PSYC 575 J OURNAL A RTICLE S UM M ARY A SSIGNM ENT I NSTRUCTIONS OVERVIEW For each Journal Article Summary, you will choose an article to review and use the Journal Article Summary Form to complete the assignment. The article you select must be a peerreviewed journal article in the field of cognitive psychology. The article must also be a primary source, meaning that the authors are discussing their own research, not others’ research (e.g. review articles). Do not use an article that conducted a meta-analysis. It is ideal to select an article that you will be using in your paper; however, this is not a requirement. If you use an article that does not meet these criteria, you will not receive credit for this assignment. See the example below for detailed explanation of the required material for each question. Submit the completed form and a PDF of the article being reviewed. All material must be in current APA format. INSTRUCTIONS 1. APA reference of article being reviewed Write the reference for the article as if it were in the reference section of your paper. 2. What is the research problem that is being investigated? What is the purpose of the research being conducted? Provide the “why” behind the paper. Why have they conducted this experiment? For example: “These experiments were designed to explore the role of second order conditioning in anxiety disorders.” 3. What is the research question? The research question is more specific. What is the specific question or questions the article will answer as a result of the study or experiment? For example: “Are adolescents more sensitive to the memory imparting effects of alcohol?” 4. What are 2 or more theories that are discussed in the Introduction? How are they used to motivate (or set up) the research question? Do the authors agree or disagree with these theories? Simply restate the theories discussed in the introduction in your own words. State how these theories are driving the research questions. If the authors’ hypothesis is correct, will it support the theory or be inconsistent with the theory? You should have good idea of where the authors stand based on the evidence presented and the arguments they are making.   5. How is the research question operationalized? First, identify the abstract constructs being studied. Next identify the concrete way these are being observed or measured. This should include your IV and DV. PSYC 575 A construct is an abstract explanatory variable that this not directly observable (e.g. memory). The concrete way the construct is measured will point you to the dependent variable (DV). For example, if the paper is concerned with memory, the DV may be the number of items recalled. The independent variable (IV) could be the amount of sleep each participant was allowed the night before the test. Remember that we cannot directly measure many of the constructs that are studied in psychology, so it is important that we identify how they are being operationalize in each research study. 6. What is the research design (i.e. between or within subjects, what type of statistical tests were used, what were the levels of each variable)? This information will be in the methods section of your paper. Be sure to provide enough detail to describe how the study was designed. 7. Describe the results (but not their broader implications). Were the results significant? Which ones? Do these support or not support the hypothesis? Describe the result in your own words. For example: Group X were able to recall significantly more words than Group Y. This finding supports the hypothesis that manipulation Y would reduce recall.   8. What limitations are mentioned? Why are these limitations theoretically interesting? Limitations can be found in the discussion section of the paper. If a limitation is that they didn’t have X control group, then explain in your own words why that is important. Does it change the interpretation of the findings? Note: Your assignment will be checked for originality via the SafeAssign plagiarism tool. Hypothesis and Theory Article published: 22 November 2010 doi: 10.3389/fnhum.2010.00211 HUMAN NEUROSCIENCE Natural memory beyond the storage model: repression, trauma, and the construction of a personal past Nikolai Axmacher 1*, Anne T. A. Do Lam1, Henrik Kessler 2,3 and Juergen Fell 1 1 2 3 Department of Epileptology, University of Bonn, Bonn, Germany Department of Medical Psychology, University of Bonn, Bonn, Germany Department of Medical Psychology, University of Ulm, Ulm, Germany Edited by: Michael X. Cohen, University of Amsterdam, Netherlands Reviewed by: Robert Blumenfeld, University of California at Berkeley, USA Patrick Khader, Philipps University, Germany *Correspondence: Nikolai Axmacher, Department of Epileptology, University of Bonn, Sigmund-Freud-Str. 25, 53105 Bonn, Germany. e-mail: nikolai.axmacher@ukb. uni-bonn.de Naturally occurring memory processes show features which are difficult to investigate by conventional cognitive neuroscience paradigms. Distortions of memory for problematic contents are described both by psychoanalysis (internal conflicts) and research on post-traumatic stress disorder (PTSD; external traumata).Typically, declarative memory for these contents is impaired – possibly due to repression in the case of internal conflicts or due to dissociation in the case of external traumata – but they continue to exert an unconscious pathological influence: neurotic symptoms or psychosomatic disorders after repression or flashbacks and intrusions in PTSD after dissociation. Several experimental paradigms aim at investigating repression in healthy control subjects. We argue that these paradigms do not adequately operationalize the clinical process of repression, because they rely on an intentional inhibition of random stimuli (suppression). Furthermore, these paradigms ignore that memory distortions due to repression or dissociation are most accurately characterized by a lack of self-referential processing, resulting in an impaired integration of these contents into the self. This aspect of repression and dissociation cannot be captured by the concept of memory as a storage device which is usually employed in the cognitive neurosciences. It can only be assessed within the framework of a constructivist memory concept, according to which successful memory involves a reconstruction of experiences such that they fit into a representation of the self. We suggest several experimental paradigms that allow for the investigation of the neural correlates of repressed memories and trauma-induced memory distortions based on a constructivist memory concept. Keywords: repression, memory distortions, PTSD, constructive memory, psychoanalysis, self-referential processing Introduction The current cognitive neurosciences have already revealed some mechanisms underlying the modulation of memory performance. However, several phenomena occurring in natural memory like memory distortions due to repression and due to trauma-related dissociations have not been adequately addressed yet by neurocognitive research. Many studies have shown convincingly that emotionally arousing stimuli are better remembered than neutral images (Heuer and Reisberg, 1990; Bradley et al., 1992; Christianson, 1992; Ochsner, 2000; Buchanan and Lovallo, 2001; Kensinger and Corkin, 2003). This effect depends on a facilitation of hippocampus-dependent memory processes by the amygdala (Seidenbecher et al., 2003; Dolcos et al., 2004; Kensinger and Corkin, 2004; Phelps, 2004; Smith et al., 2006; Figure 1A) and is related to the action of glucocorticoids (Kim and Diamond, 2002; Sapolsky, 2003). Such an interaction between amygdala and hippocampus may be necessary for the enhanced declarative memory of emotional events because these two structures support complementary processes, as revealed by a hippocampal-amygdala double dissociation: While integrity of the hippocampus is necessary for the conscious memory that a particular stimulus was, during conditioning, associated with a shock, the amygdala is required for the unconsciously associated vegetative reaction (Bechara et al., 1995; LaBar et al., 1995). Frontiers in Human Neuroscience While these studies provide compelling evidence for an enhanced memory of stimuli which induce moderately negative emotions, this is not necessarily true for two problematic cases involving extremely negative emotions: the emergence of an unconscious conflict, which is subject to repression, and traumatic events that overstress a person’s executive capabilities and thus lead to dissociation. As a result, conscious recall of these contents is impaired, but they continue to exert an unconscious effect which dramatically influences subsequent life – for example, by uncontrollably occurring intrusions and dissociative flashbacks, panic attacks, or psychosomatic symptoms (see Box 1). In other instances, victims of a traumatic experience may be able to recall details from the trauma, but only in a contorted manner – for example, from a detached view outside of themselves, or without the associated emotions. These symptoms of people which have suffered from real traumatic experiences are subsumed under the diagnosis of post-traumatic stress disorder (PTSD; F43.1, ICD-10, World Health Organization, 1992; DSM-IV-TR, American Psychiatric Association, 2000; Elbert and Schauer, 2002; Maercker, 2009). Therapeutic interventions on patients suffering from symptoms due to repressed conflicts or traumatic experiences require an understanding of the mechanisms of repression and dissociation, not only on the psychological but also on