FROM THE ANNUAL PSYCHOPHARMACOLOGY REVIEW SPONSORED BY THE UNIVERSITY OF ARIZONA
TUCSON - Recent neuroscience findings on the nature of memory provide insight into the mechanisms by which psychotherapy results in therapeutic change - and suggest a basis for selecting the best type of psychotherapy for a given patient.
The key brain science finding with profound implications for psychotherapy is that memories are not permanent and stable, as traditionally thought. Rather, they change every time they are recalled and then stored once again, Dr. Richard D. Lane explained at the meeting.
The core concept of his thesis is that all successful psychotherapy works in the same way; Automatic dysfunctional emotional processes arising from traumatic childhood experiences can be altered by activating the problematic memories, generating new adaptive emotional responses, and then storing the changed memories in stable fashion, said Dr. Lane, professor of psychiatry, psychology, and neuroscience at the University of Arizona, Tucson.
"Therapeutic change in a variety of modalities results from the reconsolidation of emotional memories by incorporating new emotional experiences in contexts reminiscent of the original problematic situations," according to the psychiatrist. "Change in psychotherapy has three necessary ingredients: activation of memories, including the old feelings; activation of new emotional experiences, the more intense the better; and practicing new ways of experiencing the world in a variety of contexts."
His research collaborator, Lee Ryan, Ph.D., highlighted three major changes in thinking about the neuroscience underpinning memory that provide new insight into how psychotherapy works. A central concept concerns what neuro-scientists call multiple trace theory, which has shown that the hippocampus and amygdala interact to bind memory and emotions during consolidation of new memories.
"Memories are malleable and constantly undergoing revision because of the process of retrieval or recollection. When you engage in recollection, the memory goes into an unstable state, so at that moment there's the possibility of adding information. We're not just laying down a new memory but actually changing in fundamental ways the original memory," said Dr. Ryan, director of the university's cognition and neuroimaging laboratories.
Two other relevant relatively recent neuroscience insights derived from animal work and human studies supported by functional MRI are that stress enhances the retrieval of both memories and emotions, and that episodic memory and semantic structures are interactive systems. "The classic way we've thought about memory is wrong. The hippocampus is equally active in both semantic memory tasks and emotional memory," she said. "Episodes can be used as a vehicle to change semantic structures and vice versa."
Dr. Lane stressed that these insights from neuroscience have clinical implications. For example, the traditional psychodynamic psychotherapy strategy of having the patient lie on a couch with the analyst out of view is probably less conducive to creating new emotionally arousing adaptive experiences than sitting up face to face. …