Neuroscience and Society

Therapeutic Forgetting: An Ethical Analysis of Using Memory Dampening Drugs to Treat Trauma-Related Mental Disorders

Sriya Venkat


Abstract

Therapeutic forgetting, through memory-dampening drugs such as Propranolol, has been shown to provide significant psychological relief for patients suffering from trauma-related mental conditions. However, bioethicists are concerned that the extended use of therapeutic forgetting could damage one’s sense of overall identity. The following article studies the arguments presented for and against the use of therapeutic forgetting, illustrating that memory-dampening drugs provide a safe, reliable, and cheap alternative to conventional psychotherapy. Thus, one can advocate for the use of therapeutic forgetting due to the fact that it increases the efficiency and affordability of mental health programs for humanity.

 

Introduction

Therapeutic forgetting or memory-dampening is the process of using FDA-approved drugs to dull the emotional pain associated with a memory. For certain individuals, this is an effective psychological treatment for past traumas. It commonly serves as a medical treatment for those who suffer from trauma-related mental disorders, such as Post Traumatic Stress Disorder (PTSD), anxiety, or depression. However, many scientists argue that the act of dampening important memories can be a hindrance to oneself. Furthemore, several bioethicists warn that memory-dampening drugs could be easily overused, affecting society in a negative manner altogether. 

According to the Norwegian University of Science and Technology, the mental state of about 15% of patients who undergo psychotherapy for mental disorders worsens after their treatment [1]. Many of these patients are war veterans, victims of sexual assault, or witnesses of tragic events such as mass shootings or burglaries. The Neuroethics Blog by The Emory Center for Ethics states that PTSD is notoriously difficult to treat with therapy [2]. Even for those who seem to improve with therapy, it takes a very long time to cope with traumatic memories. In cases such as these, memory-dampening can be extremely beneficial. One might take ten years or more to overcome extreme anxiety with regular therapy, whereas with the Propranolol drug, it may take them as little as two years. 

 

Memory-Dampening Drugs

In order to understand the debate associated with the use of memory-dampening drugs, it is necessary to consider its mechanism of action. According to The Brain and Behavior Research Foundation , in a psychiatric disorder such as PTSD, the human body goes into what is called “flight or fight” mode while experiencing trauma [3]. This releases strong physiological responses to stress through the neurotransmitters adrenaline and norepinephrine. Research has shown that the nerves connecting the amygdala (stress evaluator), hippocampus (memory area), and prefrontal cortex (rational thought and decision-making area) malfunction in PTSD patients [4]. This causes the brain to stay on high alert even when one is out of danger. Propranolol weakens the physiological responses associated with a traumatic memory, lowering the severity of the anxiety and emotional pain experienced.

 

Figure 1. Mechanism of action of propranolol [5]

 

Ethical Considerations

Although it may seem as if memory-dampening drugs are the solution to helping patients deal with trauma-related mental disorders, it is also important to consider the ethical consequences of using these medications. The President’s Council on Bioethics argues that using memory-dampening drugs can prevent someone from leading a genuine life and can weaken one’s sense of identity [6]. Adam J. Kolber’s book Therapeutic Forgetting: The Legal and Ethical Implications of Memory Dampening voices that since past actions are a major part of one’s identity, memory is necessary for self-identification [7]. However, the Emory Center for Ethics has contended that this argument is weak because drugs such as Propranolol do not completely erase memories [8]. The drug is only used to dampen the emotional pain associated with certain memories. Notably, Propranolol is used to achieve the same goal as psychotherapy; memory-dampening drugs are simply a more rapid alternative. 

 

Benefits and Costs of Therapeutic Forgetting

Some experts call for the potential ban on the use of memory-dampening drugs. If this occurred, individuals would be forced to go to therapy for their mental disorders, which is not always effective for certain mental conditions. Essentially, this would deprive people of the possibility of a speedy recovery. PTSD patients would most likely have to spend thousands of dollars on therapy for extended periods of time. Trauma-related mental disorders are known for their high rate of relapse, leaving many patients within therapy for a major portion of their lives. According to Northwestern Mutual, the average cost for one hour of psychotherapy is $75-$100, meaning that the total cost of therapy for ten years, the average therapy time for PTSD, can range from $39,000 to $52,000 [9]. Also, psychotherapy can cost anywhere from $200 to $300 per hour, which amounts to a total of $104,000-$150,000 for ten years of therapy. Psychotherapy’s high cost can lead to disproportionate amounts of lower-income citizens without access to mental health services, increasing the growth of social inequality across the nation. 

