Thursday, October 15, 2015

Biological Time-keeping Blind-spot in a New Form of Trauma Therapy

Time-perception therapy (TPT) introduces a treatment approach that tries to reform a trauma patient's viewpoint of their past, relative to their perception of their present and their future. In TPT, your condition is defined by a profile composed across these states:

TPT acknowledges the hidden influences of time perception on behavioral decision making. Over time, we develop "time zone biases" as we allow our attitudes toward our past, present, or future (or a combination of any two of these time zones) to influence our decisions. According to TPT, the way we frame our decisions helps identify those of us who pose higher chances of danger to ourselves and others. (4)  

Following trauma, the brain adopts an altered time perception that does not conform with the flow of chronological time. (0) To robustly relive a traumatic event upon sudden (and often unexpected) recall -- events that are in the distant past according to chronological time lapse -- can arguably be an example of this altered expression. TPT aims to provide "the ability to re-construct a more compassionate past", and develop an ability to control their perception of time, based on situational requirements.

These are highly promising objectives that fail to acknowledge the role of biological time keeping which allows the conceptualization of a past, present, and future. These time zones arise at the level of our cognitive faculties, but are rooted in on-going molecular events.   

We have biological timing mechanisms layered on top of each other, from an interval timer that works in the seconds-to-minutes range, to a circadian clock that operates the diurnal time frame (24 hours). These layers are the basis of the diverse "seasonal encoding mechanisms and might be related to life-span related processes".

The circadian rhythm itself is comprised of an input-output system that is maintained by a central oscillator that keeps the circadian signal in motion. This oscillator manages the input signal using "interlocking feedback loops" (5), through downstream expression/blocking of clock genes (for example) and transcription of clock proteins which "play an important role in rhythm generation".

The cyclic nature of the rhythm is made possible by feedback signals similar to that generated by PER and CRY proteins (for example) which get "translocated into the nucleus, bind to the BMAL1-CLOCK heterodimer thereby inhibiting their own transcription". This, in conjunction with their degeneration regulated in the ubiquitin pathway, "contributes to the oscillation of their mRNA and protein levels".

Such controlled (pre- and post-transcriptional) fluctuations of an orchestra of biological information is what symphonizes behavior patterns ranging from simple to the more elaborate and complex. Sleep is tied to the circadian rhythm. (1) This lays the foundation for (another example) the female menstrual cycle that delivers the time signature of the month. (2) Girls with irregular sleep patterns experience a menstruation schedule that is not easy to predict.

Every traumatic event is unique as it is intrinsic to the uniqueness of one's human experience. Therefore, the divergent expression profiles of the consequences of each (experienced) traumatic event is its own unique snowflake.

The human brain will not naturally think of its own history in terms of rhythmic patterns at the molecular level. It's much more natural to think about our lives and the things that happened to us in terms of [time zones such as] the past, the present, and the possible future.

When trauma is introduced into the system, this cognitive simplification of time-perception becomes a liability, and a great source of distress. Treatment approaches which are organized according to this simplification, and also ignore the physical workings of the biological clock, ring the sounds of familiar alarm bells of caution.

In our contemporary treatment culture with its executive-brain-heavy focus, TPT offers a necessary approach that is refreshingly temporal. However, to target and treat the brain's perception of time, without acknowledging and interacting with the brain's faculties of tracking time, is taking a half-hearted approach to fixing the problem.

Treatment should be aimed at this molecular level rather than just targeting the symptoms of the time perception problem as these symptoms are eventually expressed in cognition. Without this crucial piece, TPT, like many other forms of talk therapy, could prove to be only partially effective, with dangerous results.


(5)  Unwinding the Molecular Basis of Interval and Circadian Timing (Agostino, et al., 2011)
(4)  Time Perspective Theraphy: A New Time-Based Metaphor Therapy for PTSD (Sword, et al., 2013)  
(3)  A Different Therapy to Find Greater Happiness (Elizabeth Berstein, 2013)
(2)  Circadian rhythms, sleep, and the menstrual cycle (Fiona C. Baker, Helen S. Driver, 2006 )  
(1) The development of circadian rhythms in a human infant (McGraw, et al., 1999)
(0)  Time and Trauma (Terr, Lenore C., The Psychoanalytic Study of the Child, Vol 39, 1984 )

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