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The memory paradox
Rachel Yehuda, Marian Jols and Richard G. M. Morris
Abstract | Declarative and emotional memories are key to quality of life and day-to-day functioning. The absence of memory or the inability to recall memories properly in an emotional context leads to dysfunction but, paradoxically, memories that generate too much emotion can be equally disa bling.
The formation, persistence and loss of memories present something of a paradox. On the one hand, the ability to form and later recall memories is vital for copingwith the challenges of life. In both animals and humans, successfully remembering important aspects of arousing situations may ensure a quicker and more appropriate response when an organism faces similar conditions in the future. The centrality of memory to human experience is poignantly illustrated by the consequences of its loss in the phenomenon of amnesia. The famous case of patient H.M.1, who had sustained and irreparable damage to the hippocampus, highlighted the importance of the hippocampus and related brain structures in the formation of new memories about experienced events (episodic or autobiographical), but also demonstrated that loss of memory can render individuals severely disabled. The loss of emotional memory can also be highly impairing, as evidenced by the severe social and emotional deficits experienced following lesions of the amygdala2. Clearly, declarative and emotional memories are key to quality of life and day-to-day functioning.
On the other hand, memories are sometimes very intrusive and then interfere with normal daily functioning. This occurs, for example, in post-traumatic stress disorder (PTSD). PTSD is an extremely disabling condition in which the central problem seems to be that memories of a traumatic event are often so vivid, frequent and uncontrollable that they lead to behavioural disruption, avoidance and hyperarousal3. When traumatic memories are re-experienced, the body engages in a physical reaction that is
reminiscent of that experienced when the event occurred in real time. The recreation of a fear physiology makes the individual feel as if haunted by the past4,5. This quality, which infuses frequent and uncontrollable memories with intense distress and painful emotion, ultimately results in a severe impairment in social, vocational and interpersonal functioning3. Although PTSD has a range of trajectories, intrusive...