Forget Something? We Wish We Could
'Therapeutic forgetting' helps trauma victims endure their memories.
The Birth of Trauma continued...
Current studies have focused on a drug called propranolol, which is commonly prescribed for heart disease because it helps the heart relax, relieves high blood pressure, and prevents heart attacks. "Hundreds of thousands, millions of people take this drug now for heart disease," he tells WebMD. "We're not talking about some exotic substance."
Studies have shown that "if we give a drug that blocks the action of one stress hormone, adrenaline, the memory of trauma is blunted," he says.
The drug cannot make someone forget an event, McGaugh says. "The drug does not remove the memory -- it just makes the memory more normal. It prevents the excessively strong memory from developing, the memory that keeps you awake at night. The drug does something that our hormonal system does all the time -- regulating memory through the actions of hormones. We're removing the excess hormones."
Acting Fast to Forget
The first to treat PTSD patients with propranolol was Roger K. Pitman, MD, a psychiatrist at Massachusetts General Hospital and Harvard Medical School. He'd just as soon forget the term "therapeutic forgetting."
"We think of PTSD as an exaggeration of the emotional response to trauma," Pitman tells WebMD. "Something so significant, so upsetting, so provocative has happened that there has been a rush of stress hormones, the hormones that act to burn a memory into the brain, to the point that the memory becomes maladaptive. Our theory is that the adrenaline rush is burning the memory too deeply."
Timing is critical. Once PTSD has developed, it's too late to change stored memory, says Pitman. "It's important to intervene soon enough to affect memory consolidation."
In his study, Pitman gave propranolol to emergency room patients within six hours of a traumatic event. He found that six months later they had significantly fewer signs of PTSD.
"It's not that they couldn't remember the accident," McGaugh explains. "They couldn't remember the trauma of the accident. They didn't have as many symptoms of PTSD. It's a very important distinction."
Making Sense of Trauma
Propranolol was used to treat PTSD, with fairly good success, in a small study treating sexually abused children. It's also prescribed for specific phobias like public speaking, says Jon Shaw, MD, a PTSD expert and director of child and adolescent psychiatry at the University of Miami School of Medicine.