RESET Therapy: An Alternative Treatment for Addiction
Twenty years ago, we knew very little about how memory was stored in the brain let alone how to alter it. Neither were we aware of the critical role that memory circuitry has within the context of the addictive process. Fast forward to the present time and now thanks to advances available through neuroscience, we have the means to alter the critical brain circuitry that sustains the addictive disease process. Unknown to many, we are able to do this through noninvasive means fairly quickly and straight forwardly. Unfortunately, part of the problem has been to bring these advances to the awareness of those who are front line providers of addictive services.
Frequently, the word neuroplasticity is mentioned to describe how the brain is adaptable to changing circumstances however, there is a shortage of specific information related to how to actually and specifically harness this ability and use it to create a transformative process. My goal in this article is to provide awareness of a treatment that can actually alter the brain’s memory circuitry through noninvasive means. To accomplish this objective, I’ll familiarize you with a number of important terms associated with this intervention that I’ve come to call RESET Therapy (Reconsolidation Enhancement by Stimulation of Emotional Triggers).
I’d like to begin with a description of how trauma or cravings are stored in the long-term memory network of the brain. When this type of event occurs for the first time it is called Consolidation. After a period of time (some say up to a day or two) the trauma effect becomes locked into the memory system permanently. With addiction, it is likely built up over a variable period of time. An interesting aspect of this process is that each time the trauma memory and later the craving impulse is triggered, it goes through another storage process called Reconsolidation.
Many researchers are currently involved in developing methods to intervene at the moment this restoration occurs. Some inject medications, some use light, some are even trying it through the tongue. I use sound! At this point you might be asking why would so many researchers be spending so much of their time trying to alter this process? The answer is pretty straight forward. If we can intervene at this crucial moment, the brain will restore the memory free of the emotional component in cases of trauma and weaken the strength of the craving in addiction.
The following figure provides an overview of my perspective of the memory consolidation/reconsolidation process. The first egg shaped illustration is labeled ‘New Memory (active)’ obtained through ‘Learning’ and Consolidated into the stored ‘Inactive Memory’ circuitry. When reactivated either intentfully or not, the memory becomes active again and subject to modification through varied forms of intervention including sound.
Learning generates a new short-term memory trace. The consolidation process moves it to long-term memory. Active or passive retrieval brings it back into short-term memory. This is the magic moment where change can occur before it is restored into long-term memory again (Reconsolidation). Note in the green box, the memory as illustrated in the wave form is now altered permanently. Clinical experience indicates that the process can be changed with positive results within 15 to 20 minutes of modulated sound. A 2010 article caught my attention due to its inclusion of the terms ‘Drug Memory Reconsolidation’ in the title.
The authors concluded that: “[M]emory reconsolidation could potentially be exploited to disrupt, or even erase, aberrant memories that underlie psychiatric disorders, thereby providing a novel therapeutic target. Drug addiction is one such disorder; it is both chronic and relapsing, and one prominent risk factor for a relapse episode is the presentation of environmental cues that have previously been associated with drugs of abuse. . . Relapse, the resumption of drug-seeking and drug-taking behaviour following a period of abstinence, can be unconscious, automatic and habitual (and is markedly influenced by the presence of environmental stimuli and contexts that have been paired previously with drug use. These drug-associated conditioned stimuli (CSs), or cues, can induce craving and activate limbic cortico-striatal circuitry in abstinent human addicts. . . treatments based upon the disruption of reconsolidation would be predicted to require few, and possibly even a single, treatment with a memory-disrupting drug in order to increase the likelihood of long-lasting abstinence from drugs of abuse. . . treatments need to be developed that can target neurotransmitter systems involved in drug memory reconsolidation . . . without producing unacceptable side-effects in human patients.” (Milton & Everitt, 2010)
There is a somewhat different approach taken when the treatment of addiction becomes the primary focus. Within this context, I seek not only to down-regulate varied cravings associated with the addiction experience but also to up-regulate selected neural activity in the pleasure center network.