Researcher Radio Episode 4: ‘What doesn’t kill you makes you stronger: psychological trauma and its relationship to memory control’.

Hello and welcome to the RESEARCHER podcast your regular look at the research that’s making waves in the scientific community, and the people behind it.

My name is Joe Fenton and I will be your host today.

Today I’m delighted to be joined by Dr Justin Hulbert from Bard College. Justin is, alongside Professor Michael Anderson, the co-author of ‘What doesn’t kill you makes you stronger: psychological trauma and its relationship to memory control’. Today we’ll be finding out a bit more about the paper and the person behind it.

Justin, thank you for joining us.

Thank you for having me.

So before we get into your paper, could you tell us a little bit more about yourself and your academic career so far?

Sure thing. I was raised in New Jersey in the United States, and I found my way into a wonderful scholarship opportunity which gave me full tuition scholarship to the University of Pennsylvania thanks to the Walt Disney Company Foundation. Once at Penn, I really wanted to get involved in research as soon as possible, and the best way I found to get my foot in the door was to start off at the VA Medical Hospital doing some data entry. Whilst it did give me a lot of insight into the way that data can be managed, and just how complex it is to get the numbers from pieces of paper from participants into computer systems to actually analyse the data, it didn’t really give me the complete picture of the research process. So, from there I moved on to the Children’s Hospital of Philadelphia, just a short trip down the road, and quickly became involved in about four or five different research labs over the course of my undergraduate tenure. Whilst I continued to amass a lot of experience, I kept all of the previous opportunities and research going, which allowed me to get a better sense of my own direction, where I wanted to move forward throughout my own academic career. That led me to apply for the National Science Graduate Research Scholarship. At the same time, I was applying to graduate programs at the end of my undergraduate experience, and I was fortunate enough to receive one of those fellowships as well as an opportunity to work with Michael Anderson at the University of Oregon, where he was based at the time. Two years into my PhD programme there with Mike, he moved over to St. Andrews in Scotland, which again gave me an incredible opportunity to check out a very different PhD program in Scotland. I started up as a first-year student in Scotland, went through their own criteria for progress in the PhD, and two years later I had to move again after my PhD mentor moved over to Cambridge. I basically had a whirlwind tour throughout my PhD process which gave me an opportunity to not only see the way that different research training programs work, but it also gave me the ability to work up a laboratory alongside my fellow graduate students who made all the moves with me and my research mentor Michael Anderson. So, by the time I finished up with my PhD I had a lot of insight into how I wanted to set up my own lab that would actually come. But before that did come, I moved back to New Jersey where I did my postdoc at Princeton under Ken Norman, who runs the computational memory lab there. After a number of years working with Ken, I accepted a faculty position at Bard College, a liberal arts college in New York’s Hudson Valley, and I’ve been there for about 3 years now. But now I have the opportunity to take a sabbatical which is where you find me today. I’m sitting in Stockholm just settling into my sabbatical.

So you said that you travelled around a lot for your PhD following Michael Anderson. Is this quite common practice for PhD’s to move to universities to where their PhD supervisor might be at that moment in time?

Depending on where the individual is in their training process, it may be more likely that the person would stay back say if they were at the point of writing up their dissertation. When Mike moved, I was still in the formative years of my PhD. It seemed to make a lot of sense at that point to continue my training with him, rather than starting over under the supervision of somebody else, which may have necessitated my starting over with a very different research plan. So, for me it seemed to work out rather nicely, for others they make different decisions. In Mike’s lab, he had one graduate student who was just reaching the point of writing up his dissertation, and that graduate student stayed back at the University of Oregon to complete his PhD, rather than making the move like I did. So it’s not quite usual, but I think the PhD process is so uniquely tailored to every individual’s experience that it’s hard to say what is the standard course versus something a little bit more atypical.

