Changing Memories to Treat PTSD

Compared to Martin’s hypothetical Inception scenario, the types of modification discussed in the research review are decidedly less dramatic. Based on the studies presented, reconsolidation appears to be much less heavy-handed than its science-fiction analogue—a lessening of the emotions associated with the memory or the dulling of its details, rather than the total mental eradication of an event or the creation of a new one from scratch.

But still, the idea of reconsolidation broaches new territory for possible relief from PTSD, which affects an estimated 7 to 8 percent of Americans, by addressing its root cause rather than its symptoms. Cognitive processing therapy and exposure therapy, two common behavioral treatments, focus on coping skills and controlling fear, and according to the National Institutes of Mental Health, only two medications—the antidepressants Zoloft and Paxil—are currently approved by the U.S. Food and Drug Administration explicitly for the treatment of PTSD, though other antidepressants and anti-anxiety medications are often prescribed to treat the emotional effects characteristic of the condition.

Some psychologists, however, remain skeptical that this particular area of memory research is the answer.

Despite the findings of some of the studies addressed in the Biological Psychiatry review, the bulk of the research on reconsolidation thus far has involved lab animals rather than humans, explains Paul Reber, director of Northwestern University’s Brain, Behavior, and Cognition program—and mapping rodent brains doesn’t provide adequate insight to the intricate, messy workings of human memory, where something as seemingly inconsequential as a smell or a snippet of music can pull forward a rush of emotions from events past.

“In animal studies, you have the greatest control over the neural systems, but you don’t have any access to the subjective experience of memory,” he says. “So you can build models of things you think might be related to what humans experience with PTSD, but you don’t really know how they’re connected.”

Paller, too, questions the faith that some have placed in reconsolidation, arguing that it stems from an oversimplified understanding of the way that memories are processed in the first place. Rather than something that must be de-stabilized in order to change, a memory is a constantly shifting entity, continually updated with new context even when it isn’t being consciously recalled.

“It’s a lot different than when you put some information in your computer and just expect to get that out in the same form,” he explains. “If you learn something on a Wednesday and you learn new information the next day, that can change the memory that you stored. So every time that we learn something, subsequent events can color it differently.”

”The more sophisticated view of consolidation is, [it] can strengthen a memory, but it doesn’t reach a permanent stage ever,” he says.

Whether or not reconsolidation is a viable possibility for PTSD treatment may still be up for debate; whether or not it should be a possibility, though, is another question altogether.

Slippery philosophical quandaries abound: Does the act of taking a pill to change memory require different ethical considerations than something like psychotherapy or hypnotism? Could it pave the way for more ominous applications? And is the altering of memories a humane way of helping those who suffer, or is it some fundamental violation of what makes humans, well, human?

But on the flip side, if some people are biologically predisposed to PTSD, wouldn’t this be a way of leveling the playing field, of helping people unlucky enough to become victims of their bodies’ own chemistry?

“People say, ‘Well, it’s just wrong to interfere with the natural in the realm of memory,’” says Peter Kramer, a psychiatry professor at Brown University who studies medical ethics, “but the natural in the realm of memory does involve reshaping and forgetting. Maybe the injury is more like the unnatural.”

As the body of existing reconsolidation research expands—and as soldiers continue to return home burdened by the trauma of their experiences—it’s an issue that those who study the brain are likely to grapple with more and more often.

“I was at a conference not that long ago where the idea was brought up,” Reber says, “and it led to a lot of animated discussion: If you could edit your own memories, are there any memories you’d want to get rid of? If you have a memory of a painful event, do you lose some part of yourself if you get rid of it? Would that be worth the trade?”

“Obviously,” he adds, “it’s not a simple question.”

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Cari Romm is an editorial fellow with The Atlantic​.

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