Active suppression prevents the return of threat memory in humans

Unbidden distressing memories inflict serious damage on mental health. Extant research highlights the importance of associative learning in modulating aversive memory. We report that conscious active suppression eliminates learned fear responses independent of memory triggers and is related to individual difference in thought control ability; in contrast, thought diversion only reduces cue-specific fear response. These results suggest potential avenues for treatment of persistent maladaptive memories by engaging declarative mnemonic control mechanisms.

An Interpretative Phenomenological Analysis of the Emotional Experience of the 1947 Partition Survivors

This paper examines the emotional experience of the survivors of the 1947 India-Pakistan Partition by conducting an interpretative phenomenological analysis of their trauma narratives which were procured through the 1947 Partition Archive, an organization dedicated to the preservation of the stories of the victims of the separation of the two countries. The three participants were between the ages of 5-14 years-old when they were displaced and all of them witnessed the rampant violence that characterizes the Partition. They recall the events while maintaining a distance from the distressing memories by altering the perspective of their narratives and adopting laughter as a relieving mechanism. Their cultural identity was comprised by forced migration which they express through a deeply rooted desire to return to their homes. Their needs to be further exploration of Partition narratives across diverse demographics, such as South Indian and Muslim survivors.

EMDR as an Adjunctive Psychological Therapy for Patients With Functional Neurological Disorder: Illustrative Case Examples

Functional neurological disorder (FND) is a common diagnosis in neurology clinics, and there is some evidence psychological therapy can be of benefit. Eye movement desensitization and reprocessing therapy (EMDR) is a well-evidenced treatment for posttraumatic stress disorder (PTSD), and there is increasing evidence that it is beneficial for other conditions. EMDR is a therapy designed to focus on distressing memories, and therefore can be used for non-PTSD presentations where distressing memories are relevant. There is a small amount of case study evidence that EMDR can be used successfully with FND presentations and comorbid PTSD. This article describes two illustrative case examples of people diagnosed with FND who have distressing memories relevant to their presentation. Presenting functional symptoms included functional non-epileptic attacks and functional sensory symptoms. Psychological treatment-as-usual plus EMDR resulted in improvements for both cases and demonstrated that EMDR is a promising additional treatment option for FND presentations, appropriately selected. Recommendations regarding further research are made.

School-based psychoeducation and storytelling: Associations with long-term mental health in adolescent survivors of the Wenchuan earthquake

Aims We explored the factors promoting long-term mental health among adolescent survivors of the 2008 Wenchuan earthquake in China. We examined the associations of their long-term mental health with disaster-related storytelling and school-based psychoeducation, and of school-based psychoeducation with disaster-related storytelling. Methods A secondary school-based cross-sectional survey was conducted 6 years after the disaster. Participants with traumatic experiences such as injury, loss, witnessing someone's death/injury and home destruction (N = 1028, mean age 15, standard deviation 1.38, male 51%) were eligible. Mental health/disaster education (MHE/DE) was defined as taking one or more lessons in MHE and/or DE at school since the earthquake. Experiences of storytelling about the disaster involved expressing distressing memories and feelings regarding the earthquake since the disaster happened, according to four groups: never expressed distressing memories and feelings, expressed them through writing/drawing, expressed them through talking to lay supporters and expressed them through talking to health professionals. Analysis of covariance was used to compare mean scores on five selected subscales of the Symptom Checklist-90 (SCL-90), the Athens Insomnia Scale (AIS) and the Psychotic-Like Experiences (PLEs) scale among the four storytelling groups. Linear regression analysis was used to identify the relationships between MHE/DE and current mental health as measured by the SCL-90, AIS and PLEs. The relationship between education and storytelling was probed by χ2 test. Results The talked-to-lay-supporters group showed better mental health on the SCL-90 (p ⩽ 0.001), AIS (p < 0.001) and PLEs (p = 0.004), while the consulted-health-professionals group showed worse mental health on the three dimensions of the SCL-90: depression (p = 0.05), anxiety (p = 0.02) and fear (p = 0.04), and on PLEs (p = 0.02) compared with the never-expressed group. MHE and DE were inversely associated with SCL-90, AIS and PLE scores. Participants who received these forms of education talked about their disaster experiences to lay supporters more than those who did not. Conclusions MHE and DE at school may promote adolescents’ mental health after a disaster. Experience of storytelling about the disaster to lay supporters may be helpful for long-term psychological recovery, and may be a potential mediating factor for school-based education and better mental health. Because of the cross-sectional nature of this study, causality cannot be inferred; therefore, further prospective intervention studies are needed to elucidate the effect of these factors on adolescent survivors’ mental health.

Reconsolidating Intrusive Distressing Memories by Thinking of Attachment Figures

Thinking of attachment security can reduce arousal, and arousal has been shown to modulate memory reconsolidation. We investigated the effect of priming attachment security during reactivation of a distressing memory. We hypothesized that attachment priming would result in less frequent, distressing, and vivid subsequent intrusive, distressing memories. Seventy-one participants viewed a traumatic film and recorded the frequency, distress, and vividness of subsequent intrusive memories for the following week. The day after initial consolidation, the memory was reactivated before presentation of either an attachment or a positive nonattachment control prime. The attachment prime reduced the vividness and distress of intrusions during the ensuing week. These effects were stronger for participants with less avoidant attachment tendencies, suggesting that the reconsolidating effect of attachment priming is stronger for those with secure attachment systems. Thinking of attachment figures during reactivation of distressing memories may decrease the distressing nature of subsequent intrusive memories.

A little less talk, a little more action: a dialogical approach to cognitive therapy

Reappraisal strategies such as ‘thought challenging’ and ‘cost-benefits analysis’ are a hallmark of cognitive therapy, but sometimes fail to bring about lasting changes in the cognitive-affective structures underlying psychopathology. Modern theories of information processing suggest that experiential, action-based interventions such as chairwork may be a more efficacious route to cognitive modification. Based upon this hypothesis, a ‘dialogical’ approach to cognitive therapy is presented, which aims to bring about change through evocative, here-and-now interactions with parts of the self (self-to-self dialogues) and other individuals (self-to-other dialogues). Implementation principles and facilitation skills which guide this approach are outlined. To illustrate how dialogical interventions are utilized in clinical practice, chair-based strategies for socializing clients to the cognitive behavioural model, restructuring cognitions, facilitating emotional processing, resolving ambivalence, addressing distressing memories, building character strengths, and overcoming therapeutic impasses are described. Key learning aims As a result of reading this paper, the reader should: (1) Understand the limits of ‘standard’ cognitive techniques. (2) Appreciate some of the advantages of experiential methods of intervention, namely chairwork. (3) Learn how dialogical interventions are conceptualized, implemented, and facilitated in cognitive therapy.