Sure, that makes complete sense. Talking to some PhD’s they obviously move cities and countries and move universities to be with a particular supervisor. But I’ve never really considered the fact that people will move countries and universities to be closer to their supervisor for their PhD. So for those who may not be familiar with your work or your area of expertise being trauma and psychology, could you give us a brief overview of the paper that I mentioned in the introduction?

So students enter college with a wide variety of life experiences, and those life experiences hope, shape and prepare them for some of the challenges that they will encounter both in school and beyond that. Unfortunately, statistics suggest that many of those experiences could be characterized as traumatic in some way shape or form. Whilst these traumas are no doubt awful, we wondered whether previous exposure to certain types of trauma might actually have the ability to enhance future resilience by training individuals to more effectively cope with a wide range of unwanted memories. So to test this, we asked two sets of college students to memorise a number of arbitrary word pairs, like ‘street’ or ‘violin’. After establishing that they have learnt those word pairs, they were prompted to repeatedly suppress, that is push out of mind, some of those memories. For instance, they might be asked to push out of mind ‘violin’ whenever they saw the word ‘street’ presented on a computer screen. We call this the think-no-think task, and it is something that I continue to use in my lab and is something that Michael Anderson and colleagues developed a number of years ago. It turns out that those individuals who self-reported relatively more early life trauma demonstrated a greater ability to forget the memories that they were prompted to not think about. These results held even when they were giving money to correctly recall these suppressed memories, and it really didn’t seem as though they had difficulty accessing the memories that they had previously established. This had some relationship to the extent in which they had experienced trauma prior to coming into the laboratory. Furthermore, it held for both negative and neutral memories, neither of which were really designed to have anything to do with the participants’ actual lives. These results are consistent with the idea that individuals with relatively higher levels of life adversity are better able to cope adaptively with a wide variety of new memories, perhaps thanks to the opportunity to practice those coping abilities in the wake of trauma. So overall these findings suggest that there may be some truth into the old adage of ‘what doesn’t kill you makes you stronger’, and that traumatic experiences, and again I want to emphasize that these traumas are horrible, they may naturally contribute to the adaptation of cognitive control skills, thereby improving memory of the many survivors later resilience — at least for those who had experienced mild levels of trauma and were not predisposed to post-traumatic stress disorder.

This paper is based on trauma, and trauma, as you stated, is horrific, so how did you measure this adversity or trauma that you were studying?

There are a wide variety of ways of assessing people’s life adversity. Whilst there is no way to capture the totality of the event itself or one’s own experience without disrupting the individual’s life on a day-to-day basis, we took something that is available to us called the brief betrayal trauma inventory. This is a twelve-item inventory that simply asks people to estimate the number of times they had experienced a wide variety of life traumas. So those may include natural disasters, accidents such as automobile accidents, industrial accidents, deaths of close family members or friends, and alongside this, some more intimate types of trauma such as relationship traumas, sexual assaults and the likes. So we were trying not to be very intrusive and request details that would not be necessary to establish the general amount of trauma history in the individual’s lives. This was done for a number of reasons. One, just out of sensitivity, we didn’t want to probe too much. We didn’t want to have that information retained. Whilst we made every attempt to keep our records as secure as possible, we just don’t want those sitting around to the extent that they were necessary to address the general interests that we had in the relationship between the overall level of trauma exposure and memory control abilities. But the other important reason that we chose not to address specifics about those traumatic episodes was because we didn’t want individuals who participated in our experiment to guess what the experiment was all about. We told them the full nature of our study during the debriefing phase but we didn’t want to give in to demand characteristics and introduce other forms of biases, while the participants were partaking in the actual think-no-think task. So we adopted a more generalized approach of capturing, in broad strokes, the level of trauma that people had been exposed to, without getting into the specifics of those individual episodes.

So you mention that you capture and measure trauma in generalised broad strokes. You talk about two distinct trauma groups, so a high group and a low group. Without breaking any kind of ethical codes on this piece, could you give us an example of adverse or traumatic experiences that would separate or differentiate somebody from a low group and a high group?

