluate the interpretation.

On going to the website, more detail becomes apparent. "This matter is before the Court on the Defendant's Motion in Limine to Exclude Repressed Memory Evidence." The opinion is about admissibility of evidence, not a decision to accept the evidence. In U.S. legal practice, there is a wide spectrum from rejecting evidence as admissible, to allowing it into trial, to getting a jury decision that does not explain what evidence it considered valid, to a judge-only opinion that may or may not agree with the specific evidence. Howard C. Berkowitz 03:20, 19 March 2009 (UTC)

Examining some text just reinserted.

The citation of Herman, below, was just added. Let's look at the sentences of the paragraph:

1. Some studies have concluded that recovered memories can occur in victims of trauma[17] and that memories of child sexual abuse and other traumas can be forgotten.[18]
2. Herman stated that "the ordinary response to atrocities is to banish them from consciousness."[19][20]
3. There is evidence that traumatic memories can be recovered spontaneously.[21][22] and in some cases recovered memories of traumatic childhood abuse are said to have been corroborated.[23][24]

Sentence #2 was inserted, but what does it add to the paragraph other than two consecutive footnotes? Sentences 1 and 3 indeed speak of recovered memory. Sentence 2 speaks, using dramatic language, not of recovered memory, but of traumatic amnesia. How does Sentence #3 build on Sentence #2?

Sentence #2 should go. Howard C. Berkowitz 03:25, 19 March 2009 (UTC)

I have just moved some references around to answer some objections about too many references in one place. Herman's work is pivotal to the debate and well researched. As long as her book is included backing the idea stated, I have no objection to its being moved. Neil Brick 03:28, 19 March 2009 (UTC)

You have not made it clear that Herman says anything except that traumatic amnesia exists. Sentence 2 does not address recovered memory. As a personal request, Neil, please crank back on the repetition about how material is "well researched" or researchers are "respected"; unless that is well-sourced, it's a judgment to be made by the reader. Howard C. Berkowitz 01:36, 20 March 2009 (UTC)

Sentence 2 does address recovered memories. She is discussing traumatic amnesia. I will change it to this "Herman writes about the existence of traumatic amnesia and the healing process from it." Neil Brick 02:41, 20 March 2009 (UTC)

Respectfully, there are still some leaps of logic. "Recovered memory" still doesn't appear in it. I may guess that you believe that treatment of traumatic amnesia is synonymous with recovered memory techniques, but the information presented does not reflect such an equation. Cognitive behavioral therapy (CBT) is the gold standard of therapy for traumatic stress, and CBT is not centered on recovered memories — indeed, CBT can work without ever knowing the specific history. The therapist needs to know the feeling state that direct or indirect triggering causes, and assists the client to develop cognitive techniques to cope with the maladaptive behavior.

We might get along much better if we were talking specifically about traumatic amnesia, about the general and more specialized treatment for stress disorders (CBT, EMDR/EFT, pharmacological), etc., rather than leaping directly to recovered memory techniques as an apparent panacea. We might get along better if the discussion dealt with more of a therapeutic context than bringing in the courts. Howard C. Berkowitz 04:06, 20 March 2009 (UTC)

(undent) IMO, recovered memory (as coined) is synonymous with traumatic amnesia. I would disagree with your opinion of CBT as the gold standard of therapy for traumatic stress. Though useful, it does not deal with the needed work of abreaction, once the client is ready for such work. Herman cites six researchers, including Janet and Putnam, that all conclude that working through the trauma itself is a major stage of recovery. See http://books.google.com/books?id=3cn2R0KenN0C&printsec=frontcover#PPA156,M1 p. 156 (search Janet 1889 and click on page 156). I think the legal aspects are important also. Neil Brick 04:17, 20 March 2009 (UTC)

Coined by whom? Actually, MeSH doesn't use traumatic amnesia or recovered memory, but does use retrograde amnesia and antegrade amnesia. Traumatic amnesia, however, is widely used in such areas as military psychiatry, but recovered memory is not.

Where, in Citizendium, is the definition and discussion of abreaction, and why it is so essential? It seems as if that you are asking to assume a great deal of context-setting as a given. I can, with very little difficulty, find quite a number of psychiatric references on trauma in emergency workers and soldiers that consider working through the specific trauma to be optional. These are not areas where there are absolutely established truths; that's hard enough in neurochemistry. Howard C. Berkowitz 05:34, 20 March 2009 (UTC)

Emergency work is quite different than actual comprehensive trauma treatment. Several in the field would state that simply using CBT for severe trauma issues would not work. Neil Brick 14:25, 20 March 2009 (UTC)

Take a look at the mail archives at [[5]], and explain to them how emergency trauma is a different kind of trauma. I have a good-sized shelf of textbooks on trauma medicine and surgery. It would seem that if you want to be using a different definition of trauma than is used through much of medicine, your first task is a disambiguation page.

From a quick journal search, here are some current papers on military psychiatry and treatment of stress disorder:

• Matthew J. Friedman, "Posttraumatic Stress Disorder Among Military Returnees From Afghanistan and Iraq" [6]

Recovered memory not mentioned.

• Australian Guidelines for the Treatment of Adults with Acute Stress Disorder and Posttraumatic Stress Disorder [7]"

  A recovered memory is thought to be the recollection of a memory that has been unavailable to deliberate recall for some period of time. This is distinct from incomplete or fragmented memories that may be\ associated with PTSD. The issue of recovered memories has most commonly arisen in the area of childhood abuse. It is controversial, and has attracted debate in both the professional and public arenas. While it is possible that trauma memories can be both forgotten and then remembered, and that ‘false memories’ can be suggested and remembered as true, the former is arguably rare. Therapy that attempts to recover otherwise forgotten memories of childhood abuse as the basis for relieving emotional distress has been criticised for lacking a sound theoretical basis, failing to consider the fallibility of memory and using techniques such as suggestion that increase memory distortion and confabulation. In the absence of corroboration, it is not possible to unequivocally determine the validity of recovered memories. Risk associated with the concept of recovered memory can be minimised when practitioners are trained to professional standards, conduct full assessments at the start of treatment, adopt a neutral stance towards a history of abuse avoiding preconceived beliefs about factors that may or may not be causing the presenting problems, and avoid use of techniques that increase suggestibility and memory distortion. In the absence of corroboration of new memories of childhood abuse, treatment should enable the person to arrive at their own conclusions with some understanding of memory processes, and to adapt to uncertainty when it persists.

