#49 Wobbly beams & app development

Yooo

How’s life? Lmk as always, even if it’s about getting sunburnt, I love hearing from you who read!

TLDR;

• Talked about life over the last 18 months realised I couldn’t get over some mental blocks

• Read some research about alternatives. Found crazy info on how effective bilateral stimulation can be

• Made an app based on this research

• Sharing in case you’d like to see if it helps you. (I use it daily and it does bits)

I sometimes view the mind as a complex physical structure, with many beams and trusses, hinges and springs. Each component is attached to another component. Strengthening a single component increases the global resilience of the structure. The opposite is true for the weakening of a single component. We can’t compartmentalise life when it’s interconnected in this way. My attention and intention to write this newsletter and putting all other distractions aside doesn’t just strengthen my ‘local’ component of writing, it has knock-on effects which will be felt when I’m working, working out or making songs.

Now we have the structure of my mind established, it makes sense to introduce what I’ve been doing to strengthen all aspects. One of the most true and time-tested methods for doing this is meditation which I’ve done done 2-3 hours a day for the last 18 months (including on Christmas/birthdays/holidays). While it did strengthen many many beams, and therefore improve the resilience of my mind, I couldn’t for the life of me figure out how to work with some of the more poking out and awkwardly positioned components. Books, different meditation practices, fasting, psychedelics, and therapy: Still couldn’t resolve some of these beams and it was fucking annoying me.

In a somewhat desperate attempt to fix this, I started reading research about techniques and found out about bilateral stimulation / alternative bilateral stimulation. Sometimes known as EMDR (Eye movement desensitisation and reprocessing) this:

involves the patient recalling a trauma while being shown visual stimuli designed to stimulate repetitive eye movements, a process known as Alternating Bilateral Stimulation (ABS).

What’s crazy is that they did this on mice (sad for the mice):

Experiments with mice showed that combined extinction therapy (exposure to trauma reminders without resultant harm) and ABS led to a more pronounced and persistent decrease in fear behaviour than extinction alone.

This is super key as most other types of therapy tend to ease the difficult memory back but in a safe environment. By adding in the eye movement aspect, these memories are processed faster.

Reading on through the summary of one bit of research (REF A):

The combined approach stimulated activity in the superior colliculus (processing visual information and attention) and the mediodorsal thalamus (receiving neuronal projections from the superior colliculus). Activation of these regions predicted the extent of the decrease in fear behaviour.

The combined extinction and ABS procedure dampened the excitability of neurons in the basolateral nucleus of the amygdala (BLA) that fired when mice exhibited fear behaviour. There was an inhibitory connection between the mediodorsal thalamus and the ‘fear-encoding’ BLA neurons.

The reduced freezing behaviour was maintained in a recall test without ABS, suggesting a long-lasting modification of brain circuitry (!!!! - I added the !’s)

EMDR and ABS are proposed to recruit a neuronal pathway that links the superior colliculus and the mediodorsal thalamus, reducing the fear response generated by the BLA.

It remains unclear how ABS and EMDR aid memory extinction and fear reduction. Some propose visual stimuli serve as distractors, drawing attention away from fear and enabling the encoding of the extinction of memory.

The authors propose that ABS shifts the balance between competing brain circuits, engaging pathways that favour fear extinction and overshadowing those favouring the persistence of fear.

The study provides a plausible neurobiological explanation for the behavioural effects of ABS and, possibly, EMDR.* (REF A - citation below)

So now there knowing what it does, how does it perform against other types of therapy?

The paper: Cost-effectiveness of psychological treatments for post-traumatic stress disorder in adults look at this

The study aimed to assess the cost-effectiveness of different interventions for adults with PTSD (Post-Traumatic Stress Disorder), a severe and disabling condition that may lead to functional impairment and reduced productivity.

A decision-analytic model was used to compare costs and quality-adjusted life-years (QALYs) of 10 interventions and no treatment, from the perspective of the National Health Service and personal social services in England.

Side tangent to explain QALYs

1. A QALY gives a measure of the benefit of a medical intervention in terms of health-related quality of life and survival. It is calculated by estimating the years of life remaining for a patient following a particular treatment or intervention and weighting each year with a quality-of-life score (on a 0 to 1 scale). One QALY equates to one year in perfect health.

2. QALYs are used in assessing the value for money of medical intervention, allowing comparisons to be made between different ways in which resources can be used, such as comparing surgical procedures with pharmaceutical products or comparing different types of healthcare services.

Eye Movement Desensitisation and Reprocessing (EMDR) was found to be the most cost-effective intervention for adults with PTSD and was followed in cost-effectiveness by combined somatic/cognitive therapies, self-help with support, psychoeducation, Selective Serotonin Reuptake Inhibitors (SSRIs), and Trauma-Focused Cognitive Behavioural Therapy (TF-CBT).

Okay cool, so we now have some insight into what it it, theories on how it works, and how it performs based compared to other methods. I then wanted to find out how I can try it. The options are:

• Therapist (70$+ session) - ouch

• Online (70$/month) - ouch considering their website wasn’t particularly complicated as it’s just a moving ball on a screen and then me bringing up traumatic memories.

I, therefore, built an online version, which:

• Is FREE

• Has an AI therapist trained specifically in EMDR therapy to help you identify a triggering memory. I can’t say it’s better than a human therapist, but it’s definitely more knowledgeable and helps me, by asking questions, identify what is causing troubles.

• The page for bilateral stimulation.

• Some super short pre-post session assessments to see how your relationship to the traumatic memory changes

That’s it!! I’ve been using it daily and it’s been dope af and I would say has been the thing that has strengthened those beams which I couldn’t strengthen through other approaches.

Here’s the app (free to use as MUCH as you like + confidential. I run a tech business which helps elderly people, your data is safe dw): https://emdreams-10014.bubbleapps.io/

Peace!

Lex

BOTW:

• The Creative Act, Rick Rubin

  • The dude’s a G, if you create (which you all do cuz it’s just what humans do) then recommend

• SOTW: It’s gotta be Mac ofc

Ref A: Brains that learn not to fear Extract from: Neural circuits underlying a psychotherapeutic regimen for fear disorders (Jinhee Baek, Sukchan lee, taesup cho, Seong-Wook Kim, Minsoo Kim, Yongwoo Yoon, Ko Keun Kim, Junweon Byun, Sang Jeong Kim, Jaeseung Jeong & Hee-Sup Shin, 2019)