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workers en route to a disaster site, or even to individuals requesting prophylaxis against the shame or guilt they might incur from future misdeeds—in general, to anyone facing an experience that is likely to leave lasting intrusive memories. Yet on further reflection it seems clear that not every intrusive memory is a suitable candidate for prospective pharmacological blunting. As Daniel Schacter has observed, “attempts to avoid traumatic memories often backfire”: Intrusive memories need to be acknowledged, confronted, and worked through, in order to set them to rest for the long term. Unwelcome memories of trauma are symptoms of a disrupted psyche that requires attention before it can resume healthy functioning. Beta-blockers might make it easier for trauma survivors to face and incorporate traumatic recollections, and in that sense could facilitate long-term adaptation. Yet it is also possible that beta-blockers would work against the normal process of recovery: traumatic memories would not spring to mind with the kind of psychological force that demands attention and perhaps intervention. Prescription of betablockers could bring about an effective trade-off between short-term reductions in the sting of traumatic memories and long-term increases in persistence of related symptoms of a trauma that has not been adequately confronted. 8
The point can be generalized: in the immediate aftermath of a painful experience, we simply cannot know either the full meaning of the experience in question or the ultimate character and future prospects of the individual who experiences it. We cannot know how this experience will change this person at this time and over time. Will he be cursed forever by unbearable memories that, in retrospect, clearly should have been blunted medically? Or will he succeed, over time, in “redeeming” those painful memories by actively integrating them into the narrative of his life? By “rewriting” memories pharmacologically we might succeed in easing real suffering at the risk of falsifying our perception of the world and undermining our true identity.