Lindqvist
The Flower girl: a Case Study on the Transformation of a Traumatic Experience.
Mona Lindqvist
I will present a case study from my clinical practice as a psychotherapist. The case concerns a 26-year old female refugee from Uzbekistan who was brutally raped some time before she migrated to Sweden. I will use the case study to argue that this particular traumatic memory is at first primarily a sensory experience before it transforms itself into a cognitive and verbal memory.
Memory sensed
When talking about memories one usually refers to memories seen and heard. More seldom are memories that arise through other sense modalities such as memories associated with movements or smells. One difficulty with describing smell and scent memories is that our language has no names for odours. We are able to name forms and colours that we have seen and are also able to describe melodies and sounds that we have heard, or if things are soft or hard. But odours are considerably more difficult; try for example to describe how an orange smells.
We can describe odours in terms of being strong or weak, bad or good which is quite rudimentary when compared to the language we can use to describe the impressions from other sense organs. Accordingly, one can conclude that the sense of smell simply does not have the “presence” to provide us with a message about what we smell or how it appears. Instead the task is to decide whether we should approach or remove ourselves from the environment, the person or the article of food that the odour is referring to. This is related to the fact that the odour is given a pleasant or unpleasant character. Therefore one may say that the sense of smell “knows” what is important but it cannot say why (Classen, Howes and Synott, 1994).
The oldest and the fastest path
The sense of smell is our oldest sense and strongly connected to basic functions such as memory and feelings. The nerves associated with smell are directly connected to both the brain structure called amygdala, the centre of feeling, and the hippocampus where memory is stored. In fact there are only two synapses, two connections, between the “smell nerves” and the amygdala. The impulses from other senses take extensive roundabouts in the brain before they arrive at the amygdala.
Episodic memory is one form of memory that is supposed to be unique for the human being. Personal experiences and events that are connected to a certain time and place is stored in the episodic memory. The emotional experience in an olfactory memory is usually much stronger than visual and aural memories (Cristiansson, 1994).
The return of the country of childhood through a Madeleine soaked in decoction of lime-blossom.
One of the most notable literary examples of the phenomenon is made by Marcel Proust in his novel In search of lost time. In the novel Proust uses olfactory symbolism in a very descriptive way.
The country of childhood has ceased to exist for the narrator but its reminiscence is triggered by a taste and smell:
“…..when one day in winter, on my return home, my mother, seeing that I was cold, offered me some tea, a thing I did not ordinarily take. I declined at first , and then, for no particular reason, changed my mind. She sent for one of those squat, plump little cakes called “petite Madeleines,” which look as though they had been moulded in the fluted valve of a scallop shell. And soon, mechanically, dispirited after a dreary day with the prospect of a depressing marrow, I raised to my lips a spoonful of the tea in which I had soaked a morsel of the cake. No sooner had the warm liquid mixed with the crumbs touched my palate than a shiver ran through me and I stopped, intent upon the extraordinary thing that was happening to me. An exquisite pleasure had invaded my senses, something isolated, detached, with no suggestion of its origin (Proust, 2004).”
The reminiscence is triggered by a petite Madeleine dipped in herbal tea, the odour of his childhood. Fragments of a memory emerge and take some time to gather to a conscious memory of his childhood in Combray.
Many of us have similar memories from childhood. They are mainly emotional because of the connection between the sense of smell and the older parts of the brain that are related to emotions and motivation. Research in line with this literary anecdote has shown that smell-released self biographic memories actually are earlier than memories released by other sense impressions (Christiansson, 1994).
The return of the memory
To verbalize a memory that has appeared through odours is not easy to recall because odours are ethereal, hard to measure, name or recreate. Smells cannot be documented, stored or captured in a manner that corresponds with aural and visual memories. We have to stick to descriptions. It is hard enough to portray a positive memory from one or several odours. What about those memories that the body (the brain) have forgotten, chosen to forget and that are not pleasant but on the contrary are terrifying, brutal and grotesque and are associated with violence and assault? Forgetfulness like memory is a dynamic act; a powerful experience or a significant act does not fall off and disappear out of memory. It is stored, but difficult to bring conscious memory. When it returns it is usually fragmented and undefined ways and not in chronological order.
Proust provides a literary expression of this phenomenon as well:
“Undoubtedly what is thus palpitating in the depths of my being must be the image, the visual memory which, being linked to that taste, is trying to follow it into my conscious mind. But its struggles are too far off, to confused and chaotic; scarcely can I perceive the natural glow into which the elusive whirling medley of stirred-up colours is fused, and I cannot distinguish its form, cannot invite it, as the one possible interpreter, to translate for me the evidence of its contemporary, its inseparable paramour, the taste, cannot ask it to inform me what special circumstance is in question, from what period in past life.
