A Primer on Memory Reconsolidation and its psychotherapeutic use as a core process of profound change by Bruce Ecker, Robin Ticic and Laurel Hulley Adapted for The Neuropsychotherapist from Unlocking the Emotional Brain: E Eliminating Symptoms at Their Roots Using Memory Reconsolidation by Bruce Ecker, Robin Ticic and Laurel Hulley Routledge, 2012 82 The Neuropsychotherapist issue 1 April-June 2013 ktsdesign/Bigstock.com motional learnings underlie and and their clients, yet this extraordinary du- drive the vast majority of un- rability appears to be a survival-positive re- wanted behaviors, emotions, sult of natural selection, which crafted the thoughts and somatization ad- brain such that any learning that occurs in dressed in psychotherapy. For the presence of strong emotion—such as example, consider a man in his core beliefs, constructs and coping tactics Eearly 40s suffering from pervasive social formed in the midst of childhood suffer- anxiety, who seeks relief in therapy. He is ing—becomes locked into subcortical im- guided by the therapist to bring attention plicit memory circuits by special synapses into what he is actually experiencing emo- (see for example LeDoux, Romanski & Xag- tionally and somatically when among peo- oraris, 1989; McGaugh, 1989; McGaugh & ple, and for the first time in his life he be- Roozendaal, 2002; Roozendaal, McEwen, & comes explicitly aware of expecting harsh Chattarji, 2009). rejection from others if he were to “say or And it appeared that natural selection do anything wrong.” This previously non- had not created a key for that synaptic lock. conscious but fear-generating expectation After more than 60 years of research on the had wordlessly defined the world of people extinction of acquired responses in animals for as long as he could remember. His emo- and humans, neuroscientists had concluded tional brain had learned this implicit model by 1989 that the consolidation of a learning Eof how human beings respond from many, in emotional memory was a one-way street, many frightening interactions with his ex- making consolidated learnings indelible, plosively angry, rejecting father in child- unerasable, for the lifetime of the individ- hood, plus a few sizable reinforcements by ual. Acquired emotional responses could two schoolteachers, male and female. certainly be suppressed temporarily in vari- His autobiographical memory and con- ous ways, such as when an exposure proce- scious narratives contained much about dure suppresses fear learnings through the suffering his father’s anger, but nothing process of extinction, or through methods about the generalized model that he car- of affective regulation (for example, teach- ried into all social situations, so his social ing relaxation techniques to counteract anxiety had been for him a mysterious af- anxiety or building up resources and posi- fliction. With the shift from implicit to ex- tive thoughts to counteract depression). plicit knowing of what he had learned to However, the research had shown that expect, his anxiety now made deep sense such counteractive measures do not actu- to him as the emotion that naturally ac- ally dissolve or erase the original, problem- companied his living knowledge of how atic emotional learning (Bouton, 2004; Foa people respond. These learned constructs & McNally, 1996; Milner, Squire, & Kandel, had never appeared in his conscious expe- 1998; Phelps, Delgado, Nearing, & LeDoux, rience of anxiety. Such implicit constructs 2004). Rather, they only create a second, and models formed in emotional learning preferred learning that competes against are well-defined, yet rarely show up in con- and can regulate or override an unwanted scious experience themselves, much as a response under ideal conditions, but usu- colored lens just in front of the eye is not ally not for long under real-life conditions. itself visible. Relapses are almost inevitable, particularly A vast range of miseries is maintained by in new or stressful situations. No wonder non-conscious emotional learnings, such as therapists and clients often feel they are depression that is really the deeply forlorn struggling against some unrelenting but in- state of having learned from cold, critical visible force. parents that one is unworthy of love. Be- Indelibility implied that despite their ing completely unaware of one’s own most limitations, counteractive methods were life-shaping learnings is remarkably com- the only possible psychotherapeutic strat- monplace. Unfading across the decades, egy for reducing symptoms based in emo- emotional learnings display an inherent te- tional memory. Their extreme durability nacity that is the bane of psychotherapists makes negative emotional learnings one ktsdesign/Bigstock.com www.Neuropsychotherapist.com