BS: Removing memories to treat trauma

Subject: BS: Removing memories to treat trauma
From: freda underhill
Date: 23 May 04 - 10:15 AM

Doctors are experimenting with a drug called propranolol to see if it can heal trauma by removing painful memories. Here are excerpts from an article in favour of the treatment:

Nightmares, violent flashbacks, and an inability to simply forget painful memories for even a moment, these are some of the consequences of experiencing a trauma. Scientists are getting closer to methods to erase memories. The process is referred to as "therapeutic forgetting".

As research advances so do the debates on the ethics of the process. Therapeutic forgetting has opened a discussion among policy makers, scientists, and those who suffer from horrible memories. If successful, drugs that alter memories could help suffers of Post Traumatic Stress Disorder. However if abused the same medication could change the way we process emotional pain and hinder our ability to work through bad memories.

Post traumatic stress disorder, a disorder which often occurs in people who live through a traumatic experience, can be debilitating at its worse. Individuals with the disorder often times relive their traumatic experience through dreams and flashbacks of their violent memories (6). The psychiatric disorder is often associated with Veterans of War but its effects are felt by many survivors of traumatic experiences. In the most severe cases PTSD can be incapacitating because of the frequent flashbacks.

Recent research has shown that the ability erase or at least decrease the intensity of painful memories may soon be possible. One study led by Roger Pitman, of Harvard Medical School, tests the ability of the drug propranolol to impact the hormones involved with painful memories. This theory is based on the concept that painful memories become predominate in the mind. Adrenaline and norepinephrine are produced during a stirring experience. These homomones are believed to increase the ability of the brain to grab onto and hold a memory. As a traumatic experience is particularly stirring, memories from these experiences can be particularly haunting. The drug propranolol, once used to treat heart problems, goes to the brain and interferes with adrenaline and norepinephrine production. Pitman believes that when used immediately after a trauma the drug could help people deal with negative experiences.

Many bioethicists believe that using medication to forget is unethical. Life is about overcoming obstacles and by overcoming or learning to deal with the disorder individuals are learning how to adjust to a problem. How can individuals have empathy and understanding of emotional pain if their painful memories are dulled? Also the effects of propranolol for example are not limited to negative memories. A stirring memory that is positive could also be faded.

In October of 2003 the Presidents Council on Bioethics commented on drugs meant to help people forget trauma saying, "they could also be used to ease the soul and enhance the mood of nearly anyone". The Council then argues that the use drugs would then open a new market to help people avoid unpleasant thoughts which allow "our pursuit of happiness and our sense of self-satisfaction [to] become increasingly open to direct biotechnical intervention"(1). For these reasons the Council opposes the pursuit of therapeutic forgetting until further regulations are established.

Despite the opposition to therapeutic forgetting it is difficult to explain why individuals should be forced to relive negative experiences with flashbacks and dreams that are debilitating. Certainly the risks the Presidential Bioethics Council cite are valid but the benefits for PTSD patients are crucial. In addition, many Veterans argue that those with PTSD, as a result of combat in a War supported by the government, should be supported by politicians. Some of this support can come in the way of encouraging researchers to continue researching therapeutic forgetting. Argument that memory alteration is unethical and dangerous because it could be used unnecessarily have some validity. However, some memories such as those that cause PTSD are so hash that no person should have to live through them once let alone multiple times in flashbacks.

Altering memories is a particularly interesting subject because its possibilities are so varied. In the case of therapeutic forgetting, however, it is important to remember that this treatment could not make a person completely remove a memory. It could only soften the intensity of the traumatic experience. Studies on these should continue so that we can one day look forward to avoiding PTSD. No one is suggesting that the drugs be used to avoid all emotional pain, but rather that they be used to aid those people who would otherwise be disabled by traumatic memories.

http://serendip.brynmawr.edu/bb/neuro/neuro04/web2/mbond.html

what do you think, is it ethical?