  In other words, a small and questioning not in a 192 page document, which also explicitly describes recovered memory as different from the memory problems in PTSD.
• New Zealand Ministry of Health. "Planning for Individual and Community Recovery in an Emergency Event. Principles for Psychosocial Support: National Health Emergency Plan" [8] Recovered memory not in text
• American Psychiatric Association. "Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder." [9] Recovered memory not in text

So, yes, perhaps what you are talking about is something "different". U.S. practice guidelines don't mention it at all in the context of PTSD, while Australia thinks it's worth a cautionary note and says the memory disturbances under recovered memory are quite different from PTSD. The Australian guideline does mention it in the context of childhood abuse.

Yet your text is full of references to PTSD as essentially synonymous with PTSD. You now claim emergency-related PTSD is different. Now, if you are just talking about things in relation to CSA, which I can't help but suspect, would you say so, and go move PTSD specific material to a PTSD article? Howard C. Berkowitz 15:49, 20 March 2009 (UTC)

Could we try a clear English paraphrase of Sheflin and Brown?

Sheflin and Brown are quoted to say:

a total of 25 studies on amnesia for CSA now exist, all of which demonstrate amnesia in a subpopulation; no study failed to find it...no study has surfaced that refutes the dissociative amnesia hypothesis by failing to get reports of inability to voluntarily recall repeated childhood abuse.

Huh? Before the ellipsis, it says (presumably traumatic) amnesia exist in (undefined) subpopulations. The existence of traumatic amnesia is not in dispute here. The dispute is about techniques to recover the traumatic memories.

After the ellipsis, I am simply confused. The "dissociative amnesia hypothesis" is not clearly defined well to know whether refuting it would support, disprove, or be neutral about recovery. After that, I have great difficulty in parsing "failing to get reports of inability to voluntarily recall repeated childhood abuse." Not knowing, or frankly caring because it's not my job to make your argument, what was omitted with the ellipsis, what does this convoluted phrase actually mean?

It rather clearly assumes the existence of "repeated childhood abuse". If I were to assume the reports are of recovering such reports, there needs to be validation:

• they reflected independently verified abuse OR
• the patients recounted their memories of abuse that they had had difficulty in discussing, but without evidence of whether it happened or not

The title of the article, incidentally, "Repressed memory or dissociative amnesia: what the science says", is rather argumentative for a scientific journal, although this is a law journal. One wonders about its review process. Howard C. Berkowitz 04:29, 19 March 2009 (UTC)

Please feel free to propose a re-write on the talk page. But let's agree before it is changed. Neil Brick 04:36, 19 March 2009 (UTC)

Sorry, that doesn't work, unless it was the intent of the author to be incomprehensible. I can't propose a rewrite of what I cannot parse.

I raised specific points that I could not determine from reading the quote, points which are highly relevant to the justification to include the text. It clearly wanders and brings in material about traumatic amnesia, but I honestly can't make heads or tails of what it is saying about recovery. On occasion, I have been credited with a reasonably decent ability to read and comprehend English.

Neil, when others tell you not that they disagree, but that they literally can't understand the point, I suggest you consider that your opinion about portraying the author's intent might not be universally accepted. Howard C. Berkowitz 04:40, 19 March 2009 (UTC)

I have simplified it.Neil Brick 04:54, 19 March 2009 (UTC)

Yes, that took out the incomprehensible part, but all that it is left is additional material about the existence of traumatic amnesia. No one is disputing that traumatic amnesia exists. Many are disputing that there are special techniques of recovered memory, distinct from what comes from associations and interaction in conventional psychotherapy. The remaining text does not address the disputed points and should be deleted. Howard C. Berkowitz 04:58, 19 March 2009 (UTC)

(undent) It is in a peer reviewed journal citing scientific research. It backs the existence of amnesia in CSA and should stay. There is no requirement that it address a disputed point. Neil Brick 05:02, 19 March 2009 (UTC)

That is the first mention of "CSA" in the article, and I really don't understand what the Confederate States of America have to do with recovered memory. If CSA has something to do with the recovery of information affected by traumatic amnesia, such a point is not, in the slightest, made.

I don't know what you mean by "no requirement it address a disputed point." First, one of the requirements of collaborative editing is when other citizens (not "editors"; lower case e is a WP term and a CZ Editor has not ruled) observe something appears irrelevant, simply insisting it must stay is not collaboration. Second, what I meant was that if all it did was establish that traumatic amnesia exists, it's superfluous; no one is disputing the existence of traumatic amnesia. Howard C. Berkowitz 05:36, 19 March 2009 (UTC)

Text here was removed by the Constabulary on grounds that it is needlessly inflammatory. (The author may replace this template with an edited version of the original remarks.) Howard -- you made some pertinent points here that *should* be addressed by Neil. However, your manner of presenting them was unprofessional. I would appreciate it if you would reword your comments and reinsert them here. Thanks, Constable Hayford Peirce 15:32, 19 March 2009 (UTC)

Feel free to put a sentence, "Traumatic amnesia, or the suppression of painful memories from any cause, is an accepted concept" into the lead. Those matters are not in dispute.

What is in dispute is whether there are specific techniques of memory recovery, as opposed to regular psychotherapy, for things suppressed by traumatic amnesia. It is also strongly disputed that traumatic amnesia, separate from its recovery, is unique to child abuse. Traumatic amnesia is well documented in combat stress, in the experiences of emergency service workers, and in the victims of multisystem physical injuries. The treatment of the the latter three types of patients certainly does include psychological support, but the medical literature in those fields do not address unique "recovery" technique.

In those situations, the standard for treatment of the emotional problem is cognitive behavior therapy, with some experiments with eye motion desensitization reprocessing and emotional freedom techniques. Those techniques do not focus on the details of the memory, but on helping the patient learn to recognize those events that trigger the highly emotional response, and both to desensitize the triggering, and to reassure the patient and damp the panic response that may result from triggering. They are widely used, sometimes with the assistance of drugs during active therapy, for adult victims of rape and other sexual trauma.

These therapies are always interactive, with a therapist usually with additional training, who can cope with extreme reactions to the stimulus. Their techniques try to identify just enough of the memory to characterize its triggering properties, do not try to extract evidentiary material, and their goal is to create a functioning adult or child.

Unfortunately, many of the citations you produce keep coming back to child sexual abuse, and sometime ritual abuse. An apparent overemphasis on these etiologies may be distorting the broader therapeutic issues, and ignoring other types of victims. Bringing satanic and government conspiracies on top dilutes any core message that might establish recovered memory techniques as treatment alternatives. Howard C. Berkowitz 15:45, 19 March 2009 (UTC)

CSA stands for child sexual abuse. It is a commonly used abbreviation in the field. You stated it should be deleted. I countered that it should stay and explained why. It summarizes the scientific literature clearly. You stated the citation "does not address the disputed points and should be deleted." I stated there is no requirement a peer reviewed citation do this.

