Christine Blasey Ford came forward this weekend as the author of a letter accusing Brett Kavanaugh of sexual assault. According to the account she gave the Washington Post, she remembers being pushed into a bedroom, Kavanaugh covering her mouth, and loud music being played. She is also transparent about what she does not remember: the exact year, the reason why she was at that house party, who owned the house, or how she got there. This lack of detail, combined with the amount of time elapsed since the alleged assault, has caused some to question her story—how can she be so sure of what happened if she’s not sure what year it was? But given what we know about traumatic memories, the fact that Ford is hazy on some of the details actually increases the likelihood she is telling the truth.
Traumatic memories are processed and stored differently than those of benign events. Asked to recall a significant life episode, most of us would tell a story: My wife woke up in labor, we drove to the hospital, and a few hours later my daughter was born. Memories of trauma, though, do not share this structure. Instead, they are collections of sensory impressions: the sound of a song, the smell of cologne, the pressure of someone’s hand on your mouth. This is precisely why trauma can be so difficult to treat: It’s not a matter of avoiding a person or a place but a feeling, an emotion. This is why many of my patients who are trauma survivors have constricted their lives to avoid the possibility of being triggered and have withdrawn from life as a result.
We’ve been aware of this difference in memory storage and retention since Pierre Janet first began studying memory and trauma in the late 19th century, but recent gains in neuroscience have helped us get an even better sense of what exactly is going on. We can now look at the brains of people remembering trauma in real time to see which areas of the brain are activated and which are dormant. Flashbacks activate the amygdala, the part of the brain that monitors our surroundings for signs of danger and prepares us to take action, and repress Broca’s area, the part of our brain responsible for putting our thoughts and feelings into words. Trauma literally renders the brain speechless and fills the body with unspeakable terror.
It’s no surprise that it took Ford years before she could put her experience into words. The fact that she disclosed her assault in a couples-counseling session is consistent with what I have witnessed in my own practice. The impact of traumatic incidents never goes away but can be buried very deeply until something triggers it to rise to the surface. This happens most often in our most intimate relationships. After Ford disclosed the incident in session, she told her husband the full story and processed the event with her individual therapist the following year.
Some may find it unusual that Ford’s couples and individual therapists allowed the Washington Post to access her therapy notes. Such access could only be granted with Ford’s full approval, of course. When a patient enters my care, I am bound by strict confidentiality regarding their disclosures, but this is not a two-way street; the patient is not bound to keep anything we talk about secret. The information in the therapists’ notes is Ford’s to disclose if she wishes to do so. Medical notes don’t belong to providers but to their patients. Even though the vast majority of my patients will never review my documentation, I take care to write each word knowing that they could one day read them.
If Ford were my patient and wanted me to disclose her records, I would want to begin by making sure she was absolutely certain about what she was doing. I would want to make sure that this was not a passing whim or something she hadn’t fully thought through yet (another reason why it actually makes more sense, not less, that Ford clearly weighed this decision for months before speaking on the record). If I felt comfortable, I would have her sign a release stating what she wished me to share and with whom, and I would encourage her to share the least amount of necessary information with the fewest possible parties. Within the notes themselves I would strongly encourage her to redact anything that is irrelevant to what she wishes to share with the public.
Part of my interest in providing this advice would be to protect my patient. It’s disturbing that there are already voices asking why Ford didn’t come forward sooner and questioning the validity of her story. These reactions reveals exactly why Ford wished to remain anonymous. Traumatic memories are stored as piecemeal collections of sensory experiences and are often buried deep within our psyches. Ford deserves nothing but praise for coming forward, and everything we know about traumatic memory suggests she’s telling the truth.