the neurophysiological level (for the general benefit of cognitive neuroscience www.frontiersin.org November 2010 | Volume 4 | Article 211 | 1 Axmacher et al. Repression, trauma, and constructivist memory theory Figure 1 | Emotional effects on memory. (A) Storage model of memory: Moderately arousing emotional events are better encoded than neutral events. (B) The narrative construction of a personal past relies on an interaction between the hippocampus and self-referential processes in the medial prefrontal cortex (mPFC). This process is facilitated by (moderately) emotional events due to inputs from the amygdala. (C) In contrast, in the case of extremely negative (conflictual or traumatic) experiences, the amygdala inhibits declarative memory formation by the hippocampus and an integration of these memories with the self-image. Box 1 | Memory distortions for problematic contents – repression and dissociation. There are at least two distinct processes leading to memory distortions in the case of problematic contents involving extremely negative emotions: repression and dissociation. Repression is the process by which internal conflicts are stored in the unconscious. Dissociation, on the other hand, is the process by which parts of external traumatic events are stored in a non-declarative memory system (see below). Repression is a typical defense mechanism thoroughly described by Freud to explain clinical symptoms such as neurotic depression or psychosomatic symptoms he observed in his patients. According to Freud, the starting point is an internal conflict arising when (mostly unconscious) wishes or drives are in a strict opposition to internalized norms or standards. If this conflict cannot be solved (e.g., because opposing elements cannot be integrated with self-referential processes), it automatically produces intense anxiety signaling danger for the subject (“Signalangst”). In an effort to avoid extremely negative emotions, the entire conflict and its associated emotions and memories are pushed into the unconscious (repression). This leads to a lack of declarative memory for the conflict and often the circumstances under which it emerged. The conflictual material itself, however, continues to exist in the unconscious and, Frontiers in Human Neuroscience more importantly, exerts a major influence on the subject by causing neurotic (e.g., depressed mood) or psychosomatic (e.g., paralyses) symptoms. According to Freud, the symptom is a symbolization of the internal conflict (for details, see Person et al., 2005). Dissociation is a process mainly investigated in the context of PTSD. When external traumata involving extremely negative emotions cannot be integrated with self-referential processes and no coherent narrative can be built, memories of this trauma become dissociated, i.e., they are stored in a system with no direct verbal access. Brewin (2001, 2003) uses the term “situationally accessible memory” to denote the memory system where such dissociated elements are stored. Verbal memories of the traumatic event are often vague and include gaps. The contents stored in the SAM, on the other hand, are the source for situationally triggered and hence not controllable intrusions and flashbacks typical for PTSD. Although distinct from the process of dissociation described here on a conceptual level, the clinical phenomena of “dissociations” in the traumatic situation (e.g., depersonalization, derealization) are empirically linked to the dissociation of memories in the SAM and hence the eventual development of a PTSD (Brewin and Holmes, 2003). www.frontiersin.org November 2010 | Volume 4 | Article 211 | 2 Axmacher et al. Repression, trauma, and constructivist memory theory for understanding cognition see Henson, 2005; Axmacher et al., 2009). A number of studies investigated brain regions activated during presentation of trauma-related cues in PTSD patients by functional MRI (for a review, see Shin et al., 2005). Other studies used MEG recordings to explore the neurophysiological basis of the “trauma network” in PTSD. Elbert and colleagues found that in these patients, processing of arousing stimuli (e.g., IAPS pictures) relied more on a fast sensory processing pathway, which is uncoupled from prefrontal control, and less on elaborate processing along the ventral visual stream (Rockstroh and Elbert, 2010). This may be due to a reduced connectivity with neural assemblies representing context-related (“cold”) and trauma-related (“hot”) information; as a result, trauma victims are unable to locate their trauma memories in time and space and experience them as flashbacks (Elbert and Schauer, 2002). Psychotherapeutical treatment of PTSD patients (e.g., by narrative exposure therapy; Neuner et al., 2004) aims at re-integrating this network by placing the traumatic memories in a coherent context. However, despite the incontestable value of such studies directly investigating PTSD patients, they are necessarily retrospective and do not allow for an experimental control of the emotionally disturbing situation itself. Several experimental paradigms have been developed to capture the processes occurring during PTSD-like memory distortions in healthy control subjects. In this article, we will first describe memory distortions due to repression of internal conflicts (Memory Distortions Due to Repression of an Internal Conflict) and due to dissociation of external traumata (Memory Distortions Due to Dissociation After an External Trauma). In the Section “Experimental Paradigms of Repression,” we provide an overview of the experimental paradigms currently used in the cognitive neurosciences to study the neural correlates of repression in healthy volunteers. We will argue that these paradigms do not convincingly operationalize repression because they fall short of capturing key aspects of this clinical phenomenon. Next, we will broaden our scope and demonstrate that the concept of memory itself usually implied in cognitive neuroscience studies represents only one aspect of real-life memory, but disregards others and is therefore unable to capture several complex features of memory (Storage and Constructive Models of Memory): The criteria for successful memory retrieval – namely accurate recollections of particular events – and the corresponding measures in the cognitive neurosciences such as analyses of subsequent memory effects only capture one relevant dimension of memory but disregard its constructive aspects. This becomes most obvious in studies of autobiographical memory, which involves integration of experiences with self-referential processes (Figure 1B). In the Section “Trauma-Related Memory Distortions Due to Lack of Self-Referential Processing,” we will argue that trauma-related memory distortions can only be adequately understood (and experimentally investigated) when they are conceptualized as a failure to construct autobiographical memories, i.e., to integrate these experiences with self-referential processes (Figure 1C). In other words, these memory distortions cannot be adequately understood as a failure to store memories, but as a failure to integrate them with self-referential processes. We will present a paradigm that takes these considerations into account. Finally Frontiers in Human Neuroscience (Promising Approaches for Studying Memory Distortions Due to Repression), we will suggest a paradigm for the investigation of memory distortions due to repression. Memory distortions due to repression of an internal conflict The concept of repression was originally suggested by Herbart (1824), but was introduced as a pathological process by Sigmund Freud (see Box 1). Most of his patients had symptoms that could not be explained by common logic or medical knowledge (e.g., paralyses of isolated limbs with no medical cause). In order to explain the etiology of such symptoms, he conceptualized the construct of repression as a mechanism being applied throughout child development. It means the storage of complete internal conflicts (mostly between drives or wishes and internalized norms or standards) and their surrounding emotions and memories in the unconscious (Freud, 1915). The developing child hence represses problematic content once an internal conflict is emergent. The classical view of repression as depicted in Box 1 was significantly advanced by an increased consideration of the child’s relationship to its parents and its developing self (Ferenczi, 1933; Balint, 1969). Internalization of a safe relationship to the parents is necessary for the development of agency and a stable self (Stern, 1985), and the infantile self is only developed through such parental feedback (Fonagy et al., 2005). In this new view, repression may occur when an internal conflict cannot be integrated with the image of the parents and/or self-referential processes. It is hence mainly this problematic integration in self-referential processes that give conflicts their true “pathological” value and trigger repression as a means to cope with them for the moment. The price to pay for the relative peace the developing self obtains by repressing internal conflicts is high, though: Clinically, it is important that the repressed material still exists in the unconscious and exerts a large influence on the subject by causing psychosomatic (e.g., paralyses) or neurotic (e.g., depressed mood) symptoms. The mechanism through which repressed conflicts gain access to the “outside” in the form of symptoms is called conversion (Breuer and Freud, 1895). By symbolizing the conflict or parts thereof in a symptomatic language, the patient can gain