Cutting Edge Psychology

Psychotherapy for PTSD changing memories

Posted on December 13, 2013 at 4:35 PM

Accelerated Resolution Therapy (ART) is being touted as a new treatment approach to PTSD which research is showing to be highly effective for sufferers, including combat veterans. It shares many features with EMDR in that it re-activates the memory of the distressing event, including the emotional and physiological components. It then provides the person with bi-lateral stimulation (eye movements) which usually has the effect of settling and calming the physiological response to the unpleasant memory. In the third phase, it utilises the 'plastic' nature of memory reconsolidation to 're-write' the memory according to what the person would have preferred to have happen (rather than what did happen). I have used this approach with traumatised clients (under the EMDR rubric) and seen it to be entirely effective in resolving the trauma.


How can this be? Surely, just engaging in a fantasy about a preferred experience can't dislodge the emotional damage of what actually did happen? Well, as it turns out, the nature of memory is really quite different to what is commonly assumed. There is a tendency to think of memory as being like a video recording of an event- we need to just press the 'play' button, and the record is presented for us. In reality, memory is actually a highly creative process. Each time we engage with a memory, our mind/brain is reconstructing an internal representation of what happened, using a bunch of different elements to construct a coherent picture of the event. For example, if you remember lying on the beach while enjoying an icecream, there are a range of brain areas that become reactivated to allow you to reconstruct the experience (the memory). Your auditory centres will reconstruct the sound of waves crashing on the beach, seagulls squawking and kids playing. The parts of your brain that process tactile sensations will reactivate the feeling of the sun's warmth on your skin. The taste areas of your brain may reactivate the taste of the icecream and salty sea air. And if you found this to be a pleasant experience, your emotional centres will reactivate the sensation of pleasure. When we remember the experience, our mind/brain is actually re-writing the experience, like a re-writeable DVD.


The emotional flavour of the experience (pleasant/unpleasant) is also re-written into the memory, and the mood you are in at the time of the memory reconstruction also gets built into the reconstruction of the memory. If you layed on the beach on Saturday, enjoying the icecream and sunshine, and you meet a friend on Sunday who asks you what you did yesterday, the mood you are in at the time of remembering will become factored into the memory. If on Sunday, you are in a happy mood, then this happiness gets built into the memory- so when you next remember Saturday's experience (say, on Monday), you arent actually remembering what happened on Saturday, but you are remembering the last time you remembered what happened on Saturday (ie. you are remembering your memory recall of it on Sunday). The mood you were in on Sunday gets built into the reconstruction of the memory. If you are in a bad mood on Monday when you remember the expereince of Saturday, then the next time you recall your beach expereince (say, on Tuesday), the foul mood of Monday will also become factored into the memory reconstruction- so that when you next remember it on Wednesday, it will seem like an unpleasant memory.


This is the creative and up-dateable nature of memory. And this this why approaches like EMDR therapy and ART are able to create lasting changes in people's trauma. Having a terrible memory reactivated, then being physiologically/neurologically calmed with bi-lateral stimulation (see my article 'Inside EMDR' on my EMDR page as to why this would work), and then having a preferred scenario mentally experienced by the person creates a different emotional response- perhaps one of relief, a sense of mastery, control or personal power- which then gets factored into the memory reconstruction. As an example, i recently suggested to a PTSD sufferer, during this process, to imagine himself having any super-human power of his choice to prevent the bad event from happening. He saw himself throwing the perpetrator a great (and safe) distance away, preventing the bad event from happening. This gave him a sense of power and control in a situation where none had been present. As a result, he felt empowered and relieved when in touch with the memory (as opposed to vulnerable and anxious). These more positive feelings subsequently stayed with him in situations which previously had triggered his trauma- it worked, and he no longer presented as a person suffering from PTSD. The neuroscience behind this is a process called memory reconsolidation. For more details on this, again, see my article 'Inside EMDR', and also open the Coherence Therapy page.


Research on ART has recently been published, showing its effectiveness in relieving the suffering of PTSD. Sadly, while it is well demonstrated that processes like EMDR and ART work at relieving PTSD, most military personnel suffering from trauma are simply put on psychiatric drugs. This year, the World Health Organisation stated, based of research evidence, that there is no drug treatment that has been proved effective for trauma, and that EMDR should be considered a first line treatment option. In America, around one former service-person per hour kills themselves. It is well demonstrated by the study of pharmacogenetics that a significant part of the general population are not able to adequately metabolise psychiatric drugs like anti-depressants, and will suffer as a result. Suicidal ideation and feelings,agitation, increased anxiety and sleep disturbance are some of the adverse side effects for many people.See my Frequently Asked Questions page ('What is pharmacogenetics?') for more details on this.


Read about the ART research results:-

http://www.sciencedaily.com/releases/2013/12/131209160813.htm#.UqbvI5B0oG0.email


and listen to an interview regarding this research:-

http://acceleratedresolutiontherapy.com/

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