Understanding Memory Reconsolidation

We are sharing information like this because we think it's very important to have the information here, share it with your treatment team or trauma work buddies, and consider what tools are available out there that might be useful for your health and healing. Being kept in the dark about potential tools for trauma work is not helping our community, and not helping educate our therapists.

Please approach all trauma work with caution. Please do not retraumatize your system in the search for relief!!

For a screen scribble video on this topic see Magic or Memory Reconsolidation? on YouTube.

Introduction

Memory reconsolidation is a process that has gained attention as a potential tool for treating conditions related to traumatic experiences, such as PTSD and dissociative identity disorder (DID). The process involves using the nervous system's underlying methods for learning new information in order to change faulty predictions of threat, pain & discomfort that are no longer desirable. When done appropriately, this method modifies threat-activation neural pathways associated with traumatic memories and their associated triggers, without altering the narrative memories themselves.

We (Crisses) will use our coffee trigger as an example. Our emotionally abusive egg donor drank a pot of coffee every day, and we now have a trigger where our brain-body smells coffee and thinks that our egg donor is around so we become hypervigilant.

How Memory Reconsolidation Works

When we experience a traumatic event, our brain creates new state-dependent neural pathways to store and process the memory. These pathways can become highly activated when triggered by external stimuli, leading to intense emotional and physical reactions (Panic Reactions New). Through the process of memory reconsolidation, it is possible to modify these threat-signaling neural pathways and reduce or even eliminate the intensity of our reactions to triggers associated with traumatic memories.

Prerequisite: Neural Path Activation

Our nervous system makes a prediction

Memory reconsolidation works by accessing the neural pathway associated with the traumatic memory, without necessarily bringing up the memory itself. All it takes is for that pathway to be activated in the Here & Now. It's notable that what is really being activated is a prediction of something bad about to happen.

Smelling coffee is enough of a trigger, we don't have to remember any specific memories of our egg donor or things that happened after smelling coffee to trigger our nervous system reaction. Being low-level "activated" is sufficient to engage the neural pathway in question. Our body prediction is "When we smell coffee, it means emotional suffering."

Memory reconsolidation can work spontaneously with talk therapy and traditional memory confrontation techniques (digging around in traumatic memories to try to remember what happened), but there is a benefit to keeping the nervous system activation level low when attempting to deliberately reconsolidate memories. Being highly activated can be retraumatizing, and being in panic mode can interfere with calmness and focus that can be helpful for doing memory reconsolidation on purpose.

Thus the recommendation is to attempt memory reconsolidation with a low level of activation, such as a 1-3 on a 0-10 SUDS scale New. This would be mild activation that is very tolerable, and does not impair the client. The client can self-report, visualize, concentrate, listen and hear instructions, etc. at this level of activation where moderate to high activation can interfere with concentration and focus.

Being more activated can still result in memory reconsolidation — and is done with certain techniques at nearly any activation level.

Checking in how the client feels UNSAFE New when activated with the target learning is important both for discovery work (What will be mismatched in the next step?) and for validation as to whether or not the memory reconsolidation was successful. SUDS & UNSAFE can be paired to check in with a client, track progress, and adjust methods as needed.

Open for Learning: the Mismatch

Something is "different" which causes a prediction error

After the pathway is accessed, a mismatch is presented that (when it lands right) introduces a prediction error to the brain/body and the trauma-activation neural pathway is called into question.

Our nervous system opens up the prediction pathway for updating/editing

The prediction error itself is what convinces the body/brain that it needs to learn new information. There are many ways to do this, depending on the client, the trauma, the sensory information in question. The key is there's often a felt Ah-hah! moment or surprise involved.

Let's make something up. Our imaginary ideal therapist knows we want to work on our coffee trigger, so we both dream up a visualization scene: we get a whiff of coffee (therapist opens the K-Cup) and we think the egg donor might be nearby (activation), but then a chocolate colored puppy shows up, and it smells just like coffee (more K-Cup waving), but it's adorable and cute and wants to be held and is warm and wriggly and sweet and licks us and loves us up. When we do this visualization, our brain is like "Woah, dudes, this doesn't make sense! This puppy is the most safe and adorable wriggle-butt ever there's absolutely no way that this coffee smell predicts danger!" No! the smell of coffee predicts this adorable puppy we're going to name 'Mocha'!

Before a deliberate memory reconsolidation session, there's generally a discovery phase to figure out what will be worked on, and what a good potential mismatch is for the client in particular that might help generate a prediction error. However mismatch moments can happen spontaneously in many forms of therapy, or even outside of the therapeutic session.

To really hone in on what to mismatch, it's necessary to figure out how that person is UNSAFE New and to mismatch those sensations in the nervous system. Check out the full list to understand how to better target MR.

They don't result in memory reconsolidation because there's one last necessary step to get these surprise or Ah hah! moments to rewrite new information into the open neural pathway.

Overwriting the Trauma-Activation Response

We repeat the new learning so that the old prediction is now updated

A surprising mismatch or prediction error is enough to open up the trauma nervous system activation pathway — but there's another step. It's not enough to just do this. We need to repeat the learning. Because the first mismatch opens up the pathway for learning, it's repetition or additional information that will be saved. And from what we're learning the learning experience lasts about 4-5 hours (more-or-less).