some relief at the price of clinical symptoms. Although rooted in early twentieth century psychology and physiology, the concepts of repression and conversion via symbolization are still of high clinical relevance for recent models of psychotherapy (for a current clinical textbook see Person et al., 2005). Psychoanalytic therapies primarily working with the concept of repression are highly effective in treating patients with severe psychiatric problems (e.g., chronic depression, personality disorders), as reviewed in a recent meta-analysis (Leichsenring and Rabung, 2008). The recent trend that problematic integration in self-­referential processes is regarded as the main virulent component of repressed conflicts is reflected in newer manualized psychodynamic treatments (e.g., Wöller and Kruse, 2010): The therapist should explicitly help the patient reorganize past experiences in a way that repressed conflicts can be integrated in self-referential processes. If successful, the patient not only gains clinical improvement on a symptomatic level (less or no need for conversion of an internal conflict in body symptoms), but also achieves a new and more coherent view of the self. www.frontiersin.org November 2010 | Volume 4 | Article 211 | 3 Axmacher et al. Repression, trauma, and constructivist memory theory Memory distortions due to dissociation after an external trauma In contrast to the psychoanalytical focus on internal conflicts early in development, the concept of PTSD was primarily developed with regard to external later-life traumata, initially those during the Vietnam war. Memory distortions are, however, also among the main symptoms of PTSD. On the one hand, memories of the traumatic situation occur involuntarily as intrusions or even as flashbacks, in which patients do not remember the traumatic event as something past, but re-experience it as if it occurred again, similar to a dissociative state. On the other hand, declarative memory for details of the traumatic situation is often impaired (Brewin, 2007; Jones et al., 2007): A large body of studies have reported general declarative memory deficits in PTSD patients (Clancy et al., 2000; Behrendt and Moritz, 2005; Jelinek et al., 2006; for a review, see Brewin, 2007), and in particular concerning verbal declarative memory (Yehuda et al., 1995; Bremner et al., 2004). These memory impairments emphasize initial encoding and retention of new contents (Bremner, 2002), for instance, long lasting deficits in short-term memory have been shown in adults suffering from abuse during childhood (Bremner et al., 1995) as well as in Vietnam veterans diagnosed with PTSD (Bremner et al., 1993). Additionally, source memory referring to specific details of the traumatic event is often distorted in this population (Johnson et al., 1993). However, as we will elaborate below, the specific memory deformations following a trauma can be most accurately conceptualized not as failures to recall specific information, but as an impairment to integrate these experiences with self-referential processes, i.e., in the framework of constructivist memory theories (Trauma-Related Memory Distortions Due to Lack of Self-Referential Processing). During the traumatic experience, limited time for conscious processing of accompanying sensory or vegetative perceptions inhibits an adequate integration thereof into autobiographical memory. This effect may depend on two mechanisms. First, an impaired processing of peripheral details during a traumatic situation due to a narrowing of the spotlight of attention is known as the weapon focusing effect (Christianson, 1992). This effect reduces the integration of all trauma-related information into a coherent representation. Second, traumatic experiences may be so overwhelming that the executive processing capabilities of trauma victims fail, leading to peri-traumatic dissociative states. In these states, subjects describe that they view themselves from a detached Figure 2 | Memory distortions caused by repressed conflicts (left) and traumatic experiences (right). Both psychoanalysis and PTSD theories suggest that extremely negative contents may cause memory distortions characterized Frontiers in Human Neuroscience standpoint (e.g., Bremner and Brett, 1997; Lanius et al., 2002). The dual representation theory (Brewin, 2003) accounts for these trauma-related memory distortions by suggesting that memory contents can be encoded either via a hippocampus-dependent mechanism, which leads to a narrative integration of these contents with other experiences and makes them accessible for declarative recall (verbally accessible memory, VAM), or via an amygdala­dependent process, which does not allow for a conscious control of memory retrieval; however, unconscious experiences encoded by the amygdala are automatically recalled whenever an associated cue appears. According to the dual representation theory, this latter memory system has been described as situationally accessible memory (SAM). This theory further suggests that amygdala and hippocampus inhibit each other in the case of extremely negative events, such that the degree to which the amygdala supports encoding of an event reduces the hippocampal contribution (Metcalfe and Jacobs, 1998; Brewin, 2001; Figure 1C). Indeed, functional MRI studies in PTSD patients indicate that recall of traumatic events is associated with an increased activation of the amygdala and a reduced activation of the hippocampus (Shin et al., 2005). Alternatively, it is possible that in this case the amygdala facilitates unconscious memory processes in the hippocampus (Henke et al., 2003; Degonda et al., 2005). Although the memory distortions described in psychoanalysis (repression) and in PTSD research (memory fragmentations and intrusions due to dissociation) appear to be very different at first sight, they converge in the idea that pathological forms of unconscious memory replace declarative access to the problematic contents (Figure 2). In both cases, contents that are not verbally accessible (repressed conflicts or situationally accessible memories) exert a pathological influence on the subject by causing psychosomatic symptoms or intrusions and flashbacks, respectively. Thus, unconscious memories are created that do not refer to familiarity-based recognition memory, but to memories that induce intrusions and flashbacks following a trauma or neurotic symptoms following a repressed conflict. As will be elaborated below, both phenomena gain their true pathological value by a failure to integrate the problematic contents (internal conflicts or traumata) in self-referential processes. Finally, successful treatment of both includes the integration of problematic contents in a more coherent self. Therefore, we suggest that a common basis, or at least an overlap, exists for these two groups of phenomena, which might be defined in ­neurobiological by an impaired declarative memory for these events but pathological unconscious memories. The theories differ with respect to the relative contribution of the internal vs. external nature of the negative contents. www.frontiersin.org November 2010 | Volume 4 | Article 211 | 4 Axmacher et al. Repression, trauma, and constructivist memory theory terms – possibly a modern replacement of the Freudian “metapsychology,” which was deeply grounded in late nineteenth century neurophysiological knowledge (e.g., Stephan, 2002). Experimental paradigms of repression Cognitive neuroscience studies on repression have established two main experimental paradigms which aim at investigating repression in normal healthy subjects, the “Directed forgetting” and the “Think/No-Think” paradigm (Johnson, 1994; Anderson and Green, 2001; Erdelyi, 2006). In these paradigms, forgetting is consciously and intentionally controlled by the participants, who are explicitly asked to voluntarily inhibit randomly selected subsets of items or “not to think” of them: “On some trials they (i.e., the participants) were instructed to think of the previously learned picture; on other trials they were instructed not to let the previously associated picture enter consciousness.” (Think/No-Think paradigm, Depue et al., 2007). One might wonder whether these paradigms are actually aimed at investigating the psychoanalytical process of repression. However, this is explicitly stated; for example, the article by Anderson et al. (2004) using the Think/No-Think paradigm starts with the phrases: “Over a century ago, Freud proposed that unwanted memories can be excluded from awareness, a process called repression. It is unknown, however, how repression occurs in the brain.” (p. 232). In both paradigms, the instructions reliably lead to a decreased proportion of stimuli in the “voluntarily forgotten” condition which can be recalled in a subsequent declarative memory test. The functional MRI results show a reduced BOLD response in the hippocampus and an increased activity in the lateral prefrontal cortex, which was interpreted as index for a recruitment of inhibitory executive control processes. However, for three reasons we argue that these paradigms do not adequately operationalize the clinical process of repression. First, repression occurs specifically in situations which overload the executive processing capacities. During real repression, voluntary control is lacking; a person represses an experience because this experience induces an unbearable conflict. Therefore, attempting to induce repression by a recruitment of executive control processes is paradoxical. The process investigated by Anderson and colleagues can more precisely