Accelerated forgetting of a trauma event after a single dose of hydrocortisone(nature.com)
nature.com
Accelerated forgetting of a trauma event after a single dose of hydrocortisone
https://www.nature.com/articles/s41398-022-02126-2
111 comments
Is there anything to back up these ideas. Admittedly, I haven't read the article and am not familiar with the science.
That said, these aren't things that can be figured out based on gut feeling or how something "seems". Your body doesn't remember anything, what are you talking about?
There's no reason to think that it would be impossible to create a pill to mitigate some trauma. This seems like a dangerous obsession with "therapy", that our modern society seems to have. "Taking pill bad. Must work through"
It's been observed for a long time that some people handle trauma way better than others. Who says we can't get to a place where everyone can have that, or that we can never find medicine that helps?
That said, these aren't things that can be figured out based on gut feeling or how something "seems". Your body doesn't remember anything, what are you talking about?
There's no reason to think that it would be impossible to create a pill to mitigate some trauma. This seems like a dangerous obsession with "therapy", that our modern society seems to have. "Taking pill bad. Must work through"
It's been observed for a long time that some people handle trauma way better than others. Who says we can't get to a place where everyone can have that, or that we can never find medicine that helps?
Your body does remember things. See the book “The Body Keeps The Score”.
This is true, but only because the brain is a part of the body. The brain remembers things.
That neglects all the other ecosystems in your body that lead you to behave the way you do.
Have you ever been hangry? How about the experience of chronic intestinal irritation worsening your depression? How do you feel in your head when you can’t stop your heart from racing after a stressful day of work? Those are all examples of the inverse.
Have you ever been hangry? How about the experience of chronic intestinal irritation worsening your depression? How do you feel in your head when you can’t stop your heart from racing after a stressful day of work? Those are all examples of the inverse.
Those are all examples of the brains response.
The body is the trigger but the brain is the source of the symptoms.
The body is the trigger but the brain is the source of the symptoms.
Also, "The Body Remembers" volumes 1 and 2.
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I made a very deep PTSD syndrome once... The kind which get you homeless in matters of months.
I was having non-stop flashback of traumatic events... When I was deep in these memories(what i think they call intrusion), It was like having taken cocaine with 10e5 effect flooding my frontal lobe, a lot of anger and depression at the same time. I was enable to get out of bed except once in a week to buy some food... When I ran out of food I could stay +48h without anyintake...
I googled something about memory improvement or trauma... I don't remember well... and came to read about an hormone, sold in most dieterary shop on the internet. I decided to give it a try.
It was life saving. Instant effects. In a month of self prescribed cure, I was coming back to life. It had unfortunately a few side effect, the most dominant was burst of anger. So I stopped it. But it was enough to get me in track.
What would have been the alternative solution ? Therapy ? Which one? Most of them (if not all) are either pseudo-science gibberich when it is not plain mystical or "spiritual" bullocks, like the one that says you want to fuck your mother but you don't know it until you spend 7 years, 100$/week, on a couch telling whatever come to your mind to a guy which could as well be emulated by an 60's version of therapist bot.
I'm not sure the product I ordered was what was advertised. Years latters, I ordered it again (an other brand) and it had no the same effect if any at all.
I was having non-stop flashback of traumatic events... When I was deep in these memories(what i think they call intrusion), It was like having taken cocaine with 10e5 effect flooding my frontal lobe, a lot of anger and depression at the same time. I was enable to get out of bed except once in a week to buy some food... When I ran out of food I could stay +48h without anyintake...
I googled something about memory improvement or trauma... I don't remember well... and came to read about an hormone, sold in most dieterary shop on the internet. I decided to give it a try.
It was life saving. Instant effects. In a month of self prescribed cure, I was coming back to life. It had unfortunately a few side effect, the most dominant was burst of anger. So I stopped it. But it was enough to get me in track.
What would have been the alternative solution ? Therapy ? Which one? Most of them (if not all) are either pseudo-science gibberich when it is not plain mystical or "spiritual" bullocks, like the one that says you want to fuck your mother but you don't know it until you spend 7 years, 100$/week, on a couch telling whatever come to your mind to a guy which could as well be emulated by an 60's version of therapist bot.
I'm not sure the product I ordered was what was advertised. Years latters, I ordered it again (an other brand) and it had no the same effect if any at all.
I just want the option. I was a child. I never signed up in the business of dealing death and trauma unto others and myself. I would have loved to have had a doctor offer a hit of something to dull the imprinting of my worst day into my memories, emotions, and thought processes.
Am I supposed to live my life warning others about risks they don't care they are taking? I sometimes just want to be normal and forget what happened, and join the others in not thinking about people getting killed as part of my every day life.
Am I supposed to live my life warning others about risks they don't care they are taking? I sometimes just want to be normal and forget what happened, and join the others in not thinking about people getting killed as part of my every day life.
The study mentions that there is no degradation in "voluntary memory", only in "intrusions", which they define as "Persistent, distressing involuntary memories".
This study specifically measured only the first week after watching a trauma film, so I'm sure you're right that the extension of this to actually treating PTSD will be a lot more complicated, but it doesn't sound like the treatment is expected to cause complete forgetting of the event.
This study specifically measured only the first week after watching a trauma film, so I'm sure you're right that the extension of this to actually treating PTSD will be a lot more complicated, but it doesn't sound like the treatment is expected to cause complete forgetting of the event.
I am entirely in agreement with you. That said, humanity has never been a defense against atrocities. If anything, it is the opposite. Humanity has for as long as I've learned history been gleefully and willingly committing atrocities in war. This is a rule, not an exception.
That’s like saying “people should put in the hard work of working through depression rather than relying on medication”.
What could be the rationale for denying someone an effective treatment?
What could be the rationale for denying someone an effective treatment?
Combine with propranolol for maximum effect.
