Amnesia is a truly fascinating condition, one which has maintained the attention of scientists and the public for over a century. The simple truth that memories already attained may be lost forever is incredibly intriguing to some, yet incredibly scary to others. One’s self-identity is extremely important and to lose it is akin to losing yourself.
Through the efforts of countless researchers over the years the different types of amnesia and their neurological and psychiatric basis have been mostly elucidated. This understanding, however, is contrasted by Hollywood’s interpretation of such amnesias which is, more often than not, quite inaccurate. An investigation of these discrepancies is conducted for three movies and the three amnesias they are meant to depict:
Shutter Island – Leonardo DiCaprio as U.S. Marshall Edward “Teddy” Daniels – Psychogenic amnesia
Shutter Island (2010) follows DiCaprio’s character, Teddy, as he launches an investigation on a psychiatric facility on Shutter Island. He and his partner, Aule, are searching for a missing patient named Rachel Solando, who had drowned her three children. During the search Teddy begins having migraines, waking visions, and dreams of his dead wife, Dolores Chanal, who had been burned in a building set alight by a man named Andrew Laeddis. Laeddis was also incarcerated on the island and had also escaped. For Teddy, searching for Laeddis is admittedly an ulterior motive for coming to the island.
At one point Teddy is separated from his partner and he happens upon a woman who claims to be the real Rachel Solando. She tells him that the doctors at Shutter Island run experiments on the patients and afterward lobotomize them in the lighthouse. When Teddy hears this he assumes that Aule has been taken to the lighthouse by the doctors and breaks in. He finds the head doctor, Cawley, waiting for him. Cawley explains to Teddy that the whole investigation was setup to break his insanity and that he was Laeddis and had burned his wife alive, Rachel Solando, for murdering their three children. The realization causes Teddy to pass out. He awakes in the hospital with Cawley and Chuck Aule, who is truly Dr. Sheehan, and explains to them everything that had happened in a coherent manner. They are led to believe he has progressed but then he refers to Sheehan as ‘Chuck’ and is taken to the lighthouse to be lobotomized.
Teddy’s inability to remember the events which led to him murdering his wife are typical of dissociative amnesia or psychogenic amnesia. Psychogenic amnesia is characterized by a period of memory loss, normally in the form of inability to retrieve autobiographical information, that occurs following a traumatic event or highly stressful circumstances. Differentiable from other forms of amnesia, psychogenic amnesia cannot be attributed to explicit brain damage. The hippocampus is believed to be involved in this type of amnesia as patients reporting event-related memory loss display decreased hippocampus activation. There are 2 dominant repressor theories attempting to explain the repression: 1) Amygdala Repressor – increased activation in the amygdala simultaneous with the decreased activation in the hippocampus and 2) Dorsolateral Prefrontal Cortex Repressor – overactive dorsolateral prefrontal cortex decreases hippocampal function.
Shutter Island‘s depiction of psychogenic amnesia is accurate in some regards and inaccurate in others. It is accurate in how it coalesced in Teddy, or Laeddis, being that he watched his three children be murdered and burned his wife alive. That would absolutely qualify as a stressful experience. From a Freudian perspective the total loss of self-identity could be construed as an alternative to suicide. The movie also gives a subtle nod to the notion that Laeddis was malingering the whole time, which may be the case for many people claiming to forget an event. When he is taken to be lobotomized, Teddy turns to Aule and says “Which would be worse–to live as a monster or to die as a good man?” possibly indicating that he was, in fact, aware that he was Laeddis but simply couldn’t stand to bear what he’d done.
Shutter Island is inaccurate in portraying Teddy as having waking visions. Psychogenic amnesiacs do not report to have such visions. It is also inaccurate in depicting Teddy as unable to form new memories as Cawley reveals to Teddy that he had already conducted the same investigation several times over and he would be lobotomized if he didn’t snap out of it this time. Someone with psychogenic amnesia would be able to remember any events following the stressful episode.
50 First Dates – Drew Barrymore as Lucy Whitmore – Anterograde amnesia
In 50 First Dates Henry Roth, played by Adam Sandler, happens upon a woman, Lucy, in a cafe and introduces himself. They immediately hit it off and when breakfast is over they plan to meet again at the same place the next morning. Henry shows up as planned but when he approaches Lucy she claims to have never met him before. Obviously, Henry is confused, but the restaurant owner Sue explains to him that on October 13th of last year Lucy got in a horrific car accident that rendered her unable to create new memories and so she wakes up every morning thinking it is October 13th. Her father and brother can’t bear to see her relive the accident every day so they follow a script where they place a newspaper from October 13th out, watch the same old Vikings game, and even refill her shampoo bottles.