be termed “suppression,” the voluntary “forgetting,” or “keeping down” of unwanted content. Second, if the mechanism of repression is considered in isolation, it appears as if the contents of repression are only secondary. However, repression does not occur with regard to random situations or stimuli, but only if an intense negative emotion is evoked. Thus, repression should be automatically induced by the experimental stimuli. Third, an experimental paradigm of repression should not only reduce conscious access to “repressed” stimuli, but also exclude that these stimuli are just forgotten. In fact, it should even be shown that unconscious memory for these items is enhanced: The concept of repression was introduced to explain clinical symptoms by experiences which are not consciously accessible for the patients, but which continue to exert an unconscious influence. Thus, in a non-declarative, implicit memory test, an increased proportion of these stimuli should be “remembered,” as shown in PTSD patients (e.g., McNally, 1997). For example, these stimuli may be erroneously classified as “new” during conscious recollection (because no conscious memory exists for them), but this (incorrect) response may be given with a delayed Frontiers in Human Neuroscience reaction time as compared to stimuli which are in fact new, which could be interpreted as indirect evidence of an unconscious conflict during processing of these stimuli. Alternative paradigms can take these critiques into account. In such paradigms, the process of repression should not be voluntarily controlled; instead, they should create a situation in which repression occurs automatically due to the emotional content of a stimulus. When the “repressed” stimuli are subsequently presented in a recognition memory test, it is hypothesized that they cannot be recalled consciously, but that they continue to exert an unconscious influence on the subject’s behavior, as indicated by a measure of unconscious memory. In addition, however, there is a more general problem with the existing paradigms that are meant to operationalize repression, because they measure memory as an impairment of successful recall, but do not investigate whether memories are successfully integrated into the self. In other words, the constructive nature of successful memories is not taken into account. In the next two sections, we will explain such a constructivist concept of memory, which is particularly relevant for autobiographical memorizing (Storage and Constructive Models of Memory) and is impaired in trauma-related memory distortions (Trauma-Related Memory Distortions Due to Lack of SelfReferential Processing). Finally, we will describe paradigms which are suited to capture memory distortions related to repression of conflicts (Promising Approaches for Studying Memory Distortions Due to Repression). Storage and constructive models of memory In the cognitive neurosciences, memory is most often conceptualized as the process of stimulus encoding, storage, and retrieval. In this framework, memory recall involves an identical repetition of the original experiences – or, as Tulving (1983) described it in his famous definition of episodic memory, as a “mental time travel” back to the original situation. Accordingly, the neural correlates of memory are usually studied by analyzing “subsequent memory”-effects, i.e., differences in brain activation patterns associated with the initial presentation of subsequently remembered as compared to forgotten items. However, this storage model of memory only captures one relevant dimension of memory, which relies on the identity of encoded and remembered contents. In particular, it abstracts the specific function of memory retrieval for a subject. The cultural history of memory models has always consisted in a dichotomy of such storage models of memory on the one hand, models of constructive memory on the other hand (Assmann, 2002). Constructive concepts of memory as re-interpretation of events were, e.g., investigated experimentally by Bartlett (1932). In a number of studies, he presented his British subjects a short story, “The War of the Ghosts,” which contains several seemingly illogical and irrational elements. When subjects were afterward asked to recall the story in as many details as possible, they modified it according to their own cultural schemata; illogical elements were thus replaced by more coherent narratives. These studies illustrate the constructive nature of memory retrieval and suggest that memory is not only designed to retrieve events exactly as they happened, but supports specific functions in the interaction with the (internal or external) environment. www.frontiersin.org November 2010 | Volume 4 | Article 211 | 5 Axmacher et al. Repression, trauma, and constructivist memory theory Several current memory theories have incorporated aspects of such a constructive account on memory and also highlighted the relevance of self-referential processing. According to these views, it is not exact representations of external events that are encoded and retrieved, but the results from internal processing, evaluation, and interpretation of these events. For example, the theory of transfer-appropriate processing (TAP) interprets learning as re-performing a previous act, i.e., successful learning is an appropriate transfer of underlying structures rather than an access of a memory trace (Morris et al., 1977; Bransford et al., 1979; Baddeley, 2002). According to TAP, recall is facilitated by similarity between the encoding and the retrieval state; this effect is related to both environmental contexts (e.g., if encoding occurred in the library of the Psychology Department, recall will also be easier at that place) and internal variables such as current affective states and goals (events encoded in a sad mood will also be most likely retrieved in a sad mood). In addition, many studies investigated the effects of encoding conditions related to self-referential processing, e.g., by instructing subjects to rate the pleasantness of items (Hunt and Einstein, 1981; McDaniel and Einstein, 1993). Such effects have been described, e.g., in the framework of the levels of processing theory (Craik and Lockhardt, 1972). Furthermore, several experimental paradigms have investigated why events which have never happened are “recalled” (the false memory paradigm; see, e.g., Deese, 1959; Roediger III and McDermott, 1995), and why actual events are forgotten (e.g., retrieval-induced forgetting paradigms, Anderson et al., 1994; Macrae and MacLeod, 1999; Caroll et al., 2007). None of these theories and paradigms assumes a simple storage model of memory. Instead, they capture aspects of a constructive memory theory because they emphasize that memory encoding and retrieval depend on the construction of an integrated experience and the evaluation of its personal relevance. Furthermore, recall can be considered a “reconstruction” because it depends on the situational context during which it occurs. However, there is a fundamental difference between these accounts and constructivist memory theories in a narrower sense, which is the criterion for successful memory: In storage models of memory, recall is successful if it recapitulates crucial aspects of a previous experience; according to constructivist memory theories, however, recall is successful if it allows the recalling person to build a coherent narrative about his/her past. Imagine that two people experience the same event, but afterward report two inconsistent versions of this event. According to the storage model of memory, there are objective criteria whether the report of the first or the second person is correct. In contrast, the constructive memory theory would assume that both reports may be correct as long as subjective coherence is achieved. This view differs considerably from paradigms such as the false memory paradigm, the retrieval-induced forgetting paradigm, or paradigms of voluntary memory suppression such as the “think/no-think” or “directed forgetting” paradigms: These paradigms investigate the conditions under which memory storage fails, but not the conditions under which a successful transformation into an acceptable narrative, and integration with self-referential processes, succeed. Similarly, even though theories such as the TAP theory or models such as the Adaptive Control of Thought model (Anderson, 1976) emphasize Frontiers in Human Neuroscience the selective nature of encoding and retrieval, they do not require that experiences be integrated into a coherent and acceptable personal history for memory to be successful. Recall of autobiographical memory is a prototypical example of a reconstructive memory process. Depending on situational requirements and personal aims, recollection of a personal experience serves specific functions. The main criterion for successful autobiographical memory recall is not whether a situation is exactly reproduced; instead, as it is one of the main functions of autobiographical memories to serve the construction of a coherent and acceptable self-image, these memories have to fit into a coherent construction of the past – for this reason, the subjects in Bartlett’s studies modified the story according to their cultural expectations. Several more recent studies provide experimental evidence for this view. First, it has been shown in cross-cultural studies that autobiographical memory is influenced by the emphasis which is put in each culture on the self and on a unique life story (Nelson, 2003). Second, in each culture, autobiographical memory recall