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PATHOLOGICAL INTRUSIVE MEMORIES: DÉJÀ VU, FLASHBACKS AND OTHER PHENOMENA

Abstract

Professor Markus Reuber MD PhD FRCP I am a Professor of Clinical Neurology and Honorary Consultant at the University of Sheffield and the Royal Hallamshire Hospital in Sheffield, United Kingdom. My clinical work focuses on the treatment of patients with complex seizure disorders. In terms of research, I am particularly interested in the phenomenology and treatment of epileptic and non-epileptic seizure disorders and in communication between doctors and patients.

I grew up and started by undergraduate medical course in Germany but completed my medical course in Nottingham and my general neurological training in Leeds. However, I returned to Germany for two years of my time as a trainee neurologist to work in the Department of Epileptology at the University of Bonn, the largest epilepsy surgery unit in Europe. I have been working as a Consultant or Honorary Consultant Neurologist in Sheffield for the last 12 years and have helped to build up the epilepsy surgery and neuropsychotherapy services there.

This talk will begin with a review of previous and current ideas about the definition and pathophysiology of intrusive memory phenomena such as déjà vu and flashbacks; and consider to what extent such phenomena can be considered pathological.

Next I will explore the phenomenology of déjà vu and flashbacks and the challenges the variability and the difficulties with capturing these memory symptoms cause for researchers. Using patient interview data, I will show how déjà vu experiences in temporal epilepsy are materially different from “normal” déjà vu. I will discuss how the terms “flashback” or “pathological memory” may be understood differently by patients, psychotherapists and neuroscientists.

Finally (and bearing in mind the limitations raised by the considerations above) I will explore the relationship between déjà vu, other dissociative phenomena and anxiety in patients with Nonepileptic Attack Disorder. I will draw on research findings but also illustrate how intrusive memory phenomena may become pathological by introducing a patient complaining of a range of different flashbacks and blackouts.

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