A very overlooked drug that can be used in the treatment of many disorders related to anxiety, stress and fear. Without the risk of debiliating addiction benzos and benzolikes bring.
https://pubmed.ncbi.nlm.nih.gov/14573324/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3692719/
A very overlooked drug that can be used in the treatment of many disorders related to anxiety, stress and fear. Without the risk of debiliating addiction benzos and benzolikes bring.
https://pubmed.ncbi.nlm.nih.gov/14573324/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3692719/
Yeah, I've been on beta blockers for a heart defect for several years now. I read this paper about a year after going on them and just started exploring trauma on my own (stuff that made me weep or even pull face muscles in grief) the post sleep memory reconsolidation is basically a miracle and my emotional trauma responses were basically wrapped up within ~ 1 year. There is now nothing so awful I cannot touch, hold and examine it. I no longer even have nightmares of any kind. I don't have intrusive thoughts from past events during the day (none to speak of) and no rumination either, it's like speed running stoicism.
What is the post sleep memory reconsolidation?
My mom has severe PTSD that is causing memory and cognitive decline because all her resources are dedicated to fight or flight. She is just a ball of the most significant stress you can imagine and it’s destroying her.
Have any recommendations or suggestions?
My mom has severe PTSD that is causing memory and cognitive decline because all her resources are dedicated to fight or flight. She is just a ball of the most significant stress you can imagine and it’s destroying her.
Have any recommendations or suggestions?
Basically the protocol is to be on a beta blocker and then recall the memory and explore it followed by normal sleep.
This pulls the memory into short term storage and then when you sleep the memory will reconsolidate into long term storage but without the physiological adrenaline/stress response.
I had some terrible experiences that provoked strong grief responses and it took several cycles of recall / reconsolidation before the emotional stress response was stripped to something manageable.
This pulls the memory into short term storage and then when you sleep the memory will reconsolidate into long term storage but without the physiological adrenaline/stress response.
I had some terrible experiences that provoked strong grief responses and it took several cycles of recall / reconsolidation before the emotional stress response was stripped to something manageable.
Wow that sounds very powerful and a logical way to reduce the associated trauma from a memory. Good for you for working your way through that! And thanks for sharing.
For my moms case, she’s unfortunately buried whatever trauma it is that is causing her to eg always have her bags packed and ready to bolt such that I don’t think she can consciously identify a memory that has traumatized her. She doesn’t even think she has trauma (despite everyone having at least some trauma and her more than others). At this point she’s just put up all her defences and refuses to deal with the root of it. It’s ruining her psychologically and unfortunately negatively affects all those who are around her (considering she’s at 20/10 stress levels nearly all the time but she thinks that’s normal).
Thanks again for sharing what has been working for you. I’m trying desperately to find something that can help her become a functional human being again because I’ve been her full time caretaker for last couple years and now it’s killing me too. But perseverance they say, balanced with burn out.
For my moms case, she’s unfortunately buried whatever trauma it is that is causing her to eg always have her bags packed and ready to bolt such that I don’t think she can consciously identify a memory that has traumatized her. She doesn’t even think she has trauma (despite everyone having at least some trauma and her more than others). At this point she’s just put up all her defences and refuses to deal with the root of it. It’s ruining her psychologically and unfortunately negatively affects all those who are around her (considering she’s at 20/10 stress levels nearly all the time but she thinks that’s normal).
Thanks again for sharing what has been working for you. I’m trying desperately to find something that can help her become a functional human being again because I’ve been her full time caretaker for last couple years and now it’s killing me too. But perseverance they say, balanced with burn out.
Have any academic references for this, ? Im genuinely curious, and would like to be able to read more about it.
The non pharmaceutical variant of exactly this would be using meditation. Which is a lot of effort.
Has she looked into EMDR therapy?
Ah, propranolol... how I wished it was a thing back when I was in school. I used to practice my instrument for hours every day, just to choke when performing a solo in front of an audience. Fast forward 20+ years, and I embarrass myself by freezing up during a VP review. That damn lizard brain!
I finally got a prescription, and a full bottle of pills at the ready -- but I haven't tried it yet.
I finally got a prescription, and a full bottle of pills at the ready -- but I haven't tried it yet.
Hah, had me on the edge of my seat to hear the life altering impact, and then, bottle’s still on the shelf!
Here’s to hoping it works well next time you need it tho.
Here’s to hoping it works well next time you need it tho.
I couldn‘t do job interviews without -I‘d probably be unemployed.
Anyone with asthma doesn't qualify for propranolol. There are more "selective" beta blockers but it's not clear they're as effective for psychological use, or how much less they exacerbate asthma.
> propranolol [for] anxiety, stress and fear
I recall reading that propranolol reduces the physical manifestations of anxiety, stress and fear, but you still feel it internally. For example, when used for stage fright, you won't fidget, stutter, blush, sweat, and have a racing heart beat, but you'll still feel the anxiety inside yourself.
I recall reading that propranolol reduces the physical manifestations of anxiety, stress and fear, but you still feel it internally. For example, when used for stage fright, you won't fidget, stutter, blush, sweat, and have a racing heart beat, but you'll still feel the anxiety inside yourself.
Personal anecdote, i heard this as well, but after trying it, its very clear that it has positive results on my anxiety, not only physical (shaky hands...) but mental as well
What is anxiety except those physical manifestations and how hard they make it to think?
Traubenfuchs(3)
And, for a nonpharmaceutical intervention -- have them play a bit of Tetris.
https://www.psych.ox.ac.uk/news/tetris-used-to-prevent-post-...
I can confirm from personal experience that this works, and that it isn't specific to Tetris. Other visual/spatial puzzles are similarly effective.
https://www.psych.ox.ac.uk/news/tetris-used-to-prevent-post-...
I can confirm from personal experience that this works, and that it isn't specific to Tetris. Other visual/spatial puzzles are similarly effective.
I think Nurikabe is really good.
Isn't there a similar study where playing Tetris helped people recover faster?
Games will only cover up the symptoms. My ex-wife was a doctor who was struggling with c-ptsd that she could not treat otherwise she would loose her accreditation. She used Candy Crush everyday to reduce the impact of the PTSD on her life, unsuccessfully. I had to leave. She was a ball of rage that was always on the precipious of a full blown flash back. She said it kept her "mentally fit for the job", but i saw it was the only way she could be be idle without it creeping back into her mind. There were only so many hours between shifts, and at work she felt value and could forgot, mostly.
The Tetris wasn't used long term like that as a distraction.
It was used to keep people awake for a long time immediately after a traumatic event. The Tetris was less important than the lack of sleep.
