Why reliving is not remembering and the unique neurobiological representation of traumatic memory

Abstract

Anecdotally, the difference between autobiographical and traumatic memory is clear; one is remembered, the other vividly relived. Further distinction can be drawn between past-centered traumatic recurrences and present-centered trauma-related intrusions. While some argue sensorimotor representations to be building blocks of all memory forms, traumatic memory seems to haunt in the form of unintegrated sensations and actions. This Perspective hypothesizes a neurobiological delineation between these memory forms, where traumatic memory is uniquely characterized by alterations to lower-level and primary sensorimotor processes. The proposed demarcation has implications for legal systems, which assume interrogations of autobiographical and traumatic memory can be methodologically identical. Clinically, first-line treatments for post-traumatic stress disorder have yet to explicitly address sensorimotor processes, where up to half of individuals are non-responsive and 20% drop out. We are left with urgent needs to consider sensorimotor fragmentation of traumatic memory and advance interventions that assimilate these fragments into a past-contextualized autobiography. In this Perspective, the authors review the literature regarding the differences between autobiographical and traumatic memory and introduce sensorimotor-based implications for understanding and treating post-traumatic stress disorder.