The way that we chose to operationalize our level of adversity or trauma experience was simply by the number of estimated episodes of trauma. So that might mean that somebody who had experienced a rather major trauma, say the death of a close family member, would have been on the same level, according to the way that we were coding up the data in our study, with somebody who had been in an automobile accident and everyone survived that accident. So we didn’t actually separate the individuals into groups based upon the severity of their trauma experience, it was simply on their self-reported total number of incidents relating to trauma. Obviously, that has some drawbacks, and for future direction, it would be better to get a sense of the nature of the trauma that participants had been exposed to, as well as the timing of the trauma, so whether they experienced them at sensitive periods in their lifespan development. But our initial hypothesis was really based on this notion. Regardless of the type of trauma that one was exposed to, it is the opportunities when confronted by reminders of that trauma that will give people the ability to practice this cognitive control ability. It may be that what is more important than the underlying severity of the trauma is just the overall number of traumatic episodes the participant had been exposed to. Obviously, there is further work that would need to be done to establish whether or not this is the case. In terms of specific examples, the only information that we are really able to provide is based on the breakdown of responses to the trauma survey. So we did have individuals reporting that they had experienced one or more episodes of sexual abuse, natural disasters and of deaths of close family members and friends. We really didn’t probe beyond that. Again, for reasons as mentioned before, we didn’t want to push people too far beyond their comfort zone in the context of the experiment. We didn’t retain this data, and we didn’t want to make the link between these two elements overly clear to our participants in a way that they could be biased.

So in your piece, at the end of the first experiment, you say that ‘the experimenters could in principle have been unintentionally influenced in their scoring by the participants’ trauma status’. Could you give us a little bit more of an insight about this at all?

So participants, after going through the think-no-think paradigm in experiment one, then completed that trauma survey. The experimenters who were conducting this study then took the forms that the participants had completed and were able to quickly summarise in their heads the overall level of trauma associated with the individual that they were running. If those same researchers then went back to the computer and started coding up the verbal responses from the final test of the think-no-think paradigm, and let’s say that there was an ambiguous response, something that might perhaps have been coded as correct by some researchers could have been coded as incorrect by other researchers. If the experimenters knew the group to which the participant had been assigned, that is either high or low levels of pre-existing trauma history, and they had some sense of how they wanted the results to turn out, let’s say ‘that they wanted to find the expected relationship between higher levels of trauma and increased memory control’, perhaps that could have influenced the way in which they coded up that ambiguous response. Of course, we train up our research assistants and the people coding the data to be high-minded when doing this, and certainly not to give into those potential biases, but we’re all human. So, in experiment two, we took the extra step of blinding all of our experiments, so that the experimenters didn’t know whether the individuals coming into the room for the study were those who had experienced relatively more trauma or relatively less trauma. Similarly, for the people coding up the results, they didn’t know the participants’ trauma history either. Importantly, we also tried to distance the connection between the trauma survey and the experiment that took place in the laboratory in the eyes of the participants as well, so for the second study we administered, along with other research groups at the University of Oregon, a massive survey to most students in the introduction to psychology courses there. They completed all of these surveys which included the trauma inventory and then many weeks later we invited a subset of those individuals to the lab for a reportedly independent experiment. So the participants coming in through the door had no reason to expect that the experiment that they were about to participate in had anything to do whatsoever with the way that they responded on that trauma inventory weeks prior.

So your pool for the experiment were taken from undergraduate students of psychology, but if you were to have selected participants from a different pool i.e. soldiers, policeman, fireman, those that experience a higher amount of these traumatic events on a more regular basis, do you think he would have got different results or possibly more even more fine-grained results?