If memory-dampening drugs are made readily available for consumption, patients will have the option for faster and more efficient treatment for their trauma-related disorders. Pharmaceutical drugs offer an affordable pathway to a more complete recovery for individuals with specific mental disorders. One vial of Propranolol is about $15, which is proportionally less than the cost of one session of psychotherapy. Additionally, a 2018 study for the American Psychiatric Association revealed that patients who took Propranolol experienced a greater symptom reduction than those who did not [10]. At least thirteen million people in the United States have PTSD; using drugs such as Propranolol can reduce these numbers to create a more mentally stable society.

 

Conclusion

Though the use of memory-dampening drugs in therapeutic forgetting has long been debated by neuroscientists, they have proven to be a more efficient, reliable, and affordable approach to recovery than conventional psychotherapy. Increasing the availability and awareness of these drugs can lead to fewer complications involving trauma-related mental disorders and an overall decrease in social inequalities. By promoting the use of memory-dampening drugs as a way of therapeutic forgetting, modern-day clinicians are taking the next step on the journey to bettering mental health for humanity.


References


  1. Frances, Allen J. (10/02/2015). “Psychotherapy Works But Not for Everyone.” Psychology Today, Sussex Publishers. www.psychologytoday.com/us/blog/dsm5-in-distress/201502/psychotherapy-works-not-everyone. Retrieved: 08/05/2021

  2. Pincus, M. (2011). The Benefits of Memory-Altering Drugs. The Neuroethics Blog. http://www.theneuroethicsblog.com/2011/12/benefits-of-memory-altering-drugs.html. Retrieved: 08/05/2021.

  3. (20/08/2018). “Frequently Asked Questions about Post-Traumatic Stress Disorder (PTSD).” Brain & Behavior Research Foundation. www.bbrfoundation.org/faq/frequently-asked-questions-about-post-traumatic-stress-disorder-ptsd. Retrieved: 08/05/2021.

  4. Hammer, Paul S. (29/05/2019). T“DCoE Director Explains Science Behind PTSD.” BrainLine. www.brainline.org/article/dcoe-director-explains-science-behind-ptsd. Retrieved: 08/05/2021.

  5. Kroes, M. C., Tona, K. D., den Ouden, H. E., Vogel, S., van Wingen, G. A., & Fernández, G. (2016). How administration of the beta-blocker propranolol before extinction can prevent the return of fear. Neuropsychopharmacology, 41(6), 1569-1578. Retrieved: 08/05/2021.

  6. Erler, Alexandre. (11/2011). “Does Memory Modification Threaten Our Authenticity?” Neuroethics, Springer Netherlands. www.ncbi.nlm.nih.gov/pmc/articles/PMC3189328/. Retrieved: 08/05/2021.

  7. Kolber J. Adam. (2019). Therapeutic Forgetting: The Legal and Ethical Implications of Memory Dampening, 59 Vanderbilt Law Review 1559. Retrieved: 08/05/2021.

  8. Pincus, M. (2011). The Benefits of Memory-Altering Drugs. The Neuroethics Blog.http://www.theneuroethicsblog.com/2011/12/benefits-of-memory-altering-drugs.html. Retrieved: 08/05/2021.

  9. Stoller-Lindsey, Nina. (22/05/2017). How Much Does Therapy Cost, and How Do You Pay For It?” How Much Does Therapy Cost and How Do You Pay For It? | Northwestern Mutual, Northwestern Mutual. www.northwesternmutual.com/life-and-money/how-much-does-therapy-cost-and-how-do-you-pay-for-it/. Retrieved: 08/05/2021.

  10. (01/01/1970). Alert, Psychiatric News. “Propranolol May Help Patients With PTSD.” Psych News Alert, alert.psychnews.org/2018/01/propranolol-may-help-ptsd-patients.html. Retrieved: 08/05/2021.

Sriya Venkat

Sriya Venkat


Sriya Venkat is a rising junior at William G. Enloe High School in Raleigh, North Carolina. She is interested in Computer Science, Mathematics, and Biology, and plans to pursue these subjects in college. Sriya has participated in National Science Bowl and has competed in the national finals held by the DOE with her team. She is currently doing research in Mathematical Biology (infectious disease modeling) at North Carolina State University. Sriya enjoys learning about cybersecurity and new ways of coding in Java, Python, and MATLAB in her free time. In addition, she is passionate about Indian Classical (Carnatic) Music and has been learning and performing Carnatic singing and violin for the past several years.