What if something terrible happened to you, and you werent able to remember it? Thats one of the questions at the center of Amy Griffins memoir, The Tell, which is quickly becoming one of the years most talked-about books.Griffins buzzy bestseller doesnt offer easy answers or tidy conclusions about its dark subject matter its authors sexual assault by a trusted teacher as a preteen which only seems to make her story about recovering harrowing memories of the abuse after trying psychedelic therapy all the more powerful for readers.Griffins status as a high-powered investor and Silicon Valley girlboss working with companies like Goop and Bumble gave her attention in high places. She has the support of book club titans like Oprah Winfrey, Jenna Bush Hager, and Reese Witherspoon. Elle praised the memoir as a new kind of story about abuse. According to Elle, it isnt a book about trauma, its an investigation of what happened to Griffin and of the ways that the pressure to achieve perfection damages girls and women. Kirkus Reviews summarized the book as an important, wholly believable account of how long-buried but profoundly formative experiences finally emerge. Yet at the books center is a particularly thorny issue: that of repressed memories, which are considered an impossibility by most research psychologists and neuroscientists but touted by many therapists who work directly with patients. A repressed memory is one in which, allegedly, a memory that previously didnt exist of a previously unknown experience suddenly appears. Such memories are routinely depicted as real throughout pop culture, and while The Tell confronts the possibility that they may be false, Griffin herself quickly loses all doubt. Add in the potentially dicey treatment that Griffin underwent: psychedelic MDMA therapy. Despite reportedly helping patients with trauma and PTSD, it has yet to win federal approval in the US. Technically, its illegal. As The Tell continues to dominate the New York Times bestseller list, how should we think about the less-than-legal therapy that inspired it and the splashy, concerning revelations that came next?The complicated therapy at The Tells core A lifelong runner, Griffin uses her hobby as a metaphor for the pressure she places on herself, not only to succeed but to avoid confronting her own trauma. This is how she pushes through her overachieving childhood; through a horrifying date rape in college; through a busy life juggling work, home, and family. But all this running isnt just toward the next achievement its away from something deeper she just cant name. At one point, her then 10-year-old daughter tells Griffin that she and her sister dont feel connected to her. We dont feel like we know who you are, Griffin recounts her saying. Youre nice, but youre not real. This rejection inspires her to look deeper within, and her husband John introduces her to the therapist whose MDMA sessions hes benefited from. Over the last decade, alternative drug therapies like MDMA, ayahuasca, and a litany of other psychedelics have exploded in popularity, though as yet none are FDA-approved. Despite ethical concerns (as well as cult comparisons), the psychedelic movement continues to grow, mainly among privileged, often white people with access to the black market and money to afford therapy sessions that can run into the thousands of dollars. For most people, if theyve even heard of psychedelic therapy, its still a mysterious and exclusive club to which The Tell offers a rare amount of access.Rebecca Lemov, a historian of behavioral science and author of the new book The Instability of Truth: Brainwashing, Mind Control, and Hyper-Persuasion, points out that theres a clear appeal to psychedelic therapy: Im sure the drugs make it more fun, Lemov said, and especially if youre experiencing PTSD, you probably are thinking, the least I can have to deal with this is a little bit of ecstasy.MDMA therapy proponents proclaim that the drug promotes empathy and well-being, which has benefits for PTSD treatment. Though the treatment came remarkably close to FDA approval, the fact it was being considered was a step forward that underscores its growing popularity. Research indicates that it can induce vivid memories and can help patients revisit their traumatic experiences without any accompanying fear or anxiety. Generally speaking, though, MDMA therapy is thought to help patients process difficult memories, not recover them.Typically, prior to the actual therapy session, patients will have a few preparation meetings where their therapist sets their expectations about the drug. Griffin tells the therapist shes talking around something, saying, I dont know what it is. Its like I cant remember. Or maybe I dont want to remember. In her own telling, its not clear whether she actually even needed the drugs to recall the memory or whether, as her longtime friend Gwyneth Paltrow recently suggested to her, things in her life had just aligned at the right time.Before the drugs have even kicked in, were told, Griffins mind supplies her with a visceral flashback of being sexually assaulted by a trusted middle school teacher. Although Griffin is initially horrified and confused, she returns for further sessions, uncovering more memories of what she claims was a prolonged period of abuse that lasted through part of middle school and then recurred once more during her teen years. While the flashbacks themselves are harrowing, she describes her encounters with them as deeply cathartic, writing, I did nothing wrong. I exhaled, accepting it. This all happened.The science and messy reality of repressed memoriesIts clear from The Tell that Griffins revelations are a relief to her, and her self-conception as a survivor is firm. But the science on recovering events from the past is less certain. We owe the concept of repressed memories to who else? Sigmund Freud. In the late 1890s, Freud developed a theory that children could recall forgotten traumatic memories with therapeutic coaxing. However, he soon abandoned that theory, later writing that while the children he studied were remembering a variety of lurid scenes, I was at last obliged to recognize that these scenes of seduction had never taken place, and that they were only phantasies which my patients had made up or which I myself had perhaps forced on them. Fast-forward to the late 1970s and 80s, when psychotherapists returned to Freuds abandoned theories. As psychologist