Can Researchers Treat PTSD Without Using Triggers?

For the nearly 24 million Americans who suffer from post traumatic stress disorder at any given time, the most popular mode of treatment is also one of the most difficult to endure.  The standard treatment for PTSD involves aversion therapy, which exposes patients to high-stress triggers, but without the traumatic outcome.  "It's quite effective, but people don't tend to like doing it for obvious reasons, and often drop out prematurely," says Hakwan Lau, an associate professor at UCLA's College of Life Sciences and Psychology. Lau recently co-authored a new study that hopes to offer a more peaceful therapeutic alternative, called decoded neurofeedback.

In the study, Lau and his team of Japanese and American researchers were able to call up visual cues that stimulated fear—and then negate it—all without the participants realizing what happened. Researchers hope this could be the first step toward a more comfortable and inviting way to treat common phobias and stress disorders.

For five days, the 17 volunteers received functional (real-time) MRI scans to gauge their response to fear. On the first day, the researchers flashed red, green, blue, and yellow shapes on the screen—randomly providing electric shocks when red and green appeared, but never when blue and yellow appeared. By the end of the session, participants clammed up when they saw red and green, proving the existence of a fear response.

For the next three days, the team had the participants play a game: They were shown either a red or a green disc on the screen, and instructed to make decisions that would increase the size of the disc. When the disc got bigger, they were rewarded with money. This replaced the color's negative association (electric shock) with a positive one (getting paid). All the while, the researchers studied their brain waves to get a snapshot of the brain's response to the red or green reward.

On the final day, participants received four random electric shocks to re-trigger the fear response. That made them aware of the potential for shock, which they had previously associated with both red and green. And yet, when participants were shown those colors—red or green—that corresponded to the money reward, the fear response vanished.  In other words: Participants who had won money with the red disc were no longer afraid of the color red, but were still fearful of the color green, suggesting that subconscious rewards can subdue the cues that induce fear.

In real life applications, Lau says the research team is working on using the catalogued brain wave data to discover a way to conduct the process subconsciously.

"You can make [patients] look at picture of spiders and snakes on the screen, but if they see snakes and they pass out, you can't just present them with a snake," Lau says. "You need to be able to decode snakes without ever sending snakes to the patient. We're working on that."

Some day, the researchers hope, people with PTSD and various phobias may be able to overcome them through decoded neurofeedback without ever being exposed to the object of their fear. For now, we're just glad these 17 brave souls got shocked for the rest of us.