Propranolol and the Erasure of Pain

Propranolol is not a new drug. It has been around for a while now, particularly as a treatment for heart conditions. However, it also has a more controversial application as a treatment for sufferers of post-traumatic stress disorder, or PTSD. With some rather sinister connotations for those of us versed in Patriarchal reversals, this treatment is called Therapeutic Forgetting. After experiencing a traumatic event, the brain may release large amounts of adrenaline, leading to the memory of trauma being overconsolidated and unable to be processed in a ‘normal’ way. Or, in other words, the memory of the trauma is burned deeply into the brain and becomes an overactive memory that can lead to a variety of persistent psychological, emotional and physiological responses including things such as subjectively reliving the event, ongoing feelings of fear, anxiety and many other symptoms.

It has been found that propranolol has the ability to prevent the activation of the stress hormone adrenaline, thus stopping the overconsolidation of memory and preventing the development of PTSD. Essentially, propranolol leaves the factual memory of the traumatic event intact, but takes away the emotional content associated with the event. It has been found to be most effective if it is administered within six hours of the traumatic event. In particular, some members of the medical community are suggesting propranolol be used to treat rape victims and war veterans, both of whom suffer high instances of PTSD. As neuroscientist James McGaugh says in an online article, “The drug does not remove the memory – it just makes it more normal. It prevents the excessively strong memory from developing, the memory that keeps you awake at night. The drug does something that our hormonal system does all the time – regulating memory through the actions of hormones.”[1] The authors of another article published in 2007 in the American Journal of Bioethics go so far as to say, “we argue that the prophylactic use of propranolol for potential PTSD victims appears to have minimal risks and potentially high benefits, and deserves further study through clinical trials.” They imagine that propranolol “will be used in emergency room settings to treat patients who seek medical attention shortly after having been attacked, abused, raped, molested or involved in any sort of accident that may cause psychological trauma.”[2] Sweeping ethical concerns aside, Elise Donovan argues in an article published in 2010 in Perspectives in Biology and Medicine that propranolol is essential in the treatment of war veterans who have already lost their sense of self due to PTSD, and asserts that increasing the use of propranolol is in fact the most responsible course: “We have a moral and ethical obligation to military service members to maximize efforts to alleviate PTSD” (p. 70).[3] Apparently not sending soldiers off to war to be brutalised in the first place is not an option. Yet another article which appeared in 2006 written by an Associate Professor of Law advises caution but still ends with a general validation of propranolol and recommendation for further study.[4]

For different reasons, both abuser and abused are being drugged in such a way as to ensure compliance with the narrow, twisted Patriarchal roles of domination and submission. In the first case, the drug ensures that men will become even further emotionally numb over the horrors they have participated in as soldiers; horrors which will have most likely included things like rape, torture and murder. Such a course of action surely has the potential to create a situation in which a returned soldier will continue to perpetrate the abusive behaviours he has already learned to practice in war, since he will be literally cut off from understanding on an emotional level what he has done and how it has affected those he harmed. In the case of rape victims, women are being drugged in such a way as to ensure they passively accept abuse from men. On another level, the whole thing is horrifically ironic since war creates an environment in which women will inevitably be subjected to rape, abuse and sexual exploitation. Everything about this treatment seemed designed to enable continued human rights violations, rather than reduce harm.

Some, however, are rightly concerned about the personal, social and ethical implications of using propranolol in this way. To date, the most extended consideration has come from the often cited President’s Council on Bioethics report entitled, Beyond Therapy: Biotechnology and the Pursuit of Happiness (2003).[5] Whilst framing the issues within a somewhat socially conservative framework, this Report still makes some important points. It focuses on propranolol’s potential to interfere with and/or potentially erase parts of individual selfhood through altering memory and emotion, and by extension wonders if the drug has the ability to obscure or erase the moral consciences of both individuals and society more generally. It also questions just how far we should go in the pursuit of happiness, and what it will do to our collective humanity if we no longer have the ability to feel, recognise or understand suffering.

As far as it goes, this argument has its merits. Medical commentary has often treated the use of propranolol in terms of individual choice, talking about its importance in being able to, for example, help survivors of rape reclaim their ‘normal’ lives whilst ignoring the context of the society in which the trauma of rape takes place. So clearly, a debate about the drug’s ability to blunt emotions and thus potentially alter our perceptions of our own and others’ suffering is an important one.

What is not made clear in these analyses, however, is that it is very often the survivors of trauma and injustice who go on to transform the pain of trauma into movements of social and political resistance that seek to create a healthier society in which atrocities like rape and war will not happen. Survivors of rape go on to become the activists who organise against rape, raise awareness about the issue, analyse why it happens, create safe spaces and services to assist those who have been raped, and fight to have the legal system better recognise rape as a crime.

