Treating Memory Loss

London resident Clive Wearing’s memory is exactly seven seconds long. Anything he learns or sees or does is forgotten in the amount of time it would take him to read this sentence. But Wearing’s life was not always this way. There was a time when he was one of the world’s greatest musicians. He directed a world-famous London symphony and even created the music played at the wedding of England’s Prince Charles and Princess Diana. Then, in March 1985, he came down with encephalitis. The herpes virus, the same germ that causes common cold sores, found its way into his brain and created a life-threatening infection.

Encephalitis cases such as Wearing’s are very rare but very serious. Seven out of ten people who get herpes encephalitis die if it is not treated immediately. Wearing did not die, but his memory did. The infection attacked the main memory centers of his brain. He recovered from the illness, but he has never recovered his memories. He lives with what experts believe is the worst case of amnesia in known history.

Wearing remembers nothing from before his illness, and he has remembered nothing since. He can still speak, but every day, he greets his wife as if meeting her for the very first time. Sometimes he asks if she is the queen of England. Amazingly, though, Wearing can still play melodies. Beautifully.

“Though he could no longer read books or a newspaper,” says Jan Goodwin in an article in Reader’s Digest, “Clive, it turned out, could still read music.” The ability to play music, like the ability to speak or ride a bike, is part of a person’s pro- cedural memory—not the memory of facts such as names and faces, but of processes. All of Wearing’s new memories melt away in seconds. But he sits down at a piano, says Goodwin, “and sounds extremely accomplished.”⁴⁹

Memory Training

Thankfully, few people with amnesia have cases as serious as those of HM in the 1950s and Wearing in the 1980s. Most people lose only some of their memories. With the help of simple memory techniques and everyday tools such as sticky notes, date books, and alarm features on cell phones, they can remember what they need to know to get through a day.

“Depending on the degree of amnesia and its cause, victims may be able to lead relatively normal lives,” says Julia Barrett in the Encyclopedia of Medicine. “Amnesiacs can learn through therapy to rely on other memory systems to compensate for what is lost.”⁵⁰

Memory therapy is a form of amnesia treatment that helps some people relearn how to remember. This treatment is similar to what students call study skills, ways to improve the ability to memorize information. One useful technique in memory therapy is mnemonics, a memory trick that dates back to the time of the ancient Greeks. People use mnemonics to recall lists of things, such as items to buy at the grocery store. If the list includes milk, oranges, and potato chips, a mnemonic might take the first letter of each item to make the word mop. The shopper can then remember that the list has three items, and what they are, just by remembering the word mop, or even just the image of one. Training people with anteretrograde amnesia to use such methods can make it easier for them to live with their memory difficulties.

“Remembering is a process that must be learned, just like walking, talking, eating,” says Tanushree Podder, author of the book Smart Memory. “You learned these things when you were a child and now you can perform them without effort.”⁵¹ According to Podder, the memory process is an example of implicit learning, the kind of learning that, like riding a bicycle, rarely disappears with amnesia. “You can learn the process of using your memory just as thoroughly,” she says. “Anyone can hone up the memory by training it.”⁵²

Training people with memory problems to use mnemonics and other memory tricks is one of the best forms of treatment for the types of amnesia that affect the ability to learn new information. Memory therapy is not a cure for amnesia, however, and it does not repair the damage that has been done to the brain. It also provides little help for people with retrograde amnesia, who have lost past memories that no amount of training and relearning will bring back.

In desperation, some people with retrograde amnesia try other ways to unlock the memories they cannot reach. Doing so is often controversial. Probably the most popular method, and certainly the most notorious, is hypnosis.

Forgetful, or a Fraud?

In 2003 a stockbroker named Doug Bruce lost his memory and wound up on a New York City subway. The story of his memory loss and his struggle to rebuild his life is told in the 2006 documentary film, Unknown White Male.

Some people think the film is a hoax. It states that Bruce’s identity troubles were featured in the news before his family was eventually tracked down, but critics of the film say no such news story or newspaper article can be found. They also say it is a little too convenient that that the man who directed the film, Rupert Murray, just happens to be a longtime friend of Bruce (even though he, like Bruce these days, cannot remember exactly how or where they met).

