Abstract
OBJECTIVE: Nursing students are at risk for traumatic stress, but current treatments have limited benefits. Regenerating Images in Memory (RIM) is a verbal psychotherapeutic approach to help people safely re-experience troubling memories, then integrate them into meaningful life narratives. RIM's developers propose a mechanism of action based on nonconscious processes like emotional processing and body awareness. Two Minds Theory (TMT) is a health behavior model that suggests coping arises primarily from the speedy and non-conscious Intuitive Mind. This study was designed to test a potential mechanism of action for RIM based on TMT, where the Intuitive Mind suggests solutions that are later integrated into the Narrative Mind. METHODS: In this exploratory, descriptive, mechanistic study with no comparison group, 30 nursing students received RIM during the late COVID-19 pandemic. Participants completed validated symptom questionnaires before and after 1 RIM session lasting 1-2 h. As an exploratory measure, we measured altered states of consciousness using a scale linked to rapid improvement in studies of psychedelic treatments. Sessions were audio-recorded and participants' brainwaves were monitored using a MUSE S (Gen 1) 5-lead EEG headband with MindMonitor software. RESULTS: Students reported pre-post improvements (Cohen's d = 1.93-2.75) on 4 of 5 questionnaires. Participants reported levels of altered consciousness similar to those in psychedelic drug studies, particularly on an "ineffability" subscale linked to symptom improvement. EEG readings showed a significant shift away from the frontal lobes (associated with the Narrative Mind) and into the temporal lobes (associated with the Intuitive Mind), χ(2) = 11.0 × 10(4), p < 0.001, during the middle stage of RIM. This was followed by frontal and temporal lobe co-activation during the final stage of RIM, a finding that also mirrors psychedelic studies' finding of increased synchronization across brain areas during treatment. CONCLUSION: Replicating prior pre-post RIM studies, nursing students reported symptom improvement. These changes co-occurred with altered consciousness and increased temporal-lobe brain activity, findings that are consistent with RIM's proposed mechanism of action based on TMT. Although this uncontrolled trial does not allow conclusions about treatment efficacy, RIM is a brief verbal psychotherapeutic intervention that merits further study.