Healing Traumatic Memories, Part 1

Can you really eliminate the fear and distress associated with a traumatic memory? Until recently, researchers weren’t sure, but significant discoveries are now improving the way therapists treat traumatic memories.

Extinction therapies such as prolonged exposure have long been the gold standard for treating fears, trauma, and phobias. However, people often drop out of exposure treatment before it is complete because the protocols require them to face their fears head on, which is dreadfully unpleasant.

More importantly, exposure therapies only seem to inhibit a learned fear temporarily, so there is always a chance the fear could get triggered again in stressful situations, or after a period of time has passed — a phenomenon known as spontaneous recovery (LeDoux, 2015).

Fortunately, brain researchers have found a way that you can permanently unlearn a fear and relieve the pain of a traumatic memory. But there are precise protocols you must follow to make the new learning permanent. In the following paragraphs, I’ll share three significant discoveries that are improving the way therapists treat traumatic memories.

Work Within Time Intervals

Every time you recall a fear memory, you have an opportunity to change it, but only if you insert new learning within 10 minutes to 5 hours of recollecting the memory. This process of recalling and updating a memory is called memory reconsolidation. After this 5-hour period, the window of opportunity to modify the synapses that contain the memory closes (LeDoux, 2015; Ecker, Ticic, & Hulley, 2012).

If you’ve successfully inserted new information into the memory during this time window, the memory will be saved in this updated form forever — kind of like updating a Word document on your computer and hitting “save.” If you don’t insert new information during the reconsolidation time window, the memory will stay the same.

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Reconsolidation differs from traditional exposure therapy in that you aren’t simply facing your fear over and over during this 5-hour window of time. You have to first recall the original fear memory while having a completely different experience that invalidates prior learning. Scientists call this a mismatch experience (Ecker et al., 2012).

Juxtapose Mismatch Experiences

A mismatch experience is any experience that would cause you to feel safe, empowered, or less threatened by the feared stimulus. To illustrate the difference between traditional exposure therapy and reconsolidation, let’s say you have a spider phobia. Using traditional exposure techniques you would gradually work your way up to being in the presence of a spider while training yourself to be calm.

Yet we now know that instead of completely erasing your fear of spiders, this process just creates a new memory that competes with the original memory (Naturevideo, 2009). You end up creating one memory in which your brain learns you’re safe when you’re around spiders voluntarily, but it will still be primed to send you into a panic if an 8-legged arachnid scurries across your desk unexpectedly.

In contrast, reconsolidation updates the original memory instead of creating two competing memories. For example, my client Carol had an extreme fear of the ocean because she witnessed her mother almost drowning in a rip tide. Interestingly, this event did not stop Carol’s mother from going back into the ocean. After the incident, Carol’s mother learned to get her body parallel to the beach and a few other skills to escape a rip tide, so she had no ongoing fear. She even taught Carol how to escape a rip tide. Yet, Carol continued to feel terrified of the ocean.

Carol tried to quell her anxiety with logical reasoning and visits to the beach. But, no matter how much positive self-talk and exposure therapy she tried, her mind was still haunted by the image of her mother getting swept up by the sea.

When we experience something shocking or traumatic, our minds tend to stop the mental movie of the memory in the worst place. Evoking a mismatch experience is a way of changing the event’s context and finishing the story with a new ending.

To create a mismatch experience for Carol, I first asked her to recall the memory of her mother getting caught in the rip tide. Then, I asked her to finish the story by vividly recalling her mother surviving the event, acquiring the skills to manage any future rip currents, and swimming comfortably in the ocean. Juxtaposing these two reveries side by side helped Carol’s mind update the original memory so it became less disturbing.

Treat Implicit and Explicit Aspects of the Memory Separately

Researchers have found you can’t just update a memory by simply reasoning through it verbally. According to Joe LeDoux, an affective neuroscientist at New York University and author of Anxious, you have to treat the implicit and explicit aspects of a memory separately because they are governed by different systems in the brain.

The explicit aspects of a memory include our verbal narrative and conscious thoughts about it, which are mostly governed by the logical prefrontal cortex. In contrast, the implicit aspects of a memory include the sensory, emotional, and behavioral responses that were activated during the original event, which are governed by the subcortical, emotional areas of the brain. These implicit aspects of memory often get triggered unconsciously when a person encounters anything similar to the original event.

For instance, if you had a car accident at a particular intersection while it was raining, then you may feel apprehensive driving in the rain; and you could feel particularly anxious when approaching the intersection where you previously had an accident. These implicit responses are meant to alert you to danger based on past experiences.

You could talk back to your negative beliefs and use positive affirmations like, “I can do this” to coax yourself through the intersection. But these verbal affirmations won’t erase the learned fear, because the part of the brain that governs implicit responses does not learn through verbal reasoning, it learns through felt experiences. Ultimately, to change a traumatic memory you have to simultaneously evoke an experience that elicits an empowering resourceful emotional state while recalling it, or something that counters the helplessness you felt during the original event (Levine, 2015). The emotional part of your brain has to feel it to believe it.

In part 2 of this article, I’ll share a simple 5-step protocol you can use to heal a traumatic memory and demonstrate how I applied it to help Carol overcome her fear.

In the meantime, if you’d like to learn more about memory reconsolidation, I’ve listed several great resources at the end of this article and detail a variety of creative strategies in my book, The Therapeutic “Aha!”: 10 Strategies for Getting Your Clients Unstuck.

References

Armstrong, C. (2015) The therapeutic “aha!”: 10 strategies for getting your clients unstuck. New York: W. W. Norton.

Ecker, B., Hulley, L. & Ticic, R. (2012) Unlocking the emotional brain: Eliminating symptoms at their roots using memory reconsolidation. New York: Routledge.

LeDoux, J. (2015) Anxious: Using the brain to understand and treat fear and anxiety. New York: Viking.

Levine, P. (2015) Trauma and memory: Brain and body in a search for the living past: A practical guide for understanding and working with traumatic memory. Berkeley, CA: North Atlantic Books.

Naturevideo. (2009, December 10). Erasing fear memories . Retrieved from https://www.youtube.com/watch?v=P42DyPRdTEA.

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