The ethics of erasing bad memories

Though the emerging possibility of deleting traumatic memories could provide some people relief, the question remains whether it would fundamentally change who they are.

Electricity has been used in medical treatments all the way back to 46 C.E. when Scribonius Largus treated the Roman Emperor Claudius for headaches with an electric eel, a process that he recorded in his Compositiones Medicae. But it wasn’t until Sigmund Freud came along that electroshock therapy took on its more modern form.

From 1892 to 1893, Freud famously worked with Ilona Weiss (called Fraulein Elisabeth von R. by Freud), a 24-year-old from a well-to-do Hungarian family. She complained of constant fatigue and pain in her legs when walking or standing, which, naturally, Freud discovered had more to do with psychological trauma than physical illness. In his Studies on Hysteria,Freud wrote about Weiss’s unusual condition, noting, “If one pressed or pinched the hyperalgesic skin and muscles of her legs, her face assumed a peculiar expression, which was one of pleasure rather than pain.” As it turned out, physical pain could bring her to orgasm.

Having diagnosed her with hysteria, for four weeks Freud treated Weiss with high-tension electric currents to her legs. After a month of no results, he changed his tune on electroshock therapy. He had once claimed it “produces admirable results” in Studies on Hysteria, but later disparaged it as a little more than a “pretense treatment.”

Although Freud quickly threw it out of his repertoire, over a century later, electroconvulsive therapy (ECT) is back in use. While Freud used ECT as a localized treatment for physical maladies, it’s now predominately used on the brain as a treatment for mental illnesses.

A common perception of ECT is that it is an antiquated and gruesome treatment, like something out of Plath’s The Bell Jar or Burgess’ A Clockwork Orange, associated with cinematic images of a mental patient writhing in a straight jacket as menacing doctors and nurses flood the patient’s body with electricity. But, ECT is now surprisingly modernized, currently used in mainstream medical treatments for schizophrenia, mania, and catatonia.

Most radically, ECT is now being used to alter and destroy memories.

It may sound like fiction, like something out of Eternal Sunshine of the Spotless Mind , but a recent study published in Nature found that ECT successfully “impaired reconsolidation of episodic memories in humans.” That’s to say, memories were partially, and in some cases almost entirely, erased from participants who underwent ECT.

The lead researcher, Marijn Kroes, a neuroscientist at Radboud University Nijmegen in the Netherlands, and his colleagues found that by strategically timing ECT bursts—which induce seizures by passing current into the brain through electrode pads placed on the scalp—it is possible to target and disrupt patients’ memory of a disturbing episode.

In the study, participants were shown slideshows of two “emotionally traumatic events”—a car crash and a sexual assault—which were also narrated to the participants so as to better entrench them in their minds. One week later, participants were asked to recall the events, and a treatment group received ECT bursts as they tried to retrieve the memory. The next day, participants were given a multiple-choice memory test. It turned out that the patients who underwent the electroshock treatment were significantly worse at remembering details from the stories than those who were either anesthetized or given no treatment at all. Those who were treated with ECT performed no better than if they had simply taken a guess.

Such a finding raises serious questions, not least of which is: Should we be tampering with our memories? But in order to answer this, one must first determine the value of a memory. If it is true that our actions, our personalities, our very notions of self are based on the experiences we have had and on the memories we have collected, then to delete our memories would be to destroy a part of ourselves.

In her autobiographical essay, “A Sketch of the Past,” Virginia Woolf wrote, “I can only note that the past is beautiful because one never realizes an emotion at the time. It expands later, and thus we don’t have complete emotions about the present, only about the past.” To do away with our memories is to do away with the past, and to do away with the past is to do away with the present.

But not everyone is so sure that getting rid of our bad memories would lead to the loss of our true selves. A few years ago, when neuroscientists were testing a chemical on rats that they hoped could erase the connections between brain cells (thereby obstructing the ability to recall memories), Dr. Arthur Caplan, now the head of the division of bioethics at New York University, said that memory-erasing treatments don’t really change who we are.

