Grey Matter Episode 4: The Brain Part 2: Trauma, Memory, and Identity

“The Brain Part 2: Trauma, Memory, and Identity”
by Kaitlin Puccio

In 2017, researchers developed brain stimulation technology that would weaken the synaptic connections between neurons that form a traumatic memory, and thus would suppress an individual’s fear response to that memory. In doing so, we are potentially altering that individual’s identity.

While the benefit of normalizing fear responses is clear, it must be weighed against the ethical concerns. First, our memories and experiences as a whole contribute to our identity, which constantly evolves as new experiences create new memories. It may be argued that a person’s true identity is how that person identified before the traumatic event came to pass. However, if we could select a point in time at which we could identify a person’s “true” identity, we might run the risk of pointing to a time before that individual was capable of forming memories. For example, if a two-year-old experiences an emotionally scarring event, she may be henceforth changed. Assume that she is able to recall the traumatic event, but has no memories of the preceding two years of her life. Her “true” identity would lie at a point before the traumatic event. All of her experiences and memories from that point forward would, in essence, form a “false” identity. The question is whether her “true” identity indeed lies at a point before the traumatic event—where there are no memories, and where memories are part of forming an identity—or if the memory of the traumatic event is a necessary ingredient in formulating her true identity as she becomes capable of forming memories.

A similar question about identity arises with the possibility of brain stimulation technology being used in this way. After the synapse between neurons is weakened to suppress a fear response to a traumatic memory, does the individual indeed “go back” to the person he was before the traumatic event took place, or does he take on another, new identity? For example, say that before X went to war, at point A, he had normal fear responses to cars backfiring. After returning home from war, at point B, he suffered from PTSD and had an overactive fear response to cars backfiring, which he recalled as gunfire. After brain stimulation technology “erased” the traumatic memory, at point C he had a normal fear response once again. What brain stimulation technology does not do is erase X’s memory of going to war. So, the event at point B makes it impossible for point A and point C to be identical. X cannot “go back” to being “X at point A” when he is at point C. If the events at point B never happened, X could remain “X at point A.” At point C, he has not become “X at point A,” who would (as we know from the existence of point B) have PTSD from going to war. At point C he has become “X at point C” who does not have PTSD from going to war, necessarily making him different from “X at point A.” The artificial change imposed on X via brain stimulation interrupts the natural evolution of X as he moves along the points of his life. While this does not necessarily indicate that brain stimulation technology cannot be used, it does mean that individuals must understand that their identity will necessarily be altered by artificial means.

Patients with dementia are often considered in debates about whether changes in memory result in changes in identity. This change is not artificial or natural, but clinical. Though this is a worthwhile question, the ethical issue that dementia raises with regard to brain stimulation technology involves memory enhancement rather than suppression. Researchers have found a way to stimulate the hippocampus in rats so that they recall memories that they otherwise wouldn’t. Patients with dementia would undoubtedly benefit from such technology if it were to become available to humans. The concept of memory enhancement informs the ethical analysis of memory suppression technology as it applies to the loss of identity. In particular, where memory enhancement technology may result in the effective restoration of an individual’s identity, memory suppression technology may result in the diminution of an individual’s identity.

If memory suppression technology were to become available for clinical use, it would be regulated. Those regulations would dictate the set of individuals that are permitted to access such technology. However, determining the limits of what is a normal fear response and what is not may be a difficult task, because what is not traumatic to one person may indeed be traumatic to another. Further, the regulatory body would be faced with the question: If we have this technology, are we ethically compelled to use it to enhance healthy people? That is, if any memory leads to any level of negative reaction in an individual, why not “erase” those memories and improve that person’s overall quality of life? The technology might even be used to prevent future trauma. While it may not seem traumatic if a student has an unpleasant but innocuous encounter with his classmate, erasing that memory may prevent him from bringing guns to school as a result of ruminating over that unpleasant encounter. This in turn may prevent the need to use this technology to erase traumatic school shooting memories.

Or, we may find that it is just as traumatic for an individual to suppress a fear response to a traumatic memory if she feels that she has lost her identity during the process, resulting in a cycle of trauma. Moreover, certain individuals suffering from PTSD may not be deemed mentally competent to make their own medical decisions, leaving it up to clinicians to determine whether brain stimulation technology should be used. The question then becomes whether imposing a potentially identity-altering treatment on an individual is ethical. It can be seen as effectively bringing about the death of X at point A and forcing X to transition to X at point C. The identity question that brain stimulation technology raises necessitates a discussion of the ethics of such technology, even if it is agreed that the benefits outweigh the concerns.

Copyright © 2023 Kaitlin Puccio