I'll post the opposing view too.

freda

Subject: RE: BS: Removing memories to treat trauma
From: freda underhill
Date: 23 May 04 - 10:22 AM

Experiments indicate propranolol also blocks the effect of adrenaline upon areas of the brain involved in memory formation, including the amygdala. It seems to disconnect emotion from memory.
In a study conducted by Larry Cahill, a neurobiologist at UC Irvine, McGaugh and others in the late 1990s, test subjects were told an emotionally neutral, comparatively boring story illustrated by 12 slides. A second group of subjects was then shown the same 12 slides. The related story, however, was much more emotional, involving a severely injured boy.
When later asked what they remembered seeing in the pictures, subjects in the second group recalled much greater detail about the story than the first group did about theirs.
Cahill and McGaugh then presented the second, emotionally upsetting story with slides to a third group of volunteers who were given a standard dose of propranolol or endurol (another beta blocker). Their memories, when tested three weeks later, were "just like that of subjects who had received the boring story," said McGaugh.
Subjects remembered the story, but without any emotional depth.
Such findings suggest an obvious potential therapeutic benefit: If people who have just experienced a traumatic event could be given a memory-dampening drug like propranolol, they might avoid suffering later psychic damage, such as post-traumatic stress disorder or PTSD.

Subject: RE: BS: Removing memories to treat trauma
From: freda underhill
Date: 23 May 04 - 10:24 AM

"Let me give you an example from the 1978 PSA (plane) crash in San Diego where they made the horrible mistake of sending out desk people and baggage handlers to clean up body parts after the crash. Later, there was a follow-up report that said a very high percentage of those people were never able to work again. They had been permanently disabled because of the trauma.
"Now, that's PTSD to the nth degree, that would be a case in which something like (a memory-blunting drug) would be of value."
Two subsequent studies reinforce the potential efficacy of using beta blockers to blunt memory. In a 2002 pilot study, Roger Pitman, a professor of psychiatry at Harvard University, recruited 31 people from the emergency room of Massachusetts General Hospital who had just been involved in a traumatic event, typically an automobile accident.
Some of the study volunteers were treated with propranolol for 10 days after the trauma; some received a placebo. Evaluated one month later, none of the subjects treated with propranolol had a stressful physical reaction to re-creations of their traumatic event, while six of the 14 subjects treated with a placebo did. A similar 2003 study, conducted at two French hospitals, produced analogous results. Larger studies are being planned.

Subject: RE: BS: Removing memories to treat trauma
From: GUEST
Date: 23 May 04 - 10:26 AM

Propanolol has been used for many years to treat high blood pressure, it comes with a long list of side effects and contra-indications.

All sounds a bit spooky to me though, memory altering, removal or implanting. Very CIA.

Having said that it is used to treat hyper-tensives, surely then if they used it daily for long periods then sooner or later they would forget to take it and be back at square one.

Subject: RE: BS: Removing memories to treat trauma
From: freda underhill
Date: 23 May 04 - 10:27 AM

here's other concerns..

Despite its therapeutic potential, some people are wary of memory-altering drugs. Chief among them: the President's Council on Bioethics, an advisory group of doctors and scholars formed in 2001. In its report, the council worries that dampening painful memories – or in the future, erasing them altogether – may disconnect people from reality or their true selves.
"The use of memory-blunters at the time of traumatic events could interfere with the normal psychic work and adaptive value of emotionally charged memory," the council wrote. "A primary function of the brain's special way of encoding memories for emotional experiences would seem to be to make us remember important events longer and more vividly than trivial events."
In other words, emotional memories, however painful, serve a purpose. We remember memories linked to emotions longer and better because they help us learn, adapt, survive. Early hominids needed to know and remember that lions were dangerous. Modern children burn their fingers on a match and learn that fire hurts. We all learn to avoid bad things by remembering bad experiences.
Council members fret that dampening traumatic memories with beta blockers may short-circuit "the normal process of recovery," that in some way it may diminish our character or our personal development. Blocking emotional memories, the council asserted, risks "falsifying our perception and understanding of the world. It risks making shameful acts seem less shameful, or terrible acts less terrible, than they really are."
"It's the morning-after pill for just about anything that produces regret, remorse, pain, or guilt," said Dr. Leon Kass, who chaired the President's Council, to the Village Voice last year. (Kass noted he was speaking as an individual, not on behalf of the council.) The council expressed a host of concerns and troubling scenarios.
For example, the council posited, what if somebody committed an act of violence and then took propranolol to dull the emotional impact. Would they come to think of violence as more tolerable than it really is? Would rape victims, having taken memory-altering drugs to ease their trauma, forget key details vital to the prosecution of their attackers? More broadly, is there a social obligation for people to remember the past events for the communal good, such as victims of the Holocaust?
"The impulse is to help people to not fall apart. You don't want to condemn that," said Kass. "But that you would treat these things with equanimity, the horrible things of the world, so that they don't disturb you ... you'd cease to be a human being."

more at http://www.cognitiveliberty.org/neuro/memory_drugs_sd.html

Subject: RE: BS: Removing memories to treat trauma
From: Rapparee
Date: 23 May 04 - 10:42 AM

I'm against the use of the drug for memory "removal."

