New research is showing that every time we recall an event, the structure of that memory in the brain is altered in light of the present moment, warped by our current feelings and knowledge. When CISD fails, it fails because, as scientists have recently learned, the very act of remembering changes the memory itself. Even though every memory feels like an honest representation, that sense of authenticity is the biggest lie of all. In the past decade, scientists have come to realize that our memories are not inert packets of data and they don't remain constant. They feel like indelible portraits of the past. This, in fact, is why we trust our recollections. Once a memory is formed, we assume that it will stay the same. The metaphors for this persistence have changed over time-Plato compared our recollections to impressions in a wax tablet, and the idea of a biological hard drive is popular today-but the basic model has not. Since the time of the ancient Greeks, people have imagined memories to be a stable form of information that persists reliably. It wasn't his fault, really this mistaken notion has been around for thousands of years. It suggests that the way to get rid of a bad memory, or at a minimum denude it of its negative emotional connotations, is to talk it out. But as a treatment, CISD misapprehends how memory works. Traumatic, persistent memories are indeed a case of recall gone awry. Mitchell was right about one thing, though. (Mitchell now says that he doesn't think CISD necessarily helps post-traumatic stress at all, but his early papers on the subject seem clear on the link.) Psychologists have begun to recommend that the practice be discontinued for disaster survivors. Another trial showed CISD was ineffective at preventing post-traumatic stress in victims of violent crime, and a US Army study of 952 Kosovo peacekeepers found that debriefing did not hasten recovery and led to more alcohol abuse. A year later, those who went through a debriefing were more anxious and depressed and nearly three times as likely to suffer from PTSD. In one, burn victims were randomly assigned to receive either CISD or no treatment at all. The problem is, CISD rarely helps-and recent studies show it often makes things worse. Facilitators are trained to probe deeply and directly, asking questions such as, what was the worst part of the incident for you personally? The underlying assumption is that a way to ease a traumatic memory is to express it. A typical CISD session lasts about three hours and involves a trained facilitator who encourages people involved to describe the event from their perspective in as much detail as possible.
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