Emotional Memory is Malleable

by Ram

Inhabited Painting by Helena Almeida*

The human brain consists of about one billion neurons. Each neuron connects to about 1,000 other neurons, totaling an unimaginable trillion connections. Neurons combine with each one and help lay down many memories at a time. Furthermore, emotions associated with a memory are stored in a different area of the brain than the content of the memory itself. While we do not know the storage capacity and the size of memory space in our brains, certain memories involve more details and take up more space. Other memories that are not worth remembering or that are forgotten are cleared up by the brain through a process called neuronal rewiring, thus freeing up more memory space.

A layman would define memory as objects, colors, sizes, and shapes or more complex emotional feelings like fear, worry, anxiety, joy, happiness, anger, and so on. While memories may seem a complex combination of objective information, neuroscientists see them as electrochemical signals that are exchanged between nerves; or simply put, information in the form of electrochemical signals that arise in a nerve from one specific area of the brain to another nerve in the same area or a different part of the brain which together encode everything that we associate with a memory.

Recently, we here at Yoga for Healthy Aging had some very stimulating exchanges on the topic of trauma, which triggered a lot of interesting discussion. Lives get severely disrupted following a traumatic experience and when, where and how the memory associated with the negative experience will surface depends on each individual. While most people recover from traumatic events, many do not, and they continue to experience constant fear, worry, anxiety and/or depression. Until recently, neuroscientists believed long-lasting traumatic events created non-pliable neuronal wiring that fired off these memory events randomly upon exposure to some stimulus. So the question that these scientists have been asking all along is: can traumatic memories be erased, wiped out, or overlaid with favorable events so that the person is free from periodic recurrences of traumatic experiences?

The answer is yes, and in a seminal paper recently published in the prestigious journal Nature Bidirectional switch of the valence associated with a hippocampal contextual memory engram, neuroscientists led by a noble laureate concluded that emotional/traumatic memories are malleable, meaning that they can be manipulated such that these unfavorable memories can be turned into more favorable ones. Using state-of-the-art techniques, these scientists were able to show in mice the areas of the brain that created both positive and negative memories and how these memories areas could be switched around. In addition to identifying the nerve cells that lit up after favorable or unfavorable experiences, these scientists also showed that the negative emotional memory got relived as though it was happening all over again. But when the mice that had been exposed to a shocking experience received a favorable experience, it stripped the painful and negative feelings associated with the previous traumatic memory, suggesting that new positive information attached to an unfavorable memory event may help to diffuse its negative impact.

According to these researchers, while negative and unfavorable memories may not fade away, they can be replaced, overlaid or changed by new and contrasting experiences. Emotional valence—which is a measure of good feelings (appetitive behavior) or bad feelings (aversive behavior)—is not rigid. And, based on the studies done on these mice, circumstances/events/places that were scary, unpleasant, or upsetting could become happy, safe, or warm. In the above mentioned study, as the mice got exposed to repeated favorable experiences, their neuronal connections involved with the negative events got overlaid by newer and positive connections, tilting the balance of emotional valence towards appetitive behavior. The hope was that in due course the neuronal connections responsible for firing off the negative events would shrink or be lost.

Although the neuroscientist’s work was with rodents, it may be possible to make an effective therapy for humans that focuses on positive feelings to overlay painful memories and transforms the negative experience (see Friday Q&A: Trauma Resurfacing, Crying in Class and Post Traumatic Stress Disorder: Yoga to the Rescue). What do I mean by “transforming negative experience”? Surely the traumatic memory does not go away—or does it? According to the authors of the above-mentioned study, transformation would mean using methods/ways to lessen the impact of the harrowing event and transform it to something less traumatic. So this “transformation” would make the memory less intense to help prevent those frequent flashbacks. Cognitive neuroscientists have also discovered that in response to the stress of recalling trauma, the brain also releases “feel good” chemicals, akin to a compensatory mechanism. These calming neurochemicals that help to deal with the stress and trauma may be the brain’s answer to fighting off the traumatic memory. So whenever we feel the traumatic memory arising, we could resort to methods that will stimulate the body to flood the brain with feel-good neurochemicals.

