Forgetting the Unforgettable: Pills May Soon Erase Traumatic Memories

The erasing of memories, a staple of science fiction books and films, has become reality, and soon it may also become readily available in pill or capsule form for patients treated by physicians or psychiatrists. ABC reporter Russell Goldman’s story, “Erasing the Pain of the Past” detailed the development of drugs that target memories of traumatic events and slowly eliminate them. Using an Iraqi War veteran suffering from Post Traumatic Stress Disorder (PTSD) as a case study, the report describes how these memory erasing drugs could be utilized to target the military veteran’s memories of frequent mortar attacks and over time remove them from his long term memory.

According to researchers, available knowledge of how the brain stores memories is fairly limited, but studies have revealed an important breakthrough:

But in their early efforts to understand the way in which short-term memories become long-term memories, researchers have discovered that certain drugs can interrupt that process. Those same drugs, they believe, can also be applied not just in the immediate aftermath of a traumatic event — like a mortar attack, rape or car accident — but years later, when an individual is still haunted by memories of event.

The science involved in these studies is fascinating. The research is being conducted at a prominent hospital, Massachusetts General, by Dr. Roger Pitman, a psychiatrist at Harvard Medical School. Dr. Pitman’s work, as reported in ABC’s story, identified that adrenaline plays a critical role in imprinting memories into our minds:

"There is a period of time after you first learn something before it's retained," Pitman explained. "This is called consolidation."

Some research has shown that stress hormones, particularly adrenaline, make that process faster and more intense.

"That's why you remember what you were doing the morning of Sept. 11, better than August 11," he said.

Some scientists believe that post-traumatic stress disorder is the result of too much adrenaline entering the brain at the moment the memory of a traumatic event is being consolidated, or stored, for the first time.

But "the real hot topic," Pitman said, is not consolidation but reconsolidation, the process by which an old memory is recalled and the same "window of opportunity" to alter it with drugs is opened for a second time.

Since the traumatic memory was imprinted due to a chemical influence (adrenaline), in theory during the moment that memory is being accessed or experienced by the patient, the memory itself can be chemically influenced again. The drugs under development would work to reverse the effects of adrenaline in the storage of that particular traumatic memory, lessening its physical and psychological effects on the body and mind and making it gradually more difficult to access the memory at all. The discovery of adrenaline’s role in traumatic memory retention and PTSD involved patients brought to the hospital emergency room after suffering automobile accidents. To calm the accident victims, doctors prescribed the drug propranolol to some and a placebo to others.

Propranolol has become a popular “social phobia” medication used by performers, politicians, and others whose work demands public speaking appearances that cause anxiety and nervousness. That anxiety manifests itself in releases of adrenaline, which produces rapid heart rate, shaking, and embarrassing voice cracking that all such performers dread. Propranolol was found to counteract the effects of adrenaline, and when researchers realized the link between adrenaline and traumatic memory, the idea to explore Propranolol treatment for PTSD symptoms was born.

Of course, as with any such potential medicinal breakthrough, ethical questions take center stage. Like cloning and other controversial research, the question arises, “Because we CAN do something, does that mean we SHOULD do it?” The President’s Council on Bioethics opposes all research focusing on memory alteration, but apparently the U.S. Army is at odds with the White House on this issue. According to ABC, the Army reportedly offered a monetary grant to help fund Dr. Pitman’s research involving treatment of Iraq War veterans for PTSD.

A question not raised in the ABC story is chemical “leaching” or “bleed over.” If the hormone adrenaline is what causes the mind to store traumatic memories along with the physical and psychological reactions associated with them in long term memory, is there a possibility that chemically altering one adrenaline induced memory could “bleed over” into another existing memory that also resulted from adrenaline release? For example, competitive athletes often experience “adrenaline rush” before, during, and immediately after a race, game, or performance. If such an athlete suffered an automobile accident on the way home after the game or event, the athlete’s memories of that day, the event as well as the accident, would be almost exclusively adrenaline imprinted memories. If this athlete were treated for accident-related PTSD later using Propranolol, would the drug differentiate between good adrenaline imprinted memories (the athletic competition) and negative traumatic memories imprinted on the same day and so closely linked? In the desire to remove the trauma of the accident, will the memory of achievement and competition also be removed?

