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.

Blogs, Radio Talkers Use Mall Killer's Muslim Affiliation for Shock Value: Ignore Youth's Traumatic Escape from Bosnian Genocide

Are conservative blogs and news sites exploiting the fact that the Trolley Square Mall shooter, Sulejman Talovic, was Muslim simply to attract site traffic? Elaine Jarvik, Deborah Bulkeley, and Ben Winslow of the Deseret Morning News (Salt Lake City) provided two very important follow-up articles in today’s edition about the slayings at the Trolley Square Mall earlier this week. Jarvik and Bulkeley took conservative sites to task for declaring, without any evidence, that because Talovic was Muslim he must have engaged in “Sudden Jihad Syndrome” as argued by Jihad Watch.

The authors cite emotion-inducing headlines from Little Green Footballs and MichaelSavage.com as incorrectly distilling the tragedy in Salt Lake City down to a single theme: “Salt Lake City Killer Was a Muslim.” As a regular reader of both sites criticized in this article, and as Spy The News! readers know, I have dedicated a career to countering ideologies like radical Islam. However, I sided with the authors in their assessment that the shooter’s religion played an important role in the incident, but not for the “jihadist” reasons headlined by Jihad Watch and Little Green Footballs.

Before casting stones at Muslims in general or specifically Sulejman Talovic himself, perhaps news sites and bloggers should have delved into the background of this young man prior to publishing scathing headlines designed to incite hatred and fear.

The second Deseret Morning News article, by Ben Winslow with the assistance of a Bosnian news reporter, described in great detail the experiences that make the Trolley Square shooter very different from the teen slayers at Columbine or other youthful murderers. The article, “A Child of Violence: Talovic Survived Genocide,” should cause many to rethink their assumptions that Talovic acted out any “jihad” impulse. While it is true that he was Muslim, there is no evidence he was active in any local mosques and most of his ties to regular Islamic worship were cut when his family emigrated to the U.S. after five years as refugees from Milosevic’s genocide in Bosnia.

From Winslow’s article, the following excerpts shed light on what Talovic experienced at the tender age of 7 and through more than 5 years of his youth. Spy The News! urges readers and fellow bloggers to see the forest in this situation (suffered genocide trauma), and not merely the trees (he was Muslim):

As a little boy in Bosnia-Herzegovina, Sulejman Talovic hid in fear from the Serb military forces who were slaughtering Muslim men and boys as war and genocide ravaged his country . . . . neighbors also acknowledged that the war in Bosnia likely left its mark on the boy. During the war, the family lived for five years as refugees in Bosnia, and spent almost a year in the mountains hiding from the Serb military forces, neighbors said. Up to 200,000 people were killed and 1.8 million others lost their homes in Bosnia's 1992-95 war. . . .

The war in Bosnia-Herzegovina forced the Talovic family to live as refugees. From 1993 until they emigrated to the United States in 1998, they were on the run, moving from village to village.

They lived near Srebrenica, where more than 8,300 Muslim boys and men were killed in 1995 by Serb forces loyal to ex-Yugoslavian leader Slobodan Milosevic. Sulejman Talovic was 7 years old then.

The atrocities of war and "ethnic cleansing," and the pressures of daily life in a new country after he immigrated to the United States, could have created immense pressure on Talovic, according to Greg Jurkovic, a psychology professor at Georgia State University who has studied Bosnian teenagers in both Atlanta and Sarajevo.

"What we're finding is that so many of these kids are suffering from PTSD (Post Traumatic Stress Disorder)," he said. "What seems to be most important is what they were exposed to, their war exposure." [emphasis added]

Some argue that because he survived genocide against Muslims at the hands of “Christian” Serbs he was thus acting out a desire to kill infidels when he entered the Trolley Square Mall. However, that conclusion ignores the fact that the genocide was a personally traumatic experience that scarred the boy psychologically. Perhaps the authors of Little Green Footballs and Jihad Watch should visit the psychiatric emergency units at various Veterans Administration hospitals to witness firsthand the mental illnesses produced by battlefield trauma. Schizophrenia (acute or paranoid types), Post Traumatic Stress Disorder, sleep disorders, Bi-Polar Disorder, and these merely scratch the surface of what one finds. The veterans in those wards were combatants in wars they may or may not have understood, at ages similar to Talovic’s youthful eighteen years.

