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Mind in the Mediais an ongoing series discussing mental health and psychology topics in popular movies and television.
After falling from a boat and suffering a terrible injury that left her without any memory of her past, Sophie is trying to figure out who she was and whether her fall was really a suicide attempt like her husband James (Oliver Jackson-Cohen) and therapist Hannah (Marianne Jean-Baptiste) insist.
When the series starts, it’s been approximately five months since Sophie’s accident. Although her wounds have healed, her amnesia remains, and she’s becoming increasingly more desperate to remember. Sophie’s desire to recall who she was and why she jumped—or perhaps was pushed—from that boat, propel the story ofSurface.
But how accurate is the show’s depiction of amnesia? And is there any legitimacy to the concern that if Sophie learns too much about her past, she could attempt suicide again? We spoke to experts to understand what would happen if Sophie’s fall happened in real life.
What Kind of Amnesia Does Sophie Have?
Although the kind of amnesia Sophie’s suffering from is never identified inSurface, the clinical report Sophie accesses about her accident in the show’s first episode says she sustained a suspected brain injury and her husband and therapist indicate that they attribute hermemoryloss to this injury, indicating that they believe she has retrograde amnesia.
However, Peniston suggests that Sophie might instead be suffering fromdissociative, or psychogenic, amnesia, a kind of amnesia that occurs in response to emotional overload, not an injury.
Surfacecontinually provides clues about Sophie’s mysterious past, including the fact that Sophie is not the character’s real name and that she was very good at conning people to get what she wanted. Therefore, Peniston observes that if Sophie became caught up in a scheme that led to significant stress or trauma, Sophie’s memory loss might be the result of dissociative amnesia.
Dissociative Fugue: Symptoms, Causes, Treatment, Coping
Is Surface’s Depiction of Amnesia Realistic?
While it’s possible to identify the kinds of amnesia Sophie may be suffering from, ifSurfaceis understood as a portrayal of a character with retrograde amnesia, it’s not especially realistic.
NeuropsychologistLaurence Miller, PhD, of Boca Raton, FL, notes that the show’s depiction of memory loss following a brain injury “is exactly the opposite of what happens in a true traumatic brain injury.” In reality, Miller says, although Sophie would likely suffer from a brief period of retrograde amnesia for events that happened immediately prior to her injury, her bigger memory issues would come in the form ofanterograde amnesia, which would prevent her from forming new memories following her injury.
Based on this, it makes sense that Sophie doesn’t remember events right before she fell from the boat. Miller explains that before memories are stored inlong-term memory, they have to be consolidated, a process that takes a few seconds to approximately 15 to 20 minutes. However, suppose the consolidation process is disrupted due to an accident like Sophie’s. In that case, memories won’t be stored, leading to a loss of the memories of events that occurred just before the injury happened.
Laurence Miller, PhD[Sophie’s resulting situation] would require a brain injury so severe that other aspects of brain function would be involved. You’d be unable to think, your language would be disrupted, you’d barely be able to walk and function.
Laurence Miller, PhD
[Sophie’s resulting situation] would require a brain injury so severe that other aspects of brain function would be involved. You’d be unable to think, your language would be disrupted, you’d barely be able to walk and function.
Furthermore, Miller says that the longer the period of unconsciousness following abrain injury, the further into the past people will be unable to remember. In Sophie’s case however, the show establishes that she remembers being in the water immediately after falling from the boat and the paramedics rescuing her.
That suggests she wasn’t unconscious for a very long time and, therefore, she wouldn’t have retrograde amnesia that went back especially far in her life either. So while she might not remember making the decision to jump from the boat or falling afterward, she would likely remember almost everything else from the rest of her life.
If the injury impairs the parts of the brain that consolidate memories, that would lead to an inability to format memories in a way that would enable them to be stored in long-term memory.
As a result, Sophie wouldn’t be able to investigate the mystery of her past because she wouldn’t be able to remember anything she discovered.
However, according to Miller, Sophie would likely recover from this inability to make new memories, at least to some degree, although it could take anywhere from a few hours to a few months, depending on the severity of her injury.