If you don't sleep and play Tetris for a couple days you scramble the process of turning short term memories into long term, making them less impactful.
It was used to keep people awake for a long time immediately after a traumatic event. The Tetris was less important than the lack of sleep.
If you don't sleep and play Tetris for a couple days you scramble the process of turning short term memories into long term, making them less impactful.
Why would she lose her license over this? Is it just a weird country/law?
I'm curious because my therapist said I probably have CPTSD (not as severe as your ex had it, though; to the point it doesn't even sound like CPTSD to me).
I'm curious because my therapist said I probably have CPTSD (not as severe as your ex had it, though; to the point it doesn't even sound like CPTSD to me).
The thing about (C)PTSD is that (like all complex systems), you eventually fall into a stable pattern until something changes.
The 'apparent severity' of PTSD has more to do with the pattern you fall into.
The 'apparent severity' of PTSD has more to do with the pattern you fall into.
Paper:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5678449/
Press coverage:
- https://www.google.com/search?q=intitle:tetris+traumatic+mem...
HN posts:
https://hn.algolia.com/?dateRange=all&page=0&prefix=true&que...
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5678449/
Press coverage:
- https://www.google.com/search?q=intitle:tetris+traumatic+mem...
HN posts:
https://hn.algolia.com/?dateRange=all&page=0&prefix=true&que...
This roundup concluded that the evidence is not particularly strong:
"In short, there is no convincing evidence that playing Tetris actually helps people. The studies have methodological problems, tiny sample sizes, and have failed to replicate. Some found a reduction in “intrusive memories,” but no improvement in outcomes of PTSD or distress."
https://www.madinamerica.com/2021/10/tetris-trauma-viral-twi...
"In short, there is no convincing evidence that playing Tetris actually helps people. The studies have methodological problems, tiny sample sizes, and have failed to replicate. Some found a reduction in “intrusive memories,” but no improvement in outcomes of PTSD or distress."
https://www.madinamerica.com/2021/10/tetris-trauma-viral-twi...
That was a great article. Thank you.
Just beware that corticosteroids can destroy your vision: https://www.gov.uk/drug-safety-update/corticosteroids-rare-r...
Don't accept the irresponsible "rare" declaration, either. "Seldom-reported" is far more accurate and likely, given that CSR can be subtle. It takes a particularly knowledgable doctor to diagnose it, or a very persistent patient. When you combine those factors with the fraction of users who even have the wherewithal to go to an eye specialist in the first place, and the likelihood of the incident making it into a tracking database, you have the formula for a hugely under-reported malady that can ruin the quality of people's lives.
Patients should be apprised of all risks so they can weigh the benefits of the treatment, which may of course be deemed superior. The important part is that patients should always have the facts so they can make the choice.
Don't accept the irresponsible "rare" declaration, either. "Seldom-reported" is far more accurate and likely, given that CSR can be subtle. It takes a particularly knowledgable doctor to diagnose it, or a very persistent patient. When you combine those factors with the fraction of users who even have the wherewithal to go to an eye specialist in the first place, and the likelihood of the incident making it into a tracking database, you have the formula for a hugely under-reported malady that can ruin the quality of people's lives.
Patients should be apprised of all risks so they can weigh the benefits of the treatment, which may of course be deemed superior. The important part is that patients should always have the facts so they can make the choice.
I wonder what would have Freud said about this.
In the US it seems like it is extremely in vogue to talk about trauma and PTSD. From a layman's POV, it seems pretty obvious that talking about something very often (whether it be with a therapist or just friends) would elevate the amount of times someone thinks of something. From my understanding of the paper, this drug is a success if it lowers the amount of time someone thinks of a traumatic memory
>We found that participants receiving hydrocortisone showed a faster reduction in daily intrusion frequency. Voluntary memory was assessed once, at the end of the week, but was unaffected by hydrocortisone.
Ultimately I see some contradictions in what the goal of different types of psychiatry/therapy is. Is the end goal to just be as happy and functional as possible? Is it to avoid the worst case scenarios the most while not caring as much about baseline? Or is there a moral/humanistic good to processing the world even if it results in being less happy and more functional in concrete tasks?
I'm really not an expert in any of these things - but it does sometimes bother me that the discourse on this is jointed. I think it comes up in political/cultural talk quite often.
>We found that participants receiving hydrocortisone showed a faster reduction in daily intrusion frequency. Voluntary memory was assessed once, at the end of the week, but was unaffected by hydrocortisone.
Ultimately I see some contradictions in what the goal of different types of psychiatry/therapy is. Is the end goal to just be as happy and functional as possible? Is it to avoid the worst case scenarios the most while not caring as much about baseline? Or is there a moral/humanistic good to processing the world even if it results in being less happy and more functional in concrete tasks?
I'm really not an expert in any of these things - but it does sometimes bother me that the discourse on this is jointed. I think it comes up in political/cultural talk quite often.
What they are reffering to as "intrusions" is not just having thoughts about the traumatic event, it is having intrusive and uncontrolable toughts pop into your mind when triggered - it's very disrupting and distracting. Depending on the level of trauma, these intrusions can be debilitating.
In general, PTSD treatment involves changing one's perspective towards the traumatic event so that when triggered, the thoughts it recalls are not intrusive and debilitating - making it so the patient doesn't feel shame, fear, loss of control when trigered.
In general, PTSD treatment involves changing one's perspective towards the traumatic event so that when triggered, the thoughts it recalls are not intrusive and debilitating - making it so the patient doesn't feel shame, fear, loss of control when trigered.
There’s also the very important distinction between remembering something and experiencing something. People with PTSD and unresolved trauma relive the entire episode with emotions and all.
I realize I am being downvoted so perhaps this is settled in literature.
I know PTSD can be traumatic and takes different forms
I suppose my confusion still comes from the fact that stopping intrusive thoughts is measured as good. But what if these intrusive facts are needed (just like therapy) to process things in the long run?
I would understand if someone could ran a (very costly) experiment that said "Taking this over the course of 5 years lowered the amount of outbursts/negative behaviors someone took" but this is just measuring thoughts.
Presumably, if there had been another group that had been in a therapy group after seeing this traumatic film it is highly possible the number of times someone thought about the film (which is what they were measuring) would have gone up - but would that be bad?
