Disrupted Reconsolidation of Emotional Memory in Psychedelic-Assisted Psychotherapy

Speakers: Jim Grigsby, Shandra M. Brown Levey

CE credits offered: 1
Program Level: Intermediate

The occurrence of and reaction to traumatic events play important roles in the genesis of PTSD in older children and adults, and in shaping the developing personality during childhood. MDMA and serotonergic psychedelics have been efficacious in treating reactions to trauma associated with PTSD and with developmental traumas as the therapeutic mechanism is hypothesized to involve extinction i.e. the inhibition of access to awareness of traumatic emotional memories. It is the intrusion of these into both consciousness and dreams, and associated sympathetic hyperarousal, that are arguably the most distressing symptoms of PTSD. There is emerging evidence that neural plasticity plays a role in psychedelic-assisted psychotherapy (PAP). In research with mice, it was observed that the critical period for social reward learning reopened, with remodeling of the extracellular matrix, for periods ranging from 2 to 4 weeks or longer. An animal model of PTSD using fear learning found evidence supporting a specific type of plasticity–interference with reconsolidation of emotional memory. Hence, it follows that MDMA may play a significant role in effectively treating traumatic memories. In this presentation, we will first discuss the history of development of the psychedelic and psycholytic approaches to the use of entactogens and classic psychedelics, followed by a discussion of the nature of reconsolidation, and conclude by addressing the implications of disrupted reconsolidation, for both process and outcomes of psychedelic-assisted psychotherapy.

Learning Objectives:

Know the early history of psychedelic-assisted psychotherapy (PAP)
Be able to distinguish psycholytic and psychedelic approaches to PAP
Understand and be able to think through the implications of emotional memory reconsolidation as a therapeutic mechanism

About Jim Grigsby, Shandra M. Brown Levey

Jim Grigsby is a Professor in the Departments of Psychology and Medicine at the University of Colorado Denver. A board certified clinical psychologist, he is a cognitive neuroscientist whose research has been funded by the NIH, Medicare, the Department of Defense, and other federal agencies and private foundations since 1993. He is the developer of a comprehensive theory of personality based on the architecture of the brain as a modular, distributed, self-organizing system, published as a book by Guilford Press titled Neurodynamics of Personality. He was a co-discoverer of the previously unidentified Fragile X Tremor/Ataxia Syndrome (FXTAS), a late-onset neurodegenerative movement disorder affecting carriers of a premutation of the Fmr1 gene. Dr. Grigsby has done extensive NIH-funded research on the neuropsychological, neurologic, molecular, and neuroradiologic phenotypes of this disorder. Other research has been on the role of inflammation, and the gut microbiome, in the condition colloquially referred to as chemobrain. He was a co-investigator in a phase 2 RCT of MDMA-assisted psychotherapy for people with treatment-resistant PTSD, and with Ben Greenwood, he studied memory reconsolidation as the therapeutic mechanism of MDMA. He was a co-PI on an application funded by the National Cancer Institute to study psilocybin in treating persons with late-stage cancer. He co-edited the textbook Handbook of Medical Hallucinogens with Charles Grob,MD in 2021, and he is currently writing a book with Dr. Grob on the conduct of psychedelic-facilitated psychotherapy. He is Director and Chief Science Officer of the CU Denver Center for Psychedelic Research.

Dr. Shandra Brown Levey earned her PhD in Clinical Psychology from The Illinois Institute of Technology and is currently an Associate Professor and the Director of Behavioral Health and Integrated Programs in the Department of Family Medicine at the University of Colorado Anschutz Medical Campus. She oversees all behavioral health programs in the Departments’ network of primary care clinics, provides direct clinical care, and engages in training and supervision. She also engages in research and training for integrated behavioral health in primary care and psychedelic assisted psychotherapy for people working through the impacts of cancer.