So when we are talking about using propranolol to treat PTSD, we are talking about a drug that can change aspects of our self, our emotions and our memory, as well as potentially alter the wider social conscience. But crucially, we are also talking about something that is taking away our ability to resist, to criticise and agitate for change because it is taking away our ability to recognise that we have even been violated.

When rape is a crime of endemic proportions, the use of this drug could easily seem tempting to women who feel helpless and powerless. It creates an horrific kind of inevitable narrative. I am a woman. I know this means there is a good chance I will be raped, if I haven’t been already. There is nothing I can do to stop this, because society doesn’t care about rape or even recognise that it happens most of the time. But at least if I take this drug afterwards, I won’t be able to feel the pain.

Propranolol is attempting to make true the lies that men have been telling about rape all this time. Rape does not really hurt. Rape does not really harm women. Rape is not actually all that bad. The use of this drug forces compliance from women by taking away our ability to feel our own violation. We will no longer care about being raped. We will no longer care about other women being raped. Instead of speaking out against rape, instead of expressing our anger and articulating the abuse that has occurred against our selfhood, our humanity, we will say, oh yes, I remember when that happened to me, but who cares? It didn’t hurt.

It is also important to remember that, as stated above, propranolol is most effective if used within six hours of the traumatic event occurring.[6] This means that a woman would have to take propranolol within six hours of being raped. Obviously, in the immediate aftermath of rape, any woman is going to be in a state of extreme psychological and emotional vulnerability, and is going to be dealing with overwhelming pain. She is probably not going to be in a state where she can make a fully informed and considered decision about whether she really wants the treatment or not. And thus a medical community which is already espousing the supposed benefits of propranolol is going to have all too easy a time coercing women to take a pill to ease their pain. As these authors put it, “Considering the potential benefits of propranolol far outweigh its risks, it is likely that health professionals will accept a lower threshold for competence.”[7]

In other words, the proponents of malestream medicine have already decided that this is what is ‘good’ for women and we do not have a say in it. In the wake of being physically violated, they will force this mind-rape upon us at the time when we are most vulnerable and least able to resist, and thus attempt to convince us that the horrific experience of rape is not horrific at all, but just another day under Patriarchy.

Endnotes


[1] Jeanie Lerche Davis. “Forget Something? We Wish We Could.” MedicineNet.com. Published 9 April 2004. http://www.medicinenet.com/script/main/art.asp?articlekey=52473

[2] Michael Henry, Jennifer R. Fishman and Stuart J. Younger. “Propranolol and the Prevention of Post-Traumatic Stress Disorder: Is It Wrong to Ease the ‘Sting’ of Bad Memories?” The American Journal of Bioethics 7, 2007, p. 7+. http://ajobonline.com/journal/j_articles.php?aid=1338

[3] Elise Donovan. “Propranolol Use in the Prevention and Treatment of Posttraumatic Stress Disorder in Military Veterans: Forgetting Therapy Revisited.” Perspectives in Biology and Medicine 53.1, 2010. pp. 61-174. http://muse.jhu.edu/journals/pbm/summary/v053/53.1.donovan.html

[4] Adam J. Kolber. “Therapeutic Forgetting: The Legal and Ethical Implications of Memory Dampening.” Vanderbilt Law Review 59, 2006, p. 1561+. http://www.usa-anti-communist.com/ard/pdf/SSRN-id887061.pdf

[5] The President’s Council on Bioethics. Beyond Therapy: Biotechnology and the Pursuit of Happiness. Washington, D.C., October 2003. http://bioethics.georgetown.edu/pcbe/reports/beyondtherapy/

[6] See Davis, “Forget Something?” and Henry, Fishman and Younger, “Propranolol and the Prevention of Post-Traumatic Stress Disorder.”

[7] Henry, Fishman and Younger. “Propranolol and the Prevention of Post-Traumatic Stress Disorder.”

6 thoughts on “Propranolol and the Erasure of Pain

  1. karmarad says:

    Agreed. The article takes a thorough look at the implications for rape victims, and these are bad enough, but what I thought of first here was the soldiers. What a tool for a warmongering society this is! Soldiers can go out and perform any atrocity they are ordered to commit, knowing they will be given a pill and never have to suffer any guilt or moral qualms about their participation! These “moral qualms” are a huge problem for the military. Poof! Gone!