I never stated that traumatic amnesia is unique to child abuse. EMDR and CBT are very useful treatment methodologies. But many clinicians would agree that remembrance and mourning (which includes reconstructing the story), is a major part of the recovery process, like Herman (Herman, J.L. (1997). Trauma and recovery. New York: Basic Books. http://books.google.com/books?id=3cn2R0KenN0C))

None of the citation I have put on this page discuss ritual abuse or any other governmental issues. This is a total misrepresentation of my edits. Neil Brick 02:23, 20 March 2009 (UTC)

Proposed groundrules

If we're going to make progress here I think we're going to have to follow some ground rules. I think these must include:

1) We must ensure that the article represents an accurate account of the balance of current scientific opinion, while identifying areas of disagreement. In representing the evidence we should use peer reviewed secondary sources - i.e. peer-reviewed review articles in the academic literature, and not primary studies (unless an exceptional case can be made that a study contains important point that, for an acceptable reason, is not covered in a secondary source). (see Bibliography page). We should prefer reviews in major journals over minor, recent over old, avoid multiple citations to the same authors, and try and cover the span of views they represent. In a disputed field any choice of primary articles will be biased (unless we can make an objective case for notability e.g. by citation count), so we should avoid it. Academic books I think we should include if we can cite a published review (as evidence that it is academically noteworthy, don't care whether the review is favorable or not).

2) We must ensure that it is clear what the opinions of relevant professional bodies are. In representing consensus of professional opinion we must go by formal policy statements. (see external links).

3)The article must be comprehensible to the reader, so any statement in it that is not clearly understandable must be rephrased.

Gareth Leng 21:51, 19 March 2009 (UTC)

CSA -- what does it mean?

Howard facetiously called it Confederate States of America (which is true), but I assume that it has some other meaning pertinent to the article. Please, Neil, spell it out for us! Thanks. Hayford Peirce 02:24, 20 March 2009 (UTC)

Child sexual abuse.Neil Brick 02:41, 20 March 2009 (UTC)

Then please put it into the article in the appropriate place. Hayford Peirce 02:44, 20 March 2009 (UTC)

Trauma and memory should be in its own article, certainly not the end

I have inserted subheads and links. If recovered memory involves material blocked by amnesia secondary to trauma, then an article on recovery logically follows an article on memory, and, in turn, trauma on memory. Having the memory information at the end is illogical. The article jumps into recovered memory, a means of dealing with an effect, and only later discusses the cause.

Note that the abbreviation LTP is never defined.

Throughout the article, I am making as many links as possible. There are, for example, articles both on child abuse and child sexual abuse. If appropriate, those articles need to link here; this article needs to make appropriate links there, or it is orphaned as far as knowledge navigation. Howard C. Berkowitz 04:46, 20 March 2009 (UTC)

Since the research shows that trauma causes amnesia and some of these memories can later return and be verified, then IMO trauma and memory belong in the article somewhere. Neil Brick 19:30, 20 March 2009 (UTC)

Even if that is completely true, memory, trauma and amnesia are broader topics than recovered memory. This article should not repeat work in the existing memory article. Content here that is, in fact, general about those topics belong in those articles. This article should focus on the unique intersection of those issues and how the ideas here build on them, not try to be a new introduction to memory. Good CZ articles on nonfiction topics rarely attempt to be stand-alone. Howard C. Berkowitz 19:41, 20 March 2009 (UTC)

I think that all of the references presently in the article do show the intersection of memory and trauma.Neil Brick 03:53, 21 March 2009 (UTC)

I understand that you believe it is just right. As a collaborator, I am suggesting that it comes across as an article trying to stand on its own, and not link significantly with existing content. Do consider it, as a helpful suggestion from someone with a bit of CZ experience. Howard C. Berkowitz 04:06, 21 March 2009 (UTC)

Let me be a little more specific. The heading "Neurological Basis of Memory", as well as the first sentence following it, are identical in this article and in the main memory article. The text here then seems to take selective text from the memory article, ironically taking the abbreviation LTP, which is explained there but left as a cryptic abbreviation here. Again, it is repeating information in another article. It would be far more appropriate to delete the entire section here and, perhaps, put {{seealso|Memory#Neurological Basis of Memory}} under "Amnesia". It would be even better to move the general amnesia text here to amnesia, other than that the reference (now 38) is not about amnesia in general; it is from a book, A Primer on the Complexities of Traumatic Memory of Childhood Sexual Abuse - A Psychobiological Approach. Brandon, VT: Safer Society Press. This is an example of what I believe is introducing child sexual abuse as the core of more general topics.

It's always preferable, in an online encyclopedia, to use references available online. Just with a quick look, I find a much more general book, Memory Disorders by Takehiko Yanagihara and Ronald C. Petersen, at least partially available through Google Books. [10] I suspect a good general discussion on amnesia could be found as a full online article, but it's not my job to find it. Still, if the section is entitled "Amnesia", not "Amnesia secondary to child sexual abuse," such a reference would be closer to the section title. Howard C. Berkowitz 05:02, 21 March 2009 (UTC)

Well, lets go carefully here; I started to expand and edit Neil's text on memory, but when Howard made comments earlier, I agreed with him that we needed an article on Memory and started one, and saw it as a place where some of Neil's text would fit as a starting point for a section, so I copied some text across and edited it in both places - I may well have lost the LTP definition in the trimming across articles. I think that the bulk of the material, certainly all that's strictly technical, should be in the Memory article rather than here but think an overview or summary should stay here. It's work in progress Howard, we've a long way to go yet. Neil's text is a fine starting point, we can work with it.Gareth Leng 10:57, 21 March 2009 (UTC)

(undent) I agree with Gareth's idea above. As long as an adequate overview of the material stays in this article, I am fine with this. BTW Gareth, thank you for your excellent work on the article.Neil Brick 18:25, 21 March 2009 (UTC)

On Gareth's note on professional organizations

Very nice statement. I think it reflects that my problem with this article, which is not titled "Recovered memory of child abuse", is conflating concepts such as adult PTSD with pediatric information, and, (see bulleted list above) is principally citing "CSA". There may be perfectly good content here about traumatic memory that has nothing about CSA. There may be perfectly good content about memory and CSA. There may be advocacy about a particular CSA viewpoint. It's very hard for me to tell, in part due to the lack of subheads, completion of ideas, etc.

