I was a graduate student in psychology at École Polytechnique in Montreal when a man walked onto campus and opened fire.
Fourteen women were killed that day in a horrible anti-feminist attack. Fourteen more were injured. The shooting shocked the country.
But what stayed with me was what happened afterwards. The response was chaotic. Professors were holding impromptu therapy sessions. Students were struggling. Formal support systems were almost non-existent.
That was the beginning of my vocation – I recognised an opportunity to make a positive difference to how we treat and respond to people who have experienced traumatic events.
Since that time in 1989, we have come a long way, making great strides in the diagnosis and treatment of post-traumatic stress disorder (PTSD), including through the emerging reconsolidation therapy.
A new way to treat trauma: editing the memory
For people living with PTSD, traumatic memories from an event or events can be re-experienced with alarming intensity, often triggering physical and emotional responses as though the trauma were happening all over again.
Currently, one of the most widely used treatments for PTSD is Cognitive Behavioural Therapy (CBT), which typically involves sessions spanning over several months.
CBT can help people confront and reframe their trauma-related thoughts and behaviours.
For many, it’s effective. But it’s not without challenges: it can be time-intensive, emotionally difficult – and, in half of the case, people relapse.
New treatments, however, are emerging – including reconsolidation therapy, which helps edit the emotional response associated with memories of traumatic events.
Every time a memory is recalled, it briefly becomes malleable – we can update it – before it is stored again. This update process is called memory reconsolidation.
This new neuroscience-based understanding of how the brain creates, stores, and updates memories allows us to work with traumatic memories in a way that was not possible before.
The goal of reconsolidation therapy isn’t to erase memories – it’s to reduce their emotional sting.
As part of the process, patients are administered a small dose of propranolol, a well-known generic beta-blocker typically used to treat high blood pressure and anxiety.
In the context of reconsolidation therapy, propranolol doesn’t make someone forget – it weakens the emotional distress associated with a memory through its ability to block memory reconsolidation.
As part of the therapy, participants are guided to write a detailed account of their traumatic memory – focusing specifically on the most distressing moments.
They then read this account aloud during each session, shortly after taking propranolol, which helps reduce the emotional intensity linked to the memory without altering the memory itself.
This makes it possible to “update” how the memory feels, without changing the facts of what happened.
Where we’re up to
Some clinical trials have shown encouraging results.
One study involving people who had experienced severe emotional distress from a romantic betrayal, resulted in about 70-80 percent of the 60 participants reporting meaningful improvement in symptoms after just two assessments and six therapy sessions.
While it’s still an emerging treatment, we’ve so far been able to train more than 2,000 clinicians in this method worldwide.
It's now being used in various clinical settings and urgent-care contexts, with imminent plans to train Australian clinicians in the treatment through our Thompson Institute.
We are planning to train local clinicians in war-affected Ukraine too, where the need for effective, scalable trauma treatment is critical.
A promising tool but more work is needed
These encouraging clinical results have sparked interest in understanding how the treatment works neurologically.
At our National PTSD Research Centre, we’re currently running a study to better understand how reconsolidation therapy works – not just whether it reduces symptoms, but what’s happening in the brain and body as it does.
We’re also connecting the mind and body, through investigating the treatment from a molecular biology perspective – for example through examining changes to hormones in blood.
Through identifying how the body responds – or doesn’t respond in some cases – to the treatment, we aim to improve the therapy to increase its already promising success rate, particularly for patients who experience little relief from traditional treatments.
This study is helping us refine and further evaluate the treatment to advance its future clinical use, while ensuring that we’re applying it in a safe and ethical environment.
While reconsolidation therapy is showing strong results, it’s not yet known if it is suitable for every trauma survivor. Like any intervention, it comes with limitations and potential risks.
For example, the therapy is not currently offered to individuals with complex PTSD – a condition that often develops from prolonged or repeated trauma, such as childhood abuse or domestic violence.
Reconsolidation therapy holds promise – but it’s not a one-size-fits-all solution. Our research is helping to define where it works best and why, so we can build safer, more targeted treatments for the diverse range of people living with PTSD.
The aftermath of trauma looks different for everyone. My hope is that reconsolidation therapy becomes one more tool – grounded in science, guided by compassion – to help people write a new chapter after trauma.
Professor Alain Brunet is director of the Thompson Institute and National PTSD Centre, and founder of the Reconsolidation TherapyTM Methode Brunet.
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