Mind Matters: Transient global amnesia and emotional stress

One
client, one colleague, and two friends. What do they all have in common? They
all have been diagnosed with transient global amnesia (TGA), which is supposed
to occur to in 0.004 percent of the population. I feel statistically singled
out, on the “long tail.” Statistics don’t really disallow my experience, but I
do find it peculiar that this rare neurological syndrome would cluster in this
way (or as my husband quips, maybe I’m the “typhoid Mary” re-incarnated as “TGA
Kayta”).

Perhaps,
TGA is more prevalent than we realize, so allow me to define it briefly.
Transient global amnesia is a fortunately fleeting and probably benign syndrome
with an abrupt onset. For anywhere between four and twenty-four hours, a person
has no short-term memory. The individual knows who he or she is, and knows
family and friends, and is able to perform rote tasks—driving a car, shopping,
etc. All of a sudden, however, the questions arise, “What just happened?”
“Where am I?” or “We’re doing what?” With TGA, there are no physical
manifestations as there are with, e.g., a TIA, transient ischemic attack. That
is, there is no slurring of speech, no loss of words, no facial muscle
drooping. No loss of balance or immobility.

The
person may be in this short-term amnesia state for hours, then some awareness
of confusion and of being lost in time arises. (Sometimes the disorientation is
first observed by another.) One friend, upon return to linear time as we know
it, described her state as “being in limbo.” Another friend says that the “loss
of time still haunts me … twelve hours of my life totally gone.”

Fortunately,
TGA doesn’t usually linger and leaves as subtly as it appears. Of all the
neurological events that can occur to a human, perhaps it is the one with the
least lasting effects. Its recurrence is rare and there doesn’t seem to be any
deleterious result to the brain.

However,
as a psychologist, I think there may be an emotional component that, while
mentioned in the literature as a possible precipitating factor, may be getting
short shrift in the ER.

Research
has found over the years that anxiety and stress can engender panic attacks
that mimic heart attacks. Pardon my waxing simplistic for wondering if TGA’s
couldn’t be considered a sort of “panic attack” of the brain. There have been
some brain studies (PET—positive emission tomography—scans) of patients while
enduring TGA. These point to amygdala and hippocampus involvement. This is the
part of the brain most affected by trauma and stress and is important in
memory.

While
there may be other physiological factors involved — strenuous exercise or
diving into cold water where the breath is held — I would like to see more
attention given to the emotional components. A neurological assessment to
differentiate the diagnosis from TIA’s, brain tumors, infections, bleeds, etc.,
is, of course, important. Yet, any psychological stressors also need to be
explained.

Could
the TGA be a part of a stress response to an emotional trauma? Is there an
anniversary reaction to a past event that needs to be addressed? What part does
grief or loss play in the onset of a TGA? What part does repressed anger play?

I
facilitate a grief group for those whose loved ones died suddenly, often
violently. The members of this group recognize full well that anniversaries can
trigger severe emotional reactions—anniversaries of the death, birthdays,
holidays. While no one in this group (that I know of) has been diagnosed with
TGA, I do know of others who have had TGA where the onset coincided with a
grief anniversary.

The
emotional loss or trauma that precipitates the TGA may not be about a person
either. It may also be about a place or lost part of one’s life. In one case of
TGA, I encountered a young man who had an emotional attachment to a house where
he had lived and where his box of poetry and journals had been inadvertently
left behind. Unlucky for him, in what I believe to be an occurrence of TGA, he
was arrested and taken to jail for trespassing at his former residence. He had
no knowledge of how he had gotten there and was thoroughly confused at the
police station. For him, TGA was a nightmarish, Kafka-esque situation. And the
diagnosis was given qualitatively only after the fact of his arrest.

Better
to have loving family or friends (or knowledgeable police, for that matter)
take thee to a hospital ER than to jail when TGA might have occurred.

But at
the ER, after all the neurological workups, I trust that a thorough
history-taking would include questions about any and all emotional stressors,
about anniversary reactions, including grief and its emotional charge.

Emotional
stress creeps in on cat feet and CAT scans don’t show the tiger’s scars.

Our
bodies and our minds are not as separate as Descartes thinks. When mental
/emotional stress—be it financial anxiety, profound grief, post-traumatic
memories, fear, anger, sadness, is not expressed in healthy ways, our bodies
bear the burden.

No, we
can’t control life, but our attempt to control (not the same as healthy
containing) our feelings in the face of our fears is never the solution.