As far as organization, look where I inserted a subhead for Mechanisms of interference. I bulleted the four points clearly identified in the citation. Were all four discussed in recognizable form, as next-level subheads? Were some deliberately omitted for good reason? If so, say so. Howard C. Berkowitz 15:56, 20 March 2009 (UTC)

Bibliography

On this page I've assembled notes on review articles I should stress that I haven't selected these, they are all of the recent relevant English reviews that I have found from PubMed using key word searches (I've omitted some duplications). The bold extracts are to draw attention to points made in the article text; the bold can be removed later, I used this just so you can all see clearly where I am getting my understanding of consensus academic opinion from. I'm ignoring primary sources. Gareth Leng 17:54, 20 March 2009 (UTC)

Notes

I've deleted two links to a paper that gives a verbetim transcript of an interview with a child. I don't think it's appropriate here for several reasons, but academically we should focus on what is accepted and what is disputed. It is obviously true that some people come forward with accounts of abuse that previously they have not disclosed, and that sometimes these accounts are accurate. However some (not all) experts argue that events that were traumatic at the time are seldom if ever truly forgotten. Accordingly, they believe that, when there is a report of a recovered memory, then either the memory was in fact always present but not disclosed, or the memory is likely to be a false memory. False memories can be created in many (not all) subjects relatively easily by suggestion. Accordingly, the heat in this dispute is about a) whether some therapists, in believing that repressed memories are common, are unwittingly inducing false memories and b) about the reliability of such memories. True validation of memories is difficult - what is spoken of in some studies as validation is circumstantial evidence that some accounts may be essentially correct, but circumstantial evidence (or even corroborative support from close parties) is not robust support. But true accounts may arise from memories that have not previously been disclosed.Gareth Leng 10:30, 24 March 2009 (UTC)

Since it is authentic (video taped) evidence, I do believe we should consider it for the article. I don't understand why it was deleted as an external link, since it is connected to the topic of recovered memory.

Corwin, D (1997). [http://cmx.sagepub.com/cgi/content/abstract/2/2/91 "Videotaped discovery of a reportedly

unrecallable memory of child sexual abuse: comparison with a childhood interview videotaped 11 Years :before"]. Child Maltreatment 2: 91–112. DOI:10.1177/1077559597002002001. Research Blogging. “This article presents the history, verbatim :transcripts, and behavioral observations of a child's disclosure of sexual abuse to Dr. David Corwin in :1984 and the spontaneous return of that reportedly unrecallable memory during an interview between the same :individual, now a young adult, and Dr. Corwin 11 years later.”

Neil Brick 03:35, 25 March 2009 (UTC)

This is a wonderful example of how we are not communicating. I'm reasonably willing to believe sworn videotape is an accurate recording of a therapy session, although amazing things can be done with graphic editing. I'm perfectly willing to accept that Corwin's patient absolutely believed the truth of the disclosure. I'm perfectly willing to accept that Corwin's professional opinion is that the behavior was consistent with the effects of the memory.

It is evidence that Corwin's patient recounted a memory. It is in no way evidence that the memory accurately reflected an event. Yes, it is connected to the topic of recovered memory, but the implication is that it is a report of a validated memory. No information on validation has been given.

This parallels some of the current debate on interrogation, including psychologically coercive interrogation. There is a very strong difference between obtaining a confession, as might be desired in law enforcement or for ideological reasons, and getting accurate intelligence. Howard C. Berkowitz 03:59, 25 March 2009 (UTC)

To be explicit, The link was to an article that is not freely available. The article if accessed contains the verbatim transcript of a child's disclosure of sexual abuse. Such material is, in my opinion of academic interest but should not be linked to here. As evidence it is a single case, what we call an anecdote. It may have emotional impact but very little weight as objective evidence.Gareth Leng 09:35, 25 March 2009 (UTC)

Gareth, thanks for your reply here. As a compromise, how about we only use it as an external link. It is peer reviewed and does directly relate to the topic. We could create a new section called "Individual cases" if needed. Neil Brick 15:28, 25 March 2009 (UTC)

What value does CZ bring to a list of "individual cases" that Google does not? Again, we are not communicating: peer review refers only to the report of a patient experience; the case report apparently did not attempt validation other than in clinical terms. Howard C. Berkowitz 15:33, 25 March 2009 (UTC)

(undent) Google does include individual cases also, and this case is listed in google. I see no reason not to include it as an external link.Neil Brick 15:36, 25 March 2009 (UTC)

CZ does not have the same objectives as Google. Of course Google gives individual cases. I see every reason not to include individual cases as external links, for the reasons Gareth mentioned. Again, I'll point to a CZ success on a controversial topic, homeopathy. There is very careful use of individual studies and even clinical trials; there are no links to anecdotes. Early in the process, there was insistence on linking to celebrities endorsing it, which also were deemed anecdotal and uninformative, and essentially advertising for one position. Howard C. Berkowitz 15:58, 25 March 2009 (UTC)

Individual cases in this topic are different than celebrities endorsing a topic. The data is not anecdotal, since no claims are made to prove a case pro or con, data is simply cited. I am looking for a compromise. I have agreed not to use the reference in the article. I do believe that the studies belong in the appropriate section for external links. Neil Brick 01:58, 26 March 2009 (UTC)

Improving "Effects of trauma on memory"

I'm finding this section hard to read simply from a flow standpoint and would like to see if some collaborative tightening is possible.

• Let me remind that PTSD is not the only stress disorder and is not synonymous with it.
• Is acoustic stress response really the preferred term? Acoustic stress reflex might be a bit more general, and help make it clear that the stimulus and response need to be clearly referenced. For that matter, thinking in terms of MeSH structure, perhaps there needs to be some context for sensory gating before a leap into a specific kind.
• There are a number of "According to van der Kolk, and van der Kolk and Fisler" that have no associated citation; it looks like that paraphrases from van der Kolk then run into things that are actually sourced to Knopp. The article is about traumatic memory, so child sexual abuse, the subject of Knopp, may or may not be as general as the article indicates. Please make it clear what is from:
  • van der Kolk
  • Knopp
  • van der Kolk and Fisler
  • Lang, for which there is no independent citation

• "The body’s need to respond in danger situations can be strong. There is a tremendous physiological cost to this type of response, due to the depletion of hormones. When there is inadequate recovery time between stressful situations, alterations may occur to the stress-response system, some of which may be irreversible, and cause pathological responses, which may memory loss, learning deficits and other maladaptive symptoms." suggests quantitative context. What do "tremendous" and "inadequate" mean?