Unknown White Male is a story of a life without the benefit of a memory. It is hard to imagine someone pretending to act that way for the rest of his life just to gain fame in a documentary. Even the film’s critics admit that it is either one of the most convincing hoaxes of all time, or the story is real.

Hypnosis

In a psychotherapist’s view, hypnosis is a method of changing a person’s state of mind. When people are hypnotized, they are somewhere between being asleep and being awake. They do not know where they are or what is around them. The person doing the hypnotizing can suggest certain things, and the person being hypnotized will usually do them.

Some people are more easily hypnotized than others, but scientists think everyone can be hypnotized at least a little. In a hypnotic state, a person can be talked into certain things and talked out of others. A magician might use hypnotism during a show to make a volunteer croak like a frog or waddle around the stage like a duck, but hypnotists also have more serious jobs. Many doctors use hypnotism to help patients with pain from things like headaches, serious burns, and childbirth. Hypnotists also help people to break bad habits such as smoking or to overcome illnesses such as depression.

It makes sense that someone with amnesia might look to hypnotism to find lost memories. After all, hypnotism itself can cause amnesia. If the hypnotist tells the patient that she will remember nothing that happens while she is hypnotized, she will “wake up” with no memory of waddling like a duck. (Unfortunately for her, the brain does make memories of things that happen during hypnosis, so the hypnotist, by saying a certain word or giving a certain cue, can usually make her remember the whole embarrassing event.)

Even psychologist Sigmund Freud tried to use hypnosis to help troubled patients, whom he called hysterics, to track down memories of frightening experiences from their child- hood. “Hysterics,” he said, “suffer for the most part from reminiscences.”⁵³

The trouble with using hypnosis to “find” memories is that the memories an amnesiac gets back may not have existed in the first place. A woman may be missing her memory of the entire period from age three through six and may turn to hypnosis because she worries that some troubling event, such as child abuse, caused her mind to shut down and block terrible memories from that age. But it is difficult for a hypnotized adult to tap into memories that happened when she was three. Adults still think like adults, and three-year-olds think like three-year-olds. What the woman “remembers” under hypnosis might only be what she imagines she might have thought and remembered at that age. Worse yet, it might be what the hypnotist makes her believe might have happened.

“Age regression is first and foremost a product of the imagination,” says John F. Kihlstrom, a psychology professor at the University of California, Berkeley. “Any accurate memory produced is likely to be blended with a great deal of false recall.”⁵⁴

Hypnosis, then, is not necessarily the answer to amnesia. In fact, many memory experts think that memories recalled during hypnosis may not be true memories at all.

“Hypnosis, alas, is not a truth serum,” says Dr. Roberta Temes. “More unfortunately, hypnosis is a confidence builder. This means that when hypnotized you remember an incident which may or may not have actually occurred, and hypnosis will make you feel confident that your memory is correct and that it did occur.”⁵⁵

Kihlstrom says that because so many patients, when hypnotized, actually remember false information, “the risks of distortion vastly outweigh the chances of obtaining any useful information.”⁵⁶ In short, hypnosis is not the miracle cure a person with amnesia may be hoping for. There is, in fact, no reliable cure for this condition. So far, modern medicine’s best hope for battling amnesia is preventing the things that cause it in the first place.

Healthy Lifestyle: A Memory Backup

Amnesia is not an illness in itself, but one of the possible effects of many illnesses and injuries. Scientists may not have found a way to cure amnesia, but every day, they are finding more ways to prevent it. One of the best ways people can protect themselves is simply by doing things that are good for the brain. There is evidence that even Alzheimer’s disease, the cause of which is not entirely understood, might be headed off by healthy living. Simple habits such as eating nutritious foods, getting plenty of exercise, and keeping the mind active with lifelong learning have been shown to lower the risks. A healthy lifestyle can also help prevent strokes, another common and unforgiving thief of memory.

