Mind over Matter

Neurology-based advice on the frustrations of memory loss and pitfalls of self-sabotage

Dear Dr Ash,

I’m a science teacher in my 60s and increasingly frustrated by memory loss. It’s not just the perpetual difficulty of remembering pupils’ names, which I’ve always been bad at, but also the embarrassment of finding myself periodically staring into the equipment cupboard, wondering what I’m looking for. As I live in France (I work in an English-speaking international school), I’m also trying to learn French, but my brain simply doesn’t retain the vocabulary or grammar, despite three years of classes and many hours spent diligently doing homework. It’s dispiriting to hear my younger classmates chatting away confidently to each other, whereas I still feel anxious ordering a beer in a bar. My question is: can you tell me how our brains start to fail us as we age – and does that mean I should change my method for memorising a new language? I’ve noticed that in choir practice I have no difficulty learning the music, but need the memory aide of written lyrics to perform in concert.

Forgetful, France

Dear Forgetful,

I grew up in rural Ohio, in a nondescript cluster of 1950s American bungalows. I remember that our house was yellow, that it had two concrete steps leading to a narrow front porch with an awning, that our garden ran down to a drainage ditch that seemed as wide and impassable as a river. When we were feeling particularly bold, my sister and I would make expeditions down to a little bridge that crossed the ditch and we would dare each other to walk to the other side, past what I recall was a troll that lived underneath. I can’t remember if either of us ever crossed. In fact, I can’t remember which of these images come from my own experience, which come from stories my sister and I have told each other, and which come from looking at my mother’s old photographs. Memory, even in the best of circumstances, is slippery.

In contrast to the largely fictional, dream-like memory of childhood, the memory of young adult life is diligent and comprehensive. My thirteen-year-old son has already developed an infuriating ability to quote back enormous chunks of conversations we had weeks before, in order to enforce the terms of whatever contract he feels we made at the time. He is just entering into the stage of life where his brain will function like a highly-tuned race car, twitchy and skittish but incomprehensibly powerful. This is perhaps the feeling you lament in your letter: the absolute certainty that your memory is comprehensive and ordered.

But with age comes wisdom. You and I have lived long enough to know that, despite how it feels to a teenager, memory is still slippery. What people say is only a small part of what they mean, and what we see with our own eyes is only one perspective on what happened. The rigid and bureaucratic filing system of young adult life eventually yields to the softer more holistic memory of middle life. Precision fades in favour of meaning and insight. Rules give way to values, contracts give way to compromise. Our memories are neither dreamy photographic flashes nor stenotyped transcripts, but instead are emotional stories we tell ourselves. As young adults we are adding new books to our library all the time, but as older adults we have the pleasure of thumbing through old favourites.

Given your profession, I suspect you had a particularly prodigious memory as a young person and that now, in mid-life, you’re frustrated that your memory is more typical. Most adults would struggle to remember twenty to thirty new names while simultaneously managing a classroom, learning a foreign language and performing in a choir. To you this feels like a failure, the loss of a remarkable ability you once had; from an outside perspective, the fact that you can still almost do it is astonishing.

If you can accept these changes in your brain with a sense of humour, you may find paradoxically that your memory improves. We’ve all experienced the “tip of the tongue” phenomenon, when a fact or a name feels just barely beyond your reach and the more aggressively you grasp for it, the further it seems to retreat. Later, when you relax and have a shower or go for a walk, the forgotten fact pops into your mind with total clarity. Stress and worry suppress memory retrieval, and the more you attempt to cling to the abilities of your youth the further they will seem to be. Ageing gracefully is difficult, but it is better than any available alternative.

Best wishes,
Dr Ash

Dear Dr Ash,

Every morning I get up with the intention of doing ten minutes of yoga, but make a cup of tea instead. Every evening I plan to write my journal, but read a book instead. Every time the tide rises in the creek I find an excuse not to swim, even though I love it. Indeed, I know I’ll feel more energised and fulfilled if I do any of these things. But whenever my inner adult suggests, gently: “Why don’t you do a 30-second plank while the kettle boils?” (ref my declared preference for core-work over dieting) my inner teenager responds by folding her arms mutinously. (It goes without saying I’ve composed countless first chapters of novels in my head without ever writing them down.) The prospect of engaging in battle with this truculent alter ego feels too exhausting when there’s so much else to fight for, so I invariably give up. I don’t think I’ve got undiagnosed schizophrenia (despite the internal arguments), and I’m not generally lazy. But my resistance to doing things I know will improve my mental, physical and creative health perplexes and frustrates me. My inner adolescent is far more tiresome than the teens I’ve raised as a mother. How can I get her to (*expletive*) grow up?

Resistant of Redcar

Dear Resistant,

Your letter evokes a beautiful world of babbling creeks and dreamy cups of tea, and contrasts that with a world of vigorous calisthenics and rigorous virtue. I’m not at all surprised that you find yourself drawn towards the former. But you’ve had an important insight into the mechanisms of procrastination when you describe two versions of yourself, a responsible adult and a truculent teenager. While it is difficult to study the neuroscience of procrastination, not least because the researchers involved tend to put off the work, some interesting evidence suggests that your intuition reflects the underlying biology.

In the brain, the tension is between two competing networks that regulate emotional drive on the one hand and cognitive control on the other. The emotional drive system is made of structures in the middle of the brain, including parts of the limbic system and the default mode network, that respond strongly to emotional states and short-term rewards. This system is the teenager in our story. The cognitive control system is largely comprised of the lateral and anterior prefrontal cortex, this is the region of the brain that controls goal-oriented behaviour and future planning. Prefrontal cortex is the adult in our story.

Like all teenagers, the emotional drive system tends to respond robustly to rewards but only weakly to risks. It’s also highly present-oriented, so immediate rewards activate it much more strongly than future rewards. Counter-balancing that, the cognitive control system represents abstract rules about how actions lead to consequences. Of the two systems, cognitive control is by far the more fragile. Prefrontal cortex is evolutionarily recent and metabolically expensive, so if you are tired, stressed, unwell, intoxicated or simply overloaded, the prefrontal cortex will be the first brain system to falter.
In contrast, as you no doubt know, it doesn’t take much to get your emotional drive very active.

The lesson here is that you’ll have much better luck guiding your behaviour if you don’t have to rely on cognitive control. Your focus on virtue is changing the behaviours you desire from indulgent pleasures into important tasks, so you’re changing them from limbic functions into prefrontal ones. It’s not a surprise that this makes the behaviours difficult. I suggest you work with your biology rather than against it.

Bask in the feeling of morning yoga. Paddle in the creek indulgently rather than trying to achieve fitness or good health. Consider the pleasures in whatever you do, and if there is no pleasure in a task itself, spend a moment trying to associate it with a future pleasure. As you will certainly have discovered by parenting teenage children, rules and discipline can sometimes work if they are used sparingly, but happiness and patience work much better.

Best wishes,
Dr Ash


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