Tag Archives: neuroplasticity

Neuroplasticity and a dog’s guilt

 

So let’s tie the dog story in with that thing about neuroplasticity, the previous blog essay. Recall that according to the likes of Daniella Schiller, retriggered memories can be ‘reconsolidated’, that is re-scripted or deleted if, during a critical period, a subject is given either a protein-blocking agent, or is presented with new data that contradicts a conditioned response. Other researchers Gorman and Roose interpret that the timing of interventions must therefore exist in proximity to reactivation of traumatic material, as the Schiller experiments imply.

Skeptical analyst Richard Tuch challenges this finding, suggesting that the material of analytic patients is too complex to be modified by such behavioral techniques.

So let’s look at my shaggy dog story and identify the different elements that seem relevant to the issue: the CS or conditioned stimulus; the conditioned response, or CR; the observed outcome of an informal effort to reconsolidate. To recap: a car rolls down a slight incline, bumping into another car because…well, we’re not sure why, but it seems as if a dog had something to do with it. You see, a taciturn Doberman had been sitting in the driver’s seat at the time of rolling, so I speculate that the animal had inadvertently dislodged the car’s emergency brake, thus sending the vehicle on its way. When the owner (not ‘driver’—the distinction was important to her) appeared minutes later, she seemed concerned, but more defensive than, say, remorseful about the accident, or relieved that the misadventure hadn’t caused more harm.

My friend, another therapist, tried to intervene on this latter point, timing his explanation of averted consequences about as proximately as was possible to the accident, the putative trauma. But was it the trauma? What actually happened in this scene, and did it lend itself to things like reconsolidation of new data, contradicting a conditioned response and so on. It didn’t appear so. As I’ve previous written, the woman in question appeared to bristle at my friend’s sober counsel, rejecting it on what I sometimes describe as ‘process’ not ‘content’ terms. Meaning, her response—‘I don’t need to be counseled’—seemed not so much a rejection of an observation (the ‘someone could have been hurt’ truism), but rather of my friend’s prerogative to make the point, regardless of its validity.

In this instance, it seemed important to consider not only the timing of an intervention, or even the nature of the intervention (a confrontation versus, say, an empathetic overture) but firstly, to consider what exactly had been stirred in the woman. Not that I’m feeling critical of my friend—what he said was necessary for someone to say—I’m merely interested in a different phenomenon. By my passive and thus detached observation, it seemed from the outset that the woman was far from horrified by the disastrous possibilities of her car rolling down a hill. Initially at least, there was no sense that she would thereafter feel afraid to get in her car, or park it elsewhere, or even leave her dog in the car unattended. Immediately, she seemed more concerned with the matter of blame: whether she was being cast as the driver versus the owner; whether she’d be held responsible for the apparent damage to the vehicle her car and dog had lightly struck. If I were to guess I’d say she was embarrassed at being the center of negative attention, the object of suspicion, perhaps ridicule, due to the absurdist nature of the scene. Her backstory—or trauma, if you like—likely had little to do with car accidents, much less tragedy, but rather a memory of public humiliation, entailing a dressing down by righteous figures, perhaps more commonly male. That’s my guess.

And so it seemed that my friend’s intervention failed—partly because of its timing, I suspect (she might have been open to instruction later)—but more pertinently, because the experienced and therefore salient trauma material was not contradicted by the intervention, because it did not constitute ‘new’ data in the sense that is being discussed. If the negative memory is about humiliation and blame, then the CS—being criticized, especially by a man, or a stranger—perhaps reconsolidated old data, rather than introduce a cautionary tale about driving or concern for others, the putatively intended ‘new’ data. Therefore, a CR—defend oneself—was readily enacted and was, if you like, reinforced by the ensuing interaction, though in my opinion, the woman’s reaction was inflected more by her projections than by reality, which again, analysts would cite as complicating factors which…wait, I think I know what you might be thinking.

Are we over-thinking this?

If you really think this then you should probably stop reading my blog, and don’t even bother with my books, because you will often think this of me. Anyway, I wonder if the woman will re-visit this episode, perhaps talk it over with someone she trusts; someone who might, in turn, instruct her as my friend did, to which she might say, “That’s what this guy said, who saw what happened”—in response to which an astute and curious listener might begin a different process, introducing a new layer of data. See, that person might ask, “And what was that like? Did it stir anything up for you?”

 

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Working Through: the bad news about neuroplasticity

 

A young man stomps down the hallway to my office. He’s been told to come speak to me, is more or less cooperative, though he is fuming, or “triggered” as his peers would say by an as-yet unidentified stressor. Once inside, he sits on the edge of my couch, poised to lunge should anything else graze his volatile mood. “What’s happening?” I ask. What happened? That’s the subtext and layered backstory.

Turning out his pockets, emptying upon my table a previously hidden arsenal of knives and electronica, he raves incoherently about someone who hasn’t returned his call; about someone whom he feels threatened by–an invisible oppressor, spreading ‘lies’ about my client. Whatever’s happened has stirred old material, I surmise. The following conversation will process the present tense, assess risk for dangerous behaviors, and seek to redress a distortion or two, at least from my standpoint. Will it work? The factors in question are numerous, I figure. Much depends upon the nature of the trigger or triggers, the history of similar events in this young man’s life. The prospect of new learning, containing negative or destructive behaviors, plus installing a new and desirable response and sustaining that response will depend also upon the relationship to me, among other things. Does he trust me? Will my interventions be not only well-timed, but compassionate, insightful, true? Has he trusted people like me in his life: teachers, parents; authority figures of one sort or another?

