Traumatic memories
The management of traumatic memories is important when treating mental health disorders such as post traumatic stress disorder. Traumatic memories can cause life problems even to individuals who do not meet the diagnostic criteria for a mental health disorder. They result from traumatic experiences, including natural disasters such as earthquakes and tsunamis; violent events such as kidnapping, terrorist attacks, war, domestic abuse and rape.[1] Traumatic memories are naturally stressful in nature and emotionally overwhelm people's existing coping mechanisms.[2]
When simple objects such as a photograph, or events such as a birthday party, bring traumatic memories to mind people often try to bar the unwanted experience from their minds so as to proceed with life, with varying degrees of success. The frequency of these reminders diminish over time for most people. There are strong individual differences in the rate at which the adjustment occurs.[3] For some the number of intrusive memories diminish rapidly as the person adjusts to the situation, whereas for others intrusive memories may continue for decades with significant interference to their mental, physical and social well-being.
Several psychotherapies have been developed that change, weaken, or prevent the formation of traumatic memories. Pharmacological methods for erasing traumatic memories are currently the subject of active research. The ability to erase specific traumatic memories, even if possible, would create additional problems and so would not necessarily benefit the individual.
Effects
Biological impact
Intense psychological stress caused by unwanted, troublesome memories can cause brain structures such as the amygdala, hippocampus and frontal cortex to become activated, as they process the memory. Related to this, there is some neuroimaging (fMRI) evidence that those who are susceptible to PTSD have a hippocampus with a reduced size.[4] Research has also demonstrated the adrenal activity from intense stress dramatically increases activity in the amygdala and leads to changes in brain functioning as well as altering physiological indicators of stress; heart rate, blood pressure and an increase in salivary enzymes, all of which vary with individual responses to stress.[5]
Children who have been exposed to traumatic events often display hippocampus-based learning and memory deficits. These children suffer academically and socially due to symptoms like fragmentation of memory, intrusive thoughts, dissociation and flashbacks, all of which may be related to hippocampal dysfunction.[3]
Psycho-social impact
People who are feeling distressed by unwanted traumatic memories, which they may constantly be "reliving" through nightmares or flashbacks may withdraw from family or their social circles in order to avoid exposing themselves to reminders of their traumatic memories. Physical aggression, conflicts and moodiness cause dysfunction in relationships with families, spouse, children and significant others.[4] In order to cope with their memories they often resort to substance abuse, drugs or alcohol in order to deal with anxiety. Depression, severe anxiety and fear commonly stem from traumatic memories.[1] If symptoms of apathy, feeling of inability to control impulsive behavior, sleeplessness or irritability persist the person can discuss this with their family doctor or a psychotherapist.[6]
Consolidation
Traumatic memories are formed after an experience that causes high levels of emotional arousal and the activation of stress hormones. These memories become consolidated, stable, and enduring long-term memories (LTMs) through the synthesis of proteins only a few hours after the initial experience. The release of the neurotransmitter Norepinephrine (Noradrenaline) plays a large role in consolidation of traumatic memory. Stimulation of beta-adrenergic receptors during arousal and stress strengthens memory consolidation. Increased release of Norepinephrine inhibits the prefrontal cortex, which plays a role in emotion control as well as extinction or suppression of memory. Additionally, the release also serves to stimulate the amygdala which plays a key role in generating fear behaviors.[7]
Reconsolidation
Memory reconsolidation is a process of retrieving and altering a pre-existing long-term memory. Reconsolidation after retrieval can be used to strengthen existing memories and update or integrate new information. This allows a memory to be dynamic and plastic in nature. Just like in consolidation of memory, reconsolidation, involves the synthesis of proteins. Inhibition of this protein synthesis directly before or after retrieval of a traumatic memory can disrupt expression of that memory.[8] When a memory is reactivated it goes into a labile state, making it possible to treat patients with post-traumatic stress disorder or other similar anxiety based disorders. This is done by reactivating a memory so that it causes the process of reconsolidation to begin. One source described the process this way: "[O]ld information is called to mind, modified with the help of drugs or behavioral interventions, and then re-stored with new information incorporated."[9] There are some serious ethical problems with this process as the reactivation of traumatic memories can be very harmful and in some cases cause anxiety attacks and extreme levels of stress.[10] Inhibition of reconsolidation is possible through pharmacological means. The administration of several different types of protein synthesis antagonists can be used to block protein synthesis that occurs after a traumatic memory is reactivated. The inhibition of creation of new proteins will stop the reconsolidation process and make the memory imperfect.[11]
Ethical concerns
The prospect of memory erasure or alteration raises ethical issues. Some of these concern identity, as memory seems to play a role in how people perceive themselves. For example, if a traumatic memory were erased, a person might still remember related events in their lives, such as their emotional reactions to later experiences. Without the original memory to give them context, these remembered events might prompt the subjects to see themselves as emotional or irrational people.[36] In the United States, the President's Council on Bioethics devoted a chapter in its October 2003 report Beyond Therapy to the issue.[37][38] The report discourages the use of drugs that blunt the effect of traumatic memories, warning against treating human emotional reactions to life events as a medical issue.[37]
Issues of self-deception arise when altering memories as well. Avoiding the pain and difficulty of dealing with a memory by taking a drug may not be an honest method of coping. Instead of dealing with the truth of the situation a new altered reality is created where the memory is dissociated from pain, or the memory is forgotten altogether.[36][37] Another issue that arises is exposing patients to unnecessary risk. Traumatic experiences do not necessarily produce a long term traumatic memory, some individuals learn to cope and integrate their experience and it stops affecting their lives quite quickly. If drug treatments are administered when not needed, as when a person could learn to cope without drugs, they may be exposed to side effects and other risks without cause.[38] Loss of painful memories may actually end up causing more harm in some cases. Painful, frightening or even traumatic memories can serve to teach a person to avoid certain situations or experiences. By erasing those memories their adaptive function, to warn and protect individuals may be lost.[36][37] Another possible result of this technology is a lack of tolerance. If the suffering induced by traumatic events were removable, people may become less sympathetic to that suffering, and put more social pressure on others to erase the memories.[36]
Despite potential risks and abuses, it can still be justifiable to erase traumatic memories when their presence is so disruptive to some and overcoming them can be a difficult process.[38]