depends on an individual’s current view of herself/himself, and serves the construction of a coherent and positive self (Wilson and Ross, 2003). For example, as improving selves are particularly gratifying (e.g., Frijda, 1988), subjects tend to view their own past abilities as inferior than their current abilities, and as lower than they viewed them before (Conway and Ross, 1984). Third, it was shown that the reported number of autobiographical memory recalls which aimed at creating self-continuity was higher in subjects with low degrees of self-concept clarity (corresponding to low levels of perceived self coherence), suggesting that autobiographical memory recall indeed served to strengthen self coherence (Bluck and Alea, 2008). Fourth, brain lesions which induce a loss of autobiographical memory may also lead to an impairment of the sense of one’s self (Schacter, 1996). The functions of autobiographical memory retrieval have been described in a review by Bluck (2003). First, memorizing serves the creation of a continuous identity: “[T]hough we often think of memory as a series of events, it is also a record of a series of selves, or a record of the self across time, an autobiography.” (Bluck, 2003, p. 12). Second, memory is relevant for the creation and maintenance of social interactions: Often, personal statements are being justified by referring to autobiographical events, and a common past is created by evocation of situations that were experienced together. Finally, autobiographical memories serve a directive function, as they allow one to predict what will happen in the future and which actions will likely lead to the desired outcomes. Cognitive neuroscience studies on the neuronal correlates of autobiographical memory recall support the view that this type of memory involves the construction of a self-image. These studies revealed an increased activation of both the hippocampus and the medial prefrontal cortex (mPFC) during processing of self-related autobiographical information (Cabeza et al., 2004; Summerfield et al., 2009). Activation of the mPFC was associated with self-referential processes, for example during presentation of photographs that subjects had taken themselves as compared to photographs taken by other subjects (Cabeza et al., 2004) or during evaluation whether adjectives could be attributed to oneself instead of to another person (Gutchess et al., 2007). The theory that autobiographical memory depends on an integration of declarative www.frontiersin.org November 2010 | Volume 4 | Article 211 | 6 Axmacher et al. Repression, trauma, and constructivist memory theory memory and self-referential processes is depicted in Figure 1B. It should be noted, however, that reverse inference from activation of a given region during one experimental condition to mental processes occurring in this condition may be problematic because these activations are usually not unequivocal (for reviews on the validity of this inference see Henson, 2005; Axmacher et al., 2009). While constructive concepts of memory exerted a strong influence on research in social psychology, most studies in the cognitive neurosciences (apart from autobiographical memory studies) followed the storage model. This is particularly problematic in the case of memory distortions due to repression and dissociation: Memory, conceptualized as a constructive process, serves to build personal identities. In contrast, repressed conflicts and traumatic events cannot become part of this personal identity; their subjective meaning is not re-evaluated and integrated into a narrative continuity with other events, but remains restricted to the situation when these events were experienced. Repressed conflicts and traumatic events remain permanently present in a pathological sense – they cannot be forgotten or temporarily dismissed. Thus, the case of memory distortions shows that constructive memory and storage memory are not only alternative concepts of memory, but are actually directly opposing each other in some respects. In the following two paragraphs, we describe further evidence for this view and present promising paradigms for the investigation of trauma-related and repression-related memory distortions. Trauma-related memory distortions due to lack of self-referential processing Several observations suggest that what is central for trauma-related memory distortions is not the lack of a memory for a traumatizing situation per se, but the lack of an integration of this memory with self-referential processes. First, during traumatic events, subjects may lose their sense of agency, i.e., they do not feel themselves as autonomous human beings but just as observers. Dissociation during the traumatic event is predictive for subsequent memory impairments and also for the development of PTSD – even more than trauma severity is (Maercker et al., 2000; Ozer et al., 2003). Second, PTSD patients often describe that the traumatic scenes are remembered from a detached view outside of themselves (Brewin and Saunders, 2001; Bohleber, 2008). Thus, they also recall themselves as lacking self-referential processing during the trauma. Third, loss of agency during traumatic events may also explain why traumatic events cannot only induce PTSD, but also a complex PTSD (Herman, 1992) or developmental trauma disorder (van der Kolk, 2005) which both involve changes to the self-image and an impaired feeling of identity. Finally, flashbacks can be understood as a dissociative re-living of the traumatic situation, i.e., re-living in a state of depersonalization and derealization (Maercker, 2009). Taken together, these considerations suggest that traumatic events mainly impair the integration of experiences with the internal perception and valuation of these events, and that the resulting memory distortions need to be conceptualized within a constructive memory framework (Figure 1C). How can the reduced self-referential processing during traumatic experiences, with the resulting impairment in the construction of memories for these events, be assessed experimentally? Frontiers in Human Neuroscience The effect of dissociation on the development of trauma-related memory distortions was studied in healthy control subjects by use of the trauma film paradigm (for an overview of this method, see Holmes and Bourne, 2008). This paradigm builds on observations that intrusive thoughts do not only occur in PTSD patients, but also in many situations of everyday life after strong emotional events (Berntsen, 1996; Mace, 2005). In the trauma film paradigm, intrusions are induced by a movie which contains emotionally disturbing scenes (e.g., scenes of victims from car accidents). This paradigm has already been used in a number of studies and reliably induces intrusive memories, which disappear after a few weeks (of course, ethical reasons prohibit the induction of an actual PTSD which is defined by the persistence of symptoms, after a trauma, for more than a month). In addition to intrusions, declarative memory for the contents of the trauma film is impaired (Brewin, 2007; Jones et al., 2007). Using this paradigm, it was shown that spontaneously occurring states of dissociation predicted subsequent intrusions (Holmes et al., 2004; Kindt et al., 2005). However, any attempts to increase intrusion incidence by experimentally induced dissociation failed (e.g., Holmes et al., 2007), suggesting that dissociation may affect memory distortions via an underlying psychological or physiological process, which is not triggered by the experimentally induced dissociation – e.g., via reduced activation of brain regions supporting self-referential processing. The neural basis of memory effects in the trauma film paradigm was investigated in two recent functional MRI studies (Henckens et al., 2009; van Marle et al., 2009). Physiological parameters as well as subjective reports confirmed that stress was induced by segments of a distressing movie. In the first study, IAPS pictures were presented interleaved with these segments and brain activity related to declarative encoding of IAPS pictures was analyzed (Henckens et al., 2009). In contrast to the impairment of declarative memory for traumatic events observed clinically, the authors found that stress increased subsequent recollection of pictures. However, hippocampal activity was reduced during successful encoding of images under stress, suggesting that memory formation required a hippocampal-independent mechanism. These results are therefore consistent with the dual representation theory and suggest that a high stress level shifts encoding from a hippocampus-dependent to an amygdala-dependent encoding mechanism (Brewin, 2003), although no implicit memory tests were performed, and thus the exact memory processes contributing to the stress-induced memory enhancement could not be resolved. In line with this interpretation, the second study showed increased responsiveness of the amygdala to facial stimuli presented interleaved with the movie, although memory for these items was not tested (van Marle et al., 2009). Further research using the trauma film paradigm will be extremely useful to test predictions from the dual representation theory more directly: First, it will be interesting to test memory for the movie segments themselves (instead of interleaved stimuli). Second, not only declarative memory but also intrusions should be captured using the diary method (Brewin and Saunders, 2001; Bisby et al., 2009); i.e., intrusions during the weeks following the experiment should be collected by diaries given to the participants. Finally – and