The Neuropsychotherapist 83 of the biggest causes of suffering in human es in the final step of the natural process life, and it seemed we were forever stuck of synaptic unlocking and relocking, but with them. it can also refer to the overall process of unlocking, revising and then relocking the synapses encoding a specific memory. The The reconsolidation breakthrough intended meaning is usually clear from the From 1997 to 2000, however, a major context.) breakthrough occurred in our understand- The pivotal research that guides use of ing of how emotional memory works. Sev- reconsolidation in psychotherapy came eral studies by neuroscientists showed when Argentinian neuroscientists Pedrei- that the brain does come equipped with a ra, Pérez-Cuesta and Maldonado (2004) key to those locked synapses after all (Na- showed that memory reactivation alone der, Schafe, & LeDoux, 2000; Przybyslaw- was not sufficient for unlocking the syn- ski, Roullet, & Sara, 1999; Przybyslawski apses encoding a target learning. They & Sara, 1997; Roullet & Sara, 1998; Sara, identified a critical experience, described 2000; Sekiguchi, Yamada, & Suzuki, 1997). below, that is required in addition to the ex- Working with animals, researchers had re- perience of reactivation in order to unlock a activated a target emotional learning and target learning. This full map of the brain’s then found that its locked neural circuit had built-in process for unlocking an emotional temporarily shifted back into an unlocked, learning, allowing new learning to funda- de-consolidated, labile, destabilized or mentally unlearn, rewrite and eliminate it plastic state, which allowed the learning during the labile period, is of momentous to be completely nullified, along with be- significance for the psychotherapy field. havioral responses it had been driving. The It’s now clear that the consolidation of labile circuit soon consolidates once again, emotional memory is not, as had been be- returning it to a locked condition, which is lieved for a century, a one-time, final pro- why researchers named this newly discov- cess, and that emotional learnings are not ered type of neuroplasticity memory recon- indelible. Rather, neural circuits encoding solidation. (The term “reconsolidation” is an emotional learning can be returned to a used by neuroscientists in two ways, how- de-consolidated state, allowing erasure by ever. It can denote the relocking of synaps- new learnings before a relocking—or recon- Table 1 Symptoms observed dispelled by the reconsolidation process as carried out in Coherence Therapy* Symptoms Dispelled Aggressive behavior Food/eating/weight problems Agoraphobia Grief and bereavement problems Alcohol abuse Guilt Anger and rage Hallucinations Anxiety Inaction Attachment-pattern behaviors & distress Indecision Attention deficit problems Low self-worth Codependency Panic attacks Complex trauma symptomology Perfectionism Compulsive behaviors of many kinds Post-traumatic symptoms Couples’ problems of conflict/communica- Procrastination tion/closeness Psychogenic/psychosomatic pain Depression Sexual problems Family and child problems Underachieving Fidgeting Voice and speaking problems *An online bibliography of published case examples indexed by symptom is available at http://www.coherencetherapy.org/files/ct-case-index.pdf 84 neuropsychotherapist.com issue 1 April-June 2013 solidation—takes place. Counteracting and Oriented Brief Therapy) and have observed regulating unwanted acquired responses is its effectiveness for dispelling a wide range not the best one can do because emotional of symptoms and problems at their emo- learnings can be dissolved, not just sup- tional roots (see Table 1). That this method- pressed. (There are, however, certain clini- ology was capable of dissolving acquired, cal situations, including severe crises and implicit emotional schemas was later for- emergencies, in which use of counteractive tuitously corroborated by reconsolidation methods remains primary.) research. Neuroscientists have also shown that It is clear, though, that no single school after a learned emotional response has of psychotherapy “owns” the process that been eliminated through the reconsolida- induces memory reconsolidation because it tion process, the individual still remem- is a universal process, inherent in the brain. bers the experiences in which the response We believe this process is often carried out was acquired—as well as the fact of hav- in quite a few psychotherapies of transfor- ing had the response—but the emotional mational change (see Table 2), even though response itself is no longer re-evoked by in most of these the steps of the reconsoli- remembering those experiences. This find- dation process are not explicitly identified