Even the smallest of confrontations produces adrenaline release. The “fight or flight” response is well-documented and most adults retain vivid memories of schoolyard bullies, fights, sports achievements, and embarrassing situations. Certainly any life-threatening event induces adrenaline release. Law enforcement personnel, fire fighters, paramedics, military personnel, and civilian war survivors experience such moments frequently, and as a result PTSD is much more common among them than in the general population. Even intense training scenarios and tactical exercises will produce sufficient adrenaline to ensure long term memory of each and every such moment.

Removing some or all traumatic memories for such people would fundamentally alter who they are as well as their value as experienced professionals in critical public service fields. Whatever one thinks of Senator John McCain’s politics, it is worth considering what career he would be engaged in and what kind of man he would have become had memory erasing drug treatment been prescribed to him upon his return after 5 years of suffering in North Vietnamese POW camps. Few would suggest that President Kennedy would have been better off without the traumatic memory of his PT boat being destroyed by an enemy destroyer during WWII. He was injured in the incident and was later decorated for rescuing his surviving crewmembers.

A contrasting case to ponder might be Sulejman Talovic, the Salt Lake City youth who went on a shooting spree at a local mall. In a previous post I wrote at length about Talovic’s background as a Bosnian war refugee and genocide survivor, traumatized for five consecutive years by these events. In that post I compared Talovic’s history with battlefield experiences of a U.S. soldier who committed suicide, apparently due to PTSD, after his return home from the Iraq War. Would Talovic have gone on a shooting rampage had he been treated with memory altering medications? Likewise, would the U.S. soldier mentioned in that post have committed suicide had his traumatic war memories been suppressed or erased?

It is worth taking a moment to consider what memories you are storing, particularly those you can recall with little or no effort and that involve significant events in your life. The majority of such memories, whether traumatic or otherwise, likely involved a degree of adrenaline release. Childbirth certainly involves anxiety, nervousness, and intense physical exertion and adrenaline release for the mother, and anxiety and adrenaline release for the father as well. Childbirth is a life-altering event for everyone involved, and most people can recall with relative ease the event years later in great detail, presumably because the memories were adrenaline imprinted for long term memory storage. Who isn’t nervous and sustained by adrenaline on their wedding day? Is there a higher level of excitement induced adrenaline than that found in a child on Christmas morning?

Consequently, it is likely that most, if not all, of our long term memories, whether traumatic or happy, were chemically affected by adrenaline sufficiently to be stored in long term rather than short term memory. What if, while recollecting a traumatic event in order to have it altered and erased by medication, the mind wanders, as it often does, and recalls a different memory than the one targeted for erasure? If the drug therapy targets the memories in the moments they are being experienced, then the superimposition of a good memory or even another traumatic memory could, in theory, result in unintentional and permanent damage to or complete deletion of the wrong memory.

Clearly the research into memory alteration or erasure is still an emerging science, but the ethical questions involved with it are significant. What will be the medical standard for traumatic memory? As medical ethicist Felicia Cohn, consulted by ABC, wondered, “Who gets to decide what is horrific enough?” Cohn raised another important dilemma that anyone wanting to rid themselves of traumatic memories will face: unless the memories of everyone who has ever known the person are also erased, there will be, as the song bemoans, “always something there to remind me.” Cohn warns:

What are the effects of altering a particular person's memory but not changing the context the person is living in. We might erase a young girl's memory of a rape, but people around her will still know and inadvertently remind her.

Memory alteration drugs may not prove be the panacea hoped for by PTSD sufferers, or the ultimate government conspiracy tool depicted in science fiction stories and films, but perhaps they will, through successful and limited testing, serve to at least blunt some of the physical and psychological trauma characterized by PTSD sufficiently to help war veterans and others retain memories and lessons learned through experience, and regain control over their disrupted lives. If the release of adrenaline these sufferers experience each time they relive a traumatic memory can be suppressed, then the sufferer will be less likely to want the memory itself erased. If Dr. Pitman’s research leads down that path, rather than actual memory alteration or removal, it may prove invaluable to victims of a wide variety of traumas.