I know PTSD can be traumatic and takes different forms
I suppose my confusion still comes from the fact that stopping intrusive thoughts is measured as good. But what if these intrusive facts are needed (just like therapy) to process things in the long run?
I would understand if someone could ran a (very costly) experiment that said "Taking this over the course of 5 years lowered the amount of outbursts/negative behaviors someone took" but this is just measuring thoughts.
Presumably, if there had been another group that had been in a therapy group after seeing this traumatic film it is highly possible the number of times someone thought about the film (which is what they were measuring) would have gone up - but would that be bad?
PTSD is a disorder because people aren’t clearing or processing these things successfully and it becomes disruptive to their life. Sometimes it destroys their lives.
If someone successfully processes the trauma in a way that isn’t disruptive, they by definition don’t have PTSD anymore.
What you’re saying is a bit like saying someone who suffers from persistent, terrible constipation, to the point it causes them health issues should ‘just poop’.
If they could on their own, they wouldn’t have the problem!
If someone successfully processes the trauma in a way that isn’t disruptive, they by definition don’t have PTSD anymore.
What you’re saying is a bit like saying someone who suffers from persistent, terrible constipation, to the point it causes them health issues should ‘just poop’.
If they could on their own, they wouldn’t have the problem!
I don't really know if the poop analogy works here. If you were going to extend it here then this drug effectively makes you not feel like you have to poop - so instead it keeps the bile piling up in your intense for a few more days. Sure you prevent yourself from pooping but you do have to remove that eventually.
Perhaps therapy is an intervention where they really can remove that waste from you with minimal invasiveness? And that's the argument here? But I still sorta think there is a measurement error here where taking a drug to not think about something so you can only think of it while with others is delaying the issue, not solving it.
Perhaps therapy is an intervention where they really can remove that waste from you with minimal invasiveness? And that's the argument here? But I still sorta think there is a measurement error here where taking a drug to not think about something so you can only think of it while with others is delaying the issue, not solving it.
If you’re looking for alternative analogies, feel free to use a colostomy one here if you want.
The point remains - saying ‘but can’t you just x’ when the problem is they can’t just x doesn’t really get you anywhere.
The point remains - saying ‘but can’t you just x’ when the problem is they can’t just x doesn’t really get you anywhere.
Sure, these are all possibilities. With sufficiently able individuals who are sufficiently informed, we simply create the treatment and permit the individuals to select as required. For instance, the patient can choose to either suffer temporarily with the hope of the future positive outcome for the suffering or they can choose the immediate solution.
If the patient is not sufficiently able to choose due to being mentally unable and the drug is likely to bring them back to lucidity, then it is obvious that bringing them into a lucid state is the logical path, so we should recommend administering the drug.
For my part, I've noticed that people who dwell on these traumas have a hard time. Meanwhile I've suffered numerous things that many of these people claim have led to debilitating mental illness and I operate in a space of mental comfort. So, should I encounter another trauma event, I'll take the forgetting drug.
And presumably you, believing otherwise, should refuse it.
P.S. Here's a thought experiment for you: What if the MMR-2 vaccine instantaneously kills people at the age of 60. It was introduced in 1963 and this year is 2022, so the first recipients are not yet 60. So you simply cannot prove that it does not do this. You have a son. How do you reason whether to risk the possibility of instantaneously killing your son when he hits 60 vs the risk of him contracting any of Measles, Mumps, or Rubella?
If the patient is not sufficiently able to choose due to being mentally unable and the drug is likely to bring them back to lucidity, then it is obvious that bringing them into a lucid state is the logical path, so we should recommend administering the drug.
For my part, I've noticed that people who dwell on these traumas have a hard time. Meanwhile I've suffered numerous things that many of these people claim have led to debilitating mental illness and I operate in a space of mental comfort. So, should I encounter another trauma event, I'll take the forgetting drug.
And presumably you, believing otherwise, should refuse it.
P.S. Here's a thought experiment for you: What if the MMR-2 vaccine instantaneously kills people at the age of 60. It was introduced in 1963 and this year is 2022, so the first recipients are not yet 60. So you simply cannot prove that it does not do this. You have a son. How do you reason whether to risk the possibility of instantaneously killing your son when he hits 60 vs the risk of him contracting any of Measles, Mumps, or Rubella?
Removing a traumatic incident from your conscious memory doesn’t remove the trauma from you. The body keeps the score, and your brain is only a small part of the feedback loops that make you you.
I don't know man. I don't carry that much pain. My life is great and I can tell the tale without suffering the pain.
It doesn't take much thought to refute this idea. Talking about something can help you process it and feel better.
If you have a bad day, talking to someone about it usually helps.
Hell, bitching to a coworker about the idiot you just got off the phone with is a pastime for the average office workers.
If you have a bad day, talking to someone about it usually helps.
Hell, bitching to a coworker about the idiot you just got off the phone with is a pastime for the average office workers.
I'm still a bit confused - sorry if I don't sound earnest.
This drug eliminates the amount of time you think about a past event. This is pitched as good. Is the model that thinking about something is bad but talking about something is good? What if talking about something changes how or when you think about something? As you said with your co-worker example (which I realize is not PTSD levels) I think it could be pretty easily argued that fixating about your current situation is actually contributing to negative mental processes.
I have done therapy for specific issues and it worked for me - but nonetheless still dont see some contradictions between therapy and a pill that makes you think about something less.
This drug eliminates the amount of time you think about a past event. This is pitched as good. Is the model that thinking about something is bad but talking about something is good? What if talking about something changes how or when you think about something? As you said with your co-worker example (which I realize is not PTSD levels) I think it could be pretty easily argued that fixating about your current situation is actually contributing to negative mental processes.
I have done therapy for specific issues and it worked for me - but nonetheless still dont see some contradictions between therapy and a pill that makes you think about something less.
Much of the therapy I have been involved with has been arranged not just around dealing with negative thoughts, but more fundamentally getting into a position where you can approach negative thoughts without moving into a triggered state.
I think I get what you're saying; I could, for instance, just drink a lot every day to ignore a variety of ideas, but it's much healthier in the long run to deal with those ideas directly.