maybe most importantly – the effects of dissociation during the movie should be investigated. As described above, it appears to be extremely difficult to induce dissociation by experimental www.frontiersin.org November 2010 | Volume 4 | Article 211 | 7 Axmacher et al. Repression, trauma, and constructivist memory theory modifications. Therefore, dissociation could be measured on the neural level, by a reduced activation of regions supporting selfreferential processing. Promising approaches for studying memory distortions due to repression The neural signature of self-referential processing during memory recall can be used as a measure of successful reconstructive recall – or the lack thereof – not only in the trauma film paradigm, but also in paradigms investigating memory distortions due to repression. In one important paradigm (see Figure 3), which was initially suggested by Jung (1918), words in a list are presented consecutively and subjects are instructed to generate an associated word to each word in the list using the psychoanalytical technique of “free association” – i.e., they are asked to say the first word which comes into their mind. The idea of “free association” is rooted in Freud’s psychoanalytical technique: When patients with neurotic symptoms say spontaneously what comes to their minds, they may eventually reveal material that can be linked by a skilled therapist to repressed conflicts which lead to or maintain their symptoms (Freud, 1913). The clinical usefulness of this technique has been shown many times (e.g., Person et al., 2005). According to Freud (1913), patients typically start to repress spontaneous thoughts once they may link to conflicts or memories that have to be kept unconscious. In Jung’s (1918) original experiment, the process of “free association” is believed to reveal contents that are primarily unconscious but relevant for the subjects because they may be related to repressed conflicts. The behavioral result of the hypothesized repression – resistance against revelation of these contents – can be confirmed experimentally by an increase in skin conductance response (SCR) and reaction times. The link between repression and the hypothesized increase in skin conductance is an indirect one: It is known that psychological arousal (activation) leads to increased skin conductance (Lang et al., 1995). Clinical experience suggests that patients may show increased signals of stress and arousal when repressing critical contents (Person et al., 2005). Thus, it is assumed that repression may be operationalized by increases in skin conductance. Next, the same list is presented again, but now subjects are not asked to name a new word by free association, but to recall the word they have initially generated. Finally, all initially associated words are presented again, and subjects are instructed to indicate the emotional valence and intensity of these words (as an indicator of conscious emotional content). In contrast to the often described increase in declarative memory for negative emotional material (Heuer and Reisberg, 1990; Bradley et al., 1992; Christianson, 1992; Ochsner, 2000; Buchanan and Lovallo, 2001; Kensinger and Corkin, 2003), this paradigm reliably results in an impaired memory for words whose initial generation is associated with physiological signs of resistance (increase in skin conductance and reaction times) and which are subsequently rated as emotionally negative (Levinger and Clark, 1961; Köhler and Wilke, 1999; Köhler et al., 2002). In particular, Levinger and Clark (1961) found that high SCRs during association predicted failure of subsequent recall. Furthermore, recall was worse for words which were afterward labeled as emotional as compared to words Figure 3 | Repression of self-generated emotional words. (A) Presentation of cue words, participants were instructed to speak out loudly the first word which came to their minds while skin conductance response (SCR) and reaction latencies were recorded. (B) At memory test, the same cue words were presented again, and participants had to recall the word which they previously associated with the cue word during phase (A) of the experiment. (C) Emotional rating of the self-generated words. Table 1 | Experimental paradigms for studying memory distortions. Paradigm Automatic Implicit memory Declarative memory Self-referential stimulus effects? enhanced? impaired? processing considered? No ? (not tested) Yes No Trauma film paradigm Yes Yes (intrusions) Yes Yes (dissociation) Levinger/Clark/Köhler (Figure 3) Yes Yes (reaction times) Yes Yes (subject-specific cues) Directed forgetting; Think/No-Think Frontiers in Human Neuroscience www.frontiersin.org November 2010 | Volume 4 | Article 211 | 8 Axmacher et al. Repression, trauma, and constructivist memory theory which were labeled as neutral. Several alternative explanations might account for these results. First, word frequency of the presented words may determine recall of associations. However, frequency was equilibrated between emotional and neutral words. Second, it is possible that recall depended on the number of possible associations to a word (“response entropy”). For words associated with high response entropy, the possible associations interfere with each other, making it more difficult to recall the initially associated word. In fact, Levinger and Clark found that forgotten words had higher response entropies than remembered words. However, partial correlations revealed that emotion and response entropy contributed independently to memory. Several shortcomings of the study by Levinger and Clark (1961) should be noted. First, recall was only tested immediately after initial associations, leaving open the possibility that it does not induce sustained effects on memory. Second, reaction times as another possible measure of resistance toward revelation of repressed conflicts were not tested. In a follow-up study designed to overcome these shortcomings, Köhler and Wilke (1999) conduced a similar experiment, but (1) also measured reaction times during initial association, (2) asked subjects to recall the associated words not only directly after the association, but again after one week. They found that increased SCRs and reaction times during association as well as emotional ratings predicted both immediate forgetting and forgetting after 1 week. To our knowledge, this paradigm has never been used for cognitive neuroscience experiments. However, the dual representation theory (Brewin, 2003) predicts that generation of subsequently forgotten words is associated with increased amygdala and decreased hippocampal activation, and a negative correlation of activity in these regions. Furthermore, based on the idea that repression is related to reduction in self-referential processing, we would expect that generation of these words leads to decreased activation of the mPFC, and to a reduced functional connectivity between this region and the hippocampus. References American Psychiatric Association (APA). (2000). Diagnostic and Statistical Manual of Mental Disorders – DSMIV-TR, 4th Edn, Text Revision. Washington, DC: American Psychiatric Association. Anderson, J. (1976). Language, Memory and Thought. Hillsdale, NJ: Erlbaum Associates. Anderson, M. C., Bjork, R. A., and Bjork, E. L. (1994). Remembering can cause forgetting: retrieval dynamics in longterm memory. J. Exp. Psychol. Learn. Mem. Cogn. 20, 1063–1087. Anderson, M. C., and Green, C. (2001). Suppressing unwanted memories by executive control. Nature 410, 366–369. Anderson, M. C., Ochsner, K. N., Kuhl, B., Cooper, J., Robertson, E., Gabrieli, S. W., Glover, G. H., and Gabrieli, J. D. E. (2004). Neural systems underlying the suppression of unwanted memories. Science 303, 232–235. Frontiers in Human Neuroscience Assmann, A. (2002). Erinnerungsräume. Formen und Wandel des kulturellen Gedächtnisses. München, Germany: C.H. Beck. Axmacher, N., Elger, C. E., and Fell, J. (2009). The specific contribution of neuroimaging versus neurophysiological data to understanding cognition. Behav. Brain Res. 200, 1–6. Axmacher, N., Gossen, A., Elger, C. E., and Fell, J. (2010). Graded effects of social conformity on recognition memory. PLoS ONE 5, e9270. doi: 10.1371/ journal.pone.0009270. Baddeley, A. D. (2002). Human Memory: Theory and Practice. Hove, UK: Psychology Press. Balint, M. (1969). Trauma and object relationship. Int. J. Psychoanal. 