Do psychological issues involve reactivation of an earlier memory such that the reactivation plays a causal role in the issue?
Can you address an issue without explicitly working with an earlier memory?
For the first question, I’d say “it depends”. On one end, we have something like PTSD flashbacks—here a reactivation of a memory is clearly in a causal role, since “a memory getting reactivated to such an extent that the person experiences themselves as literally reliving it” is what a flashback is.
Slightly less strong but still strongly suggestive of a causal role is something where a person imagines themselves doing something, but then—maybe just at the back of their mind—recalls a painful memory and flinches away from doing that. E.g. they consider speaking up, but then a flicker of a memory comes up about a time when they spoke up and somebody ridiculed them, and they quickly close their mouth. Here there seems to at least be a causal path from the memory to the issue, in that the memory is charged with negative affect and that the memory coming up causes the person to reorient to something that makes the memory recede in intensity.
Then we have cases where there’s no obvious memory at first, but directing attention to the issue and asking questions about it brings up a memory, even though none of the questions ever ask about memories directly. For example, someone might feel like they have to act in a certain way in a particular social situation despite finding it unpleasant. Now a therapist might ask them something like “what would be bad about acting differently” and have them focus on what feels emotionally or intuitively bad about it (rather than what logical justifications their mind would offer). Then there might be a line of questioning that went something like:
“I have difficulty getting a turn to speak because I tend to wait extra long to make sure others have finished speaking before I speak up. And then I wait so long that someone else always starts talking before I can.”
“Okay, so what would be bad about speaking up before you’re certain that others have finished speaking?”
“Then I might interrupt them before they’re finished.”
“Okay, what would be bad about interrupting them before they’re finished?”
“That’d feel unfair toward them.”
“In what way does it feel unfair?”
“Hmm, I’m getting a memory of a time when I was trying to speak up but my father interrupted me, and then I tried talking anyway and then he acted like I had interrupted him and that I should let him talk first. That felt really bad and unfair. I guess I want to make sure to act better than he did, and make sure that I never interrupt someone else when it’s their turn to speak.”
Is the memory in a causal role here? Probably depends on how exactly we define “causal”. But at least it seems like there is some kind of a model about how the person wants to act or not act (“interrupting other people is unfair toward them, and should be avoided”) that was formed due to an earlier experience. When one tries to elicit details about how exactly the model works, the model seems to structurally incorporate the original experience as a reference point for what exactly the core bad thing is. And working with the memory often seems to help with one’s issues.
Given that this kind of a memory seems to have a similar character as the PTSD and the “I can hear the people mocking me” memories, just buried slightly deeper, to me the simplest and most plausible explanation would be that it has a causal role in the same way as the less-buried ones do.
Then on the other hand, it’s not always the case that this kind of questioning leads to any clear-cut memory. Sometimes what comes up feels more like a general model that has been formed out of multiple different life experiences, with none of original instances having been stored. Or there might be an issue that seems to go back to an age young enough that the person doesn’t have any explicit memories of it, and it has only left a general emotional imprint. In those cases the memory doesn’t seem to have any causal role, because there doesn’t seem to be any memory around to begin with.
Or at least not one that would be easily accessible. I’ve heard of claims from people who got into states of deep meditation or strong doses of psychedelics that they managed to access very early painful memories that wouldn’t have been available in a normal therapeutic context, and then got independent confirmation for the truthfulness of those memories afterward. I’ve not looked into these in detail but I’m inclined to suspect they’re true. In part due to my personal experiences of old memories spontaneously coming up in altered states of consciousness (and this sometimes shifting behaviors), in part because “all behaviors involve an original memory trace being stored somewhere and that trace then driving behavior, with some of those traces just being buried deep or in not normally forward-compatible storage formats” would again seem like the most parsimonious model.
As for the second question, I’d again say it depends. If someone is suffering from a PTSD flashback, it’s going to be hard to do anything about that without working with the traumatic memory in some way! But for the ones where the problem isn’t so directly driven by an explicit memory reactivation, there are definitely a lot of approaches that work by changing other parts of the model. E.g. if the model makes a particular prediction about the world in general (“people will always find it unfair if I speak up before being absolutely certain that they’re finished”), then it’s often possible to disprove that prediction without going into the details of the original memory. And while some therapies focus on the episodic memory component of the learned model, others work on different components.