Unfortunately, the reason why there are so many palliative coping strategies is that unless a person is in a state where they can examine those uncomfortable thoughts, then it's just creating more harm and the person isn't able to deal with the issue. That in turn often leads to the maladaptive coping that leads people into therapy in the first place.
So a common therapeutic goal getting people to a point where they can first recognize that they are in an upset state, second calm themselves without totally disengaging from the event and, then (if possible) work on whatever thoughts or events led to becoming upset in that manner.
That work is contingent on the first two parts of that; palliative care to help people get into a place where they can do the first two things without engaging in more harmful types of coping strategies (drinking, for instance) seems like a reasonable method.
I think I get what you're saying; I could, for instance, just drink a lot every day to ignore a variety of ideas, but it's much healthier in the long run to deal with those ideas directly.
Unfortunately, the reason why there are so many palliative coping strategies is that unless a person is in a state where they can examine those uncomfortable thoughts, then it's just creating more harm and the person isn't able to deal with the issue. That in turn often leads to the maladaptive coping that leads people into therapy in the first place.
So a common therapeutic goal getting people to a point where they can first recognize that they are in an upset state, second calm themselves without totally disengaging from the event and, then (if possible) work on whatever thoughts or events led to becoming upset in that manner.
That work is contingent on the first two parts of that; palliative care to help people get into a place where they can do the first two things without engaging in more harmful types of coping strategies (drinking, for instance) seems like a reasonable method.
Right. I think I mostly agree with you. Perhaps I just think involuntary/intrusive thoughts in the study is a bit of a loaded term. These words to me sound implicitly negative - but unless they resulted in serious negative behaviors then I don't see why they should be considered such a negative. From my own perspective it seems that even if my own thinking about something a lot may not be as effective as therapy or meditation, thinking about something does help process it and does help you come to a similar calmness about it.
The drug in the paper, to me, seems more like the coping strategies you talk about but without the other physical harms. Like what if alcohol made you not think about something but actually kept your physical and mental health the same/stable? Would that be desired? Isn't that what this drug is hoping to achieve?
The drug in the paper, to me, seems more like the coping strategies you talk about but without the other physical harms. Like what if alcohol made you not think about something but actually kept your physical and mental health the same/stable? Would that be desired? Isn't that what this drug is hoping to achieve?
This is a pre-clinical study that is designed to model an aspect of a "traumatic" event and assess how the treatment condition (hydrocortisone) can affect behavior. Moreover, this experiment is designed to probe the effects of trauma in the moments immediately after the traumatic event, where the stress response is initiated. This is likely the period of time where the most synaptic changes occur. Of course, this paper doesn't directly posit that forgetting thoughts associated with trauma is therapeutic, as that would require an empirical study that include patients with PTSD.
Also, the purpose of therapy, such as CBT, is not to fixate on one's current situation, but be able to unlearn feelings of trauma / anxiety from the event. This is done by engaging with a trained professional who can help the patient carefully break down their thoughts and feelings. Reflecting on a traumatic situation with a partner is different from reflecting on a traumatic situation amongst oneself.
Also, the purpose of therapy, such as CBT, is not to fixate on one's current situation, but be able to unlearn feelings of trauma / anxiety from the event. This is done by engaging with a trained professional who can help the patient carefully break down their thoughts and feelings. Reflecting on a traumatic situation with a partner is different from reflecting on a traumatic situation amongst oneself.
It eliminates the times you uncontrollably think about a past event - note that voluntary recall isn't affected. So it's saying that this lets you process the trauma in a controlled environment when you're in a position to deal with it, but otherwise resume a life that isn't interrupted or dominated by it.
I think there's a difference between (mediated) constructive reflection with the goal of processing an event, and Repetitive Negative Thoughts (RNT) about an event. The latter can of course have long lasting negative effects.
I think it's probably better to reflect on and process a _potentially_ traumatic event, than it is to repress or otherwise force yourself to forget it. But either of those is preferable to dwelling on it and spiraling in negativity.
Perhaps this is just a matter of degree. For really bad trauma (mass casualty, etc) it's probably good to have stronger tools available.
I think it's probably better to reflect on and process a _potentially_ traumatic event, than it is to repress or otherwise force yourself to forget it. But either of those is preferable to dwelling on it and spiraling in negativity.
Perhaps this is just a matter of degree. For really bad trauma (mass casualty, etc) it's probably good to have stronger tools available.
I have been and I am still dealing with intrusive thoughts for the past year. I am still unable to talk about most of them or recall them voluntarily - only the rough circumstances, but not the actual situation(s). For the first months after the event, I was unable to drive a car or a bike because the thoughts come with body reactions: muscle spasms, blurred vision, loss of hearing, etc. It is still somewhat dangerous for me to drive because my hands or feet can suddenly cramp and I am unable to release. Intrusions can happen suddenly and without a trigger. Most of my intrusions now come with no "attached memory" at all, just emotions and very painful body reactions. I am still mostly unable to participate in "ordinary life" because you have a lot of situations where you don't want to have that happen around other people, because their reactions will really not help you "feel safe", which then contributes to retraumatization.
I still have this multiple times, every day, even with 2-3x therapy per week since a year.
This is nothing like "recalling a memory". Also, since I am unable to clearly express what I have witnessed/experienced, talking to "ordinary people" (e.g. most my friends) about it is mostly met with reactions that really don't help at all.
I still have this multiple times, every day, even with 2-3x therapy per week since a year.
This is nothing like "recalling a memory". Also, since I am unable to clearly express what I have witnessed/experienced, talking to "ordinary people" (e.g. most my friends) about it is mostly met with reactions that really don't help at all.
And there's a big difference between suffering from intrusive thoughts about a traumatic experience, and talking about that experience voluntarily. The former is stressful; the latter is therapeutic.
I guess my skepticism of this is a bit unpopular - but the way they measured intrusive thoughts is whether or not the people mentioned the traumatic film they saw in a journal for a week.
It seems plausible to that thinking (even if involuntary) about any other traumatic memory may result in short term stress but in the long run help you process it and be healthy? Like in my own experience thinking about something a lot on my own is part of therapy - since I really think about how I explain the situation and what really happened - so I guess I'm skeptical that not thinking of something is actually good for mental health in the long run even if in the short run it works.