50, 429–435. Bartlett, F. C. (1932). Remembering: A Study in Experimental and Social Psychology. Cambridge, UK: Cambridge University Press. Bechara, A., Tranel, D., Damasio, H., Adolphs, R., Rockland, C., and Damasio, Conclusions To summarize, we argued that storage models of memory as usually employed in the cognitive neurosciences are unable to capture the constructive nature of autobiographical memories and the impairment of this construction due to repression and traumatic experiences, and presented a number of experimental paradigms to study memory distortions in healthy subjects (Table 1). It should be noted that other lines of research have started to question the storage model of memory in cognitive neuroscience as well. First, the concept of reconsolidation implies that memories are not encoded for permanent storage, but that each recall involves a weakening of the memory trace and its possible re-integration with new experiences (Nader et al., 2000; Nader and Hardt, 2009). Second, studies of autobiographical memory often focused on the reconstruction of experiences rather than their exact recall. Third, the “prospective memory theory” describes that similar brain regions are activated during remembering the past and imagining the future, suggesting that both processes rely on similar constructions, or simulations, of currently absent stimulus representations (Schacter and Addis, 2007; Schacter et al., 2007). Fourth, social psychological studies exploring effects of social conformity on memory retrieval (Cialdini and Goldstein, 2004; Wright et al., 2009; Axmacher et al., 2010) could, in principle, also be adapted for neuroimaging research (Berns et al., 2005; Klucharev et al., 2009). Finally, the emerging field of “neuro-psychoanalysis” attempts to bridge the traditional gap between cognitive psychology and neuroscience on the one hand, psychoanalysis on the other hand, and might contribute relevant conceptual enhancements to cognitive neuroscience (Solms and Kaplan-Solms, 2000). Acknowledgment Anne T. A. Do Lam was supported by a grant from DFG FE 366/5-1. A. R. (1995). Double dissociation of conditioning and declarative knowledge relative to the amygdala and hippocampus in humans. Science 269, 1115–1118. Behrendt, A., and Moritz, S. (2005). Posttraumatic stress disorder and memory problems after female genital mutilation. Am. J. Psychiatry 162, 1000–1001. Berns, G. S., Chappelow, J., Zink, C. F., Pagnoni, G., Martin-Skurski, M. E., and Richards, J. (2005). Neurobiological correlates of social conformity and independence during mental rotation. Biol. Psychiatry 58, 245–253. Berntsen, D. (1996). Involuntary autobiographical memory. Appl. Cogn. Psychol. 10, 435–454. Bisby, J. A., Brewin, C. R., Leitz, J. R., and Curran, H. V. (2009). Acute effects of alcohol on the development of intrusive memories. Psychopharmacology 204, 655–666. Bluck, S. (2003). Autobiographical memory: exploring its functions in everyday life. Memory 11, 113–123. www.frontiersin.org Bluck, S., and Alea, N. (2008). “Remembering being me: the self continuity function of autobiographical memory in younger and older adults,” in Self Continuity: Individual and Collective Perspectives, ed F. Sani (New York, NY: Psychology Press), 55–70. Bohleber, W. (2008). “Einige Probleme psychoanalytischer Traumatheorie,” in Psychoanalyse, Neurobiologie, Trauma, eds M. Leuzinger-Bohleber, G. Roth, and A. Buchheim (Stuttgart, Germany: Schattauer), 45–54. Bradley, M. M., Greenwald, M. K., Petry, M. C., and Lang, P. J. (1992). Remembering pictures: pleasure and arousal in memory. J. Exp. Psychol. Learn. Mem. Cogn. 18, 379–390. Bransford, J. D., Franks, J. J., Morris, C. D., and Stein, B. S. (1979). “Some general constraints on learning and memory research,” in Levels of Processing in Human Memory, eds L. S. Cermak and F. I. M. Craik (Hillsdale, NJ: Erlbaum), 331–354. November 2010 | Volume 4 | Article 211 | 9 Axmacher et al. Bremner, J. D. (2002). Does Stress Damage the Brain? Understanding TraumaRelated Disorders from a Neurological Perspective. New York: Norton. Bremner, J. D., and Brett, E. (1997). Trauma-related dissociative states and long-term psychopathology in posttraumatic stress disorder. J. Trauma. Stress 10, 37–49. Bremner, J. D., Randall, P., Scott, T. M., Capelli, S., Delaney, R., McCarthy, G., and Charney, D. S. (1995). Deficits in short-term memory in adult survivors of childhood abuse. Psychiatry Res. 59, 97–107. Bremner, J. D., Scott, T. M., Delaney, R. C., Southwick, S. M., Mason, J. W., Johnson, D. R., Innis, R. B., McCarthy, G., and Charney, D. S. (1993). Deficits in short-term memory in posttraumatic stress disorder. Am. J. Psychiatry 150, 1015–1019. Bremner, J. D., Vermetten, E., Afzal, N., and Vythilingam, M. (2004). Deficits in verbal declarative memory function in women with childhood sexual abuserelated posttraumatic stress disorder. J. Nerv. Ment. Dis. 192, 643–649. Breuer, J., and Freud, S. (1895). “Studies on hysteria,” in The Standard Edition of the Complete Works of Sigmund Freud, Vol. 2, eds J. Strachey, A. Freud, A. Strachey, and A. Tyson (London: The Hogarth Press and the Institute of Psychoanalysis), 125–134. Brewin, C. R. (2001). A cognitive neuroscience account of posttraumatic stress disorder and its treatment. Behav. Res. Ther. 39, 373–393. Brewin, C. R. (2003). Posttraumatic Stress Disorder – Malady or Myth? New Haven: Yale University Press. Brewin, C. R. (2007). Autobiographical memory for trauma: update on four controversies. Memory 15, 227–248. Brewin, C. R., and Holmes, E. A. (2003). Psychological theories of posttraumatic stress disorder. Clin. Psychol. Rev. 23, 339–376. Brewin, C. R., and Saunders, J. (2001). The effect of dissociation at encoding on intrusive memories for a stressful film. Br. J. Med. Psychol. 74, 467–472. Buchanan, T. W., and Lovallo, W. R. (2001). Enhanced memory for emotional material following stresslevel cortisol treatment in humans. Psychoneuroendocrinology 26, 307–317. Cabeza, R., Prince, S. E., Daselaar, S. M., Greenberg, D. L., Budde, M., Dolcos, F., LaBar, K. S., and Rubin, D. C. (2004). Brain activity during episodic retrieval of autobiographical and laboratory events: an fMRI study using a novel photo paradigm. J. Cogn. Neurosci. 16, 1583–1594. Caroll, M., Campbell-Ratcliffe, J., Murnane, H., and Perfect, T. J. (2007). Retrieval-induced forgetting in educational contexts: monitoring, expertise, Frontiers in Human Neuroscience Repression, trauma, and constructivist memory theory text integration and test format. Eur. J. Cogn. Psychol. 19, 580–606. Christianson, S. A. (1992). Emotional stress and eyewitness memory: a critical review. Psychol. Bull. 112, 284–309. Cialdini, R. B., and Goldstein, N. J. (2004). Social influence: compliance and conformity. Annu. Rev. Psychol. 55, 591–621. Clancy, S. A., Schacter, D. L., McNally, R. J., and Pitman, R. K. (2000). False recognition in women reporting recovered memories of sexual abuse. Psychol. Sci. 11, 26–31. Conway, M., and Ross, M. (1984). Getting what you want by revising what you had. J. Pers. Soc. Psychol. 47, 738–748. Craik, F. I. M., and Lockhardt, R. S. (1972). Levels of processing: a framework for memory research. J. Verbal Learn. Verbal Behav. 11, 671–684. Deese, J. (1959). On the prediction of occurrence of particular verbal intrusions in immediate recall. J. Exp. Psychol. 58, 17–22. Degonda, N., Mondadori, C. R., Bosshardt, S., Schmidt, C. F., Boesiger, P., Nitsch, R. M., Hock, C., and Henke, K. (2005). Implicit associative learning engages the hippocampus and interacts with explicit associative learning. Neuron 46, 505–520. Depue, B. E., Curran, T., and Banich, M. T. (2007). Prefrontal regions orchestrate suppression of emotional memories via a two-phase process. Science 317, 215–219. Dolcos, F., LaBar, K. S., and Cabeza, R. (2004). Interaction between the amygdala and the medial temporal lobe memory system predicts better memory for emotional events. Neuron 42, 855–863. Elbert, T., and Schauer, M. (2002). Burnt into memory. Nature 419, 883. Erdelyi, M. H. (2006). The unified theory of repression. Behav. Brain Sci. 29, 499–551. Ferenczi, S. (1933). Bausteine der Psychoanalyse. Bern, Switzerland: Huber, 511–525. Fonagy, P., Gergely, G., Jurist, E. J., and Target, M. (2005). Affect regulation, Mentalization, and the Development of the Self. (New York, NY: Other Press). Freud, S. (1913). “On beginning the treatment (further recommendations on the technique of psycho-analysis I),” in The Standard Edition of the Complete Works of Sigmund Freud, Vol. 12, eds J. Strachey, A. Freud, A. Strachey, and A. Tyson (London: The Hogarth Press and the Institute of Psychoanalysis), 121–145. Freud, S. (1915). “Repression,” in The Standard Edition of the Complete Works of Sigmund Freud, eds J. Strachey, A. Freud, A. Strachey, and A. Tyson (London: The Hogarth Press and the Institute of Psychoanalysis), Vol. 14, pp. 143–158. Frijda, N. H. (1988). The laws of emotion. Am. Psychol. 43, 349–358. Gutchess, A. H., Kensinger, E. A., and Schacter, D. L. (2007). Aging, self-referencing, and medial prefrontal cortex. Soc. Neurosci. 2, 117–133. Henckens, M. J., Hermans, E. J., Pu, Z., Joëls, M., and Fernández, G. (2009). Stressed memories: how acute stress affects memory formation in humans. J. Neurosci. 29, 10111–10119. Henke, K., Mondadori, C. R., Treyer, V., Nitsch, R. M., Buck, A., and Hock, C. (2003). Nonconscious formation and reactivation of semantic associations by way of the medial temporal lobe. Neuropsychologia 41, 863–876. Henson, R. (2005). What can functional neuroimaging tell the experimental psychologist? Q. J. Exp. Psychol. 58, 193–233. Herbart, J. F. (1824). Psychologie als Wissenschaft, neu gegründet auf Erfahrung, Metaphysik und Mathematik. Königsberg: A.W. Unzer. Herman, J. (1992). Complex PTB: a syndrome in survivors of prolonged and repeated trauma. J. Trauma. Stress 5, 377–391. Heuer, F., and Reisberg, D. (1990). Vivid memories of emotional events: the accuracy of remembered minutiae. Mem. Cogn. 18, 496–506. Holmes, E. A., and Bourne, C. (2008). Inducing and modulating intrusive emotional memories: a review of the trauma film paradigm. Acta Psychol. 127, 553–566. Holmes, E. A., Brewin, C. R., and Hennessy, R. G. (2004). Trauma films, information processing, and intrusive memory development. J. Exp. Psychol. Gen. 133, 3–22. Holmes, E. A., Oakley, D. A., Stuart, A., and Brewin, C.R. (2007). Investigating peri-traumatic dissociation using hypnosis during a traumatic film. J. Trauma Dissociation 7, 91–111. Hunt, R. R., and Einstein, G. O. (1981). Relational and item-specific information in memory. J. Verbal Learn. Verbal Behav. 20, 497–514. Jelinek, L., Jacobson, D., Kellner, M., Larbig, F., Biesold, K.-H., Barre, K., and Moritz, S. (2006). Verbal and nonverbal memory functioning in posttraumatic stress disorder (PTSD). J. Clin. Exp. Neuropsychol. 