    • weirdward says:

      Yes, absolutely. The implications for how this could be used to create the ‘perfect’ amoral and emotionally dead soldier are very frightening. As we’ve seen from the Vietnam War, the Iraq War, the War in Afghanistan there are soldiers who will come home shattered from their experiences and become peace activists who criticise the military machine and speak out against war. These voices are a huge problem for the military and war-mongering governments; and potentially propranolol could just make them go away.

      In an ironic twist, the article by Donovan about war veterans actually argues that one of the reasons soldiers *should* be given propranolol is to protect women, since there are so many documented cases of soldiers coming home and behaving abusively towards their wives and children, sometimes to the point of murdering them.

      The brutalization of men in itself isn’t seen as a problem; only the unfortunate side effects of women being beaten and murdered…and that only matters because it makes the military look bad, not because women are dying.

  2. seebster says:

    Wow. Wow to the issue and wow to your analysis.
    Learning about feminism and rape culture was the reason I realized, ten years after the fact, that I was raped. The thing that disturbed me the most about this revelation was not that I got PTSD all of a sudden or suddenly had the fear/shame/disgust/panic associated with being raped come flooding at me. What was disturbing was my LACK of feeling in regard to the whole thing. My therapist has called it a dissociative response; the effects the Propranolol sound awfully similar to my lack of emotional activation with regards to my own rape. Really, it horrified me that I could be raped and THEN BE OKAY ABOUT IT.

    After telling my therapist that I was “technically raped,” and a little bit surrounding the circumstances, I asked my him, “How could I be okay with it?” and only at that point did I feel tears. And those tears were such a fucking relief. Because of course I wasn’t okay with it. You shouldn’t be okay with someone entering your body without regard for your person. You should not be okay with someone intentially inflicting damage on your psyche.

    I still do not feel much in the way of emotions when I think about that abusive situation. I can look back and know what happened, see where he was cruel and treated me unjustly, see how it twisted my mind and world view, start to put the pieces together to explain how I reacted in response to genuine trauma. But it’s as if I experienced these things only vicariously. My reactions indicated trauma but it was all taken very calmly and in ways that absolutely did not feel connected to the source(s) of the trauma.

    I feel deprived, just like you were saying, of a righteous anger toward my abuser. I can only learn about other women and girls’ victimization and be furious on their behalf. He hurt me, I feel deprived of a pain to which I was entitled to IN ORDER TO ACTUALLY DEAL WITH IT.

    Then again, maybe I reacted the way I did because I could not have handled the full impact of the trauma at that time? Maybe my mind was protecting me from that pain…maybe the drug would be a mercy to those who are less inclined to dissociation than I am and are not equiped to turn their experience into active political struggle. She shouldn’t be obligated to. Suicide does happen, and even if that’s the fault of an unsupportive community in the aftermath of the trauma, the suicidal person cannot/will not wait for a transformed society. Dunno.

    REALLY interesting how this has ethical implication for PTSD in soldiers, too. Thank you for this article!

  3. weirdward says:

    That is an awful experience you had – I hope you are getting the help you need to help you work through it. I’m not a therapist, but a lot of women do dissociate from rape, sexual abuse and the like, because it is so horrific that the mind has to find ways to protect itself from the pain. Realising or acknowledging past abuse is hugely painful, but I hope it is the starting point for a healing journey.

    And I totally get why women would be tempted to take a drug that would make them not feel the pain, especially when rape and the associated traumas are usually not even taken seriously or treated as horrific assults upon our personhood, as you so clearly point out. I wouldn’t condemn a woman who took that option if she needed to do that to keep herself alive.

    Remember though that the drug has to be taken within six hours of the traumatic event, and that the literature quite happily admits that women who’ve just been raped are only capable of “diminished consent” and yet the doctors are still pushing for this as a solution.

    But it’s absolutely not about judging women’s survival strategies, it’s about the fucked up men who would do anything to be able to keep raping women, including drugging us up and depriving us of our right to anger and our right to not have this shit happen to us anymore.

  4. Can i ask question? Propranolol is discovered that it can be used to block stress hormones that etch memories in the brain. Along with therapy, this drug is said to be effective to ‘dampen’ memories of trauma victims, bad memories etc. Is forgetting your memories, For better or For worse?

    • weirdward says:

      I don’t know if I can answer that simply – what I wanted to do was pose the question, and ask what kind of a society we live in where it is seen as simpler to allow women to go on being raped and abused as long as they can take a happy pill afterwards, instead of recognising the constant wrongness of not allowing women to be fully human.

      Also, experiencing our pain and our grief and our anger when someone else disrespects our personhood, that is our right. To say that it would be better for women not to feel the violation of our rights is profoundly disturbing. At best it points to a profound lethargy to change a toxic culture, at worst it suggests a desire to create a class of compliant victims who will never complain or fight back.

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