It seems plausible to that thinking (even if involuntary) about any other traumatic memory may result in short term stress but in the long run help you process it and be healthy? Like in my own experience thinking about something a lot on my own is part of therapy - since I really think about how I explain the situation and what really happened - so I guess I'm skeptical that not thinking of something is actually good for mental health in the long run even if in the short run it works.
> I guess my skepticism of this is a bit unpopular - but the way they measured intrusive thoughts is whether or not the people mentioned the traumatic film they saw in a journal for a week.
That's a fair criticism. Doing research on real PTSD is tough -- everyone's experience is a little different, and is colored by their personal history -- and it'd be wildly unethical to put test subjects through an in-person experience stressful enough to induce lasting PTSD. Some studies, like the Tetris intervention one I linked elsewhere [1], used real trauma patients; others, like this one, have to rely on stress simulants like a violent film.
I will note, however, that Irréversible [2] -- the film this study used excerpts from -- is exceptionally violent. It's not a run-of-the-mill action film. One of the scenes the study probably used graphically depicts a man being beaten to death with a fire extinguisher.
[1]: https://www.psych.ox.ac.uk/news/tetris-used-to-prevent-post-...
[2]: https://en.wikipedia.org/wiki/Irr%C3%A9versible
That's a fair criticism. Doing research on real PTSD is tough -- everyone's experience is a little different, and is colored by their personal history -- and it'd be wildly unethical to put test subjects through an in-person experience stressful enough to induce lasting PTSD. Some studies, like the Tetris intervention one I linked elsewhere [1], used real trauma patients; others, like this one, have to rely on stress simulants like a violent film.
I will note, however, that Irréversible [2] -- the film this study used excerpts from -- is exceptionally violent. It's not a run-of-the-mill action film. One of the scenes the study probably used graphically depicts a man being beaten to death with a fire extinguisher.
[1]: https://www.psych.ox.ac.uk/news/tetris-used-to-prevent-post-...
[2]: https://en.wikipedia.org/wiki/Irr%C3%A9versible
Yeah. Perhaps its a bit unfair to pick out in the weeds details of the study.
I guess maybe the core of my confusion comes with the term "intrusive" or "involuntary" memory. To me, in reference to PTSD, this sounds extremely negative. But perhaps you were in a situation where you saw someone die, perhaps even someone you know, should the goal be to only think about these things in therapy or when you sit down to meditate? Is involuntary/intrusive thoughts on these bad so long as it doesnt have major effects on your stability?
Not nearly as traumatic - but when I went through my last break-up I thought about it non-stop for a few weeks. I was able to get through my work and keep up social engagements fine, but otherwise it consumed me. Would it have been better to only think about the situation in therapy sessions and allotted meditation time? Maybe? But I'm not that sure on that I probably needed a few weeks of internal "involuntary" struggle in order to be free of the negative thoughts around it going forward.
I guess for me the answer is that if your brain is thinking about something, even if it seems a bit disorganized, you are still processing it on your own time and the short term benefits of not thinking about it then may not actually be good for your long term. Though perhaps this runs counter to established literature I'm not aware of.
I guess maybe the core of my confusion comes with the term "intrusive" or "involuntary" memory. To me, in reference to PTSD, this sounds extremely negative. But perhaps you were in a situation where you saw someone die, perhaps even someone you know, should the goal be to only think about these things in therapy or when you sit down to meditate? Is involuntary/intrusive thoughts on these bad so long as it doesnt have major effects on your stability?
Not nearly as traumatic - but when I went through my last break-up I thought about it non-stop for a few weeks. I was able to get through my work and keep up social engagements fine, but otherwise it consumed me. Would it have been better to only think about the situation in therapy sessions and allotted meditation time? Maybe? But I'm not that sure on that I probably needed a few weeks of internal "involuntary" struggle in order to be free of the negative thoughts around it going forward.
I guess for me the answer is that if your brain is thinking about something, even if it seems a bit disorganized, you are still processing it on your own time and the short term benefits of not thinking about it then may not actually be good for your long term. Though perhaps this runs counter to established literature I'm not aware of.
People routinely cross the threshold from thinking about something and processing it on their own time into a state of nonproductive recurrence of said thoughts in which no real processing is done. Managing this kind of symptom is often the first step in successful long-term recovery; the goal of psychiatry is never just to sweep problems under the rug instead of helping patients process their world effectively.
Oh, I'm quite aware. I spent most of my life dealing with them. Psychosis, paranoia, and flashbacks are a bitch.
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>>I'm really not an expert...
A lot more people should come to this conclusion, reflect on it, and then not post whatever thought helped them come to this realization. Just go read enough to inform an opinion on the matter before sharing it.
A lot more people should come to this conclusion, reflect on it, and then not post whatever thought helped them come to this realization. Just go read enough to inform an opinion on the matter before sharing it.
I strongly disagree. People who are experts in field X are self-selected people who agree with the assumptions that define the field.
There should not be discussion forum on the website if there is a belief that smart people (who have read plenty of books on clinical psychology and neurology) can't ask questions about something they haven't personally worked in.
There should not be discussion forum on the website if there is a belief that smart people (who have read plenty of books on clinical psychology and neurology) can't ask questions about something they haven't personally worked in.
>>There should not be discussion forum on the website...
I would be fine with this, but the cat's out of the bag now.
I would be fine with this, but the cat's out of the bag now.
Why is stress after trauma a 'disorder'? And how is it a solution to drug people up, making them forget this?
The "disorder" is a description of about how it's causing people pain / trouble in their lives. Experiencing something, and processing it, and it having a lasting impact on your life and your thinking isn't by definition disordered. But having it cause problems in your life, e.g. physical touch from people you trust causing panic attacks, that's a disorder.
Forgetting, as a treatment, may be something some people want.
To my eyes your comment is pretty dismissive ("drug people up"). A little empathy, and an open heart goes a long way here.
Forgetting, as a treatment, may be something some people want.
To my eyes your comment is pretty dismissive ("drug people up"). A little empathy, and an open heart goes a long way here.
A long time ago my wife shattered her wrist. In the ER, they explained that they needed to reset it so it could be put in a splint before surgery could be scheduled. They weren't going to use anesthetic. She would be conscious of the pain as they moved her wrist into position, but they'd give her something so she wouldn't remember the experience.