I just want to point out that some of our undergraduates were returning war veterans, as well as people who have side jobs as medical professionals, EMS and service members and people who fight fires as well. But it is also the case that the individuals who were able to make it into the college sample from which our results are based are individuals who have displayed no small amount of resilience. Given the fact that they had experienced traumatic events earlier in their lives, they still made it through a rigorous selection process to get into college and were even willing and able to come in to participate in our experiment. It is a selected sample of people that may not reflect the broader population of individuals who might experience quite a different set of circumstances and different types of traumatic experiences in their lives. Were we to sample from a wider population, my expectation is that we would see not necessarily the linear relationship that had appeared in our current data, but perhaps something more non-monotonic, a u-shaped function, in the sense that individuals with extremely high levels of trauma experience perhaps would show an impaired ability to control their memories. This is something that Mark Seery and others have been exploring in longitudinal studies, looking at people’s cumulative life adversity and the health outcomes associated with those same individuals. They find that while moderate levels of adversity and trauma tend to be correlated with better types of control, both in real life and in the laboratory, people with extremely high levels of trauma might not be able to do that, perhaps because those extreme levels of trauma become toxic and even wear down important regions of the brain that control memory as well as memory centres themselves, like the hippocampus.

Moving away from the academic side of this podcast and towards impacts of the piece and publishing of it, what was it like to work with professor Michael Anderson on this piece, especially with the distance and time zones involved? How did it affect the process of writing and publishing?

The writing of this paper was affected by differences in time zones. But in some ways that worked to our benefit because at the point at which my day would be wrapping up, I could send this off to my collaborator and then he could start working on it while I was sleeping, and vice versa. For Skype meetings, that became slightly more complicated to try and find times that were workable for the both of us. But as a consequence of moving around with Michael Anderson during the course of my graduate study, we got quite used to this. In fact, after moving over to St Andrews in Scotland, I was still managing a research group of undergraduates at the University of Oregon and I recall having to Skype in around 2 a.m. a number of times in order to match the only lab meeting time that would work for those individuals. So it forced me to become a little bit better at scheduling my time, but certainly not without the complications. Moving around from one institution to the other also affected the data collection and the data handling process. We had to make sure that everything had transitioned over with us after moving institutions, and that was one of the reasons why we helpfully had those undergraduates still working at the University of Oregon. If we needed something coded up, they would be there to help us out in that situation.

So the whole idea of the cycle, going to sleep and the other person working on it is the only practical way to accomplish this, so with this continuous cycle, and without dropping Professor Michael Anderson in boiling water, was there any conflict between the two of you over which direction to take the piece or over the writing style?

Mike has been at the game for longer than I have and has an amazing ability to write very persuasively and speak very fluently on the topics that have been of utmost importance to his own research career. As a relatively new academic in the field, it is still taking me a little time to get my head out of the weeds and be able to think at all levels. So there was a bit of back and forth as you can tell from our conversation. Sometimes my verbiage travels in loops making it a bit more difficult to unpack. But I think that it is actually a useful thing to have two or more authors work at the same time so that the low-level details and the bigger picture generates a tension between getting each one of those ask backs transmitted into the document itself, and eventually it ends up at this perfect meeting point at the centre.

So pushing this perfect meeting point forward and into the realms of wider academic circles, what responses have you had so far?

