TIFT #98: Hooray, I Was Wrong!

Being right teaches us little, but finding out we got it wrong is exciting and enlightening. Holding an idea one thinks is true, a working hypothesis, then discovering clear evidence that points the other way, can open up new vistas. For many years I have believed (with niggling doubts), that the values, attitudes, ideals, and prohibitions that govern shame, guilt, and pride are essentially indelible. That is, they cannot ever be erased. I believed that, at best, they could be overpowered by healthier values through some form of competition. I have written about this before, (TIFT #9) but always with a bit of doubt.

Recently, I learned that I was wrong. Values (I use that one word to cover attitudes, ideals, and prohibitions, as well as values per se), it turns out, can be erased and rewritten dramatically through memory reconsolidation. This is still not easy to accomplish, but now I know it is possible. Building healthy values to compete with the dysfunctional ones is still worth doing, but now I can think about change through MR. That means activating the old pattern while supplying disconfirming information, which causes prediction error, renders the old memory volatile, and becomes the basis of a new version of the implicit memory, no longer demanding shame or guilt.

How I came to know my understanding had been incorrect

Here is what happened. The story is a bit complex but has interesting lessons as well. A woman had been molested by her male babysitter when she was five. The abuse was physically painful, but when she innocently reported the event to her mother, instead of receiving comfort, she was shamed and even blamed for what had happened. The loss of motherly love became the source of three threads:

• A small but inextinguishable hope of somehow finding love and validation.
• Turning shame against herself in an identification with the aggressor to save the connection with her mother.
• Internally holding back forbidden knowledge of the details of what had taken place, as if the revelation would prove her mother right. This entailed aggressive self-punishment, thoughts of suicide, and destruction of things she loved.

Pressure mounted as she first wrestled with doubts, then found growing hope that she could, in adulthood, find the validation her mother had always refused her. Perhaps she might even learn the truth of what had taken place. At the same time, being manipulated and overpowered by others in her life reawakened the physical pain she had experienced at five, as the memory of what had happened made its way toward consciousness.

In one session, she realized that she was caught in an impossible dilemma. If the truth came out, if she found that she actually deserved love and validation, then there would be a terrifying backlash. The self-punishing part within would unleash violent retribution. A few days later, she woke up from a recurring dream she had had for 30 years. For the first time, she knew the dream was revealing the full extent of what had happened at age five. Astonished, she experienced an unfamiliar sense of relief. On the other hand, experience told her that, within hours, the backlash would return, shaming and punishing her for the truth that had been denied and hidden for almost a lifetime. She called for an emergency session.

A reality that must not be: An “impossible imperative”

Here is the part I find most amazing and enlightening. Deep in her limbic mind, a rule had been written and committed to implicit memory. Translated into words, the rule was that the truth of what had happened must not be. I think of this as a red line, a commitment against reality, which is an impossible imperative. It wasn’t denial, because, built into the structure, the punishment was an admission that the unacceptable reality was real and true. The way she had braced herself against a reality that must not be real was to maintain a constant pressure of self-deprecation and punishment throughout her life. One could picture the Berlin Wall, built, reinforced, protected with men and machine guns for decades. But once breached, its fortification had no further meaning. The solid masonry, the guns and soldiers, were suddenly pointless. In a similar way, my client’s bracing through shame and self-negation suddenly lost its meaning. The truth was out and could never be returned to unknowing and darkness.

She called for an emergency appointment because there was one check that still had to be done. Would her therapist reject her, now that the truth was out? She had to share what she knew and see through her therapist’s eyes, not words, what he felt. She knew there was still potential for overwhelming backlash and wanted support to neutralize it as much as possible. Since then, the need for self-harm has come apart, piece by piece. There is no longer a red line to protect, no longer a reality that can’t be faced.

As I have worked to visualize the nonverbal rules that are the sources of our entrenched maladaptive patterns (EMPs), I have begun to see more clearly how some of them serve to guard against pieces of reality that, to the child, must not be. Once again, it isn’t really denial, because that would make the reality disappear. Rather, a red line is a dynamic refusal to know something that, on another level, is known. That creates an impossible imperative. The not knowing must be kept intact by strenuous, energy sapping, ongoing bracing. Once the truth is out, everything changes and the red line, now serving no purpose, is erased through the magic of memory consolidation. Of course, that's  not the only type of rule. There are others like the five enumerated in the previous TIFT (#97).

What can we say in general about rewriting maladaptive values?

What this experience shows is that values, attitudes, ideals, and prohibitions are a special form of rule, but they are made of the same stuff as other implicit learning. They are encoded in unconscious, nonverbal memory by the relative strength of synapses binding together groups of neurons representing specific chunks of knowledge. Why, then, are they so hard to change? The inclusion of values among mental contents subject to MR extends the principle that the bigger the threat, the more tightly the inner mind holds onto its protective rules. Values are internalized in order to maintain our acceptability to ourselves and to the group. In fact, for humans, survival of the tribe has had more evolutionary value than survival of the individual. We are driven to maintain connection to the social group, so we use values to form judgements that enforce conformity through shame and guilt.

What made a dramatic change possible for my client was that we had come to a “do-or-die” moment. Literally, her implicit rule was demanding that she give up all hope of self-worth in order to keep reality from being what it was. Crucially, the therapy leading up to that moment had given her a measure of hope that a positive outcome might be possible. In effect the red line had slightly faded to pink. The stakes had been lowered. Just maybe, if the truth turned out to be real, the result might not be the end of life. The anticipated backlash of self-punishment might not be necessary. Absolutes had subtly shifted towards being relative. The imperative had softened. Maybe the truth would turn out to be survivable and there might even be room for a life. Those subtle changes set the stage for her to take what, for her, was an ultimate risk.

Jeffery Smith MD

 Photo credit: Ben White, Unsplash