15+ years later she remembers telling them to go ahead and do it, then there's a hole in her memory for about 10 minutes.
I'd say that's one good solution.
15+ years later she remembers telling them to go ahead and do it, then there's a hole in her memory for about 10 minutes.
I'd say that's one good solution.
Interesting -- I recently had a similar experience (very bad wrist fracture), but they used a nerve block instead. I was conscious and it was painful, but not unbearably or traumatically so. I wonder why a nurse would choose one over the other.
Dunno. It was about 15 years ago and may have had something to do with the extent of the injury? She was 25 at the time and the orthopedic surgeon kept saying he couldn't imagine the amount of energy it took to do that much damage to such young bones. The wrist was shattered into at least 5 pieces.
This is one reason we always give a shoutout to Tria Orthopedics in the Twin Cities, MN region when someone needs an orthopedist: she was one of their first patients and the wrist maintained full range of motion after healing.
This is one reason we always give a shoutout to Tria Orthopedics in the Twin Cities, MN region when someone needs an orthopedist: she was one of their first patients and the wrist maintained full range of motion after healing.
Ah, mine was "only" three pieces... still the talk of the ER though :P They did insist on full anesthesia for the surgery (the fracture was unstable so I needed a plate). Glad to hear she recovered full range of motion; getting close myself.
Wow. Do you happen to know what it was they gave her?
I believe midazolam can cause amnesia, it's not technically an anesthetic in the sense that it doesn't knock you out, but it's a sedative.
https://en.wikipedia.org/wiki/Midazolam
https://en.wikipedia.org/wiki/Midazolam
Versed’s ads on radiology magazines literally say “For when they need to forget.”
Ketamine has been something I have seen used. The lack of reaction from people having broken bones manipulated while under its influence is very disconcerting.
Because sometimes there's no war left to fight but the soldiers still can't return their minds to civilian life. They're disabled, unable to hold down a job reliably, unconfident in their ability to do normal tasks like go grocery shopping without having a debilitating panic attack which causes additional heart damage every time.
There's tons and tons of examples why stress after trauma is a disorder. Also a very good wikipedia article if you'd like a place to start: https://en.wikipedia.org/wiki/Post-traumatic_stress_disorder
There's tons and tons of examples why stress after trauma is a disorder. Also a very good wikipedia article if you'd like a place to start: https://en.wikipedia.org/wiki/Post-traumatic_stress_disorder
> Why is stress after trauma a 'disorder'?
It isn't. Sometimes you can experience trauma, then experience stresses, and react to the stress in normal ways.
The disorder is when this doesn't happen, and you have atypical reactions to stress, which can be debilitating.
It isn't. Sometimes you can experience trauma, then experience stresses, and react to the stress in normal ways.
The disorder is when this doesn't happen, and you have atypical reactions to stress, which can be debilitating.
That's a bit like asking "why is pain after an injury a 'disorder'"?
Just like some people are left with persistent recurrent pain in an otherwise healthy and recovered limb (often known as rheumatism), some people are left with persistent recurrent stress after trauma - such as suddenly bursting out crying or cowering in fear after incidentally remembering trauma that happened 20 years ago while doing the dishes.
When this sort of thing happens, we call it "post-traumatic stress disorder", and are looking for ways to treat patients. Making them forget the event is one possible treatment, and there are others (such as trying to disassociate the event itself and the strong negative feelings).
Just like acute pain is useful to keep us healthy, acute stress is very important. But chronic pain and post-traumatic stress are not useful to anyone, they are failure modes of these otherwise useful systems, and it makes sense to try various ways of correcting them.
Just like some people are left with persistent recurrent pain in an otherwise healthy and recovered limb (often known as rheumatism), some people are left with persistent recurrent stress after trauma - such as suddenly bursting out crying or cowering in fear after incidentally remembering trauma that happened 20 years ago while doing the dishes.
When this sort of thing happens, we call it "post-traumatic stress disorder", and are looking for ways to treat patients. Making them forget the event is one possible treatment, and there are others (such as trying to disassociate the event itself and the strong negative feelings).
Just like acute pain is useful to keep us healthy, acute stress is very important. But chronic pain and post-traumatic stress are not useful to anyone, they are failure modes of these otherwise useful systems, and it makes sense to try various ways of correcting them.
>That's a bit like asking "why is pain after an injury a 'disorder'"?
It isn't. If anything that supports OPs point
It isn't. If anything that supports OPs point
Disorder doesn't mean an unexpected outcome. It's a disruption in the norm for the system. The stable state for a human body is not constant pain.
I should have said (and I believe explained in the rest of the comment) that it's a bit like asking "why is pain after an injury a 'disorder'" of a person suffering from chronic pain. PTSD is a disorder beacause it is a chronic version of a completely normal accute reaction.
I don't consider any kind of acute pain acceptable personally. Even if short-lived. Unless it's needed as a signal to pull your hand out of a fire or something.
If you didn't feel pain while having an injury, you'd quickly find that you are extremely likely to greatly aggravate that injury (e.g. walking with a broken bone in your foot is possible, but it hurts terribly to help you not do it, sine it will ruin the bone and any chance of ever recovering).
We know this for sure since there is an extremely rare disease in which people literally feel no pain. These people have a very tough life, and have to constantly manually inspect their bodies to make sure they don't have injuries they're not aware of (cuts, sprained ankles etc.), and are also essentially unable to participate in any kind of sports because of this.
We know this for sure since there is an extremely rare disease in which people literally feel no pain. These people have a very tough life, and have to constantly manually inspect their bodies to make sure they don't have injuries they're not aware of (cuts, sprained ankles etc.), and are also essentially unable to participate in any kind of sports because of this.
I'd prefer to be careful rather than be tortured into the correct behavior. As for walking on a broken ankle, I'd categorize that under temporary pain signals to notify you to stop a behavior. Also it takes a lot less than acute pain to keep normal people from injuring themselves.
If you didn't feel pain, you wouldn't know that you had an injury, or even that you are getting close to injuring yourself.
