Sleep Therapy Hein van Marle strongly believes in using our understanding of the brain when exploring new treatments in psychiatry. He’s currently looking at the therapeutic benefits of sleep. “For as long as I can remember, I have been
the memory-boosting potential of sleep. We
intrigued by human nature and what goes
treat people with PTSD with a regular, day-
awry in mental disorders. What is it that ma-
time EMDR session. In EMDR we activate
kes a patient with a borderline personality di-
the traumatic memory by asking patients to
sorder feel intense emotional pain one instant
picture a scene that is key in their trauma.
and nothing at all the next? That is why I wan-
Meanwhile we ask the patient to pay attention
ted to become not only a psychiatrist, but also
to a specific sound pattern, overloading their
a neuroscientist. I think that if we as psychia-
working memory. This results in re-encoding
trists gain a better understanding of the brain,
of the memory with less negative valence and
we can significantly improve our practice.
less arousal. After a successful EMDR session
Think about EMDR, for example. We all use
we invite the patient for the second, nightly,
it in our treatment, and we see that it works,
part of the therapy. They sleep in our labo-
that symptoms of Post-Traumatic Stress
ratory and when they reach a specific phase
Disorder (PTSD) become less pervasive. But
of deep sleep, we repeat the sound pattern,
many psychiatrists have no idea how it works.
triggering the brain to prioritise the sleep-
Neuroscience tells us that every thought or
dependent memory consolidation of the
feeling or action has a substrate in neural ac-
newly updated, less negative memory in an
tivity that arises from electrochemical signal-
attempt to increase therapeutic effectiveness.
ling in our neurons. I want to build from these
We are the first to test this new technique,
certainties of neuroscience to understand the
referred to as Targeted Memory Reactivation
volatility of people with psychiatric problems.
(TMR), in a clinical population. It will take some time before we get our results, but if
Thousands of scientists worldwide study brain
our intervention indeed enhances the effects
function, like memory, in animals or in healt-
of EMDR, we will have opened up sleep as a
hy subjects. Many of these studies identify
new therapeutic window in the treatment of
the important role of sleep in memory con-
traumatic memories. In addition, sleep inter-
solidation, along with ways to optimise this
ventions could help patients with all types of
function of sleep. And inevitably they mention
problems related to maladaptive memories,
in the discussion section of their publicati-
like specific phobias, but also addiction, where
ons how valuable these insights might be in
positive associations with the substance are
helping people who suffer from psychiatric
at the root of the problem. It is a challenging
illnesses, like PTSD. But as far as I know, not
project, both conceptually and methodologi-
many groups are trying to translate these new
cally, but I want to pursue it because I believe
insights to a clinical population.
that patients have a lot to gain by this type of neuroscientific research in psychiatric
In our study we try to enhance the positive
disorders.”
effects of exposure-based therapy by using
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Amsterdam Neuroscience