Many of these precious veterans have attempted suicide with various weapons or available household items; many have assaulted family members they love and responding law enforcement, not because they truly wanted to hurt anyone but because they were no longer in control. A break from reality, or psychotic episode, can occur rapidly or gradually, and the fact that Talovic was calmly walking through the mall does not indicate he was acting rationally or with legally defined criminal intent. A comparison of PTSD manifestations in a U.S. Military veteran and in Talovic is enlightening. Consider the tragic situation of just one Marine, Jonathan Schulze:

Schulze, a machine gunner and a corporal, had fought in Iraq in battles where Marine casualties were high. He had told his family that he felt guilty that he had lived and close friends had died [emphasis added]. He left the Marines in late 2005 after four years of service.

Schulze's stepmother said that she witnessed Jonathan telling VA staff workers in St. Cloud that he felt like killing himself. She said she also heard him tell a VA counselor over the phone the next day that he was suicidal. After that conversation he told his stepmother that he learned that he was No. 26 on a waiting list for admittance to the St. Cloud psychiatric unit.

The St. Cloud VA has no waiting list for its locked, acute psychiatric unit -- where suicidal or homicidal veterans would be taken . . . [emphasis added]

Two other members of Minnesota's congressional delegation expressed concern about the VA's ability to cope with a growing wave of troops returning from Iraq. Many of those veterans are expected to need counseling because of combat stress, lengthy separation from families, financial problems and other worries. [emphasis added]

"The hidden costs of this war are not being addressed," said Rep. Tim Walz, D-Minn., a member of the U.S. House Veterans' Affairs Committee and a veteran. "I've been deeply concerned. I think there's been almost nothing done to prepare for this."

Examine carefully the words or phrases emphasized in red. All of these were a part of daily life for Talovic. Survivor's guilt? Watching your friends and neighbors being exterminated while you manage to flee would cause that. This was also common among Jewish Holocaust survivors. Combat Stress? Being hunted for extermination in the middle of a war zone seems to fit that criteria. Separation from families? Talovic's extended family remain in Bosnia today. Financial problems? Talovic's family fled and lived in abandoned shacks, working odd jobs to survive in Bosnia until they could emigrate to America. In America Talovic's father and Talovic himself have worked many low wage jobs to provide for the family and save money to help bring family from Bosnia to the U.S. Other Worries? Wouldn't these other factors be enough? Add being a teenager in a new country, with few friends to the stresses already described, and a very different picture of Talovic emerges from the "Mall Killer is a Muslim" frenzy.

Note the use of the word "homicidal" by the VA hospital official. Clearly PTSD and other psychological problems stemming from war trauma have led some of our veterans to act on homicidal impulse. Is it so hard to imagine someone who had gone through what Talovic experienced acting similarly? Or is it just easier and more newsworthy to assume he killed because he was nominally Muslim?

Many who suffer mental illnesses are “high functioning” and it is only when you sit down to interview or visit with them does the paranoia become apparent. Talovic’s actions, although horrendous, likely had no connection to the U.S. War on Terror, the Iraq War, or jihad against America despite current events. America is where his family fled to in order to escape Bosnia and find safety. By all accounts, Talovic’s family had no ties to any groups sympathetic to radical Islam, and the FBI has ruled out terrorism in this incident. Talovic’s family worked various jobs in an effort to provide funds for extended family to emigrate to the U.S. as well. This does not appear to be the portrait of a jihadist family.

Ascribing Talovic’s actions to his religion itself or some jihadist mentality may have shock value in the headlines, but it omits the central factors of the incident: The perpetrator’s mental capacity and intent. Both of those were likely influenced tremendously by his childhood experiences in Bosnia. In our criminal justice codes, those with mental illness or even “temporary insanity” are judged by different and more compassionate standards than criminals with clear intent. While Talovic’s death in this incident prevents a definitive assessment of his intent, there is far more in his background that points to genocide trauma, rather than jihad, to explain his terrible actions.