As a writer, I’m always looking for real life events that would make a good story. Back in 2010, I came across an article in the New York Times about the use of morphine to treat PTSD, and how its use might spread from soldiers wounded in the field to victims of other traumas, like rape. When I finally decided to use this in a novel, I knew it would make an intriguing psychological thriller.
I wrote All is Not Forgotten in the spring of 2015, and by that time the research into memory reconsolidation had exploded. At the core of this research was the finding that memories are like files on a computer – they can be recalled and then altered, or perhaps even erased entirely.
Now, a range of PTSD therapies are being developed which utilize this new understanding about how memory works. Within the first few hours after an event, drugs can be administered to try and block the memory entirely. By interrupting the stabilization process which turns a short-term memory into a long-term memory, the short-term memory can (possibly) be erased. Alternatively, pain medication like morphine or propofol can be administered so the emotional attachment to the memory is lessened. Theoretically, a victim could remember the event but not have any emotional reaction. For victims whose traumas have already been stabilized into long-term memory, the same treatments are given in an attempt to reconsolidate that memory either factually, or by lessening the emotional attachment. As the person recalls the painful memory, the drug or other method is used so that the memory becomes altered before it is re-filed – just like changing a computer file before hitting the save button.
When I thought about using this in a novel, I was drawn not only to the science but to the moral and legal implications if these treatments were to be used on victims of crime. The choice between justice and emotional pain, for example, fascinated me. I also wondered about the ability to truly erase the emotional implications of a traumatic event. As a mother, I had come across information about brain development in children and how early traumas can cause lasting emotional issues even if the child had no factual memory of a painful event (because the brain was not mature enough to store the memory). In those cases, the child can have unusual fears or phobias that do not have any causal relationship to the triggers. That made me wonder – even if we can pull out a painful memory, uncouple it from the emotional element and then return it to storage, does that emotional element really go away? Or does it live inside us, looking for a home, and provoking us at times or for reasons that make no logical sense?
Combining all of these theories and questions, I came up with the story of Jenny Kramer.
There can be no doubt that the next decade will bring groundbreaking changes to the way we see our memories, and the treatments available for PTSD, addiction and other disorders like anxiety and OCD. And like most scientific advancements, we will be faced with the legal and moral implications that arise.
When I tell people about this story, I always go back to the question that was in my mind back in 2010 – what would I choose, for myself or a loved one? Would I choose to remember? Or would I choose to forget?
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