Richard Beck details in his book We Believe the Children: A Moral Panic in the 1980s, they were looking to explain what they claimed were thousands of Satanic ritual abuse and extreme domestic abuse cases being recalled by their patients. Today, its well-known that memory can be extremely malleable, and we now know these particular claims to have been entirely manufactured as part of a widespread cultural hysteria. Yet many of the therapists who perpetrated the Satanic Panic continue to have influence. Some, like the controversial therapist group International Society for the Study of Trauma and Dissociation, still fixate on likely fictional causes of trauma in children such as mind control and organized ritual abuse. And many of the pseudoscience-based therapy techniques of the 80s, such as hypnosis, are still with us today. The Tell which arrives with an avalanche of stories mainstreaming the idea of repressed memories appears at a moment when pseudoscience, conspiracy theories, and debunked medical techniques are all making an aggressive resurgence.The focus on trauma as the pivotal underlying cause has continued to dominate the publics understanding of memory loss. And that makes sense after all, amnesia and other kinds of memory blackouts are real; why wouldnt repressed memories, sometimes called dissociative amnesia, function in a similar way?Because memories arent made that way, explains Lawrence Patihis, a scientist specializing in memory reliability. Scientific research has shown that people who experience traumatic events are more likely to remember them with full accuracy, not less. While many therapists roughly half of licensed psychologists in one study believe in the possibility of recovered memories, the scientific evidence for it just isnt there. Reliable science on memory, Patihis emphasizes, comes from cognitive psychology and extensive, well-defined quantitative data using random subjects in large-scale experiments, rather than individual case studies. The good science is slow, he said. Its careful. Its also consistent with research on other areas of memory.The research shows what is likely to happen when a person experiences trauma, Patihis said: It tells us, first of all, it will be well remembered. Second of all, PTSD symptoms will be highest immediately after the trauma and fade over time. It is not the case that PTSD will suddenly occur in 2020 when somebody starts going to therapy. That is a bad sign. Thats not how real trauma works. Patients with PTSD can lose track of their traumatic memories over time and then remember them but, Patihis emphasizes, thats not a repressed memory, its a forgotten one. Recent research has found that memories are inscribed as neural patterns that can be overwritten. Traumatic memories are typically quicker to form neural patterns than other memories and theyre harder, not easier, to overwrite. Whats likely happening instead is that a combination of factors, probably different for every individual, are leading the patient to believe theyve had a memory when they havent, or believe a memory is newly revealed when its not. In the case of drug-assisted therapy, they could easily mistake a hallucination for a memory. And its also always possible that they could simply not be telling the truth, either about the memory or the idea that they had not previously recalled it.Why we cant totally ignore repressed memory claimsSimply dismissing all instances of repressed memories, however, gets complicated. For one thing, repressed and recovered memories can frequently play a role in peoples experience of dissociative identity disorder, which, while not well understood, reportedly impacts millions of people. For another, despite the research of scientists like Patihis that casts doubt on memory repression, the psychiatric Diagnostic and Statistical Manual of Mental Disorders, the DSM-5, includes dissociative amnesia as a reason why trauma survivors may forget key aspects of their trauma. Its inclusion is a sign of its increasing acceptance among practicing clinicians. Another ongoing concern is simply the power and importance of a narrative like Griffins. If we adhere to science that undermines survivors experience of their abuse, who is that science really serving especially given that survivors are frequently disbelieved to begin with? What if the abuse is real, even if the specific memory isnt? And if we truly want to believe abuse survivors, how do we reconcile a claim like that of Griffins with the refuting science? Patihis acknowledges those are difficult questions but for him, at least, the science is clear that trauma and memory repression arent inherently linked. I think theres a correct answer scientifically to whats going on with memory, he said, and the idea of repressed memories being reliable when they come back is not correct. Patihis stresses that the idea of having and then overcoming a repressed memory through therapy is popular because theres a promise of cure. Theres hope, and its popular because a lot of people come to believe it. Thats not easy to discount, and Lemov, the historian and author, isnt sure we should. The author of The Tell reports profound healing from this experience, she said. I would want to [ask], Can I open up a space for not knowing? Affirmation is one of the keys to successful therapy, after all, and its significant that therapists, who have more direct contact with patients than researchers, are more likely to embrace their clients realities. While Patihis holds that the best therapeutic results belong to patients who abandon their belief in repressed memory, the therapeutic process is what matters.I think clinicians have a responsibility to inform clients that memory distortions are possible in therapy, and then just let the client come to their own conclusion, he said. And also, if they dont come to that conclusion on their own that is, that repressed memories are not a real phenomenon you have to continue to do good therapy.And that, he added, is so difficult. The conversation poses new questions for him as a researcher: If I were a clinician and somebody brings to me memories that could be false, do I work with them through those memories as if they were real trauma? Oh my gosh. That this core uncertainty lingers despite the knowledge that repressed memories have little scientific backing illustrates the complicated nature of therapy in an age where we know both more and less than ever.See More: