Well-Being

Unforgettable? Not Necessarily.

yenwen / iStock

yenwen / iStock

COPING WITH BAD MEMORIES that interfere with daily life is a hot topic, whether the memories concern traumatic stress or mere misery.  During one week this May, major articles on the subject appeared in two top publications but covered opposing camps. A story in The New Yorker focused on approaches to interfering with or erasing the memory, while The New York Times Magazine described psychomotor therapy to plumb the emotions attached to it. Research is underway in both areas, with no certainty yet about which will prove more effective in the long run.

In the process of recalling an old memory, it is possible to change that memory in order to eliminate the fear attached to it, explained McGill University psychology professor Karim Nader  in The New Yorker article. The very act of remembering makes memory vulnerable to change.

Exposure therapy, which has been widely practiced in the United States to help with Post-Traumatic Stress Disorder (PTSD) as well as with phobias and addiction, involves recreating the trigger (for vomiting phobias, it might be videos of vomiting; for addiction, the place or people connected with the desire or its pleasurable relief) in the presence of a positive experience, often simply the absence of a negative one.  The old memory becomes “reconsolidated” with the new experience, and thereby separated from the fears or other negative effects of the original experience.

Nader first tested his theory on rats using a drug that interfered with recall.  Rats were trained to connect a tone with fear of being shocked.  Two weeks later, within four hours of hearing the tone without receiving the shock, they were given a drug that erased their fear.  At Mt. Sinai Hospital in New York, psychologist Daniela Schiller tested Nader’s results on people using a behavioral method called “extinction training,” similar to exposure therapy.  People were trained to associate a picture of a colored square with the fear of being shocked, and afterwards were shown the picture minus any shock several times in a row.  Timing was crucial: people who were shown the square with no shock, and then shown it again within ten minutes were able to forget the fear completely.  But people who saw the square with no shock, and then didn’t see it again for several hours remained fearful.

Early research showing that memories can be manipulated came from Elizabeth Loftus, now at the University of California at Irvine.  Loftus gave subjects a journal that described three detailed events of their childhood, based on interviews with friends and family, along with one fictitious event.   Later, one fourth of the subjects recalled the fictitious event as true, and some added “remarkable detail,” leading Loftus to conclude that memory “works a bit more like a Wikipedia page…You can go in there and change it, but so can other people.”

In both the U.S. and China, reconsolidation has worked very well with drug abusers, the idea being that “you cannot be addicted to a desire that you don’t remember,” according to The New Yorker.

Proponents of the alternative “psychomotor” techniques are vehemently opposed to exposure and extinction therapy, as well as to the similar and also popular, Cognitive Behavior Therapy (CBT).  Exposure therapy works less than half the time, and even then doesn’t provide true relief, Boston psychiatrist Bessel Van der Kolk told The New York Times.  Van der Kolk prefers what is often referred to as the Pesso-Boyden method, named for its founders.

This method involves recreating the original trauma in a group setting by arranging for others to play the roles of the people who were originally involved.  To help a soldier who suffered from PTSD after seeing a mother weep over her son whom he had just shot, participants played the role of the mother, of the son and of others involved.  The rest of the group watched and acknowledged the soldier’s emotions to validate them and to provide a new sense of security to the soldier.

Van der Kolk believes psychomotor therapy works because, he told the Times, “Trauma has nothing whatsoever to do with cognition…it has to do with your body being reset to interpret the world as a dangerous place.”  His contention is supported in part by the number of physical ailments, including headaches, fatigue and digestive troubles, that plague PTSD sufferers.  Van der Kolk also believes in using other body-centered methods such as yoga, acupressure and Eye Movement Desensitivation and Reprocessing (EMDR). In the latter, using a moving light, vibrations or the therapist’s wiggling finger during the sufferer’s retrieval of the memory helps them process the scene so that it is no longer traumatic.

Psychomotor therapy, however, is hard to find outside of a few centers, whereas exposure therapy and CBT are much more widely available from therapists in the D.C. area, who specialize in these or at “anxiety” treatment centers.

–Mary Carpenter

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