Repressed Memories and Flashbacks of Car Crash Trauma

Reader’s Question

How do I know if my memory loss of a car crash is caused by repression or by trauma?

I was in a car crash about four years ago and think that I may be suffering from PTSD; I seem to have most of the symptoms common with it. However, I know that the main symptom is flashback of the traumatic event, which I don’t have — at least until recently, when I have started to think that I am having nightmares about it that I can’t remember because I have repressed the memory. Is it possible that I have repressed the memory of the trauma, and still be suffering from PTSD by having these flashbacks in my dreams that I just can’t remember? Or do you think it’s more likely that I’m just trying to find something to explain why my life isn’t as good as I would like it to be?

Many thanks,
AF

Psychologist’s Reply

Yes and yes. Your questions are not mutually exclusive. You can be curious about your life and also be suffering from PTSD or another disturbance at the same time. But there’s more to it than that. Let’s take a look at this.

When we are exposed to something scary or painful, we naturally try to defend ourselves against it. If someone tried to hit us, for example, we’d instinctively raise our arms to ward it off. We do the same thing psychologically. We have a whole array of psychological defenses that get activated in traumatic situations such as a car crash. One of those defenses is repression, or the ability to drive a painful memory out of our consciousness because it is intolerable. It’s like slamming a door on a painful memory. To use defenses is healthy: it’s necessary, it’s how we survive. The problem comes when the trauma has passed and our survival strategies and defenses cause problems of their own. For example, in PTSD we slam the door on the memory, but sometimes it swings open all by itself. When that happens, the memory comes out so vividly and intensely that we relive the original experience. It’s terrifying and it blindsides us, coming out when we least expect it. Then we somehow push the door closed again with a sigh of relief. But the dread and fear that the door will reopen never leaves, and one is left to deal with the dread left behind by the memory. That could be why so many with PTSD self-medicate with alcohol or something else, to deaden the pain and the dread.

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Can a memory remain repressed for years and then suddenly the memory comes to light? Yes. Can repression give way little by little, so that memories appear first in dream? Yes. Why would they appear in a dream first? Because the veil of repression is thinner in sleep, when we can entertain notions and memories that we could not when awake. Sometimes, we dream and then forget those dreams — repress them — as soon as we do awaken because we cannot hold them alone.

PTSD can start with any frightening, potentially life threatening event such as a car crash, domestic violence, or combat. We mostly hear about it from our returning military. Perhaps we can all pause for a moment to empathize with the hardships that all of these people face on a day-to-day basis.

A few of the positive outcomes of the recent war include different and effective treatments for PTSD. One, for example, is called cognitive processing therapy and is designed to help you remember something without reliving it in a flashback. There has never been more hope in the treatment of PTSD. As always, early intervention is very important. Although the car accident happened for you four years ago, you are only starting to have symptoms of this now. I encourage you to get help now, because this is early intervention for you.