And that’s just scratching the surface, and so it goes. The question of what contains danger, or causes meaningful change, ‘reconsolidating’ traumatic memories remains mysterious, yet to hear some speak you’d think that neuroscience of the last decade or so has at long last delivered the long awaited elixir to traumatic response. In the April issue of The Journal of the American Psychoanalytic Association, Richard Tuch challenges some of the claims made by neuroscientific researchers in recent years, especially as it pertains to the so-called reconsolidation of traumatic memory.

During a seminar, Tuch opined that emotional memories continue to exert an influence over an individual’s emotional life even after a transference (within treatment) has been ‘worked through’. Nuancing his message, Tuch stated that a more likely outcome was for a patient to learn the ability to stand apart from the experience and recognize it (an emotional memory) for what it was. In shorthand: to develop an observing ego. A student challenged this modest assertion, citing “breakthrough” research which proclaims the discovery of the brain’s ability to delete specific, emotional memories, as well as non-conscious beliefs and schemas, at the level of physical neuronal synapses. Indeed, some studies have demonstrated how retriggered memories can undergo a process of “reconsolidation” if, during a critical period, a subject is given a protein-blocking agent, or is presented with new data that contradicts the conditioned response. I even cited some of this research myself to support ideas proselytized in Working Through Rehab, my incendiary critique of adolescent drug treatment. Recent discoveries in research have been hailed as provided evidence of the mind’s flexibility, or “plasticity”, suggesting renewed hope for meaningfully curative responses to trauma.

The problem, as Tuch writes, is that such research involves a particular kind of memory that is readily subject to operant conditioning: the kind of memory that is short-term and responsive to a simple stimulus, such as an accident, or a stimulus that can be simulated in a controlled, experimental setting. Take the work of Daniella Schiller (et al), whose 2010 paper, “Preventing (blocking) the return of fear in humans using reconsolidation update mechanisms”, has been among the sources influencing the new enthusiasm about neuroplasticity. I detailed (though later edited down) the specifics of Schiller’s consolidation experiments in Working Through Rehab. In her study, human subjects took part in what may seem to have been an old-fashioned behavioral experiment: individuals were shown colored squares (CS) paired with electric shocks to the wrists, while physiological reactions were measured via skin conductance response technology (SCR). On the following day the group of subjects was to undergo an extinction exercise wherein the CS would be paired with no shock. The experiment called for a control group to be given a CS ‘reminder’—a CS paired with a shock—ten minutes prior to the extinction exercise, where the CS is paired with no shock. Follow me so far? The ten minute window between exercises was dubbed a reconsolidation window, as in an opportunity to contradict data, delete previous responses; demonstrate plasticity, and so on. Then, on the day after that, another trial experiment was conducted, with subjects exposed to the CS again, again without the accompanying shock. The control group subjects consistently exhibited no SCR, in contrast to their counterparts who had not received the CS reminder and extinction exercise.

This led to some interesting, and again—influential—interpretations. Gorman and Roose (2011) point to the study as an indicator that timing (just timing?) of interventions (from their standpoint, interpretations, not instruction per se) must exist in proximity to reactivation of trauma material in order to block consolidation of maladaptive response, and to allow for a re-writing of a traumatic narrative through a therapeutic discourse. In 2012, when I was writing my book, I thought this a worthwhile assertion, but today it seems overreaching, and in retrospect, I wish I’d waited upon the sober skepticism of Richard Tuch: “Whether these findings can be extended to include memories that are the product of the sort of ‘cumulative trauma’ typically responsible for the disturbances we see in our offices seems highly unlikely,” he writes. Furthermore, the so-called reconsolidation efforts described in the research follow soon after the memory-producing experience, reinforcing the heuristic belief that proximity of feedback to a stimulus is essential to learning.

Or, as I put it to a parent recently: “if Jonny speaks out of turn in class one day, you don’t wait several days, or ‘when the time is right’ to admonish the behavior. You address the behavior in the here and now.” That’s a tenet of teaching, not to mention operant conditioning: to address children quickly and succinctly about what’s happening, as defined in strictly behavioral terms, ignoring psychodynamics. Outside the academic or experimental realm, matters seem different: emotions count in so far as they exist, though they are avoided. Memory counts. Relationships matter, and time is somehow a fuzzier element between people. The emotional context of these moments is anxiety—the fear that accompanies complex memory, the interaction of projections and introjections, the unconscious. I can think of many words to describe the mind. Complex is one of them. The word plastic is not yet among my favorites.

 

Gorman, J.M., & Roose, S.P. (2011). The neurobiology of fear memory retention and psychoanalytic theory. Journal of the American Psychoanalytic Association. 59: 1201-1219.

Schiller, D., Monfils, M.H, Raio, C.M., Johnson, D.C., LeDoux, J.E., & Phelps, E.A. (2010). Blocking the return of fear in humans using reconsolidation update mechanisms. Nature. 463: 49-53

Tuch, Richard (2015). Brief Communication: problems applying neuroscientific research to the clinical setting. Journal of the American Psychoanalytic Association. 63: 311-316.

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