Let me try to sort out

Changes in hippocampal functioning during uncontrollable stress may limit the consolidation of the input into the explicit memory system. Some mental representations of the input may remain in cortical emotional memory, which may cause phobias and anxiety. This explains how trauma sufferers may have amnesia for specific events, but not the emotions connected to them. According to van der Kolk, in animal studies, memory is damaged when a situation can no longer be helped by the animal’s activity. Panic and freeze responses may be defenses to allow an organism to not consciously experience overwhelming stress or to not remember an occurrence of overwhelming stress. The second is by changing one’s interpretation of detachment. These events are characteristic of dissociative responses. These influences may cause memories unrelated to or dissociated from the normal methods of explicit memory retrieval

Is there a better way of phrasing so things don't drift between "explicit memory" and presumably "hippocampal-cortical"?

Are the panic and freeze responses specific to animal studies? Is "remember an occurrence" or "changing one's interpretation" still specific to animals, as well as dissociation? If so, how is dissociation evident in animals? I wonder if there is, somewhere in this text, an unsourced transition from Van Der Kolk to some other source dealing with human stress; the latter part of the paragraph seems more anthropomorphic. Well, yes, some cats probably do interpret, although the last eighteen hours or so have dealt with the less detached Dot-Dot and his panic responses, as opposed to Mr. Clark's apparent ability to visualize food as a calming meditation.

"In animal studies, high levels of cortisol can cause hippocampal damage, which may cause short-term memory deficits; in humans, MRI studies have shown reduced hippocampal volumes in combat veterans with PTSD, adults with posttraumatic symptoms and survivors of repeated childhood sexual or physical abuse." This is pretty specific science; the reference is to A Primer on the Complexities of Traumatic Memory of Childhood Sexual Abuse - A Psychobiological Approach is a narrower reference than I think is appropriate here. I'd like to see some information on the neuropharmacology of how cortisol damages the hippocampus. I can see, for example, [11] on the relationship between cortisol levels and hippocampal volume in aging; is "hippocampal damage" synonymous with volume reduction, or are there functional changes? There's a lot of convoluted material in this sentence and I'm not sure what it is telling me. Yes, I removed passing mention to neuroendocrine hormones just as a list: I need to know what cortisol, epinephrine, norepinephrine, etc., are actually doing — if we know.

Howard C. Berkowitz 18:33, 24 March 2009 (UTC)

Recovered memory therapy needs clarification

I temporarily removed the text, in the lead paragraph, about recovered memory therapy. This certainly can go into the article somewhere below the lead, probably in its own section that starts with defining it. The text I removed,

The term "recovered memory therapy" was coined by members of the "False Memory Syndrome Foundation" to describe the process of recovering long-forgotten memories from people.

is not written neutrally. "coined by" deprecates it, and putting False Memory Syndrome Foundation (FMSF) in quotes can be read as deprecation. Unquestionably, there is a False Memory Syndrome Foundation.[12]

The citation (see below) for the sentence I removed is from a book critical of the FMSF, with authors including the president of the Leadership Council on Child Abuse and Interpersonal Violence (LCCAIV) [13]. Both organizations appear to have reputable people in them, which simply establishes that this is a controversial subject.

A more useful discussion would focus on what iss are, or are not, considered recovered memory therapy, and how they differ from other psychotherapy. Rather than citing criticism, why not actually quote or paraphrase what the FMSF says? Their home page, in fact, does not contain a definition of recovered memory therapy. It does, however, say (italics in original):

The information on this site focuses on the current controversy about the accuracy of adult claims of "repressed" memories of childhood sexual abuse that are often made decades after the alleged events, for which there is no external corroboration....The controversy is about the accuracy of claims of recovered "repressed" memories of abuse.

Where is the FMSF definition? I certainly hear the term being used, but I still don't know what the techniques are. Right now, the CZ article discusses the output of therapy that produces recovered memory, and controversy about its accuracy, but I really would like to know how the material is elicited. Deprecating the term doesn't give unbiased information.

<ref name=Whitfield>{{cite book|title=Misinformation Concerning Child Sexual Abuse and Adult Survivors |last= Whitfield |first=Charles L. |coauthors=Joyanna L. Silberg, Paul Jay Fink |pages=56 |publisher=Haworth Press |year=2001 |isbn= 0789019019}} </ref>

I think that the article should clearly state "Recovered Memory Therapy" is not listed in the DSM-IV nor is it used by any mainstream school of therapy. I do agree it should be moved from the lead. I also agree with taking the quotes off of the term.Neil Brick 03:45, 25 March 2009 (UTC)

Letter from Fink

Howard, can you provide us with a webpage or copy of the letter. Thank you.Neil Brick 03:57, 25 March 2009 (UTC)

Sorry, I didn't realize I had just given the DOI. URL is now in the article [14]. The full text is paid content; but the article is what came back on doing a Google search on the quote given in the article here. Perhaps someone with paid access to Science can provide the actual letter; in the meantime, anyone certainly can reproduce my search [15], which returns the quote. Howard C. Berkowitz 04:06, 25 March 2009 (UTC)

"Neurologic basis of memory" needs work

I really don't want to get into Other Place style for sourcing, but there are some fairly flat statements being made here; given the section title, there is no information to explain the assertions. Bullets below:

• This memory is thought to depend on electrical activity in neuronal circuits, and is very easily destroyed by interruption or interference.

What is a "neuronal circuit" in this context? "Neural network" has a specific technical meaning, with slightly different flavors among different disciplines. "Electrical activity" is quite an oversimplification; were it purely electrical, then presumably microelectrodes could retrieve all of memory. "Memory is thought" is a bit awkward, to put it mildly; we simply don't know exactly how specific memories are stored. It's not purely electrical; it certainly involves chemically mediated potential differences; the encoding probably has something to do with the complex and redundant interconnection of neurons.

• In humans, traumatic stress is associated with acute secretion of epinephrine and norepinephrine (adrenaline and noradrenaline) from the adrenal medulla and cortisol from the adrenal cortex. Increases in these are thought to facilitate memory, but chronic stress associated with prolonged hypersecretion of cortisol may have the opposite effect.

Well, yes. The fact that catecholamines and glucocorticoids are expressed from the adrenals is not in dispute. I think some sourcing is in order to explain the science for how they are "thought" and "may" do anything. Gareth's comment about "a neuroscientist's distaste for neuropsychologists who use the words of neuroscience but don't dance the dance" is relevant here.

• The limbic system, is critically involved in memory storage and retrieval as well as giving emotional significance to sensory inputs. Wihin the limbic system, the hippocampus is important for explicit memory, and for memory consolidation; it is also very sensitive to stress hormones, and has a role in recording the emotions of a stressful event. The amygdala is thought to assign emotional values to sensory inputs which are then elaborated upon by the neocortex and imbued with personal meaning.

