TMS: Stopping Fearful Memories in Their Tracks
December 4, 2020
Having fearful experiences is a normal part of life--one that will likely occur more than once. Originally intended to keep us out of harm’s way by way of fight or flight, fear can be quite adaptive. But sometimes, memories that are too difficult to process remain in the body. This may show up physiologically or psychologically to perceived triggers that do not pose a real threat. When this happens on a regular basis, fear becomes a hindrance rather than a survival skill. Luckily, new options are beginning to emerge.
A New Study
Breakthrough research conducted by the University of Bologna has shown promising new treatment methodology which has been successful in reducing fear memories. When using TMS (transcranial magnetic stimulation) shortly after surveying fear-triggering images, researchers observed lowered fear responses than those who hadn’t.
In walking through the procedure, primary researcher and author, Sara Borgomaneri explains--
“This experimental protocol combining transcranial stimulation and memory reconsolidation allowed us to modify an aversive memory that the participants had learned the day before.”
This is groundbreaking stuff.
Rather than soothing the physiological effects of fear memories after the fact, TMS and fear conditioning have the power to go straight to the source, altering the memory itself. By doing this, the memory is subdued--and later on, can be neutralized.
The initial altering had taken place only a day after 98 participants were presented with unpleasant stimulation and images. This was ample time for reconsolidation, but how does this work with long-standing fear memories?
Are Memories Cement or Plastic?
The study conducted by The University of Bologna relies on the ability to re-consolidate memories.
To understand this central portion of the study, learning about how pain memories are created and stored is a must.
Here’s how it works:
Essentially, consolidation is the process by which the brain turns new information (short-term memory) into re-callable information (long-term memory). One misconception about memory is that once information is stored, it’s neatly put away in one area of the brain, ready for us to recall at our earliest convenience. But in reality, our memories do not have a set locale in our minds--they’re spread throughout the brain.
“Through the consolidation process, the brain creates a sort of neural map, allowing memories to be retrieved when they are needed.”
It’s important to note that while our brains do create these map-like connections, our memories along with other stored information is not cemented in our minds. Instead, the act of remembrance is done by consistently recalling information.
This is called re-consolidation.
While we think re-consolidation only further solidifies the information we took in the first time, there are other things to consider.
Like food in a fridge, our memories have shelf lives. Even when we take steps to reconsolidate, there are factors which may affect the way we recall information. Along with information, we bring ourselves into it. In other words, our experiences, dispositions, and feeling states have the ability to alter our memories. In certain cases, this is a liability, as the recall process may not allow for objectivity. However, that flexibility has been primo for the University of Bologna.
But when thinking of a sort of plasticity in relation to memory altering, it can be seen as an opportunity--but only for a time.
“The protocol we developed exploits this short time window and can, therefore, interfere with the re-consolidation process of learned aversive memories.”
This makes sense considering that TMS was used on participants only a day after being exposed to fear stimuli. Had it been any longer, researchers would most likely have to restart the process.
PTSD and TMS
PTSD (Post-Traumatic Stress Disorder) is commonly characterized by recurring fear memories. Identified as flashbacks, fear memories can take different forms--nightmares, fear memories, etc.
As it stands, treatment for PTSD usually consists of talk therapy and psychotropic medications (antidepressants and anxiety medications).
Talk therapy typically requires the afflicted to relive fear memories--no easy feat, to say the least. And while it is a necessary part of healing, the residual pain might get worse before it gets better. To mitigate symptoms, people living with PTSD are often prescribed antidepressants, along with other medications to help alleviate some of the pain.
But such chronic, capital P pain, these typical methods may not always do the trick.
For treatment-resistant mental illness(s) like PTSD, TMS is a great option. Rather than ingesting medication, transcranial magnetic stimulation is a purely external process. By using magnetic pulses, different parts of the brain are stimulated to create new connections. This can alleviate symptoms in as little as four weeks. Of course, TMS is mainly used to treat the depression and anxiety associated with the illness--not the memories themselves.
So what about trauma memories?
Trauma memories are more difficult to re-consolidate and alter because of how they’re stored. Like other memories, they may not have a specific area where they stay. What sets trauma apart from other fear memories is how they break up and hide in plain sight..
How does this happen?
When someone experiences trauma, sensory information is processed through the amygdala (i.e. emotional regulator) where it is imprinted and dispersed through the limbic system, which affects memory, emotion, and behavior. What makes an event traumatic is our inability to take in the stress that is being placed on us.
“The amygdala stores the visual images as sensory fragments, which means the trauma memory is not stored like a story, rather how our five senses were experiencing the trauma at the time it was occurring. The memories are stored through fragments of visual images, smells, sounds, tastes, or touch.”
Because triggers can be so unpredictable, it would be difficult to come up with images that would bring up consistent traumatic memories. The other senses mentioned above would have to be taken into account as well.
While treatment options to alter trauma memories are not there yet, the ability to alter fear memories at all shows promise.
“This result has relevant repercussions for understanding how memory works. It might even lead to the development of new therapies to deal with traumatic memories. We’re dealing with a new technique that can be employed in different contexts and can assume a variety of functions, starting with PTSD, which will be the focus of our next study.”
Right now, TMS is recommended for the following conditions:
-Treatment resistant depression
-Obsessive Compulsive Disorder
-Post-traumatic Stress Disorder
When it comes to fear memories, trauma only is a natural connection to make. Still, there are other instances where TMS might be helpful.
Phobias along with other anxiety disorders revolve around fear responses. Since triggers, especially when it comes to phobia, tend to have similar themes, it’s feasible to imagine how the combination of adverse memory reinforcement combined with TMS might work to mitigate phobic symptoms as well. In fact, the methods researchers used at the University of Bologna are not so far off from what has been used in the past. In studying phobia, researchers used similar conditioning methods to previously been learned about phobia and what we now know about fear memories is a far more effective way of handling it. Image recall gives vital information about fear memories, but TMS provides a new way of tackling the problem--by detaching fear from memories and objects.
Thinking of fear memories associated with other types of anxiety disorders, like social phobia might also be viable in terms of re-consolidation. While the study above involved fear objects which were exclusive to specific things, like spiders, the same might be done for more experiential fears. For example, large social gatherings or public speaking.
It appears to be as simple as an extra step in the treatment protocol. That extra step, however, may make a world of difference in so many contexts.
Fear memories can take a serious toll when they continue to show up in our daily lives. Transcranial Magnetic Stimulation has already shown to be effective in soothing major depression, anxiety, and other psychological ailments. But little did we know, that was just the beginning. Changing the feeling states associated with fear memories is a monumental discovery--one that can potentially open doors to making PTSD more livable, among other things. And of course, this is just what the researchers at the University of Bologna have thought up so far. Who knows what the future holds!