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Too shameful to remember: a 17-year-old Chinese boy with psychogenic amnesia

C K Wong1

  • 1Department of Psychiatry, Chinese University of Hong Kong.

The Australian and New Zealand Journal of Psychiatry
|December 1, 1990
PubMed

Insights

This case study presents prolonged psychogenic amnesia in a teenager, highlighting the impact of family communication patterns and shame on conversion symptoms and abnormal sick roles.

Area of Science:

  • Psychiatry
  • Psychology
  • Medical Sociology

Background:

  • This study examines a unique case of psychogenic amnesia in a 17-year-old Chinese male, lasting six weeks without typical dissociative symptoms like pseudodementia or fugue.
  • It explores the patient's condition through the lenses of abnormal sick role behavior and communication models of hysteria.

Observation:

  • The patient's family exhibited a preoccupation with physical illness and communicated distress non-verbally.
  • Shame was identified as a core psychodynamic factor, preventing the patient from articulating his predicaments.
  • Prior to amnesia, the patient experienced seven months of multiple conversion symptoms.

Findings:

  • The prolonged amnesia was unusual, lacking pseudodementia or fugue, and linked to family communication dynamics and psychodynamic shame.
  • Misunderstood communication of distress led to extensive, unnecessary medical investigations and treatments, including an appendectomy for a normal appendix.

Implications:

  • This case underscores the importance of understanding non-verbal communication and psychodynamic factors in somatoform disorders.
  • It highlights the potential iatrogenic harm from misdiagnosis and over-investigation in patients with conversion symptoms.
  • The findings suggest a need for integrated psychological and medical approaches to manage complex cases of hysteria and psychogenic disorders.

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