Henry is not perturbed by the news and courts Lucy anyway. When Lucy’s father and brother find out what Henry is doing they tell him to stop seeing her. Again, Henry isn’t perturbed and begins fabricating reasons to run into Lucy like his car breaking down or setting up a fake road block. The father and brother pick up on Henry’s antics after some time as Lucy would always sing “Wouldn’t It Be Nice” by The Beach Boys on days when she saw Henry.
Henry decides to make a tape for Lucy explaining everything that has happened and shows it to Lucy. She is hurt but then decides to move on and that Henry needs to move on as well. He is upset, but grudgingly agrees and destroys all the records of his past with Lucy. When he is preparing to leave on a sailing trip, however, Lucy’s brother tells him that she is living at a brain institute and sings often and then gives him a Beach Boys CD. The CD convinces Henry that Lucy remembers him and he goes to her to discover that she has been dreaming of him and painting him even though she doesn’t realize who it was. The movie ends with Lucy waking up on a boat to a video of her wedding with Henry.
The symptoms Lucy exhibits in the film correlate mostly with anterograde amnesia. This particular type of amnesia constitutes the inability to form new memories of events occurring after brain damage. Research has revealed that damage to the hippocampus, thalamus, and mammillary bodies will result in anterograde amnesia. It will commonly manifest in frequent “awakenings” in which patient loses information as soon as focus is diverted.
50 First Dates illustrates anterograde amnesia surprisingly accurately relative to other Hollywood depictions of amnesia. Firstly, though, it should be noted that her condition was called “Goldfield’s Syndrome” in the film, which doesn’t exist at all, and that most people with amnesia live in a hospital setting due to the extent of how deeply anterograde amnesia interferes with one’s daily life. Besides those two points, however, the movie does a pretty good job.
Lucy living everyday thinking it’s the day she suffered the brain damage causing her amnesia is possible. Individuals with anterograde amnesia do create new memories but those memories cannot then be accessed, and Lucy therefore would only recall the day before her injury. This is contrasted by the character nicknamed “10 Second Tom” who, as him name indicates, could only hold onto memories for ten seconds before losing them forever. This discrepancy is validated by the type and extent of brain damage between the two characters. A real life comparison may be drawn with an English man named Clive Wearing, who could only remember things for 7 seconds.
Another thing from the movie that is in actuality possible is how Lucy would paint Henry without knowing who he was, even if it’s extremely cheesy. Anterograde amnesia prevents people from accessing memories but since they are still creating memories they are still affected by them. In Clive Wearing’s case he was told by his doctors to keep a journal. Clive would and even though he would say he knew not of any journal of his existing he did know it was kept. He also wouldn’t show any surprise or inability to recognize his wife even after 20 or 30 years. So in concept, Lucy could be able to paint Henry without realizing who it was.
In conclusion, Hollywood does tend to take certain artistic liberties when depicting individuals with memory deficits. They are able to due to a lack of understanding of the population at large and adding a few elements to an amnesia like waking visions or headaches only makes things more interesting to an ignorant audience. Some movies (Shutter Island) are worse than others (50 First Dates) but as amnesia will continue to provide intriguing material to directors we are sure to see many more movies centering on amnesias in the future.
Sources:
1. https://en.m.wikipedia.org/wiki/Dissociative_amnesia
2. https://en.m.wikipedia.org/wiki/Shutter_Island_(film)
3. https://www.psychologytoday.com/blog/psychologist-the-movies/201212/amnesia-in-50-first-dates
4. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC535990/?tool=pmcentrez
5. Diagnostic Statistics Manual
6. Kikuchi et al. (2009): “Memory repression: brain mechanisms underlying dissociative amnesia”
7. Yasuno et al. (2000): “Functional anatomical study of psychogenic amnesia”.
8. Kopelman (2000): “Disorders of Memory”.
9. Textbook.
10. Harding et al. (2000): “Degeneration of anterior thalamic nuclei differentiates alcoholics with amnesia”.
11. Deborah Wearing: “Forever Today: A True Story of Lost Memory and Never-Ending Love” (2005).
12. Nahum et al. (2014): “Neural correlate of anterograde amnesia in Wernicke-Korsakoff syndrome”.