So first we open up the learning experience, but we still need to provide new information and emotional experiences that contradict the original emotional experiences. This can be journaling, continuing to repeat the mismatch, talking about the realization with others, re-experiencing the visualization, or otherwise affirming "Yes! This is the new information we need to store about this." Then the neural pathway can be modified, leading to a reduction in the intensity of the emotional and physical reactions triggered by the original stimulus.

So we repeat the visualization several more times and write a little story about Mocha, maybe purchase a stuffy to symbolically represent our experience, and even figure out some way to make our puppy plush smell of coffee, even if just for a day or so.

Benefits of Memory Reconsolidation

Memory reconsolidation can be used as a non-invasive method for treating conditions related to traumatic experiences, such as PTSD and DID. Unlike other methods that may involve invasive forms of therapy, memory reconsolidation can be used to modify trauma activation neural pathways associated with traumatic memories without necessarily requiring the patient to confront the memory itself.

Another benefit of memory reconsolidation is that it can lead to long-lasting changes in trauma responses, leading to a reduction in the intensity of reactions to individual traumatic triggers. By engaging in memory reconsolidation, patients may be able to achieve a greater sense of emotional regulation and reduce their reliance on coping mechanisms that may be maladaptive.

Now in this theoretical scenario we can now walk into Starbucks and hang out with friends and we might even decide we like coffee and wonder what we ever did without it. Seems extremely unlikely from where we are now.

Limitations of Memory Reconsolidation

We don't know what we don't know. Some techniques that likely rely on reconsolidation will talk about "aspects" of a traumatic incident and that some testing is needed to figure out whether the trigger is fully gone or not.

So, say for example it's not just Columbian coffee that's a problem for us. It's also French Roast. If we have trained our brain based on Columbian black coffee but say our sense of smell can tell the difference, so we think this is all over, and we walk into Starbucks, and immediately feel we have to flee — not because the Mocha puppy magic is gone, but because we're not only sensitive to Columbian brew, and our brain says "Ok, that's safe but there's still this other one." There was a separate neural pathway for a different type of coffee. Or say cigarettes + coffee — a favorite egg donor combo. Hopefully you get the idea, there can be other "aspects" to the trauma that may need to be worked on separately.

This is why trauma work can be tricky. Sometimes we'll remove one underlying trauma and a bunch of other triggers vanish. Other times we think we have it, and it turns out that we were missing aspects. So if we look at this as an experiment, it can help figure out what's really working or not.

The obligatory fine print:

Memory reconsolidation is not a panacea and may not work for everyone. Patients who have experienced long-term trauma may have more deeply ingrained neural pathways that are harder to modify through the process of memory reconsolidation. Additionally, memory reconsolidation is a relatively new field, and more research may find ways to make it more reliable and predictable.

Another limitation of memory reconsolidation is that it may be tricky to engage in memory reconsolidation on your own. It's kinda harder to surprise yourself. There are ways to do so, but a trained professional can work with you to ensure that you're on the right track and help keep you from retraumatizing yourself, potentially leading to negative outcomes.

Post-Reconsolidation Processing

When we target trauma triggers (implicit autonomic nervous system memories) for memory reconsolidation, we are not processing the cognitive portion of the memory. Memory reconsolidation, when successful, is resolving the panic portion of the memory. Once this is removed, we still may need to process the grief, sadness, or settle ourselves with the memory of what happened. But it will no longer be a flashback, and we will gain an accurate sense of distance from the initial event(s).

Sometimes a traumatic memory is complicated (i.e. "complex trauma" or C-PTSD) and may contain several layers of trauma as well. Reconsolidating a surface trigger or wrapper around trauma can still reveal there's other layers that still need to be processed. Sometimes we get the whole issue, sometimes we find out it's like an onion (but not like an Ogre).

So we may need to process, or we may need to tackle new trauma targets, even after we have success in memory reconsolidation.

In Summary

Memory reconsolidation is a promising area of neurological research and has been shown to be useful for treating conditions related to traumatic experiences. By modifying the neural pathways associated with traumatic memories, clients may be able to achieve greater emotional regulation and reduce their reliance on maladaptive coping mechanisms. It's a new field, but it is being used successfully in practice as well.

How Memory Reconsolidation Works

1. Our nervous system makes a prediction
2. Something is "different" which causes a prediction error
3. Our nervous system opens up the prediction pathway for updating/editing
4. We repeat the new learning so that the old prediction is now updated

This process is repeatable. When these factors are present, old patterns & predictions can be permanently updated with new information.

Where memory reconsolidation isn't achieved in any given attempt, it may be an opportunity to assess other ways to approach the issue in question.

Credits

Written by Crisses with a big boost from ChatGPT to start it off.

Based on the work of Alun Parry (affiliate link) and on work by Alain Brunet & others. Also this pathway/formula is likely the reason why there are inconsistent but verifiable benefits from a bunch of other therapeutic schools. In theory, if we can more reliably evoke these stages, regardless of which techniques or schools of thought are being utilized, then trauma resolution may be more reliable.

More Info

• Helpful video about the brain as a prediction device, prediction error, and how prediction errors lead to new learning - https://www.youtube.com/watch?v=zXDzo1gyBoQ - this is exactly how memory reconsolidation works.

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