"Is thought" again? There is a rather far reach between this level of brain structure and chemistry, and the main point of this article, dealing with expressed memories of events. Less speculation; if it can't be tied to recovered memory verbalized by human beings, it doesn't belong in this article. Howard C. Berkowitz 04:37, 25 March 2009 (UTC)

There's a balance to be struck between clarity and technical detail. Take statement A("This memory is thought to depend on electrical activity in neuronal circuits, and is very easily destroyed by interruption or interference.") First this is absolutely correct; 'thought' reflects the fact that this is current theory, 'electrical activity' that short term memory is thought to be encoded as electrical signals (action potentials) in reverberating neuronal circuits. Neuronal circuits are networks of neurons, we avoid the term neural networks because of its extension to other disciplines. Interruption or interference - well this is true by almost any definition. So statement A is a) accurate and b) uncontroversial so I don't think it needs sourcing. Does it have content? - yes, the point is that none of these things are true of long term memory. Is it clear? I thought so.

On effects of cortisol and catecholamines. Again I reduced the text to what the core relevant accepted data. Cortisol is a glucocorticoid, receptors for which are present throughout the CNS, with many target genes; there is a particularly high density of expression for those receptors in the hippocampus, which has a major role in memory as well as being a key regulatory site of the stress axis. There is considerable evidence of effects of glucocorticoids on memory in the hippocampus, at a cellular level by its effects on long term potentiation, and also at a behavioural level. How catecholamines affect memory is less clear but they strongly affect attention. Again I don't think there's anything disputed or controversial in that statement. The third statement - yes "thought" I'm afraid has to be widely used, these are current "working hypotheses" and I wouldn't put it more strongly than that. We don't have a grip on how emotion translates into cellular neuroscience. But all the elements of that paragraph are I think uncontroversial.

So these statements are, I think, statements that probably any neuroscientist would pass as unexceptionable statements of current thinking. But I don't think they could be expanded upon much without getting into areas of important differences of opinion. For example, in Neil's original text he mentioned opioids, I took that out because I happen to know that is an area where there have been considerable changes in interpretation.

I suggest that maybe you can trust me with getting the neuroscience right, but tell me if it's not clear. Is it needed? Well I think there has to be some brief explanation of memory and how stress might affect it, but I'd rather keep that account simple and restrict it to the undisputed core.Gareth Leng 10:20, 25 March 2009 (UTC)

Purely from a lower-case editorial standpoint, I'd much rather see more of this text in memory, with options of getting deeper information. Let me make a computer science analogy: if someone tells me that a computer stores short-term information in random access memory, and it's any kind of context beyond which understanding of the term is expected, I would expect to hear a little understanding of RAM, such as that mostly conventional RAM is accessed by a numeric location, and then an option to go find out that there are refinements such as static and dynamic, virtual, and content-addressible memory.

It troubles me, though, when I find sourcing that often comes from a book about child abuse rather than one about neuroscience. Given the medicolegal aspects, I think it needs to me minimally clear when something is a model from animal systems, when it comes from psychotherapeutic case reporting, and when it is generally accepted admissible testimony. I live with some cats that I consider both empathetic and intelligent (and some pretty oblivious), but I would hesitate before seriously using "detachment" to describe their defensive response to stress.

On the third paragraph, my first concern with "thought" is that it's an awkward word; the purely English-structural verb "thought", with regard to "memory", gave me doubletakes as to whether it referred to cognition or was just part of a sentence. It would be clearer to say something like "a majority hypothesis in neuroscience is..." Yes, that's more wordy, but less ambiguous given the specific subject. I've certainly been taken to task by book editors when I've offered terms like "think", "feel", and "believe", which were restricted to clearly indicated opinion. If we are speaking generally, my test is that if it went into court — as is much of the controversy in this article — would the statement be admissible? Howard C. Berkowitz 13:45, 25 March 2009 (UTC)

Just to be clear

The section Neurological basis of memory I'm happy with, it's not sourced and shouldn't be in my view; this is background uncontroversial and should be supported through links to other articles.

On the intro Howard, personally I do not like putting names to uncontroversial statements. In this case it is not disputed that a) this is controversial or b) that some hold the stated views and the quotations are referenced. If you feel that these statements must be referenced by name because of the quotes, I'd simply rephrase very slightly to remove the direct quotes.Gareth Leng 18:46, 25 March 2009 (UTC)

Gareth, I put those names on there because Larry had criticized, in Satanic ritual abuse, introducing a name without a description of the name; I personally have no problem with a citation alone. My sense is there may be some different writing styles in the sciences and in other fields.

Where my problems began is with the now-removed statement about recovered memory therapies coming:

• A critic, from an apparently reputable organization, of a term attributed to another apparently reputable organization, rather than from the alleged source of the term
• Said term not being present on the website of the source organization.

Things then may have drifted. There is still a problem, in this and other articles, of text presenting a controversial view without balance, especially when there seems to be a disparity between the real-world support of one position, recovered memories are accurate, and the majority of legal and scientific organizations. I would far rather be working on improving noncontroversial article content than fighting neutrality wars. My sincere apologies if this frustration spilled onto your efforts. Howard C. Berkowitz 19:29, 25 March 2009 (UTC)

The sentence you removed "The term "recovered memory therapy" was coined by members of the "False Memory Syndrome Foundation" to describe the process of recovering long-forgotten memories from people." is, I think, simply accurate, but I'll check. The term was invented by one (reputable) campaign group. Coining a word has no derogatory implications that I know of, but the term itself, whether or not it is accepted has to be put in quotes at first mention because the validity of the very concept of recovered memory is at issue. Putting quotes around the name of the Foundation is simply a common way of uniting an unfamiliar compound term at first mention, but it's easy to get rid of them.

I think you're reacting too fast to text in flux. I don't have the time to go through everything at once; relax, go work on stuff you enjoy and come back in a couple of weeks when it's a bit more evolved and then see if there's still anything to fret about with this article. Neutrality isn't something that can be micromanaged, there has to be an overall shape. The controversy is more complex than you indicate. The dispute is not about whether recovered memories are accurate, but primarily about whether there is any such thing as a recovered memory - which is one reason why some account of memory and trauma and amnesia is unavoidable. This is the core dispute. Accracy is also an important issue, especially in legal terms - but this is not the essence of the scientific argument. The 'scientific' view is that genuinely traumatic events are never truly forgotten. However some people may for a long time refuse to admit to such memories. In this case it's not a matter of recovering a memory, but eliciting a disclosure. If someone truly has no memory and then apparently recovers one - then it is likely to be a false memory (according to that side of the fence). Obviously some people may be denying a memory and then when they make a disclosure may prefer to claim that they have recovered a memory, so sorting out fact from fiction is complex. The issue is not semantic because it has very important implications for therapy; if therapists believe that memories are often repressed, then (it is feared) by their suggestions and questioning they may be helping to induce false memories.Gareth Leng 20:34, 25 March 2009 (UTC)

[corrected the spelling of accuracy ;-)] There may be a difference in AE and BE here. In quite a bit of AE, putting a term in quotes, other than as part of a larger quotation, has the connotation of putting so-called in front of a term. May I suggest that a more CZ-friendly solution is to avoid quotes at first mention of a new term, but rather to make it a Wikilink? That way, it will stand out from the text, and also provide a clear way to get to the definition when it is available.

