Blocking Bad Memories

 

Result of a serious automobile accident.

Image via Wikipedia

 

The last thing Jim (not his real name) remembered was the growing lights in his rear view mirror. When the garbage truck actually struck his car, spinning him 360 degrees and slamming him into a bridge abutment he had (thankfully) lost consciousness. He spent several days in the ICU recovering from a head injury, then several weeks in rehabilitation recovering from multiple broken bones. Once released, he came to the office for a follow-up evaluation. On the outside, he looked amazingly well; few visible scars and walking normally, although slowly due to a healing fractured ankle. He spoke about the accident, recounting only what others described to him about the aftermath. I thought it was great that he had been spared the mental trauma of the event—I couldn’t have been more wrong.

He admitted that just getting into a car caused him to break out into a sweat. While riding he remained hyper vigilant, constantly turning and twisting in his seat in trying to scan continuously for other traffic. “By the time we get to where we’re going I’m drenched in sweat,” he admitted. “It’s not something I can seem to control. My wife thinks I’m just overreacting, but honestly at times I think I’m losing it. She wanted me to talk to you.”

Jim was describing post-traumatic stress disorder or PTSD. It can affect 20 percent of people in serious automobile accidents; some have mild anxiety that wanes over time while others may have lifelong disability. Imagine if we could administer a medication at the time of such trauma that would block these fear-inducing memories. Fortunately, researchers are closing in on remedies that may do just that. Were learning that one part of our brains, the amygdala, generates the fear response, also known as the fight or flight response. The amygdala generates powerful emotions result in changes to our brain chemistry that become hard to turn off.

New research suggests we can practice now to prevent future occurrences of these anxiety–provoking emotions. Something as simple as deep breathing exercises engage our nervous system into ratcheting down the flight or fight response. Relaxation breathing, one of the effective tenets of yoga and meditation, can literally retrain our nervous system and produce calm, where there was once storm. Jim showed interest in this form of therapy; he already believed he took too many medications related to his accident. Six months later after undergoing behavioral therapy, Jim was driving again without any outward signs of stress. “It’s funny,” he related. “Now my wife calls me ‘Mr. Pacifist.’ She says nothing seems to get me upset. I never thought that mediation could be so relaxing.”

In medicine, we often reach for the prescription pad when presented with a patient in distress. But when it comes to dealing with trauma, we look forward to the day when preventively practicing relaxation may make painful events a distant and non–disabling memory.

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About Steve P. Sanders

A general internist writing and sharing ideas and art.

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