Where would such use stop? With being raped while watching your children hacked to death? With a firefighter who rescued a child, only to have the kid die in his/her arms? With holding your dying best friend? With someone involved in a minor traffic accident? With failing a test in college? With a splinter?

It seems to me to be a more acceptable form of electroconvulsive therapy.

Yes, some people might need it or other things. With most, acceptance and therapy comes with talking, with living. NEVER forgetting, but with, oh, let's call it cleansing and acceptance.

Dispassionate art? Wilfred Owen's poems without feeling? Duncan's photos of Khe Sahn without his disgust? "Guernica" without passion?

Subject: RE: BS: Removing memories to treat trauma
From: Amos
Date: 23 May 04 - 11:36 AM

Seems to me the big thing being missed here is the possibility of confronting the painful memory to the degree needed to make its contents non-aberrative. The only difference between a memory of--say--sharing a chocolate soda and one of being slapped hard ion the face is the degree to which the owner is willing to be there with the memory, understand its, time-tag it correctly and see it as it is. The problem with traumatic memories is the unwillingness to do this.

Kass' remarks are germane but you have to distinguish between the appropriate (meaning responsive to the reality) emotions of the incident when it is happening, and the real problem caused when the memory reappears uninvited, replete with overhwleming emotions, and is simultaneously generated and abhorred. That dual action of generating the memory blindly (because, usually, of some present-environment similarity to something in the picture) and fleeing from it, is what creates the aberrative power of painful memories. Dicking with the brain isn't the right answer. Bringing the individual to be able to confront the memory without flinching is the right answer, IMHO, because ity leaves a stronger individual, someone who has overwhelmed the memory rather than be overwhelmed by it, through his own ability. Doing it with chemical magic is a cheap and tawdry second.

A

Subject: RE: BS: Removing memories to treat trauma
From: wysiwyg
Date: 23 May 04 - 12:21 PM

Effective drug-free natural process for healing painful memories:

www.rc.org

~Susan

Subject: RE: BS: Removing memories to treat trauma
From: Peace
Date: 23 May 04 - 04:57 PM

We carry memories of damn near everything that has ever happened to us within the ken of our senses. Maybe even some memories we don't know about.

In the past two days I have helped with three Motor Vehicle Collisions. The patient count--that is, people needing ambulance transport to hospital--is nine. No deaths as yet. I always thought I'd become inured to the sight of trauma victims, but two from the past stay with me. There was nothing that different about them, because we deal lots with death. Just something about them that stuck. We undergo CISD after very bad calls, but sometimes it's the sound of a person in pain, a few words, or a look that stays. Rough as all that can be, and lots of people on the 'cat have been through similar stuff, I wouldn't want some hotshot with a hypo ridding me of memories. That just don't strike the right chord for this old boy's melody.

Subject: RE: BS: Removing memories to treat trauma
From: McGrath of Harlow
Date: 23 May 04 - 05:44 PM

This makes me think about how lobotomy was introduced, with very similar reasons given. Or electro-shock treatment. This seems like a chemical version of the same thing.

And like those predecessors if it catches on it'll be used for a far wider range of problems, and eventually rejected and abandoned by the medics. Leaving a whole range of people with memories permanently screwed up. People with emotions without the memories that explain the emotions, people with the memories but without the emotions that belong with them... Even chemically induced psychopathy.

We just aren't within sight of knowing enough about how the human mind works to be able to responsibly risk this kind of thing.

Subject: RE: BS: Removing memories to treat trauma
From: Uncle_DaveO
Date: 23 May 04 - 05:57 PM

Propanolol, in much lower doses than what is presumably used for these memory matters, has another use, of much more direct relevance for performers, musical and otherwise.

Stage Fright. One propanolol pill an hour before what is expected to be a stressful appearance will help big-time.