There are, indeed, two reputable groups, the False Memory Syndrome Foundation and the Leadership Council (also appears as Leadership Council on Child Abuse and Interpersonal Violence). Even the more extreme papers to which they link still are credible; my concern is the co-opting of those legitimate concerns you raise into the realm of moral panic, an article with which, I hope, this article can reasonably cross-link. Both we USAians and our British cousins have our panics, but I tend to see you channel them into tabloids (complete with Page 3) while we tend to legislate and police them. That observation adds to the complexity here; there are issues both at the level of individual psychology but also blurring into the social psychology/sociology.

Again at least an American sensitivity, I have too many friends that suffer from emotional trauma from warfare, and, indeed, in civilian emergency service, who are concerned with the tendency to co-opt traumatic memories into "it's all about the children". Part of my difficulty with neutrality here is the broader CZ history of this article and things that link to it. Perhaps I can put together some material on combat stress and the closely related fire-EMS operational stresses, and how they are being managed — and in some cases not managed; there is considerable concern with increased prevalence of suicide and domestic violence among Soldiers, with a considerable effort to detect traumatic stress and intervene early. Gareth, you are certainly not co-opting but dealing with the more general issue; I simply ask a sensitivity that the social and etiologic breadth of traumatic stress be respected by all. Howard C. Berkowitz 21:05, 25 March 2009 (UTC)

Neutrality etc

Thanks Howard, I take your point and will respect it.

I have deleted some more primary sources and should explain that I am not trying to suppress anything. I have tried to ensure that the implications drawn from those studies are included and referenced. In particular I have just removed some references to primary studies reporting evidence that, for many memories recovered during psychotherapy, some corroborating evidence was subsequently found. I have now made it clear that some believe in the validity of recovered memories because of such studies, and have cited reviews etc confirming that this is so, but have not cited the primary studies themselves. Selecting primary studies to cite is a major problem - where do we stop. There are many studies in the literature, often saying very different things, and the studies are of very variable quality and often ambiguous in interpretation or incomplete in different ways. I don't think we should get into implicitly asserting that some (and by omission, but not other) primary studies are particularly noteworthy except in exceptional cases. What we can reasonably do is state (verifiably) that some experts hold particular opinions from their consideration of the evidence as a whole, and that I think is what we must try to do. We report views, but stand back from appearing to support them or disparage them ourselves.Gareth Leng 13:49, 26 March 2009 (UTC)

Judgment is always appropriate. There can be disciplines and circumstances where primary documents are relevant. For example, in computer networking and many other engineering disciplines, there are published specifications that are authoritative definitions of how to build or interface something. Even within the Internet Engineering Task Force, there are specifications, which I would call primary, but also supporting Frameworks/Architecture/Requirements that are not. As a standard gets close to the level of Approval-equivalent, there are required Applicability Statements, Implementer Experience, etc., documents, which are more secondary although still reviewed.

In international law and in matters dependent on international law, the primary documents are relevant, especially when a treaty is written reasonably well. Many issues, for example, depend on interpretations of the Third Geneva Convention on prisoners of war; I believe it relevant to cite (and comment upon) what it actually says. In this case, I consider news reports more tertiary. Defense and prosecution statements in court are more secondary, but still useful. In analyzing current politicomilitary issues, sometimes the position statements of those ordering a policy are relevant and primary, as an anchor for secondary and tertiary contents. We can give great value by thoughtfully rationally selected quotes from different official documents side-by-side; this is, to me and others, a valuable and controlled synthesis that well-distinguishes CZ. Maybe it's blurred into secondary, but, without judging, it's valuable to put the UN, perhaps Geneva, and Bush Administration definitions of torture side-by-side and let the reader judge, with a little guidance on key phrases.

If you think about it, a treaty, or indeed an internal government, probably has gone through at least internal peer review. It isn't a question of validation when a President or Prime Minister issues a proclamation through public means. That's very different than validation of case studies. I have written that there are different theories of why the North Vietnamese chose to fight the Battle of the Ia Drang, and there are data that support each of the three major theories. That the battle was fought, or how it was conducted, is not in serious question. Primary battle reports from both sides, showing the perception at that time, are, I believe, useful.

The video case report, however, has no place in this article, even as an external link. It only establishes that a patient elicited a memory, the memory may be therapeutically consistent with some explanations of clinical experience, but there cannot be an implication that the memory accurately reflects an event — it is not suppressing if we refuse to recognize that it does not support accurate recovered memories. That psychotherapy elicits things not consciously aware to the client is not in dispute. Intense value comes from a simple realization, which is not dependent on external validation, when the client says "when I think such-and-such, it makes me feel so-and-so. I didnt't realize that when I see or do X, it triggers thought Y. If the feeling is not useful, methods such as cognitive behavioral therapy work on changing the feeling state and subjective triggers, not proving the accuracy beyond feeling-behavior being accurate for that client. Howard C. Berkowitz 15:13, 26 March 2009 (UTC)

I do believe that certain peer reviewed individual case studies should be listed in the external links. I believe that it is not up to editors to decide the inferences a reader may make from a scientific study, but to allow the readers to decide for themselves what to think. We could put them in their own section at the bottom with the caveat "These are individual case studies only and should not necessarily be generalized as applying to other cases."

Duggal, S; Sroufe LA (1998). "Recovered memory of childhood sexual trauma: A documented case from a longitudinal study". J Traumatic Stress 11: 301–21. DOI:10.1023/A:1024403220769. Research Blogging.

[[16]

Corwin, D (1997). "Videotaped discovery of a reportedly unrecallable memory of child sexual abuse: comparison with a childhood interview videotaped 11 Years before". Child Maltreatment 2: 91–112. DOI:10.1177/1077559597002002001. Research Blogging.

[17]

"This article presents the history, verbatim transcripts, and behavioral observations of a child's disclosure of sexual abuse to Dr. David Corwin in 1984 and the spontaneous return of that reportedly unrecallable memory during an interview between the same individual, now a young adult, and Dr. Corwin 11 years later."

