The repressed road to trauma recovery.

The Repressed Road to Trauma Recovery

Many mental health workers contend that the key to getting on with one's life after a close brush with death or some other severe psychological trauma lies in carefully confronting and sorting out memories and emotions linked to the ordeal. But a new study indicates that stamping traumatic memories out of consciousness -- rather than dredging them up -- may be essential for long-term adjustment, at least among survivors of World War II's Holocaust.

This conclusion stems from an investigation in which well-adjusted Holocaust survivors displayed a striking inability to remember their dreams. "Most were not only unable to recall any dream content but actively denied having dreamt at all," says psychologist Peretz Lavie of Technion-Israel Institute of Technology in Haifa, who presented the findings last week at the annual meeting of the Association of Professional Sleep Societies in Washington, D.C.

Lavie says the massive, unconscious repression of dream recall, as well as the repression while awake of memories and emotions connected to the Holocaust, crucially helped survivors to adapt more than 40 years after the war ended.

Lavie and graduate student Hanna Kaminer recruited 10 men and 13 women who had been imprisoned in a concentration camp or had hidden out from the Nazis for a prolonged period, much as Anne Frank did. Survivors averaged about 60 years of age and suffered no major physical or mental illnesses.

The researchers interviewed the survivors regarding six areas of postwar life: work problems, marriage and family problems, social relations, physical complaints, mental problems and general satisfaction with life. Eleven "less-adjusted" survivors reported significant problems in at least three areas. The remaining 12 were considered "well-adjusted." Concentration camp and hideout survivors were included in both groups.

A control group of 10 healthy Israelis about the same age as the survivors reported problems comparable to those of the well-adjusted group.

All subjects then spent four nights in a sleep laboratory, where researchers continuously monitored physiological functions, including brain waves and eye movements. On three nights, they awakened subjects from all periods of rapid eye movement (REM) sleep and asked them to recount what they were dreaming.

REM sleep is associated with vivid dreaming, although dreams also occur in other sleep stages. Less-adjusted survivors slept less and took much longer to fall asleep, but there were no differences in REM sleep among the three groups.

When roused from a REM slumber, controls recalled their dreams 80 percent of the time. Less-adjusted survivors recalled dreams just over half the time, and well-adjusted survivors gave dream reports one-third of the time.

But well-adjusted survivors were often convinced they did not dream at all, Lavie says. Dreams they described were typically short, and although the dreams contained disturbing events, these individuals denied accompanying emotions. Less-adjusted survivors reported significantly more anxiety and aggression in their dreams.

The repression of dream recall in well-adjusted survivors parallels their general tendency to keep emotions in check and to put Holocaust memories in cold storage, Lavie notes. Similar reactions among Holocaust survivors were noted several decades ago by psychologist Bruno Bettelheim, he adds.

Although the sample did not include subjects with post-traumatic stress disorder, Lavie says the results suggest psychotherapists might examine the benefits of helping such patients to forget, rather than reexperience, traumatic events.