So obviously there is a lot of interest and not only in the field of memory but generally, especially with ageing populations across the globe, and people sensitive to the frailties of their memory performance given how central memory is to defining who we are; from basic survival skills, finding where we had left our food, finding our keys, finding our car at the end of the day, but also the relation to trauma given the high prevalence that is striking to many people. Some reports indicate that 80% or more of undergraduates may have experienced rather significant traumas in their life just up to the point of entering college. So given the prevalence of trauma, and given the interest in trying to find ways to increase people’s resilience to an ever-changing and in many cases quite challenging world environment, there is a great deal of interest from the public and from researchers in trying to move this work forward. Since publishing this paper, I myself have heard from a number of individuals who reached out with their own stories of overcoming trauma and putting that to good use and being able to effectively manage other challenging situations that they had come to face in the years since. Of course, everybody’s situation is unique, and our goal at the time as well as our continuing goal, is to try as best as possible, as researchers, to set aside some of these individual components and look at the population level to first establish whether there is a general linkage between these two factors — trauma exposure and memory. Once we have a better handle on that, we can start to re-incorporate some of the individual differences that might allow to better predict, say, individuals who go on to develop post-traumatic stress disorder. They might be less able to control their memories versus others who might have a predisposition to being better able to control those memories, and somewhere in between, perhaps allowing people who are starting out from say a weaker point of memory control to build up those skills and that type of training and who need not come through trauma experience. We wouldn’t want to throw people into traumatic situations that they may not be able to handle, but perhaps we could have more benign training processes at our fingertips that could build up some of those practical skills.

What are the biggest issues that you are currently facing in your area of research at this moment in time?

So I think some of the major challenges to the study has been the lack of insight that we have to the specific nature of the types of timings of the traumas that people had reported on that inventory. So a natural next step might be to include a little bit more of that documentation, again without disrupting the lives of the individuals who are so generous as to provide their experiences for our research. Because so many of these studies that are out there currently are correlational in nature, as is ours, that still leaves us with the problem of discerning directionality; that is, whether the trauma experienced precedes changes in cortical plasticity brain changes, as well as the behavioural changes that we were trying to tap with the think no-think paradigm. So by combining these two efforts, we might in the future want to take a group of people who experienced verifiable trauma and then track them longitudinally. That way we would know the ground nature of that traumatic experience and we would have a better sense of whether the brain changes and the behavioural changes follow the trauma, or if they came into that situation with some of those differences that lead to better or worse ability to control intrusive memories. So I think that getting our heads wrapped around the experiences both objectively and subjectively of our participants will be the next step forward for this type of work.

So obviously yourself and this paper deal with memory and trauma and adversity, and some of your students have experienced extremely traumatic events. So with this in mind, were there any difficulties getting this paper published at all especially with ethical backgrounds linked directly to it?

There was a lot of back and forth with our reviewers who in some cases were coming from more of a clinical background than others, but in the end I think that actually served our paper and our ability to communicate the potential importance of our work in a much wider scope. I say that because there is a general sense that clinicians and clinical researchers commonly believe that suppressing unwanted thoughts and memories is actually a maladaptive coping response to trauma, and is associated with worse overall mental health outcomes. But what we are arguing, and we tried to make the case to both the reviewers as well as in the paper, that this potentially overlooks the adaptive benefits of suppression. So to take one example; exposure therapy is thought to be effective because it encourages patients to stop avoiding unwanted memories and confront the associated reminders until they become somewhat less distressing. This may seem at odds with our own approach, but we can reconcile these two accounts. I think that by highlighting a distinction between avoiding reminders, which doesn’t necessarily build the coping strategy that we’re talking about here, and suppressing the underlying memories after directly confronting the reminders, that’s what we’re asking participants to do in this experiment, so they still have to look at that reminder on the screen and at the same time try and prevent the unwanted memory associate from flooding back. That seems to be the type of practice that perhaps gives rise to better generalised coping abilities in the future. We believe that training retrieval suppression might actually augment the benefits of cognitive behavioural therapy by enabling patients to confront reminders and redirect their thoughts. So through this conversation that we had during the review process, I think we were able to come to the agreement that we’re actually not arguing for two different things, but we are really coming together at a certain point. By recognising both the challenge and adaptive benefits that go along with traumatic situations and by really driving to understand how the individuals, patients or non-patients, can adapt in those certain circumstances.

So you’ve moved from St Andrews to Princeton to Bard College and now you’re on sabbatical in Stockholm. Could you give us a little insight into this life and lifestyle?