“I think we can change some memories without changing fundamentally who we are or how we behave,” said Caplan, who is also the editor of Contemporary Debates in Bioethics. “And even if it does change a little bit of our personal identity, it makes us able to function. We have to understand the plight of those who are prisoners to bad memories, to awful memories, to horrible memories.”

Although, as Caplan said, tragic memories can potentially make us prisoners to ourselves, it is worthwhile to note that our personalities are made up of a delicate interplay of memories. Many experts believe that to disrupt one memory runs the risk of disrupting everything.

“Our memories and our experiences are fundamental to our personhood, to our lives, to everything that makes us who we are,” said Dr. Judy Illes, professor of neurology and Canada research chair in neuoroethics at the University of British Columbia. “When you pull one brick out of the wall of memories, many other memories go with it. Memories are incredibly interlocked with one another.”

To think that memories can be separated would be a categorical error—our lives are complex, rich with interweaving remembrances that affect our decisions, our present selves, and our future selves in ways that would be impossible to predict. As Illes adds, “There isn’t a moment in time that we aren’t building memories.”

Dr. Hank Greely, director of the center for law and biosciences and professor of genetics at Stanford School of Medicine, agreed, saying, “Memories make up our identity, including our personalities, and in some important ways, we are our memories so if we lost or changed our memories we would be different people.”

“But,” he said, adding a layer of nuance to the potential effects of memory deletion. “Changing or losing memories could make you happier or sadder depending on if you’re losing sad or happy memories.”

Although somewhat skeptical, Greely predicted that in 10 to 20 years there is “a reasonable chance” that memories could not just be disrupted, but pinpointed and deleted entirely.

So if someone undergoes a deeply disturbing experience—a moment that could scar for life—why shouldn’t he be able to do away with that sad memory, if it is a safe process, and could lead to a significant increase in happiness? Initially, it seems like an obvious answer, but messing with memories is far from a simple process and to snip away at one memory is to inevitably infringe on others.

Even when disrupted by chemicals or bursts of ECT, the emotions behind long-term memories are preserved in our subconscious. For instance, if someone has been abused, he would still feel a sense of unease if he met the abuser again, even if the memory had been “deleted,” according to Steven Johnson’s Mind Wide Open: Your Brain and the Neuroscience of Everyday Life. That’s because, as Johnson explains, our brains are wired to preserve emotionally serious memories. It’s a great evolutionary mechanism for bonding people together—for remembering all the details of our wedding or evenings spent with close friends—but it wreaks havoc on our ability to suppress distressing memories, even with the use of memory-altering treatments.

As Johnson writes, “Even amnesiacs, under the right circumstances, can remember their past feelings.”

Short-term memories can also be effectively wiped from our conscious mind, but just as with long-term memories, the attached emotions tend to hang on in our subconscious. A recent study published in the Proceedings of the National Academy of Sciences found that subconscious visual memories could be weakened without ECT or chemicals. All one has to do is try to forget the moment as it is happening. The study found that when participants were reminded of an image—such as a coffee mug—that they had been instructed to forget about a few days earlier, they had significantly less brain activity than when they were reminded of images that they had not actively tried to forget. And although the study proposed that subconscious memories may not hang on quite as much as previously thought, there’s not yet proof that underlying emotions can be deleted along with memories.

Yet even if researchers do find a way to entirely delete memories in a clean-cut, simple manner, we would still be posed with a moral dilemma—not just the issue of playing God with our minds but also the question of whether we no longer want our past to inform our present. Would total forgetfulness really guarantee our mental freedom? Or would a mind void of bad memories only presage a future of monotony, of a tendency to lose track of who we were, and in so doing, lose track of who we want to be?

Perhaps Freud was smart to throw electroshock therapy out early on in his career. In the case of memory, it’s possible that it could do more harm than good. As with many ethical quandaries, the true importance of memory only comes into high relief when confronted with its destruction.

-BBC