Forgetting Pain

For those of you interested in a greater understanding about the "painful experience", a recent article in wired magazine may be of benefit to you.

This article by Jonah Lehrer titled, "The Forgetting Pill Erases Painful Memories Forever", goes into detail behind the mechanisms of which painful memories both develop and occur, as well as potential treatment for such memories.

Now while I'm less concerned about the specificities of the treatment, there were take home lessons from this article that refreshed and deepened my understanding about painful experiences.

Here are some of the ideas the resonated with me, particularly as they relate clinically to painful experiences (as opposed to painful memories):

• While painful experiences are often triggered by stressful incidents, they are really diseases of memory.

"Even though PTSD is triggered by a stressful incident, it is really a disease of memory. The problem isn’t the trauma—it’s that the trauma can’t be forgotten. Most memories, and their associated emotions, fade with time. But PTSD memories remain horribly intense, bleeding into the present and ruining the future. So, in theory, the act of sharing those memories is an act of forgetting them."

• Each painful experience, and its very act of remembering, changes the memory itself.

"New research is showing that every time we recall an event, the structure of that memory in the brain is altered in light of the present moment, warped by our current feelings and knowledge. That’s why pushing to remember a traumatic event so soon after it occurs doesn’t unburden us; it reinforces the fear and stress that are part of the recollection."

• Painful experiences initiate as a dynamic imprint, a "neurotag", that activates connections among cells in the brain. Such cells and their connections become more sensitive to each other resulting in greater potential for their activation.

"Every memory begins as a changed set of connections among cells in the brain. If you happen to remember this moment—the content of this sentence—it’s because a network of neurons has been altered, woven more tightly together within a vast electrical fabric. This linkage is literal: For a memory to exist, these scattered cells must become more sensitive to the activity of the others, so that if one cell fires, the rest of the circuit lights up as well. Scientists refer to this process as long-term potentiation, and it involves an intricate cascade of gene activations and protein synthesis that makes it easier for these neurons to pass along their electrical excitement."

• How we think affects how we feel and as R. Dworkin, Ph.D once said "the hurt that you feel becomes the feeling you're hurt". Therefore, it is important that not all painful experiences are musculoskeletal in nature. We must remember that there is always a cognitive and behavioural aspect to clinical management.

Memories are not formed and then pristinely maintained, as neuroscientists thought; they are formed and then rebuilt every time they’re accessed. “The brain isn’t interested in having a perfect set of memories about the past,” LeDoux says. “Instead, memory comes with a natural updating mechanism, which is how we make sure that the information taking up valuable space inside our head is still useful. That might make our memories less accurate, but it probably also makes them more relevant to the future.”

I urge you to read the article and generate your own take home points. For more information on how the brain works, another suggestion is to pick up an issue of Scientific American Mind..