Now, before someone says, "I don't want to be drugged up when I sing," or "I don't want to lose my edge," or "I don't want to get hooked on drugs," or the like, let me tell you:
A. It's not habit-forming.
B. It does NOT dull your senses.
C. Neither does it make you play/sing/act any better; it only keeps the nervousness from causing tremors, clumsiness, etc. It just lets you play/sing/act as well as you have already learned to do.

One does not become dependent on propanolol used in this way. From what I've read and from my own experience and that of my Beautiful Wife, a professional pianist, only on the first, maybe second or so event is it necessary. The explanation seems to be that on repeat occasions the performer comes to the stage without so much anticipatory fear, and thus has less need of help in this quarter. Then, supposing a performance in a new or larger venue, or otherwise a more stressful than normal occasion, propanolol's help might be indicated again.

It is common with highly trained classical musicians, when faced with life-or-death, career-making-or-busting auditions, to use propanolol to avoid having "the shakes" blow their chances.

This is a well-known and accepted medical use of this drug, and there should be no problem getting a prescription from a doctor for this use. About eight years ago, on my wife's recommendation, I got a bottle of propanolol. I used it I think twice, with success; then later, when facing a concert with a large audience and lot of press exposure, I used it on a one-time basis. The remainder of the bottle of propanolol sits in the cabinet, unneeded, unused. But it was well worth it for those three or four pills that I did use.

Dave Oesterreich

Subject: RE: BS: Removing memories to treat trauma
From: Rapparee
Date: 23 May 04 - 06:04 PM

Right on. A legitimate use, and one I can support. I have NO quarrel with drugs properly used when necessary (I use some myself -- prescriptions, I mean).

But it's my feeling that my memories are MINE, and they help very much to define who I am. There are other ways of dealing with PTSD than drugging it, healthier ways, ways that don't screw with your memories.

It comes as a shock to some physicians that medical school doesn't even make them infallible, much less even a minor deity. Good physicians learn that quickly and never forget it. As for the others...well....

Subject: RE: BS: Removing memories to treat trauma
From: freda underhill
Date: 23 May 04 - 07:12 PM

I agree, and find the development sinister - i put this in to spark discussion, not as an advocate for the idea. I have worked with torture survivors in a previous job, over a ten year period.like the saying goes, what doesn't destroy us strengthens us.

i think like in so many areas, so much more effort could be put into treating & supporting victims of trauma, and helping them rebuild, recover and survive. and life is not a sanitised event.

i find it interesting to see how people age, dealing with all the things that happen in a life. I respect people who have experienced extremes, pain and grief, and are still contributing to help other people.

Subject: RE: BS: Removing memories to treat trauma
From: Amos
Date: 23 May 04 - 07:21 PM

Yeah, but it only strengthens us if we are willing to face that it happened.


A

Subject: RE: BS: Removing memories to treat trauma
From: freda underhill
Date: 23 May 04 - 07:40 PM

yesterday I had some friends over - one is a grief counsellor in her late 50s. she is a Hungarian Jew and works with Holocaust survivors and their children. Her parents are Holocaust survivors.

She said yesterday (while talking on another topic) that the generation that have survived the camps have two ways of dealing with it. They either never mention it, or they mention it every day.

Those that don't mention it havent forgotten, they still see their camp number tattood into their arm every time they shower.

I have another friend who worked as an art therapist in psychiatric institutions for a decade and a half. She is of the view that for some people, it is better not to talk about it, that there are other forms of therapy that can assist, that some people don't want to pick at sores.

I did gestalt group therapy for about five years. it was a fantastic experience, there were 8 women in the group, a fantastic therapist, it changed my life very positively.

Subject: RE: BS: Removing memories to treat trauma
From: mack/misophist
Date: 23 May 04 - 09:39 PM

They once used electroshock therapy to remove memories. It's not done much any more. The price was too high. Memories make us who we are. I think the cost or removal will always be too high.

Subject: RE: BS: Removing memories to treat trauma
From: Peace
Date: 23 May 04 - 10:23 PM

freda, I certainly didn't think you were in favour of this ( and I don't think anyone else did either) just because you posted it. Good thread, because we all don't keep up with what's happenin' where and with what to whom, etc. Gawd, I can't believe I just wrote that. So, what's this stuff called?