28, 940–948. Johnson, H. M. (1994). Processes of successful intentional forgetting. Psychol. Bull. 116, 274–292. Johnson, M. K., Hashtroudi, S., and Lindsay, D. S. (1993). Source monitoring. Psychol. Bull. 114, 3–28. www.frontiersin.org Jones, C., Harvey, A. G., and Brewin, C. R. (2007). The organisation and content of trauma memories in survivors of road traffic accidents. Behav. Res. Ther. 45, 151–162. Jung, C. G. (1918). Studies in ­W o r d - A s s o c i a t i o n . L o n d o n : Heinemann. Kensinger, E. A., and Corkin, S. (2003). Effect of negative emotional content on working memory and long-term memory. Emotion 3, 378–393. Kensinger, E. A., and Corkin, S. (2004). Two routes to emotional memory: distinct neural processes for valence and arousal. Proc. Natl. Acad. Sci. U.S.A. 101, 3310–3315. Kim, J. J., and Diamond, D. M. (2002). The stressed hippocampus, synaptic plasticity and lost memories. Nat. Rev. Neurosci. 3, 453–462. Kindt, M., Van den Hout, M., and Buck, N. (2005). Dissociation related to subjective memory fragmentation and intrusions but not to objective memory disturbances. J. Behav. Ther. Exp. Psychiatry 36, 43–59. Klucharev, V., Hytönen, K., Rijpkema, M., Smidts, A., and Fernández, G. (2009). Reinforcement learning signal predicts social conformity. Neuron 61, 140–151. Köhler, T., Thiede, G., and Thöns, M. (2002). Kurz- und längerfristiges Vergessen von Wortassoziationen – eine experimentelle Studie zur Freudschen Lehre von Widerstand und Verdrängung. Z. Klin. Psychol. Psychiatr. Psychother. 50, 328–333. Köhler, T., and Wilke, W. (1999). Das Vergessen von Wortassoziationen in Abhängigkeit von Indikatoren ihrer Emotionalität: Eine Möglichkeit der Überprüfung des Freudschen Verdrängungskonzepts? Psychother. Psychosom. Med. Psychol. 49, 64–67. LaBar, K. S., LeDoux, J. E., Spencer, D. D., and Phelps, E. A. (1995). Impaired fear conditioning following unilateral temporal lobectomy in humans. J. Neurosci. 15, 6846–6855. Lang, P. J., Bradley, M. M., and Cuthbert, B. N. (1995). International Affective Picture System (IAPS): Technical Manual and Affective Ratings. Gainesville, FL: The Center for Research in Psychophysiology, University of Florida. Lanius, R. A., Williamson, P. C., Boksman, K., Densmore, M., Gupta, M., Neufeld, R. W. J., Gati, J. S., and Menon, R. S. (2002). Brain activation during script-driven imagery induced dissociative responses in PTSD: a functional magnetic resonance imaging investigation. Biol. Psychiatry 52, 305–311. Leichsenring, F., and Rabung, S. (2008). Effectiveness of ­long-term November 2010 | Volume 4 | Article 211 | 10 Axmacher et al. ­ s yc h o d y n a m i c p s yc h o t h e rp apy: a meta-analysis. JAMA 300, 1551–1565. Levinger, G., and Clark, J. (1961). Emotional factor in the forgetting of word associations. J. Abnorm. Soc. Psychol. 62, 99–105. Mace, J. H. (2005). Priming involuntary autobiographical memories. Memory 13, 874–884. Macrae, C. N., and MacLeod, M. D. (1999). On recollections lost: when practice makes imperfect. J. Pers. Soc. Psychol. 77, 463–473. Maercker, A. (2009). Posttraumatische Belastungsstörungen. Heidelberg, Germany: Springer. Maercker, A., Schützwohl, M., and Beauducel, A. (2000). Trauma severity and initial reactions as precipitating factors for posttraumatic stress disorder and chronic dissociation. J. Trauma. Stress 13, 651–660. McDaniel, M.A., and Einstein, G. O. (1993). The importance of cue familiarity and cue distinctiveness in prospective memory. Memory 1, 23–41. McNally, R. J. (1997). Implicit and explicit memory for trauma-related information in PTSD. Ann. N. Y. Acad. Sci. 821, 219–224. Metcalfe, J., and Jacobs, W. J. (1998). “Emotional memory: the effects of stress on “cool” and “hot” memory systems,” in The Psychology of Learning and Motivation: Advances in Research and Theory, ed L. D. Medin (San Diego: Academic Press), 187–222. Morris, C. D., Bransford, J. D., and Franks, J. J. (1977). Levels of processing versus transfer appropriate processing. J. Verbal Learn. Verbal Behav. 16, 519–533. Nader, K., and Hardt, O. (2009). A single standard for memory: the case for reconsolidation. Nat. Rev. Neurosci. 10, 224–234. Nader, K., Schafe, G. E., and Le Doux, J. E. (2000). Fear memories require protein synthesis in the amygdala for reconsolidation after retrieval. Nature 406, 722–726. Nelson, K. (2003). Self and social functions: individual autobiographical Frontiers in Human Neuroscience Repression, trauma, and constructivist memory theory memory and collective narrative. Memory 11, 125–136. Neuner, F., Schauer, M., Klaschik, C., Karunakara, U., and Elbert, T. (2004). A comparison of narrative exposure therapy, supportive counseling, and psychoeducation for treating posttraumatic stress disorder in an African refugee settlement. J. Consult. Clin. Psychol. 72, 579–587. Ochsner, K. N. (2000). Are affective events richly recollected or simply familiar? The experience and process of recognizing feelings past. J. Exp. Psychol. Gen. 129, 242–261. Ozer, E. J., Best, S. R., Lipsey, T. L., and Weiss, D. S. (2003). Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychol. Bull. 129, 52–73. Person, E. S., Cooper, A. M., and Gabbard, G. O. (eds). (2005). The American Psychiatric Publishing Textbook of Psychoanalysis. Washington, DC: American Psychiatric Publishing, 602. Phelps, E. A. (2004). Human emotion and memory: interactions of the amygdala and hippocampal complex. Curr. Opin. Neurobiol. 14, 198–202. Rockstroh, B., and Elbert, T. (2010). Traces of fear in the neural web – magnetoencephalographic responding to arousing pictorial stimuli. Int. J. Psychophysiol. 78, 14–19. Roediger, H. L. III, and McDermott, K. B. (1995). Creating false memories: remembering words not presented in lists. J. Exp. Psychol. Learn. Mem. Cogn. 21, 803–814. Sapolsky, R. M. (2003). Stress and plasticity in the limbic system. Neurochem. Res. 28, 1735–1742. Schacter, D. L. (1996). Searching for Memory: The Brain, the Mind, and the Past. New York: Basic Books Inc. Schacter, D. L., and Addis, D. R. (2007). Constructive memory: the ghosts of past and future. Nature 445, 27. Schacter, D. L., Addis, D. R., and Buckner, R. L. (2007). Remembering the past to imagine the future: the prospec- tive brain. Nat. Rev. Neurosci. 8, 657–661. Seidenbecher, T., Laxmi, T. R., Stork, O., and Pape, H. C. (2003). Amygdalar and hippocampal theta rhythm synchronization during fear memory retrieval. Science 301, 846–850. Shin, L. M., Rauch, S. L., and Pitman, R. K. (2005). “Structural and functional anatomy of PTSD: findings from neuroimaging research,” in Neuropsychology of PTSD: Biological, Cognitive, and Clinical Perspectives, eds J. J. Vasterling and C. R. Brewin (New York: The Guilford Press), 59–82. Smith, A. P., Stephan, K. E., Rugg, M. D., and Dolan, R. J. (2006). Task and content modulate amygdala-hippocampal connectivity in emotional retrieval. Neuron 49, 631–638. Solms, M., and Kaplan-Solms, K. (2000). Clinical Studies in NeuroPsychoanalysis: Introduction to a Depth Neuropsychology. London, UK: Karnac Books. Stephan, A. (2002).“Was die Psychoanalyse im Lichte interdisziplinärer Forschung erwartet,” in Psychoanalse im Dialog der Wissenschaften. Band 1: Europäische Perspektiven, ed P. Giamperi-Deutsch (Stuttgart, Germany: Kohlhammer), 76–87. Stern, D. N. (1985). The Interpersonal World of the Infant: A View from Psychoanalysis and Developmental Psychology. New York, NY: Basic Books. Summerfield, J. J., Hassabis, D., and Maguire, E. A. (2009). Cortical midline involvement in autobiographical memory. Neuroimage 44, 1188–1200. Tulving, E. (1983). Elements of Episodic Memory. Oxford, UK: Clarendon. van der Kolk, B. (2005). Developmental trauma disorder. Towards a rational diagnosis for children with complex trauma histories. Psychiatr. Ann. 35, 979–987. van Marle, H. J., Hermans, E. J., Qin, S., and Fernández, G. (2009). From ­specificity to sensitivity: how acute stress affects amygdala processing www.frontiersin.org of biologically salient stimuli. Biol. Psychiatry 66, 649–655. Wilson, A. E., and Ross, M. (2003). The identity function of autobiographical memory: time is on our side. Memory 11, 137–149. Wöller, W., and Kruse, J. (2010). Tie fe npsycholog isch fundier te Psychotherapie, Basisbuch und Praxisleitfaden. Stuttgart, Germany: Schattauer. World Health Organization (WHO). (1992). The ICD-10 Classification of Mental and Behavioral Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organization. Wright, D. B., Memon, A., Skagerberg, E. M., and Gabbert, F. (2009). When eyewitnesses talk. Curr. Dir. Psychol. Sci. 18, 174–178. Yehuda, R., Keefe, R. S., Harvey, P. D., Levengood, R. A., Gerber, D. K., Geni, J., and Siever, L. J. (1995). Learning and memory in combat veterans with posttraumatic stress disorder. Am. J. Psychiatry 152, 137–139. Conflict of Interest Statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Received: 05 May 2010; accepted: 11 October 2010; published online: 22 November 2010. Citation: Axmacher N, Do Lam ATA, Kessler H and Fell J (2010) Natural memory beyond the storage model: repression, trauma, and the construction of a personal past. Front. Hum. Neurosci. 4:211. doi: 10.3389/fnhum.2010.00211 Copyright © 2010 Axmacher, Do Lam, Kessler and Fell. This is an open-access article subject to an exclusive license agreement between the authors and the Frontiers Research Foundation, which permits unrestricted use, distribution, and reproduction in any medium, provided the original authors and source are credited. November 2010 | Volume 4 | Article 211 | 11
Purchase answer to see full attachment