Hollywood vs. RealityExperts agree that Surface’s depiction of memory loss is pretty inaccurate. In the case of a real-life traumatic brain injury, Sophie would not be able to make or store new memories, which would have hindered her search for truth following her accident.Additionally, given the course of events stated in the plot and her alleged retrograde amnesia, Sophie should have been able to remember previous events and elements of her life.That being said, it’s possible Sophie’s true diagnosis is dissociative amnesia, given the mysterious nature of the injury she sustain and the trauma she suffered.
Hollywood vs. Reality
Experts agree that Surface’s depiction of memory loss is pretty inaccurate. In the case of a real-life traumatic brain injury, Sophie would not be able to make or store new memories, which would have hindered her search for truth following her accident.Additionally, given the course of events stated in the plot and her alleged retrograde amnesia, Sophie should have been able to remember previous events and elements of her life.That being said, it’s possible Sophie’s true diagnosis is dissociative amnesia, given the mysterious nature of the injury she sustain and the trauma she suffered.
Experts agree that Surface’s depiction of memory loss is pretty inaccurate. In the case of a real-life traumatic brain injury, Sophie would not be able to make or store new memories, which would have hindered her search for truth following her accident.
Additionally, given the course of events stated in the plot and her alleged retrograde amnesia, Sophie should have been able to remember previous events and elements of her life.
That being said, it’s possible Sophie’s true diagnosis is dissociative amnesia, given the mysterious nature of the injury she sustain and the trauma she suffered.
Both Miller and Peniston concur that one of the most unrealistic parts ofSurfaceis the frequent runs Sophie takes.
According to the show, in addition to a brain injury, Sophie sustained multiple fractures and other physical injuries. Peniston points out that it’s highly unlikely that Sophie would be physically capable of taking daily runs just five months later. “There can be balance issues after a head injury, there can be motor planning issues, like not being able to plan the movements to run, so there’s a lot of things [about Sophie’s physical condition] that aren’t making sense.”
Similarly, Miller explains that while retrograde amnesia that totally wipes out someone’s autobiographicalmemoriesis possible, it’s exceedingly rare and “would require a brain injury so severe that other aspects of brain function would be involved. You’d be unable to think, your language would be disrupted, you’d barely be able to walk and function.”
Since Sophie’s physically able to take daily runs and isn’t neurologically compromised outside of her memory loss, the show’s insistence that Sophie has lost all her past memories but has recovered otherwise is entirely inaccurate.
From a neurological standpoint, then, Sophie’s memory loss may fit more comfortably with a diagnosis of dissociative amnesia, as Peniston noted.
That’s because just like Sophie, “in dissociative amnesia the person does actually act as if they have lost their identity," Miller describes, “and in most cases, the person is neurologically intact, and in many cases there isn’t even any accident to explain it, so it happens spontaneously. And it’s usually attributed to a person due to severe conflict, sometimes severetrauma.”
Consequently, althoughSurfacehas only hinted at any severe conflict or trauma that Sophie may have suffered, dissociative amnesia seems to do a better job realistically accounting for her condition.
Causes of Memory Loss
Would Sophie Continue to Be Suicidal After Losing Her Memories?
The possibility that Sophie attemptedsuicide—and that she will try again—hangs overSurface, and although the show eventually reveals the truth of what Sophie was really doing when she jumped from the boat, her husband’s and therapist’s worries about the possibility that she could attempt suicide a second time are well founded.
Laurence Miller, PhDThe best predictor of future behavior is past behavior. If somebody had a tendency towards suicidality prior to the injury, then generally that’s going to persist.
The best predictor of future behavior is past behavior. If somebody had a tendency towards suicidality prior to the injury, then generally that’s going to persist.
“The best predictor of future behavior is past behavior,” observes Miller. “If somebody had a tendency towards suicidality prior to the injury, then generally that’s going to persist. One of the ironies is [suicide attempts]… can leave the person with fairly serious brain injury. So now you’ve got somebody who was suicidal to begin with, and now they’re impaired.” That might increase someone’s depression further, increasing the likelihood that they’d attemptsuicideagain.
Ultimately,Surfacehas taken a certain amount of dramatic license with its amnesia-based plot that’s prevented it from shedding light on the realities of the condition. If the series is renewed for Season 2, perhaps it will provide both more information about who Sophie really was before her amnesia as well as a more realistic explanation for her memory loss.
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