Bruce M

Subject: RE: BS: Removing memories to treat trauma
From: dianavan
Date: 24 May 04 - 03:45 AM

UNETHICAL!

Most drugs are manufactured with a target market in mind. Seems to me that since the causes of PST are many and varied, maybe this is a drug designed for soldiers.

Many drugs are used as a cost saving measure. How many children are on Ritalin when, in fact, counselling in combination with behaviour modification is more effective. Why? The drug is less expensive.

There are many therapies available: art therapy, music therapy, etc. In addition, there is alternative medicine of every description. Post traumatic stress is mental anguish but there is so much you can do to help yourself overcome the most debilitating aspects of this syndrome.   
What kind of a human being has no memory? Its scary when you think of all the different ways a drug like this can be abused.

Subject: RE: BS: Removing memories to treat trauma
From: Ellenpoly
Date: 24 May 04 - 04:02 AM

Very interesting thread, freda.

I have mixed feelings about this. I agree that as is true with many medications, there can be a sinister side to how they may be used. But whether this means we can ever entirely dump something that could also save some from enormous trauma is not to my mind appropriate.

I'm a little unclear, since it seems that memories are not erased so much as they are made less invasive emotionally. For people who suffer from Post Traumatic Stress Syndrome, I can see a great benefit to this.

Also for those who have severe depression. I myself, after decades of therapy (and Amos, in many cases it's not about confronting one's memories, it's about the impact that they still have years after the event) I finally took a medical friend's advice and began anti-depressants. The feeling was one of immediate relief, not that I lost anything (I had been surpressing memories for years because they were simply too painful to dwell on) but I could more easily start to examine many incidents without feeling that terror of bringing up memories that would leave me emotionally trammeled.

So herein lays the dichotomy of many of these drugs. It's not how good they are, it's how they will be used or abused.

I'm concerned with the use of the word "ethics" here. It comes too close to what is going in with the debate about cloning and stem cell research. Let's face it, The Pandora's Box of Science and Medicine was opened long ago, and whether we like it or not, new discoveries are going to be implimented daily.

This research, along with others need to be followed by the public, as it's the only way we can try to make sure the scenarios of their uses remain positive...xx..e

Subject: RE: BS: Removing memories to treat trauma
From: GUEST,freda
Date: 24 May 04 - 04:35 AM

true Ellen. Often detachment and understanding can be helped with medical intervention.

Yes, I am concerned about the political use of such drugs, and also about the personal impact for people who have their brains "cleansed" of trauma. But I also understand that some people have such extreme experiences that the rest of their life is crippled. You have proposed the possibility that such assistance could be useful.

therapy is a brave and idealistic course, and many believe that anyone can be helped with therapy, for any problem. I don't. And for survivors of shellshock, torture, childhood abuse, violent attack or the witnessing or participation in emergency situations, yes, some people can be helped with therapy, some cope through their own personal qualities or through circumstances, and some can be detsroyed.

removing memories is scary. but anything that can assist with removing flashbacks, anxiety attacks or desensitising extreme traumatic events, is worth investigating. As with many things, this medical development has the potential to have a huge social impact, and at the very least needs to be watched.

ps ellen, I'll be in the chat room tonight.

freda

Subject: RE: BS: Removing memories to treat trauma
From: mooman
Date: 24 May 04 - 04:42 AM

Interesting thread...

I have worked with or known several people who have suffered traumatic memories and I tend to be totally with Amos on this one. Unfortunately, in the past, there has been a lack of understanding by the appropriate authorities of the need for proper and appropriate support for the traumatised person although I have detected a change for the better in recent times.

Peace

moo

Subject: RE: BS: Removing memories to treat trauma
From: Ellenpoly
Date: 24 May 04 - 05:37 AM

I'm in agreement with you on this, freda. The examples you gave were perfect reasons for research to continue with this medication.

Also, the fact that it can be used in even minor capacities, as in the example Dave Oesterreich gave shows there is a wide span here for usage.

..xx..e

Subject: RE: BS: Removing memories to treat trauma
From: Wolfgang
Date: 24 May 04 - 08:09 AM

They once used electroshock therapy to remove memories. (Mack)

No, they didn't. The indications were severe depression, mania, acute psychotic states. The loss of memory for the periods surrounding the treatment was an unwanted side effect and not the reason for treatment. The same can be said for lobotomy, except that the memory side effects mostly did not only involve memories close in time to the operation.