For example, when putting your hand on a surface, if you didn't feel the pain of extreme heat, you wouldn't know that your skin is getting burned. Or, if you miss-stepped and sprained your ankle but didn't feel the pain, you would keep putting your full weight on that sprained ankle and probably turn it into a serious injury. Without pain, you wouldn't know you're having a heart attack and wouldn't seek any medical attention. I can go on and on: accute pain is extremely important to basic health. You can't "be careful", unless you think it's reasonable to get full medical checkups after every walk.
Note that "acute" means "short lived", it doesn't mean it's particularly strong. It's the opposite of "chronic", which means "long term". For example, when you prick your finger, you're feeling some (very mild) accute pain, which serves the purpose of letting you know your skin was pierced and you need to stop pushing in that direction.
For example, when putting your hand on a surface, if you didn't feel the pain of extreme heat, you wouldn't know that your skin is getting burned. Or, if you miss-stepped and sprained your ankle but didn't feel the pain, you would keep putting your full weight on that sprained ankle and probably turn it into a serious injury. Without pain, you wouldn't know you're having a heart attack and wouldn't seek any medical attention. I can go on and on: accute pain is extremely important to basic health. You can't "be careful", unless you think it's reasonable to get full medical checkups after every walk.
Note that "acute" means "short lived", it doesn't mean it's particularly strong. It's the opposite of "chronic", which means "long term". For example, when you prick your finger, you're feeling some (very mild) accute pain, which serves the purpose of letting you know your skin was pierced and you need to stop pushing in that direction.
Indeed. And now that you've repeated your point, I shall repeat mine: "I don't consider any kind of acute pain acceptable personally. Even if short-lived. Unless it's needed as a signal to pull your hand out of a fire or something." Please pay extra careful attention to that last sentence this time around. Anyway let's recall this isn't a thread about fun physiology facts and making magic wishies that turn into nightmares or something, but about the appropriateness of intervention in someone's emotional suffering. Since you've written so much on the importance of acute pain, how long would you say is an appropriate amount of suffering before someone can get relief? Here's an odd one, what about an acute anxiety attack??
I don't know what point you think I'm making. The poster I was replying to was claiming that stress after a traumatic experience is normal, and not a disorder that should be treated.
My whole point was that this is utterly wrong, and that, while stress during a traumatic experience is normal and potentially even required (akin to pain), stress after the experience is definitely not a good thing, and should be treated in any way possible (whether that's family support, therapy, or medication is up to every individual case) - just like chronic pain.
Relating to pain, people should get relief as soon as the pain has done its job - that is, as soon as they know about the injury and the area they have to protect - any more pain than that is unnecessary, even if normal. In the vast majority of circumstances, I imagine this is probably a matter of seconds or minutes after the injury occurred. I can imagine some weird, vanishingly rare, circumstances where the pain may legitimately need to be endured for longer, but that would be splitting hairs.
And an accute anxiety attack (assuming this occurs without some traumatic event) is obviously not normal or helpful and should be treated immediately. If this anxiety attack is happening during a traumatic event (say, I am currently being held at gunpoint), taking a pill to calm down may be less required (though even that is debatable, especially for a panic attack, which generally leaves you entirely helpless).
My whole point was that this is utterly wrong, and that, while stress during a traumatic experience is normal and potentially even required (akin to pain), stress after the experience is definitely not a good thing, and should be treated in any way possible (whether that's family support, therapy, or medication is up to every individual case) - just like chronic pain.
Relating to pain, people should get relief as soon as the pain has done its job - that is, as soon as they know about the injury and the area they have to protect - any more pain than that is unnecessary, even if normal. In the vast majority of circumstances, I imagine this is probably a matter of seconds or minutes after the injury occurred. I can imagine some weird, vanishingly rare, circumstances where the pain may legitimately need to be endured for longer, but that would be splitting hairs.
And an accute anxiety attack (assuming this occurs without some traumatic event) is obviously not normal or helpful and should be treated immediately. If this anxiety attack is happening during a traumatic event (say, I am currently being held at gunpoint), taking a pill to calm down may be less required (though even that is debatable, especially for a panic attack, which generally leaves you entirely helpless).
I think you're repeatedly "dad-splaining" basic science facts. True of false?
When has grief done its job? I've never been held at gunpoint yet somehow experienced stress on many occasions. How many of those do you want to subject me to? The DSM generally says 6 months to become a disorder for most things from what I've read. How about considering a question that isn't trivial to answer?
When has grief done its job? I've never been held at gunpoint yet somehow experienced stress on many occasions. How many of those do you want to subject me to? The DSM generally says 6 months to become a disorder for most things from what I've read. How about considering a question that isn't trivial to answer?
It is if it sticks around long after the original triggering trauma is gone and prevents you from leading a healthy life.
It’s a disorder if the stress interferes with your daily life, e.g. you can’t hold down a job or your personal relationships suffer.
Not all stress after trauma is a disorder. A disorder, by definition, is a big problem. It’s “an illness or condition that disrupts normal physical or mental functions”. Think PTSD as “disorder from stress from trauma”.
How is it a solution? If giving people a drug reduces disorders and that benefit outweighs the cost, then it’s generally considered a good idea.
How is it a solution? If giving people a drug reduces disorders and that benefit outweighs the cost, then it’s generally considered a good idea.
PTSD has strong negative impacts on a person’s life. Treating it mitigates these negative impacts.
PTSD is a serious medical condition. It's not merely a feeling of "stress."
Spoken like someone that hasn't experienced PTSD.
Our brains are complex entities, this treats it as a simple one. I think it will leave a hole in continuity and it may well be helpful, but residual awareness that something horrible has occurred will linger and it will be harder to resolve.
I guess what I am trying to say is that the body remembers, even if we manage to pluck out one simple way the body goes about remembering. This may trigger reactions to certain stimuli which will make less sense when the person cannot relate it to remembered trauma.
I think PTSD is something you have to work on, and get help for. I did eventually for mine but years and years of not having any treatment.
This is the McDonalds solution.
A terrifying branch of this is the military's interest in using it in war zones.
It fills my mind with images of soldiers getting "reset" on a frequent basis. What would they be like after a year or two of that? (I have also read ideas on preventative drugs to help a soldier not remember).
Humanity, whatever someone is able to retain in a war zone, is the last defense against atrocities. The remembrance of atrocities is the only way to bring them to light later.