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The Brain's Rules for Change
Translating cutting-edge neuroscience into practiceby Bruce Ecker What we clinicians have learned in recent years about the intricacies of the brain's implicit memory systems has certainly helped us better recognize the linkage between distressing or traumatic experiences and many of the previously puzzling symptoms clients bring to our offices. But now brain science is beginning to offer more specific and powerful guidance about clinical methods that can help free clients from the emotional distress and problematic behaviors triggered by disturbing implicit memories. These days, more and more therapists have moved from simply talking about emotional issues and the past to using experiential approaches based on the recognition that implicit memory is living memory. But once a client has achieved direct access to the raw living memory of difficult or traumatic experiences, how do we know what to do next to resolve those memories? And what does "resolving" such memories actually mean? Most clinicians are all too aware that implicit memory often maintains an emotional chokehold, even after it's become conscious. Yet sometimes we do see our clients experience a deep, liberating, lasting shift, after which their behavior changes and their mood vastly improves. The only problem is that we often don't know why or how this shift happened. In the late 1980s, my clinical collaborator, Laurel Hulley, and I began a close study of cases in which clients experienced such deep emotional breakthroughs. Over time, we noticed consistent patterns in these cases and eventually developed clinical guidelines for how to help clients dissolve implicit memories more reliably. But then we decided to go the next step to see how the methods we'd crafted corresponded to the rules and processes neuroscientists had identified regarding change in the synapses and circuits of implicit memory. I immersed myself in neuroscience journals such as Neuron and Learning and Memory, and began searching through dozens of highly technical research articles to see what clues neuroscience might offer about unwiring a specific, long-standing, implicit memory. Until quite recently, a century of research on learning and memory had established that, while all newly formed memories are unstable and relatively easily disrupted, experiences accompanied by intense emotion set down implicit memory circuits in the limbic system that last a lifetime, once the complex consolidation of these memory traces is complete. Such consolidated circuits are locked in by specially formed, extraordinarily durable synapses. Even the process of extinction at best suppresses, but never erases, an implicit memory in the subcortical limbic system (and likewise for cognitive regulation approaches such as CBT). Neuroscientists, like their professional brethren in the mental health field, have long been aware of the devilish tenacity of emotional memory. Yet, decades ago, there'd been a few hints to the contrary in the neuroscience literature. Electroshock procedures that had been completely ineffective for dispelling an implicit memory became dramatically successful in some animal and human studies when the implicit memory was reactivated just prior to the shock. In these studies, not only did the emotional and behavioral responses driven by the implicit memory cease, but they couldn't be reevoked, distinguishing the process fundamentally from extinction and other suppressive methods. However, these few articles received scant attention from brain scientists and even less from clinicians, and the immutability of consolidated memory traces remained dogma in brain science. |
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