Can memory reconsolidation increase psychotherapy's effectiveness?

April 19, 2024 10:39 AM

In “A Proposal for the Unification of Psychotherapeutic Action Understood as Memory Modification Processes”, Bruce Ecker lays out the case for a unifying account of therapeutic processes, and why that matters. (Link is to a publicly available pre-print copy of the article.)

Recent research provides more information about the neuroscience of memory change processes in learning and symptom development. The process of memory reconsolidation (MR) can achieve true unlearning (disappearance and enduring non-evocability) of a target emotional learning, and the resultant behavioral, emotional, and physiological responses that comprise undesirable symptoms in mental health. MR can be achieved in many ways that are already being used. These new understandings may help therapists more optimally tailor their services and finally cause an improvement the long-stagnant overall rate of success in psychotherapy outcomes.

posted by concinnity (11 comments total)

Oh, this is going to be some meaty reading. My first thought was something like, wait, we can't talk about target memories in adults with anxiety disorders, because by the time you're an adult you've got thousands of experiences that have reinforced your anxiety, so it's not like there's one singular memory that, if you can unlock it, will resolve everything for you. You've got the whole narrative of your life you have to work with. (Unlike rats getting a few shocks in the cage!) But no: "Importantly, the target for the memory modification of unlearning was not [the patient's] episodic memory of what he suffered under his father, but rather his semantic memory of the mental model or schema he formed from those sufferings."

The idea that we are storing the memories that create/reinforce our anxiety in a different "memory network" than the memories that might disprove the need to be anxious, is interesting and powerful (that is, why can't you 'think through' your anxiety by automatically remembering all the times the world didn't end?).
posted by mittens at 11:07 AM on April 19 [5 favorites]

I'm digesting a lot of stuff about therapy at the moment because I started therapy a few months ago and am DESPERATE to find relief from what has me out of work and feeling disabled much of the time. I'm making some progress, but this is an interesting concept that I might need to talk about next week.

Thank you for posting!
posted by hippybear at 11:31 AM on April 19 [4 favorites]

I wish papers had layperson-type summaries. At least there's the abstract! Thanks for posting this.
posted by somebodystrousers at 11:40 AM on April 19 [1 favorite]

"Importantly, the target for the memory modification of unlearning was not [the patient's] episodic memory of what he suffered under his father, but rather his semantic memory of the mental model or schema he formed from those sufferings."

This is interesting, and it rings pretty true to my own experiences of what good therapy feels like - gaining a better mental model for what the world is like / what I am like / what other people are like that doesn't seek to overwrite my bad experiences, but to integrate them with a broader perspective.
posted by Jeanne at 11:52 AM on April 19 [7 favorites]

As a complete outsider in such a field, I'm wondering how good the reputations and backgrounds of Ecker, Hulley, and Coherence Therapy are. How does their approach fit into other psychotherapy and psychology? Should I even be bothering with their stuff?
I'd sure like to believe it. The world really needs such breakthroughs.
posted by Flight Hardware, do not touch at 6:12 PM on April 19 [1 favorite]

I have trained and worked in the field, and have also studied and practiced Coherence Therapy to some extent (among many other therapy systems, models, approaches, and techniques). I'm not otherwise connected to the Coherence Therapy organization or its founders, but am happy to share further info about my professional/personal experiences with it, here or by PM.

There are a number of of CT articles and other resources (including at least one book) out there that are more accessible to the layperson. I wish there was a more "everyday language" version of this article. Even as an academic paper, this piece is pretty dense and complexly written.
posted by concinnity at 8:57 PM on April 19 [1 favorite]

I’ll take a good look at this a little later today if I get a chance, but on quick skim it appears to have some good thoughts but what I saw also appeared at odds with evidence-based treatment for trauma and OCD (where bringing a “positive” memory to the “unwanted state” counters the effects of exposure), but there may be more nuance on a closer read.
posted by brook horse at 6:13 AM on April 20 [1 favorite]

I have an academic neuroscience and research psychology background and I have never heard of this type of therapeutic framework before.

From a super quick search it seems like they do not really publish or work with any of the more mainstream clinical journals which raises some red flags for me. It seems like a bit of a bubble where all of the "evidence" for this approach is generated by organizations, journals, and individuals who are already invested in the validity of this specific approach.
posted by forkisbetter at 11:04 AM on April 20 [1 favorite]

I have an academic neuroscience and research psychology background and I have never heard of this type of therapeutic framework before.


With respect, (and I understand there’s a link here due to the topics of memory and psychotherapy) but this sounds like someone saying because I’m expert in one field I know and can discount something in another field? What research psychologists do is far far far removed from the reality of what therapists and clients experience in the therapy room. Also, perhaps the mainstream clinical journals have their own biases that produce “evidence” that is generated by organizations and individuals who are already invested in the validity of their specific worldview?
posted by flamk at 11:24 AM on April 20

this sounds like someone saying because I’m expert in one field I know and can discount something in another field?

I didn't get that impression. I'm hearing that someone with academic experience in the general field (psychology), which implies they know more than the average person about how research on therapies is done and published, is simply cautioning us that they are not finding much in the expected clinical journals.

It's a caveat, not a condemnation. It's an invitation to give us more links to research that validates this approach.
posted by Artful Codger at 2:36 PM on April 20

My field is clinical psychology and I am much more heavy on the practice than research side of psychology, and I had also never heard of coherence therapy. Upon researching it further it’s a rebrand of depth-oriented brief therapy, which is an attempt to make psychodynamic therapy time-limited. It’s possible something new and effective could come out of psychodynamics, but I’m seeing this currently more as marketing stuff we already know differently than a true breakthrough in our understanding.
posted by brook horse at 6:31 AM on April 21 [1 favorite]