Strange things sometimes happen in therapy. If they happen enough and form a pattern, they develop into a likely tool for systematic use.
I'd known Sandy for a couple of years but was surprised by her visit to my office. I learned she recently nursed her husband of 6 years through a sudden cancer death. He was a jeans and flannels guy and wanted to die in his own bed. She helped him through it and at 23 wanted to die herself. I felt absolutely helpless but unwittingly asked where she was at age 15, the year before meeting him. She lived with her grandfather on his farm in a town 40 miles distant. Yes, the farm and her grandfather were still there; yes, she could get to them. She called a few days later and remarked that the smells, sounds, and chores brought back memories that happened before her husband. She no longer wanted to die even though she missed him in quiet moments.(1)
Sara was usually angry with her husband; they made little progress with behavioral and cognitive methods and appeared likely to separate. He, discouraged, quit coming to our joint sessions. She saw him as ignoring her "one more time." However, one evening she arrived smiling. She had fixed his dinner, cleaned their home, and tolerated the children better than usual. She had opened an old trunk earlier in the week and discovered forgotten photos of an earlier infatuation, a suitor that brought her flowers, always called, and was highly attentive. She immediately felt an "incredible wave of peace." She finished with the pictures, then tidied the house, made dinner, and smiled at her husband. He, surprised, reciprocated. Things got much better.
Finally, Ned was angry and despondent after an especially intense ending to an affair. He had done the usual things such as returning her property and cleaning the reminders out of his apartment. Still, he felt alone and bitter. I asked, in a random moment, who his next prior relationship was and how did it end. She had also dropped him but he still had some pictures tucked away. I asked him to get them out and put them in his wallet and display them in his room. He did and his mood lifted immediately. His attractions and annoyances with the earlier girl predated his current grief; he felt better.
In each of these cases, a mood shift away from grief, anger, or depression was effected by shifting the client's focus to earlier memories, ones that predated the time of loss or frustration.(2)
There are many other examples:
a) Pete went to a strip bar. He swore the relaxation was enhanced by memories of college days, before he knew his spiteful wife, when he spent a lot of time in similar places.(3) b) George had a devastating divorce. He fought depression with thoughts of grad school in Montana and reveries about his tough grandfather from Siberia who was once crucified on the side of a barn by Cossacks and left to die. Grand dad pulled himself free from the nails, survived a Siberian winter, and worked his way south and eventually to America. The "toughness" image is especially helpful to George. c) Susie goes out dancing with her sister on alternate months. She uses the memories to dampen her emotional reactions to her husband's criticisms. d) Mary was despondent and alone on a Friday night during her separation. She was distracted out of the mood by a call from her niece that let her talk about the days before marrying Herman. e) Missy traveled to Virginia to float in her childhood pool where there were no thoughts of her job or her ADHD child. f) Andy was abruptly left by his wife. He lifted his mood by playing Brahms and other classics that he first heard in college 20 years ago. g) Mike obsessed about his father's recent death but got a break by visiting an old girlfriend who seemed to act as a living photo, eliciting memories that predated his father's illness. h) Martin dropped $10K for a 4-wheeler because it reminded him of childhood, relived some earlier memories and shed a lot of depressive thoughts.
Different memories elicit different Psychological Adaptations. Each PA has ties to varied emotions such as relaxation, sexual interest, anger, fear. Some of these PAs (feelings as well as cognitions, muscle and endocrine patterns, etc.) are mutually incompatible. Memories that were associated with fun, safety, or adventure elicit generalized mood shifts and perhaps lead to some behavioral activation. If early memories of running are helpful; actually running may be even more so. Meditation, self-hypnosis, hypnosis, and guided imagery may be useful because of the lateral inhibition between PAs. Thus, a mechanism, lateral inhibition (or reciprocal inhibition) that is effective in sensory and motor systems may also be operative in handling the coordination of PAs.(4,5) We see some of this in therapy. There are many opportunities for research with these phenomena.
1) A more dispersed culture would have had her in a hospital, charged her $30K, and put her on some medicine. They still would have done the effective thing by discharging her to her grandfather's care.
2) Earlier memories can be destructive. Jeff (26) was getting lost; he missed turns & signs, he neglected changes in traffic signals. He was a competent driver before separating from Marcia; however, he didn't have the customary signs of depression. Still, their separation 6 months ago and his driving problems started about the same time. I was considering some interventions when Jeff mentioned an aside. Marcia's photo was still on his car dash. He put away the photo and stopped getting lost.
3) Probably some other psychological adaptations were elicited as well!
4) Several recent notes in the Harvard Mental Health Letter (Grinspoon L, Ed., 74 Fenwood Rd, Boston, MA 02115) summarize reports that "activation" techniques are equally effective with cognitive treatment, and "client ability to form alliances" is more important to therapeutic outcome than cognitive methods. (1997) Cementing the alliance. a) Pete went to a strip bar. He swore the relaxation was enhanced by memories of college days, before he knew his spiteful wife, when he spent a lot of time in similar places.(3) b) George had a devastating divorce. He fought depression with thoughts of grad school in Montana and reveries about his tough grandfather from Siberia who was once crucified on the side of a barn by Cossacks and left to die. Grand dad pulled himself free from the nails, survived a Siberian winter, and worked his way south and eventually to America. The "toughness" image is especially helpful to George. c) Susie goes out dancing with her sister on alternate months. She uses the memories tems as a means for emphasizing contours of stimuli. It was extended to hearing and tactile systems. See Attneave F (1954) Some informational aspects of visual perceptions, Psych Rev, 61(3) 185-193; Von Bekesy G (1967) Mach band type lateral inhibition in different sense organs, J of General Physiology, 50 (3), 519-532.