So what suitable remedial procedures exist for humans suffering from long-standing traumatic memories, such as those involved in PTSD? In addition to psychotherapy, group therapy, and neuro-medications, yoga practices, such as asanas, pranayama, meditation, self-inquiry and yoga nidra, may help to transform any negative experience. Through these methods it is hoped that the individual may come to terms with or accept the traumatic event, allowing him or her to build self-confidence and become stronger in both body and mind. This way, not only does the individual remain connected to his or her inner self, it also keeps the person in the present moment. 

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Trauma Resurfacing in the Body, Part 3

by Nina

Meditating Together by Melina Meza

Three years ago when Baxter, Brad, and I started this blog, I was hoping that it would not only be a place where we could share some of our own knowledge about yoga, aging, and yoga for healthy aging, but that we would be able to engage in some interesting discussions with our readers as well. After all, we all have so much to learn from each other. In a way, perhaps because many of readers weren’t that comfortable using the comments section—or perhaps we just didn’t have enough readers in the early days—that “discussion” part of our blog never really took off. However, I’m very pleased that recently we have been getting some really interesting comments (see Friday Q&A: Trauma Resurfacing, Crying in Class, Part 2 ) and that some very stimulating exchanges have been taking place. And one particular topic, trauma resurfacing in the body, has triggered a lot of interesting discussion. Just the other day a reader wrote to me privately with some very interesting comments and suggestions related to the two posts Friday Q&A: Trauma Resurfacing, Crying in Class and Friday Q&A: Trauma Resurfacing, Crying in Class, Part 2. I found the comments so important, that I asked the reader for (and received) permission to post the email on our blog. So today, our main post will be written by this reader, who prefers to remain anonymous. (All of you should know that if you write to me privately or leave an anonymous comment, I will do everything possible to protect your anonymity if that is what you prefer.)

After this reader’s comments, I will provide an additional note from myself to clarify something that I believe the reader misunderstood. We corresponded about this misunderstanding and the reader also approved the content of my note. I’m only including the note because I believe that this clarification would be helpful for all our readers.

Email from Our Reader 

First, thanks to you and Baxter for addressing these concerns so thoroughly and providing resources. Having seasoned teachers like you take this seriously is very meaningful and reassuring.

I have only one qualm with what the two of you pulled together. I think you may run the risk of over-pathologizing emotional issues. They are really no different from physical ones, especially if they begin in the physical. Here is what I think is appropriate, from a student’s perspective (which I know is different than yours and you are free to disagree with me):

1. First, we all acknowledge yoga can kick up difficult emotions for people. So ideally teachers should get a tiny bit of training in this area. For example, Mental Health First Aid is a program that gives people tools to be helpful, while also setting boundaries. The training is not intensive and is designed for non-professionals. The result for yoga teachers would be something close to an intervention in class like Baxter described. But an explicit focus as part of teacher training would offer new teachers some scientifically grounded information, a couple concrete tools, and would de-stigmatize the emotional aspects of the practice—which is very empowering for both teachers and students.  

2. Second, if a student approaches you after class, here is what would have helped me (I am lucky to have gotten some of this). Please recall I was a beginning student at the time. More seasoned students might not need this. 

3. A bit of sympathy and an acknowledgement that it took courage to trust you with this information (the amount of shame associated with certain kinds of trauma cannot be overstated). 

4. Validation that, yes, yoga can surface strong emotions and memories. The student is not crazy. This happens, a lot and for different reasons.   

5. Empowerment —Reiterate that :  

• the student is welcome in your class 
• class is a safe place
• the student can retreat to child's pose (or whatever helps) whenever he or she likes during future classes 
• as the student learns his or her triggers (which can take time), the student should feel free to modify or ask for help with modifications from you. For me, I learned it was using a strap in bridge and other poses that was triggering me. So it was no straps for a long time.

