We come now to the clinical heart of the matter: the sequence of experiences required by the brain for launching reconsolidation and then using new learning to erase a target learning, as identified in reconsolidation research. In this regard, both animal and human studies have yielded the same results. For clinicians, human demonstrations are perhaps most credible and reassuring, so we focus here on the findings garnered from studies in which learnings created in human subjects were erased, weakened, or revised via reconsolidation using natural, behavioral techniques of new learning.
What neuroscientists sometimes term the “updating” or “rewriting” of specific learnings has been demonstrated in humans for several different types of memory:
procedural, motor skill memory (Walker et al., 2003)
operant conditioning (Galluccio, 2005)
declarative memory (Forcato et al., 2007, 2008)
episodic memory (Hupbach, Gomez, Hardt, & Nadel, 2007;
Hupbach, Gomez, & Nadel, 2009)
classical fear conditioning (Schiller et al., 2010)
memory for cue-triggered heroin cravings (Xue et al., 2012).
(The inclusion of declarative and episodic memory in this list may seem to imply a contradiction of the finding, described earlier, that erasure of an emotional learning leaves autobiographical memory unaffected, but that is not the case. Reconsolidation is highly selective and affects only the memory that is experientially mismatched, whatever type of memory that may be. Thus if emotional memory is so targeted, as in the Galluccio and Schiller et al. studies listed above and as is the case for psychotherapeutic application, then autobiographical memory remains unaffected, but if autobiographical memory is targeted it will consequently be the memory affected.)
In each of these studies, the target learning was first destabilized by the two steps of being reactivated and then mismatched by a novelty or contradiction. Then, in a third step, the target learning was completely or partially “rewritten” by new learning within the five-hour reconsolidation window—the memory’s labile period. The altered memory was then allowed to reconsolidate naturally (in contrast to eliminating the memory’s neural circuits by chemically disrupting their reconsolidation). Behavioral tests then verified the erasure or alteration of the target learning. These demonstrations have confirmed what neuroscientists surmised soon after reconsolidation was discovered, namely that it is the brain’s adaptive process for updating existing learnings with new ones. Reviewing these studies, Hupbach (2011) has inferred that whether the effect of the new learning is to completely replace, impair (weaken), or integrate into (supplement) the target learning depends upon “the degree with which the newly presented information [within the reconsolidation window] competes [i.e., is incompatible] with the
previously encoded information.” Our understanding will undoubtedly be refined by future studies of how new learning can be applied for the rewriting and updating of existing, unwanted learnings.
Thus, from the totality of research to date, we see that the natural, behavioral process of transformational change of an existing emotional learning—the brain’s rules for unlearning and erasing a target learning—has three steps.
1. Reactivate. Re-trigger/re-evoke the target knowledge by presenting salient cues or contexts from the original learning.
2. Mismatch/unlock. Concurrent with reactivation, create an experience that is significantly at variance with the target learning’s model and expectations of how the world functions. This step unlocks synapses and renders memory circuits labile, i.e., susceptible to being updated by new learning.
3. Erase or revise via new learning. During a window of about five hours before synapses have relocked, create a new learning experience that contradicts (for erasing) or supplements (for revising) the labile target knowledge. (This new learning experience may be the same as or different from the experience used for mismatch in Step 2; if it is the same, Step 3 consists of repetitions of Step 2.)
After this three-step sequence, researchers also conduct an erasure verification step consisting of behavioral tests of whether the target learning still exists in memory. We will refer to this as Step V (for verification).
The erasure sequence, steps 1–2–3 above, is a research finding that appears to have the potential to revolutionize the practice of psychotherapy. Reconsolidation research has identified this process for utilizing new learning to unlearn and erase all or part of an existing learning, including the emotional implicit learnings that so often underlie clinical symptoms. As of this writing, this is the only
behavioral process known to neuroscience that achieves true eradication of an emotional learning, and it does so through the only known form of neuroplasticity capable of unlocking the synapses maintaining an existing learning: memory reconsolidation.
In this book we refer to the erasure sequence also as the transformation sequence, particularly in the context of psychotherapy, in order to help emphasize the distinction between transformational and counteractive change. Our clinical case examples are intended to show the potency of the transformation sequence for routinely achieving a level of clinical effectiveness well beyond current norms.
Importantly, the three-step erasure sequence is a series of experiences defined without referring to specific techniques for bringing about those experiences. This means that in its application to psychotherapy, it can be carried out by therapists using their own choices of experiential techniques from a range of possibilities that may well be unlimited—or rather, limited only by the inventiveness of therapists. The erasure sequence is a theory-independent, universal meta-process, and as such it can richly foster integration within the psychotherapy field. We address this topic in Chapter 6 by surveying several experiential psychotherapies with methods that differ greatly from one another, showing that all three steps of the erasure sequence are detectable in the implementation of each therapy and appear to be responsible for the effectiveness of each.
Dwell with us for a moment on the “new learning” that serves to rewrite and erase the target learning in Step 3 above. Quite differing forms of new learning were used in the studies listed at the start of this subsection. Researchers have yet to find how the form, duration, and intensity of new learning determine its effectiveness in rewriting the target learning. What is clear is that the new learning must feel decisively real to the person based on his or her own living experience. In other words, it must be experiential learning as distinct from conceptual, intellectual learning, though it may be accompanied by the latter. The case studies throughout this book provide many examples of new learnings that successfully nullified
and permanently eliminated targeted emotional learnings. Some of the examples will show that it is often extremely useful to take advantage of the fact that the emotional brain hardly distinguishes between imagined and physically enacted experiences (as demonstrated empirically by, for example, Kreiman, Koch, & Fried, 2000).