“There is no specific medical treatment to help reverse the memory loss that occurs after a stroke,” says Dr. Alberto Maud. “The best way to prevent dementia after stroke is to avoid having a stroke.”⁵⁷

Keeping clear blood vessels, and thus, clear memories begins with a low-fat diet and plenty of exercise. It also means not smoking or abusing alcohol. The sooner a healthy lifestyle begins, doctors agree, the better the odds that the brain will never be damaged and memories will forever remain safely stored. Healthy habits are an important investment in a person’s memory bank.

A Helmet for the Mind

Healthy living involves an active lifestyle, but ironically, this too can cause amnesia if a person plays contact sports or has other hobbies that can be risky for the head. For every per- son in the United States having a stroke right now, two people are hurting their heads on sports fields, bicycles, halfpipes, or roller blades. Every twenty seconds, someone in the United States gets a brain injury, and many of these people, after being knocked unconscious, have posttraumatic amnesia—memory loss that results from an injury to the brain.

Strokes and other memory-robbing diseases usually do their work later in life. Traumatic brain injury, on the other hand, is the most likely cause of amnesia in kids, teens, and young adults. Head-harming accidents are responsible for most of the memories lost in people who are young. Professionals in the field of athletics are among those helping to make more people aware of the dangers of head injury.

“Team physicians, athletic trainers, and other medical personnel responsible for the medical care of athletes face no more challenging problem than the recognition and management of concussion,” says author and doctor Robert C. Cantu. “Such injuries have captured many headlines in recent years and have spurred studies within both the National Football League and the National Hockey League.”⁵⁸

Preventing traumatic brain injury takes a combination of technology and common sense. Simply remembering to put on a helmet before climbing on a bicycle or to buckle a seat belt in the car could prevent a serious, life-changing brain injury.

“In children, brain injuries usually result from motor vehicle or sports accidents, or from falls,” says author Lisa Schoenbrodt. “These events tend to create violent movement of the brain within a closed skull.”⁵⁹

Traumatic brain injuries can do more harm to the brain than almost any other cause of amnesia. According to On With Life, an Iowa-based nonprofit organization providing brain-injury rehabilitation services, posttraumatic amnesia usually gets better after a few days, weeks, or months. In the meantime, however, those who know the person may feel puzzled by his or her inability to remember things from day to day or hour to hour.

Survivors of serious brain injury may also be embarrassed during this period of amnesia. Amnesia sufferer Jill Robinson writes, “How many of these questions did I ask yesterday, and how many have already been answered?”⁶⁰

Living with Lost Memories

Life with amnesia is very difficult, not just for the person with memory loss but for friends and family, who may feel as if they are strangers to someone they love. Even if memory loss only affects short-term memory, life is no picnic. A person with short-term memory loss remembers friends and family, as well as most of the important details of his life. But if someone asks him to go to the store for a carton of milk, he not only forgets the milk, but he may also forget to go to the store at all and could wind up someplace else entirely.

Mnemonics and other memory-training techniques can be helpful, but even so, learning anything new takes a lot of time and effort for someone with short-term memory loss. Studying for a test at school might take most kids an hour, but a student with amnesia could spend days trying to memorize the same facts (and still do poorly on the test). Sadly, once memories or the ability to remember are gone, they may be gone for good.

Time occasionally fixes things and puts memories back where they belong, but doctors have found no cure for amnesia.

There is no pill someone can take that will bring back lost memories. How the brain works is still so poorly understood that doctors have a hard time figuring out just what goes on in the brain to create memories or to lose them, much less what kind of medications could repair the many types of brain damage that can lead to amnesia. In fact, some medications and treatments that have been used for mental disorders such as depression have in turn caused amnesia.

Electroconvulsive shock therapy is one such example. This treatment, which is sometimes used for people who suffer from very severe depression, involves having electrodes attached to the temples of the head so that mild electric shocks can be applied to the brain. The goal of this therapy is to reset circuits in the brain that might not be working properly, which scientists believe may cause depression. One common side effect of shock therapy, however, is mild amnesia that lasts for hours or even days. Because electroconvulsive shock therapy usually requires many treatments, some scientists believe that the repeated shock sessions may lead to long-term amnesia.