Neil Brick 02:05, 27 March 2009 (UTC)

Sorry, absolutely not, especially in the second case under any circumstances; the article is not freely available, only the abstract. All copies of the article as far as I can see have been removed from public access, quite properly, because now the identity of the child and of the accused are now in the public domain. The material is unsuitable for linking to from this public encyclopedia because it is a verbatim transcript of explicit sexual allegations. As evidence it is also near worthless in my opinion simply because of the intrinsic weakness of single cases, even apart from the difficulties of independent corroboration.Gareth Leng 10:04, 27 March 2009 (UTC)

The Constabulary has removed a conversation here that either in whole or in part did not meet Citizendium's Professionalism policy. Feel free to remove this template and take up the conversation with a fresh start.

Constable comment: I am considering editor Gareth's comment above as being a decision of sorts concerning the use of primary sources in this article. Any further discussion has been removed so we can start with a new and fresh subject. At this point, any new conversation on this subject will require an editorial intervention in the form of an editor or EIC. D. Matt Innis 03:24, 28 March 2009 (UTC)

Difficult to review when substantial quotes are in footnotes only

One can read the article text and not easily see substantial additions when the additional text is present only in footnotes. It may be legitimate editing to put certain text in footnotes with an article near approval, but, when it is still in active change, a reviewer is forced either to stop and check every footnote while reading in display mode, or read the text in edit mode. Howard C. Berkowitz 02:06, 27 March 2009 (UTC)

Good new content on amnesia

It's now a sufficiently good general discussion that I wonder if it should move to the existing amnesia article(s), linked from here, indeed, with explanatory text to a subhead/subarticle about dissociative amnesia being the kind of memory of interest in recovered memory. Even there, dissociative amnesia has significance in other than recovered memory.

Question: are not both anterograde and dissociative amnesia associated with trauma, with a more specific kind of trauma response causing dissociative amnesia? Again, this may be because "trauma" certainly implies more than psychological trauma. Retrograde amnesia (and sometimes anterograde amnesia) are often secondary to head injuries. This is a worthwhile distinction, as one might have dissociative amnesia of a frightening automobile accident, which puts the trauma surgeons managing the acute case into a search for a brain injury that isn't actually present.

According to the Trauma and Critical Care mailing list, London just now deploying the first U.S.-style multicenter trauma system in the U.K. Even in the U.S., a Level 3 trauma center doesn't necessarily have in-house neurosurgery; you may be getting to Level 1 before a psychiatrist is routinely consulting to multidisciplinary trauma treatment. On the mailing list, some frustrated neurosurgeons at Level 2 have asked for informal opinions when they have a patient with post-traumatic amnesia but no discernible traumatic brain injury (TBI), and "psychiatric consultation" isn't always intuitive.

There are stubs (MeSH) for retrograde amnesia (now with retrograde amnesia/Related Articles and anterograde amnesia. I'm not finding MeSH terms for dissociative amnesia or childhood amnesia; should I be looking elsewhere?

There certainly could be

or

under the section subhead here.

One of the reasons moving this content is having an anchor for stubs, about the subtypes, which fit nicely into the Related Articles knowledge navigation system. Otherwise, more general information about amnesia would, at best, be reachable through Recovered memory/Related Articles.

Having the amnesia details with their own Related Articles certainly doesn't preclude Recovered Memory, for example, being a subarticle in Dissociative Amnesia/Related Articles, Dissociative amnesia being s subarticle Amnesia/Related Articles. Howard C. Berkowitz 13:07, 27 March 2009 (UTC)

Williams reference sentence section moved to talk

I have moved this to talk, because I feel uncomfortable about the article commmenting on the study without taking into account the author's answers to potential study questions.

• questions: "were these women simply refusing to admit to having been victims, or were the incidents not genuinely traumatic in those cases, or were the memories repressed in some way?"

• a possible response: "The study states that the percentages of those not being genuinely abused was probably very low, well under 8% of the total sample. The study also states that their simply refusing to admit to having been victims was unlikely due to embarrassment, since they did discuss other highly embarrassing events in their childhoods, including other sexual assaults."

Wiiliams in the article itself does respond to a variety of questions that could be asked of the results of her study. This is an example: "Is It Possible That Some Women Did Not Recall the Abuse Because the Abuse Never Occurred, Not Withstanding the Documentation in Our Records? An unknown number of original reports may have been fictitious. The best research suggests that between 4% and 8% of reports of child sexual abuse today are fictitious.

Is It Likely That the Women Were Embarrassed or Just Did Not Want to Talk About Such Personal Matters? Most of the women told the interviewer about many other very personal matters, such as information on other sexual, physical, and emotional abuse suffered in childhood, personal histories of substance abuse, and intimate details of their adolescent and adult sexual functioning, so it is unlikely that embarrassment was the reason that so many women did not tell about the index abuse. Of the women who did not recall the child sexual abuse that brought them into the study, 68% told the interviewer about other sexual assaults (clearly involving different perpetrators and circumstances) that they experienced in childhood.

Perhaps there is a skillful of way of asking these questions and letting her study "respond" somehow, without the article becoming a debate.Neil Brick 02:28, 28 March 2009 (UTC)

Again, the CZ way is to synthesize. We try to avoid extensive direct quotes, but rather synthesize, as Gareth did. No one on the other side of the issue is insisting on direct quotes or individual studies; consider that in saying what is to be done. Howard C. Berkowitz 02:56, 28 March 2009 (UTC)

Yes, I agree about synthesizing. Therefore, the sentence should contain the study author's point of view and not just a critique, at least as a brief reply, like I had originally added to the article. The quote above is an example of the author's reply, not what I would want to put in the article. And there are individual studies cited in the article from the other side, like Loftus.Neil Brick 03:04, 28 March 2009 (UTC)

I'd hardly call Loftus an individual study in the sense of a case study such as the one you cite. Loftus is one of the key theorists on one side. If, for example, there were to be an individual report by Fink, a person of equivalent credentials, I don't think anyone would object.

The study author's point of view is quite well represented by the paraphrase. I understand you want the author's words in the article. I disagree with that position, and, while I won't speak for Gareth, one might guess that he wouldn't have paraphrased them if he wanted the author's words. Howard C. Berkowitz 03:14, 28 March 2009 (UTC)

(undent) Restoring my comment deleted by another editor see [18] I disagree. There are key theorists on both sides of the debate. Both should be cited in the article. The author's point of view is not "well represented by the paraphrase." The quotes above I cited show this clearly. Neil Brick 03:29, 28 March 2009 (UTC)

Howard, why did you remove Neil's last (unindent) comment?

This conversation has been moved to User Talk:Howard C. Berkowitz. D. Matt Innis 04:05, 28 March 2009 (UTC)