6. Offer more resources if the student asks or you think they would be helpful. It is preferred that these recommendations are specific, not 'find a therapist,' but 'this is the name of a yoga teacher who specializes in things like this.'

In reflecting on this aspect of my yoga practice, it occurs to me that we spend a lot of time talking about our edges in class. And for me—after a lot of confusion and ups and downs—these memories simply turn out to be an unconventional kind of edge. Holding it in that space has allowed yoga to do its good work. And I am profoundly grateful for that.

Thanks again for all your thoughtful responses and for being willing to dig deeper into this topic.

Note from Nina

So many of those suggestions are excellent, don’t you think? And I love what the reader said about how the memories “simply turn out to be an unconventional kind of edge” and that “Holding it in that space has allowed yoga to do its good work.”

I would say, however, that I don't feel Baxter and I “over-pathologized” emotions that arise during yoga. What we meant was a person could be crying for ANY reason. For example, though some kind of trauma could be resurfacing, crying could also be the result of something more mundane, such as the person broke up with their lover, their cat is sick, the teacher read a poem that was so beautiful it brought tears to their eyes, or even they just feel relieved to be at yoga class after a stressful day—whatever. That's why the teacher shouldn't make assumptions about the reason for crying and try to comfort the person with words (which would also disturb the class in general and draw attention to the person in question). And, of course, if the student approaches the teacher before or after or before class to explain why there will be (or was) crying, it is completely appropriate to express sympathy and compassion in general, and for the teacher to reassure the student that it is not uncommon and that the class is a safe space. And if the student’s situation is serious, such as depression, anxiety, trauma resurfacing, and so on, it might be kinder to ask gently, “Are you seeing a professional about this?” because if the answer is yes, then you could just let them know this is a good idea and that yoga can be an excellent supplement to therapy. And if the answer is no, you could gently suggest, “Perhaps you should consider doing so. If you like, I can find some recommendations for you.”

I would also like to say that I hope this blog is a safe space where we can respectfully discuss controversial topics. So speak up, everyone! You can do this either in the comments section of our blog (see How to Comment) or on our Facebook page.  I moderate all the comments but I always publish anything legitimate, even if the reader disagrees with our postings. The only comments that I delete are those I believe to be spam. And you can always write any of us privately via the Contact Us page. 

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Post-Traumatic Stress Disorder: Yoga to the Rescue

by Ram

Tokugawa with help from the Jodo monks of the Daijuji temple in Okizaki,
defeats the Ikkō ikki at the battle of Azukizaka by Yoshitoshi

Post-traumatic stress disorder (PTSD) is an anxiety disorder that develops after a person is exposed to a traumatic event. The individual could be either experiencing or witnessing the event.  Generally, people who are exposed to a traumatic event have difficulty adjusting and coping for a while but the symptoms get better with time and good care. However, if the symptoms get worse and protracted and interfere with daily tasks, the individual may have PTSD. Symptoms may include: recurring flashbacks of the event, hyperarousal, nightmares, severe anxiety, difficulty concentrating, feeling "jumpy" or getting easily startled, insomnia, uncontrollable thoughts about the event, self destructive behavior or withdrawing from social relationship. Women in general are more likely to develop PTSD than men, children are less likely to experience PTSD-like symptoms after a traumatic event than adults, especially if they are under ten years of age, and war veterans are at high risk for PTSD.

Anyone who is exposed to a dangerous situation naturally feels frightened.  The fear triggers the Fight or Flight response in the body to defend against the incoming danger or to evade it. This is a normal and healthy response of the body to protect the individual. But in PTSD, the Fight or Flight response is abnormally altered and as a result the individual may feel stressed or frightened even when they’re no longer in danger. Though PTSD was first recognized in war veterans, it can also result from a variety of incidents, including brutal assault, rape, torture, child abuse, abusive relationships, accidents, such as, car crashes, bombings, natural disasters, kidnapping or long-term captivity. The symptoms of PTSD may show up following the traumatic event or, surprisingly, may appear several years after the event. The symptoms cause significant problems at home, work, or in a social situations and can affect the individual’s normal functioning. 