It’s all still very new to me. So I’ve just been in Stockholm for a week and yet to start up at the university where I’ll be spending my time working with the research group on a series of experiments looking at Odor memory. But a little bit later on today, I will be hosting a lab meeting over Skype with my research group at Bard College. So just trying to get the practicalities of that worked out. It has taken up a lot of my time. Other practical things that I knew about coming into my sabbatical but have been made a bit clearer in actuality, just comes down to being able to say no when requests come through email, especially at odd times of the day given the time change. But I want to make sure that I’m still available to my students back at the college, to the colleagues in the psychology programme over there, as well as the administrators, while still preserving what the sabbatical is meant to do — giving us a bit more time to focus on research. So it’s a balancing act, and I can’t say it’s one that I’ve mastered yet, but it’s only been a weekend so I’m looking forward to making strides in that direction.

Throughout your academic career, who for you has been the most influential person?

The notion of memory suppression or repression I suppose has been around for a really long time. Freud popularized that notion, but his technique simply couldn’t establish the effectiveness of the proposed response. It has taken a while, but I think we now coming to the point where we have the behavioural and neuroimaging techniques to take a real critical look at the question and test the causes and consequences of the attempts to control unwanted memories empirically. The thing I want to underscore here is the empirical approach to doing so. The Freudian connection I think comes along with a lot of baggage and it is for that reason that I think it is incumbent upon us to keep a sceptical mind in exploring these things, and really do our due diligence in order to nail down the relationship that we’re looking at. But in many ways, I think that Freud’s work, given the popular notions that he gave rise to, is something that has been influential. In the development of my own work, an in terms of this particular research project, Mark Seery of the University of Buffalo has been doing a lot of great work looking at factors linked to coping abilities in the face of potential stressors, and these studies really laid the groundwork for future studies including ours linking memory control abilities to those same factors.

Do you have any advice or tips or tricks for any PhD students or young academics to increase their own academic productivity?

Another line of my research focuses on the influence of sleep in consolidating and transforming memories. As a sleep researcher, I sometimes laugh at myself because I’ve given a few other responses to my own inability to follow doctor’s recommendations and get as much sleep, as regular sleep, as I should. But I try to impress upon myself, as well as my students, trainees and about anyone I can talk to about how important getting regular sleep can be, and it’s a real challenge in today’s environment where sleep is very often seen as something to be avoided because it hampers productivity. In reality, it’s sleep that is serving such an important method of consolidating and solidifying our memories, refreshing us to able to take on the challenges of the new day and even giving us insights by recombining some of the experiences that we had prior to going to sleep. In a way that leads to novel thoughts, breakthroughs and whatever challenges that we’re working on, I regularly find that once I do have the opportunity to get some quality sleep, those are the days I wake up and realise that’s what I should be doing in my next study or here’s a novel analytical approach to take. So I think by spending that time away from the computer I can actually serve quite well.

And finally, the last question that we like to ask every one of our guests that come on the RESEARCHER podcast is what would be your one-piece advice for anyone either beginning a PhD or now starting a career in academia?

To anyone starting a career in academia I really recommend fostering cross-disciplinary collaborations and doing so as early as possible. More and more in order to have one’s work reach a broad audience and gain support, it’s important to include a wide range of perspectives and emphasize that no single level of analysis is the right one. For a very long period of time, inhibition at the cellular level was kind of laughed off, and now we have real substantial evidence backing this and we’re moving into a territory where we’re dealing with the same type of tension at the cognitive level. That is where to the extent to which cognitive inhibition can be measured empirically and how that relates to cellular inhibition. So I think it’s only by working across different levels of analysis and working both in the basic and applied domains, working with clinicians who are using some of this research to adapt the way they are treating some of their patients that we actually make our research accessible to the general public, fundable and really fulfilling as a researcher because we’re able to do the life-changing work that we can.

Well, that’s all we have time for today. It’s been really interesting speaking to you today Justin, so thank you for coming on.

Thank you for your time, it was fun.

And thank you for listening everyone.

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