Will it ultimately reach the clear surface of my consciousness, this memory, this old, dead moment which the magnetism of an identical moment has travelled so far to importune, to disturb, to raise up out of the very depths of my being? (Proust, 2004) ”
Loss of memory
Loss of memory is more than just forgetting, it can appear for both psychological and physiological reasons. One can distinguish between psychogenic and organic loss of memory. Pathological forgetfulness can strike as a reaction to severe emotional stress. Psychogenic loss of memory can take place in a person that has suffered a psychological trauma, a powerful negative emotional experience that the person has no prior experience of or defence against and therefore cannot bear in his or her consciousness (Kihlström and Schachter, 1989). Rape for example, can cause a complete blocking out of the entire course of events, both the information about the event in itself and the detailed information about what happened. What the person suppresses is the specific information about the event. The emotional experiences on the other hand, the discomfort and the anguish remains and may become clear if the person is exposed to sense stimuli (image, sound, smell etc.) that are associated with the traumatic event (Christiansen, 1994).
A crowd of symptoms without an explanation
I have chosen to make a case description in order to illuminate the importance of odour in bringing back a traumatic memory.
Natasha was remitted to the psychiatric outward clinic for refugees where I work as a psychotherapist. According to the remittance she was suffering from sleep disturbances, nightmares about being chased, severe pain especially in her stomach and pelvis with no somatic cause. Natasha was agitated, agonized and periodically extremely tired.
When I met Natasha for the very first session in the mid of December she had recently arrived to Sweden. She told shortly about her background. She was 26 years old, educated as a speech therapist and had been working at the theatre in her home country Uzbekistan. Natasha had also been politically active. She was of Korean origin, an ethnic minority in the area. The background caused her and her family a lot of problems. It was not unusual that they where exposed to harassment and verbal treats. When the threats and the harassments became more powerful, Natasha and her brother decided to flee. It was more a matter of chance than choice that they ended up in Sweden. Upon arrival in Stockholm they applied for asylum.
Natasha is very verbal and it was easy for her to describe her background and her current situation. But somehow the symptoms seemed not to be related to her everyday life. In the beginning of our contact we dealt mostly with her nightmares. Natasha was able to describe them in detail as well as the fear and the panic she experienced in the dream, but despite that there was no clue to the symptoms she had in her everyday life.
Certainly the threats against her and her family had been quite severe, but she felt that she had always succeeded in defending herself in her home country. The pain also seemed to be torn loose from any reasonable context. Natasha related to the pain as if it had its origin in poor nutrition and in the worry and stress associated with thinking about the future.
The Christmas holidays where approaching and in Scandinavia it is common to use hyacinths for Christmas decorations. A hyacinth was placed on the table in my office when Natasha came for her therapy session. The scent of the flower made her very agitated, it was hard for her to remain seated and she began to wander around in the room. Her breathing became faster to the point of hyperventilation. The flower was removed and she calmed down. Natasha herself was very surprised by her reaction. Hyacinths had a great symbolic value for her and intellectually she had only positive connotations with the flower and the scent. During the therapy sessions that followed certain images were raised to the conscious surface piece by piece, which were diffuse and disconnected from any chronological perspective. Finally it took its form into the following account:
The return of the memory
The international woman’s day, the 8th of March, is greatly celebrated in Uzbekistan. It is late in the evening and it is getting dark. Natasha has been drinking but is not drunk. All the women have been provided with flowers, Natasha as well as the others. She has gathered a bouquet of pink and blue hyacinths. It is tradition in Uzbekistan to give this particular flower on this particular day. The flowers are spreading a heavy scent around and Natasha is feeling tired after the party and decides to take a short cut through a park.
Halfway through the park she is suddenly attacked by a man. He hits her in the head and shouts violent and racist comments about her looks. She attempts to run away but fails. He abuses her and rapes her brutally. He finishes it off kicking her in the pelvic area. When Natasha rises she is mostly worried about her stockings being broken. She walks home and goes to sleep. The next day she wakes up sore in her whole body, bruised and scratched but has no memory of what caused her injuries. She assumes that she had been in a fight, and remembers the party and that she decided to walk home. After the bruises and the scratches have healed she no longer thinks about what happened.
The symptoms that finally lead her to therapy appeared no earlier than after her migration to Sweden. Probably her flight from Uzbekistan consumed so much mental energy and strength that her body never had the opportunity to release any symptoms, especially the memory of the abuse.
Sense and migration
Natasha’s story is unfortunately not that unusual. Suppressed memories or psychogenic loss of memories is quite frequent among refugees that have been traumatised. When talking about migration and memory we usually assume that the migrant or the refugee is aware of his or her history and what to talk about in therapy. Since Freud therapy has been considered the talking cure, and in many ways it still is but the difficult part in working through them is how to transform a vague reminiscence created by one or several sense modalities into words and then to a comprehensible narrative about the person or patient.
The sense of smell plays an important role in carrying reminiscences of odours from one part of the world to another and from the past into the present. Linked with fragments from other senses it can give a more holistic view of the personal history of a human being.
Christiansson, S-A. (2002). Traumatiska minnen. Natur och Kultur. Stockholm.
Classen,C., Howes,D. & Synott,A.(1994). Aroma, the cultural history of smell. Routledge. London.
Proust, M.(2004). In search of lost time. Swann´s way.Modern Library Paperback Edition.USA.
Schachter, O.L. & Kihlstrom,J.F (1989). Functional Amnesia. IF. Boller & J. Grafman (Red.) Handbook of Neuropsychology,vol 3.Amsterdam, Elsevier.
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