“Electroconvulsive therapy is actually one of the safest and most effective treatments for severe depression,” say neuroscience researchers Mary H. Kosmidis and Andrew C. Papanicolaou, but they point out concerns about this treatment that come from its link to amnesia and its “potential for causing permanent brain damage.”⁶¹

The risks involved with treatments such as electroshock therapy are evidence that scientists still have a great deal to learn about the human brain. Experimenting with new treatments for amnesia might mean causing even more damage to an injured brain. The lessons learned from cases such as the epilepsy treatment of HM make doctors and scientists wary of trying to treat amnesia with medications or surgery. For now, most people who have amnesia must simply learn to live with it the best they can.

Life with Amnesia

Perhaps the hardest part of living with amnesia is that so many people do not understand this condition. TV and Hollywood often portray the disorder to be much different than it actually is.

“Real, diagnosable amnesia—people getting knocked on the head and forgetting their names—is a rare condition, and usually a brief one,” says Jonathan Lethem, editor of The Vintage Book of Amnesia: An Anthology of Writing on the Subject of Memory Loss. “In books and movies, though, versions of amnesia lurk everywhere. Amnesiacs might not much exist, but amnesiac characters stumble everywhere through comic books, movies, and our dreams.”⁶²

Clinical neuropsychologist Sallie Baxendale says, “In most films, memories are not lost, just made temporarily inaccessible. Recovery of memory is possible, via various unlikely means.”⁶³ In reality, however, as most people who work or live with amnesia know, memories can hide and never be found. The brain is an incredibly complicated thing, and reaching in after foggy memories often means coming up empty-handed. Living with amnesia requires a great deal of patience on the part of the amnesiac as well as his or her family and friends.

Gentle, frequent reminders may be the best help yet for amnesia of all kinds. A person who cannot remember names and faces or what day of the week it is may simply need kind reminders of these things. Friends and family members of people who have Alzheimer’s disease learn not to be offended if their loved one forgets their name or cannot remember important events such as birthdays, and the same patience and kindness can help anyone whose memory has been damaged by injury or disease. Helping someone with retrograde memory loss, the absence of memories from a period of time in the past, might mean sharing pictures and stories of the times that have been forgotten. Unlike the cases of amnesia in movies and television shows, these activities and reminders probably will not bring lost memories back in a sudden, joyous flood. However, they might help the amnesia patient to make sense of life with lost memories.

Hoping for a Cure

Current medicine offers little promise for people who have lost their ability to remember things, but even as some brains bury memories, other brains are inventing new technology that brings science closer to finding them. New methods for taking pictures of the brain and for mapping its activity have given brain researchers the tools they need to continue learning how this mysterious organ, the most complicated in the human body, works. The more scientists know about the brain, the closer they get to repairing the damage caused by illnesses, injury, and psychologically disturbing events that have the power to destroy memory.

Amnesia in Hollywood

Too many movies to count feature characters with some kind of impaired memory. Popular movies like 50 First Dates and Santa Who? show a funny side of what life might be like with a memory glitch. In Men in Black, agents wipe out people’s memories on purpose to protect them from nightmarish recollections of aliens that walk in disguise among us.

The idea of putting forgetful characters in leading movie roles is nothing new. At least ten of the silent movies made before 1926 had this theme, and screenwriters have never tired of it. But in real life, amnesia does not always make a good story, and it rarely goes away just in time for a happy ending. Perhaps one of the most true-to-life amnesic characters to hit the big screen did so in the animated film Finding Nemo. The absent-minded fish, Dory, cannot learn new things or remember where she is going. This everyday forgetfulness is perhaps much closer to the reality of life with amnesia than the daring, heroic stunts Jason Bourne pulls off in The Bourne Identity, even without knowing how he learned them.

The loss of memory is not life threatening, but it is certainly life-changing. Amnesia patients and their loved ones have little choice but to hope for a miracle, a key to the memory abilities locked away in their brains. Science currently offers these people very little hope, but one day, doctors may learn enough about the brain to find a cure for lost memories, giving back to amnesiacs their past—and their future.