Take a
moment to reflect on your own life when different events have occurred. Might
you consider an emotional precipitant you never considered before?

I
certainly know in my own life there are emotional connections to a few
“accidents.” I have several broken bones as a result of some angry feelings
turned inward. Sure, they were “accidents”—falls—a slippery rock, a funky
step—but they were also the result of mental pre-occupation with my feelings
that were not being resolved in healthy ways.

That
is, I was imploding with my feelings, which is a form of emotional reactivity.
Emotional reactivity can take opposite forms but neither is healthy. Turning a
feeling inward onto oneself is emotional reactivity that is implosive (gestalt
psychologists call it retroflection); turning the feeling on another is
explosive reactivity—e.g., when a person reacts hostilely and aggressively to
another. Neither is the solution.

The
solution is to be able to fully acknowledge the feeling in oneself first of all
and then to find healthy ways to express or discharge the feeling. (In the case
of anger at another, this could take the form of airing of grievances in a way
that respects both parties—the giver and the receiver of the communication).

In the
case of grief reactions, to know that we can give ourselves permission to feel
whatever arises.

Our
bodies carry emotional wisdom that needs to be heard. If we don’t take the time
to listen, our bodies will slow us down one way or another, giving us legs
akimbo or putting us in limbo.

For
more on the emotions and the body, see: Waking
the Tiger
by Peter Levine; Healing
Through the Dark Emotions
by Miriam Greenspan; Courage to Feel by Andrew Seubert; and The Body Remembers by Babette Rothschild.

* Kayta Curzie Gajdos
holds a doctorate in counseling psychology and is in private practice in Chadds
Ford, Pennsylvania. She welcomes comments at MindMatters@DrGajdos.com
or 610-388-2888. Past columns are posted to http://www.drgajdos.com.

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About Kayta Gajdos

Dr. Kathleen Curzie Gajdos ("Kayta") is a licensed psychologist (Pennsylvania and Delaware) who has worked with individuals, couples, and families with a spectrum of problems. She has experience and training in the fields of alcohol and drug addictions, hypnosis, family therapy, Jungian theory, Gestalt therapy, EMDR, and bereavement. Dr. Gajdos developed a private practice in the Pittsburgh area, and was affiliated with the Family Therapy Institute of Western Psychiatric Institute and Clinic, having written numerous articles for the Family Therapy Newsletter there. She has published in the American Psychological Association Bulletin, the Family Psychologist, and in the Swedenborgian publications, Chrysalis and The Messenger. Dr. Gajdos has taught at the college level, most recently for West Chester University and Wilmington College, and has served as field faculty for Vermont College of Norwich University the Union Institute's Center for Distance Learning, Cincinnati, Ohio. She has also served as consulting psychologist to the Irene Stacy Community MH/MR Center in Western Pennsylvania where she supervised psychologists in training. Currently active in disaster relief, Dr. Gajdos serves with the American Red Cross and participated in Hurricane Katrina relief efforts as a member of teams from the Department of Health and Human Services' Substance Abuse and Mental Health Services Administration.Now living in Chadds Ford, in the Brandywine Valley of eastern Pennsylvania, Dr. Gajdos combines her private practice working with individuals, couples and families, with leading workshops on such topics as grief and healing, the impact of multigenerational grief and trauma shame, the shadow and self, Women Who Run with the Wolves, motherless daughters, and mediation and relaxation. Each year at Temenos Retreat Center in West Chester, PA she leads a griefs of birthing ritual for those who have suffered losses of procreation (abortions, miscarriages, infertility, etc.); she also holds yearly A Day of Re-Collection at Temenos.Dr. Gajdos holds Master's degrees in both philosophy and clinical psychology and received her Ph.D. in counseling at the University of Pittsburgh. Among her professional affiliations, she includes having been a founding member and board member of the C.G. Jung Educational Center of Pittsburgh, as well as being listed in Who's Who of American Women. Currently, she is a member of the American Psychological Association, The Pennsylvania Psychological Association, the Delaware Psychological Association, the American Family Therapy Academy, The Association for Death Education and Counseling, and the Delaware County Mental Health and Mental Retardation Board. Woven into her professional career are Dr. Gajdos' pursuits of dancing, singing, and writing poetry.

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One Response to “Mind Matters: Transient global amnesia and emotional stress”

  1. jeanne-marie says:

    Thank you for such an amazing column. I just posted it on my facebook as this is such valuable information.

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