So I think we have two separate questions here:
Do psychological issues involve reactivation of an earlier memory such that the reactivation plays a causal role in the issue?
Can you address an issue without explicitly working with an earlier memory?
For the first question, I’d say “it depends”. On one end, we have something like PTSD flashbacks—here a reactivation of a memory is clearly in a causal role, since “a memory getting reactivated to such an extent that the person experiences themselves as literally reliving it” is what a flashback is.
Slightly less strong but still strongly suggestive of a causal role is something where a person imagines themselves doing something, but then—maybe just at the back of their mind—recalls a painful memory and flinches away from doing that. E.g. they consider speaking up, but then a flicker of a memory comes up about a time when they spoke up and somebody ridiculed them, and they quickly close their mouth. Here there seems to at least be a causal path from the memory to the issue, in that the memory is charged with negative affect and that the memory coming up causes the person to reorient to something that makes the memory recede in intensity.
Then we have cases where there’s no obvious memory at first, but directing attention to the issue and asking questions about it brings up a memory, even though none of the questions ever ask about memories directly. For example, someone might feel like they have to act in a certain way in a particular social situation despite finding it unpleasant. Now a therapist might ask them something like “what would be bad about acting differently” and have them focus on what feels emotionally or intuitively bad about it (rather than what logical justifications their mind would offer). Then there might be a line of questioning that went something like:
“I have difficulty getting a turn to speak because I tend to wait extra long to make sure others have finished speaking before I speak up. And then I wait so long that someone else always starts talking before I can.”
“Okay, so what would be bad about speaking up before you’re certain that others have finished speaking?”
“Then I might interrupt them before they’re finished.”
“Okay, what would be bad about interrupting them before they’re finished?”
“That’d feel unfair toward them.”
“In what way does it feel unfair?”
“Hmm, I’m getting a memory of a time when I was trying to speak up but my father interrupted me, and then I tried talking anyway and then he acted like I had interrupted him and that I should let him talk first. That felt really bad and unfair. I guess I want to make sure to act better than he did, and make sure that I never interrupt someone else when it’s their turn to speak.”
Is the memory in a causal role here? Probably depends on how exactly we define “causal”. But at least it seems like there is some kind of a model about how the person wants to act or not act (“interrupting other people is unfair toward them, and should be avoided”) that was formed due to an earlier experience. When one tries to elicit details about how exactly the model works, the model seems to structurally incorporate the original experience as a reference point for what exactly the core bad thing is. And working with the memory often seems to help with one’s issues.
Given that this kind of a memory seems to have a similar character as the PTSD and the “I can hear the people mocking me” memories, just buried slightly deeper, to me the simplest and most plausible explanation would be that it has a causal role in the same way as the less-buried ones do.
Then on the other hand, it’s not always the case that this kind of questioning leads to any clear-cut memory. Sometimes what comes up feels more like a general model that has been formed out of multiple different life experiences, with none of original instances having been stored. Or there might be an issue that seems to go back to an age young enough that the person doesn’t have any explicit memories of it, and it has only left a general emotional imprint. In those cases the memory doesn’t seem to have any causal role, because there doesn’t seem to be any memory around to begin with.
Or at least not one that would be easily accessible. I’ve heard of claims from people who got into states of deep meditation or strong doses of psychedelics that they managed to access very early painful memories that wouldn’t have been available in a normal therapeutic context, and then got independent confirmation for the truthfulness of those memories afterward. I’ve not looked into these in detail but I’m inclined to suspect they’re true. In part due to my personal experiences of old memories spontaneously coming up in altered states of consciousness (and this sometimes shifting behaviors), in part because “all behaviors involve an original memory trace being stored somewhere and that trace then driving behavior, with some of those traces just being buried deep or in not normally forward-compatible storage formats” would again seem like the most parsimonious model.
As for the second question, I’d again say it depends. If someone is suffering from a PTSD flashback, it’s going to be hard to do anything about that without working with the traumatic memory in some way! But for the ones where the problem isn’t so directly driven by an explicit memory reactivation, there are definitely a lot of approaches that work by changing other parts of the model. E.g. if the model makes a particular prediction about the world in general (“people will always find it unfair if I speak up before being absolutely certain that they’re finished”), then it’s often possible to disprove that prediction without going into the details of the original memory. And while some therapies focus on the episodic memory component of the learned model, others work on different components.
That’s very helpful, thanks!