What’s intriguing is why only some people suffer from PTSD. As with most mental health problems, PTSD is probably exacerbated in those who have:

• inherited some mental health risks (genes that play a role in fear associated-memory formation and acquisition)
• exposed themselves to frequent episodes of traumatic events
• dysregulation in the release of chemicals and hormones in response to stress

The primary treatment for PTSD is psychotherapy in combination with suitable medication. This type of combinatorial treatment approach seems to improve the symptoms, help individuals feel better about themselves and enable the individuals to adopt lifestyle changes to manage the symptoms that recur. Medications include antidepressants and/or anti-anxiety medications. The drawback is that these medications have the potential for abuse and patients complain of several non-specific side effects. So non-pharmacological remedies could serve as a perfect add-on treatment. Fortunately, there are now nearly a dozen research studies describing mind-body intervention therapies, including yoga and meditation, for management of PTSD symptoms that arise from exposure to various stress stimuli. See Managing Mental Health Disorders Resulting from Trauma through Yoga: A Review.

Yoga for War Veterans with PTSD: The effectiveness of a yoga program for improving PTSD symptoms was conducted in a pilot study involving twelve war veterans who suffered from military-related PTSD. The veterans participated in a six-week yoga intervention that was held twice a week. The researchers noted a significant improvement only in a subset of PTSD symptoms, including hyperarousal symptoms, overall sleep quality, and daytime dysfunction related to sleep. 

Yoga for Tsunami Survivors: In another study, the effect of a yoga breath program alone or in combination with a trauma-reduction exposure technique was evaluated on the 2004 tsunami survivors who were confirmed to exhibit PTSD symptoms. The 183 tsunami survivors were divided into three groups: 1) yoga breath intervention, 2) yoga breath intervention followed by 3–8 hours of trauma-reduction exposure technique, and 3) six-week wait list that served as a control group. PTSD measures (17-item PTSD checklist and depression) were checked at the start of the study and at 6, 12 and 24 weeks.  Eight months after the 2004 tsunami, survivors who performed the yoga program alone or in combination with the exposure therapy had significantly reduced scores on PTSD symptoms checklist compared with the control group. Additionally, the yoga group alone or in combination with the exposure therapy had significantly reduced scores on depression measurements compared with the control group. The benefits from the yoga program alone or in combination with the exposure therapy were maintained for 24 weeks, even without a regular practice. 

Yoga for Youth Incarcerated in a Correctional Facility: Juvenile delinquency requires interventions to help the youth cope with the stress.  A randomized controlled trial was carried out on 28 girls between 12 and 16 years of age, all of whom had a history of committing legal offences. The 28 girls were divided into two groups:  1) yoga and 2) games. The girls in the yoga group received training in postures and guided relaxation sessions for 60 minutes daily for 5 days a week. At the end of 6 months, both groups’ heart rate and breath rate were assessed to evaluate their physiological stress levels. While both groups showed significantly reduced heart rate, the yoga group also showed a significant decrease in breath rate, suggesting that a combination of yoga and meditation was helpful in combating fear, anxiety and hyper arousal like symptoms associated with PTSD.

Similar mind-body intervention programs were conducted on people exposed to civil wars, tsunami, hurricanes, interpersonal violence, combat, and terrorism in several places, including Kosovo and Sri Lanka. And in all such cases it was noted that yoga and meditation were extremely useful in reducing mental health disorders and other PTSD symptoms. Researchers believe that yoga and meditation may improve the functioning of traumatized individuals by relieving their psychological distress, increasing their mental awareness, and helping them to tolerate physical and sensory experiences associated with fear and helplessness. So if you know of someone who is experiencing PTSD or similar symptoms, kindly roll out the mat and encourage the individual to incorporate yoga and meditation into their lives. Both these practices do not require extensive hospital visits, expensive gear, space or setup and do not have any baggage of side effects. And the benefits are immense. Furthermore the healing power is in its simplicity!

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