Why Talk About The Past?

Posted on November 4th, 2017

This is one of the most common questions I get as a psychiatrist. For good reason, many people balk at the thought of recounting painful past memories. Why dredge up the sadness and trauma of the past? The past is the past and you can’t change it. Even old aphorisms echo this sentiment, “There is no use crying over spilled milk.” Life is difficult enough, why not just focus on the present?

This was a difficult question for anyone in the field of psychology to answer on a scientific basis. However, recent advances in neuroscience have dramatically altered our understanding of how to respond to this question. In particular, the emerging concept of memory reconsolidation, the process of previously consolidated memories being recalled and modified, has galvanized the field. While we can’t change the events of the past, it increasingly appears that we can modify memory, which is how we interact with the past.

What is memory? Memory is our ability to encode, store, retain, and subsequently recall information and past experiences in the human brain. Experiences that make a strong enough impact are imprinted and then recalled. In humans, approximately 10,000 out of 100 billion nerve cells make up a single memory. A memory is formed when nerve cells produce proteins which are packaged and then laid out in axons and branching dendrites, which sprout to connect with other neurons (Figure 1).

The different parts of the memory are in different parts of the brain (Figure 2). Close your eyes and think back to your favorite birthday party. Images, sounds, feelings, and maybe even scents come to mind. These are all separate brain cells in the visual, auditory, limbic, and olfactory parts of the brain all working at the same time, connected centrally in the hippocampus. The positive feeling of joy evokes a belief of being cared about and loved within milliseconds. Neurons that fire together, wire together.

Previously, we believed that memories like these were formed and then consolidated, like a book written in ink. Remembering was like searching for this book in a dusty library. The book could be read intact, perhaps fading over time, but with the original story unchanged.

Building on work by pioneers in psychology and neuroscience such as John Watson and Eric Kandel, Karim Nader’s experiments on memory refuted this theory. It was already known that certain drugs can block new memories from being formed by blocking the synthesis of proteins that create the connections between cells. Nader showed, for the first time, that these drugs also alter access to old memories if given during recall. He discovered that new proteins must be produced to reconsolidate, or rewire, the memory back into its existing network of connections, each time an attempt at remembering occurs. Therefore, the act of remembering itself makes memory vulnerable to change: less like a library book, and more like a computer file that can be opened, altered, and then resaved.

As memories were being recalled, they were also being modified. Subtly, like a sculptor chipping away at a block of clay, the memory itself was being transformed, simply by being accessed.

The impact of this discovery was seismic. On the one hand, legal testimony based on past recall was suddenly thrown into doubt. But just as important, there was an opportunity to rewrite past memories with new, helpful information. There was scientific proof that, in the hands of a skilled, compassionate listener, not only could the past be modified, but the pain, sadness, and fear associated with it could be healed.

To do this two things have to occur. First, the painful memory sequence has to be activated by conscious recollection or exposure to a triggering reminder. Second, something unexpected needs to occur in order to modify the negative past association. The associated feelings and beliefs have to be challenged in a novel way, with a new outcome, dissimilar to one’s first experience.

For example, Clinical Psychology professor Dr. Merel Kindt, exposed arachnophobes to tarantulas, asking them to touch their cages. This triggered fearful memories. Soon after the exposure, she gave the patients a blood pressure medication that reduced the adrenaline rush of fear they anticipated would occur next. Astonishingly, her patients could handle and pet the spiders without fear within a few days. Their old association of fear with spiders had been permanently weakened by the positive new experience.

On a broader scale, this discovery validated therapeutic approaches that involved memory activation and therapeutic support elements. If these occur with enough repetition and compassion, painful memories can soften in intensity, and distorted negative beliefs about the self, the future, and the world can be transformed into resilient, positive attitudes. Even traditional, non-clinical approaches to healing can now be understood in a new light.

Memory reconsolidation is an emerging field with much yet to understand. What has been learned already, however, is that the past is not just the past. We knew the past could affect the present. Now we know the present can reshape the past and give hope for a better future.

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