PTSD: Confronting fear is the remedy

Photo above: U.S. Army Soldiers from Company C, 2nd Battalion, 12th Infantry Regiment, watch the surrounding hills for insurgents, while fellow Co. C Soldiers race to their position, dodging heavy sniper fire, during a three-hour gun battle with insurgent forces in Kunar province, Afghanistan’s Waterpur Valley, Nov. 3, 2009. The 4th Infantry Division Soldiers had been battling insurgent forces in the Waterpur Valley since arriving in Afghanistan in June of that year. (Wikipedia)

may14_cover_SmithsonianLike many people, I entertain myself — and save money — by reading magazine articles when I’m in public places. A few weeks ago, I picked up a copy of the May 2014 Smithsonian, containing an article entitled “Fearless” by Richard Conniff. He focused on the techniques used to treat Post Traumatic Stress Disorder (PTSD), particularly fear extinction therapy and pharmaceutical drugs.

As it turns out, the best way to eradicate a memory, or at the very least lessen its potency, is to recall the triggering event with as much accuracy as possible. As the author explained, “Stirring up a memory makes it a little unstable, and for a window of perhaps 3 hours, it’s possible to modify it before it settles down again, or ‘re-consolidates’ in the brain.”

With roughly seven percent of American adults reporting some experience with PTSD, any effective treatment to relieve them from the negative remnants of unwanted memories is appreciated. Because we do not yet have a computer program that simply locates memories like files and deletes them, a la Eternal Sunshine of the Spotless Mind, fear extinction therapy (a mix of cognitive behavioral techniques and exposure therapy methodology) is often recommended by psychologists. For those unfamiliar with exposure therapy, first used by psychologist and researcher Albert Bandura, it was originally used to eliminate phobias by simply exposing the person to their greatest fear until they no longer felt the physical and psychological sensations of panic.

Kate Winslet and Jim Carrey in a scene from the film "Eternal Sunshine of the Spotless Mind." (Publicity photo)
Kate Winslet and Jim Carrey in a scene from the film “Eternal Sunshine of the Spotless Mind.”
(Publicity photo)

Fear extinction therapy works under the same basic premise, but with memories rather than actually placing someone in a pit of snakes or a room full of bats. In Conniff’s words, it works largely due to the fact that “Reliving traumatic moments over and over in safe conditions can help a person unleash the automatic feeling of alarm.” In other words, as a person’s brain continually reprocesses an event, the bio-psychological reactions and chemical responses dull as they become more immune to the experience and make new associations. Just as the person with a phobia of serpents soon realizes that no harm has come to them whilst surrounded by garden snakes, a person who recalls fear-inducing memories over and over will soon find those memories less threatening.

However, a new drug has been discovered which allows memories to be even more accurate; This results in a more effective wipeout.

Li-Huei Tsai of MIT and Johannes Graff offer a combination package of extinction therapy with a drug that acts on HDAC (histone deacetylose inhibitors) to vastly improve memories, which unlocks them for easier and more thorough retrieval, allowing the patient to use fear extinction therapy to displace the panic and discomfort associated with thoughts of the initial event.

U.S. 10th Mountain Division in Afghanistan. (Wikipedia)
U.S. 10th Mountain Division in Afghanistan.

One can gleam even more insight from acclaimed author and neuropsychologist Antonio Damasio’s book, Self Comes to Mind: Constructing the Conscious Brain. Naturally, recall and memory exists in the function of being conscious. Damasio, an expert on neurological phenomenon and explorations of the mind, asserts that consciousness is not as simple to define as you might think. “Consciousness is not merely wakefulness,” he writes, but rather an organized connection with the world around you, as it relates to your self-image, thoughts, emotions and actions. Memories are built upon connections and associations.

Perhaps that is why breaking the link between a memory and the feelings of terror is vital in alleviating the painful symptoms of PTSD. With so many coming back from Afghanistan and Iraq tours and other life-altering experiences, this research could not come to fruition at a more pertinent time.