The drug does not remove memories, it acts upon the emotional impact of these memories, like any other drug-free procedure (hypnosis, reliving,...). If a drug-free procedure works, it is preferable for many good reasons. Only if not (concentration camp survivors, for instance), this drug may be considered an alternative.

But any idea to give this drug as a kind of precaution, after a possibly shocking experience, just in case this experience may lead to a lasting memory with uncontrollable emotions which cannot be controlled in a drug-free way, is silly and dangerous. We might as well tell all women to get their breasts removed (and men the same for the prostate gland) just as a kind of precaution.

Wolfgang

Subject: RE: BS: Removing memories to treat trauma
From: Mr Red
Date: 24 May 04 - 08:12 AM

er tried one for ex-wife trauma - it is called Folk Clubs -

The experiment continues - though I have forgotten why...............

Subject: RE: BS: Removing memories to treat trauma
From: Peace
Date: 24 May 04 - 06:13 PM

I'd rather have a bottle in front of me than . . . .

Subject: RE: BS: Removing memories to treat trauma
From: Steve in Idaho
Date: 25 May 04 - 12:10 PM

Thank You Wolfgang - I was about to say the same thing. As much as I would like to not have the emotional impact of some of my memories - I think I'd rather keep them. They are part of who I am, much as some may not like that, and what the Good Lord gave me I'll keep.

My son once said, "We each have our cross to bear."

And there are so many new means of alleviating PTSD symptoms, dreams, intrusive thoughts, that medication of this nature may be an option for a very small select few. And it seems a very different medication from some we now have.

Just my rambling .01 worth
STeve

Subject: RE: BS: Removing memories to treat trauma
From: GUEST,Chris B (Born Again Scouser)
Date: 26 May 04 - 10:31 AM

I've forgotten what I was going to say....

Subject: RE: BS: Removing memories to treat trauma
From: freda underhill
Date: 26 May 04 - 11:13 AM

there were two old ladies, Ethel and Elsie, who lived in an old house.

One evening, Ethel, who was upstairs in the bathroom, called down to Elsie - "Elsie, can you help me up here with the bath? I can't remeber whether I'm just about to get into the bath, or just about to get out of the bath."

Elsie called patiently from downstairs - "Just a minute, I'll be right up." as Elsie walked up the stairs, she thought to herself "thank goodness I'm not as bad as that yet, touch wood".
Then she called out to Ethel - just a minute - I'll just see who's at the front door...

Subject: RE: BS: Removing memories to treat trauma
From: Sue M
Date: 27 May 04 - 08:13 AM

For a very simple, drug free, method of dealing with trauma (and a host of other negative emotional issues) look at this web site: www.emofree.com

There is a free downloadable manual available and lots of examples of issues that it has been successfully used on (with about an 80% success rate)

The technique is called EFT and has been used to deal with severe cases of trauma - you don't forget the incident but it no longer carries the emotional charge associated with it.

It is well worth a try :-)

Subject: RE: BS: Removing memories to treat trauma
From: Amos
Date: 27 May 04 - 10:53 AM

Sue M:

Thanks for the link to EFT -- very interesting. It supports the argument with as lot of case histories that a wide spectrum of dysfunctions of one kind or another can be remedied through non-invasive techniques (i.e., no shock, no psychopharmaceuticals, and no surgery).

This sort of address has one thing which recommends it above all others: it increases the self-reliance and self-detemrination of the inddividual, rather than increasing his or her dependency on a practitioner or a chemical. This is the core essence of genuine therapy in my opinion.

A

Subject: RE: BS: Removing memories to treat trauma
From: Sue M
Date: 28 May 04 - 09:36 AM

Hi Amos,
Glad to hear you found the link useful. EFT also helps with the more 'minor' emotional issues - like cigarette, alcohol and food cravings, all the fears and phobias as well as performance issues (sports, public speaking and exams).

It's easy to learn (either find a therapist or download the free manual and teach yourself)and once learnt can be applied to anything without having to keep going back to a therapist. Also you need no equipment to make use of it and its very safe and easy to use.

In fact - if I was limited to using one therapy it would be EFT as it can be used on such a wide range of issues.

Sue M