Here is a brief excerpt from an article by Eugene Rubin, M.D., Ph.D. for Psychology Today during which he explains using a pulse of medication to augment a behavioral therapy. To read the complete article, check out others, and obtain subscription information, please click here.

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One of the most exciting and clinically relevant areas of neuropsychiatric research involves “neuroplasticity.” What is neuroplasticity? Neuroplasticity refers to the processes by which the brain modifies its function in response to changes in internal and external environments. It underlies the incredible flexibility that nerve cells have for forming and eliminating connections with each other and for altering the strengths of their existing connections. Cells and brain regions that are highly connected are in a position to strongly influence each other. Networks of interconnected cells, and the modification of these connections, form the basis of learning and memory, i.e., how we store new information and retrieve older information.

Certain experiences can be more effective in influencing cellular connections than other experiences. For example, a dramatic emotional event can be extremely effective at causing the formation of strong and lasting connections. Such strong connections can be difficult to “disconnect.” As most of us know from our own experiences, there are highly emotional events from decades ago that we remember easily and vividly. An overwhelming trauma, for example, often can lead to the development of emotionally-laden, strong cellular connections. Posttraumatic stress disorder (PTSD) likely reflects the ability of major stressors to produce powerful circuitry changes in the brain, resulting in persistent and recurring symptoms. On the other hand, routine life events typically involve weaker changes in cellular connections that are more easily disrupted. Thus, in contrast to highly emotional situations, many of us have trouble remembering the exact events of a routine day at work, particularly after a delay of several weeks. Such weaker changes in connectivity are prone to fade over time.

Since neuroplasticity is involved in how we process memories, it seems logical that if we could influence neuroplasticity while we are trying to learn, we may be able to modulate learning. Could this be applied to “unlearning” something? For example, some individuals are handicapped by specific fears that fall outside of what most would consider normal. Some people are profoundly afraid of heights, for instance. It is likely that the nerve cells in these persons’ brains are wired in such a manner that exposure to heights provokes a dramatic fear response.

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Eugene Rubin, M.D., Ph.D., is Professor and Vice-Chair for Education in the Department of Psychiatry at Washington University in St. Louis – School of Medicine. He is also Professor of Psychology at Washington University in St. Louis. He is a clinical investigator in the Washington University Alzheimer’s Disease Research Center, and he is involved in clinical research studying depression in the context of co-morbid medical illness. He was the director of the psychiatry residency training program at Washington University in St. Louis School of Medicine from 1987-2007. He has authored or co-authored approximately 125 publications, including 75 in peer-reviewed journals. He and Dr. Charles Zorumski recently published a book for the general public entitled Demystifying Psychiatry: A Resource for Patients and Families.

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