New insights into memory are helping to explain treatments for serious problems, and guide us to making them better. Many psychotherapies use the one-two punch of targeting (focusing on a memory or other source of anxiety, flash backs, or related symptoms) and state change (the best-known being relaxation, as in systematic desensitization, and bilateral stimulation in EMDR). Now, researchers are exploring other ways to accomplish this, and they are being guided by new insights into how memory works.

The theory in play is that memories are more vulnerable to change when they are brought to mind, and they can be connected with different feelings most readily at that time. There is a window of time, perhaps 10 hours, for this, but in psychotherapy, the work is done at the same time. Thus, if a veteran’s flashbacks are depriving them of sleep, the understanding is that those flashbacks are encoded with intense emotion that can be changed. The memories can go from stormy and tormentous to significant and meaningful. For trauma therapists, this is a very familiar process, and they are very intuitive about doing this work.

There hasn’t been a popular word for this experience, so I coined the term “shimmering” for it. I teach people a version of this targeting/state change under that generic term. The professional terms related to this include desensitization and reprocessing, and memory reconsolidation.

It’s becoming more obvious why there are so many variations of this process, and why they can be found in numerous approaches to therapy, and countless processes and rituals found in cults, personal growth programs, and religions. The difference is that, instead of intuitively stumbling into it, we can continue to improve upon this through research and application. Joseph Wolpe, MD, really got the ball rolling in 1955, and now, 57 years later, this is headed for a new level.

Essentially, we’re talking about altering memories while they are volatile so they can be reconsolidated in long-term memory without disturbing emotions or destructive unconscious beliefs attached. There is reason to believe that matching the stimulus with the main sense modality that is disturbing will be an improvement on existing protocols. So, if the person has intrusive visual memories, using a visual stimulus while the person recalls the memory would be more effective than a sound.

I think it’s sad that, with such a great need for continued improvement in PTSD treatment, there are studies with veterans being published that still use longer, more arduous treatments such as prolonged exposure (where there is no sophistication regarding using state change such as relaxation in order to make the treatment less traumatic and prolonged — they even use the word prolonged in the name of the therapy. How’s that for being stuck in a paradigm?)

Now, researchers are even exploring Tetris as a stimulus.

Reference

Holmes EA, James EL, Kilford EJ, & Deeprose C (2010). Key steps in developing a cognitive vaccine against traumatic flashbacks: visuospatial Tetris versus verbal Pub Quiz. PloS one, 5 (11) PMID: 21085661

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