One of my biggest complaints after my Traumatic Brain Injury (TBI) was having a terrible memory all of a sudden. There was nobody I knew or trusted more in the world than myself and then abruptly and without warning, I couldn’t even trust my own mind anymore! I was constantly anxious that I’d forgotten something; I felt useless and was forced to rely on others for everything. It was such a frightening experience that left me with zero self-confidence!
I was going through one of the hardest and most stressful things I had ever had to deal with in my life, yet to look at me there was no sign anything was wrong at all. The only way anyone would know was if I explained the way I had been affected to them, yet I couldn’t do this because by the time I’d finished one sentence I had forgotten the start! This was incredibly frustrating for me and no doubt to anyone who I was talking to. The best I could come up with was something like “my memory is really bad!” to which people would inevitably reply with things like “yeah, my memory is really bad too!” and “I always forget things, and I don’t even have a brain injury”.
It wasn’t the same thing - I had a genuine memory problem! It used to make me angry that people didn’t understand. I stayed this way for years and things didn’t get better until I accepted that it didn’t really matter to anyone else. Even though it was a major event for me and I thought about it for hours, it was very unlikely that anyone else did!
So, what did I do about it?
I realised that there are two ways you can respond to any problem. You can really let it affect you and become depressed, or you can do something about it. While the former is understandable and is usually the easier option, it doesn’t tackle the issue and will often attract sympathy. As a young man, I didn’t want people’s sympathy, as that made me feel weak. I wanted to be strong and gain people’s respect. Trying to do something about it is the more challenging route but, in my experience, attracts respect both from others and yourself.
Whilst organically your memory may never return to how good it once was before your TBI, there are techniques you can use, and with organisation you can be better at remembering than you ever were! If you remember things by keeping them in your head, then you can easily forget them. Using things that do not forget like pen and paper, dictaphones and smartphones to remember things for you means that you will never forget anything again (providing you use them correctly!).
Memory is how we hold information in our heads, but it is not that simple as there are different types of memory. Something that initially confused me was the fact that I could recall so many things from my childhood; I could remember the telephone numbers of childhood friends and registration plates of old family cars we had when I was a child, even my bank account and sort code. Why could I remember such detailed information if I had a memory problem? I was certain that they were all wrong and there was nothing wrong with me!
It turns out that those memories are long term memories (LTM) and stored deep within the brain. Traumatic Brain Injury usually affects areas of the brain close to the surface, leaving inner areas of the brain relatively intact. Look at your LTM as a warehouse for the storage of memories - my memory warehouse is where my friend’s old phone numbers and the old car registration numbers are stored.
Every memory starts life as short-term memory (STM). If, for example, you see a new red car you like, then this memory will stay with you as an STM for the next 15-30 seconds. To hold the memory on a more permanent basis involves transferring the memory from the short term to the long term memory (LTM). For an STM to successfully transferred to the LTM, you must first be concentrating on it. Otherwise, you will forget the information you are trying to transfer. Poor concentration means that your attention is likely to drift off, something else may grab your attention and you start thinking about that.
What is so often affected is your ‘working memory’. This is the mechanism that holds the memory in your head and then transports the STM to the LTM. Imagine that an STM like that new red car is delivered to the warehouse on a truck, then your working memory is the forklift truck that lifts the red car off the truck. The car will stay on this truck for about 15-20 seconds before it is either given a shelf in the memory warehouse for storage or it falls off the truck (i.e. it is forgotten). After a TBI your forklift truck no longer works as reliably as it once did and needs repairing.
You can repair this forklift truck (working memory) by improving your concentration, and the good news is that your concentration can be strengthened like a muscle in a gym. The more you practice concentrating, the stronger it will get. I found that as my concentration improved, so did my life in general, not just my ability to remember information.
To improve concentration, you can do specific exercises. These may be given to you by your neuropsychologist or you can simply Google ‘concentration exercises’ and you will find that there is no shortage of them available online. However, if you’re anything like me, then it is very unlikely that you will do a concentration exercise regularly unless it is something you enjoy doing. The trick is to find something that you enjoy doing that requires concentration. Some things that I have tried include:
Mindfulness and meditation: the mediation that I did was concentrating on your breathing for as long as you can and when your mind does drifts off, then have another go. I used to go to a mindfulness class where I lived in Scarborough and whilst I enjoyed the meditations in the class, I found it difficult to meditate in my own time without instruction. I then discovered something called guided meditation. This is where you meditate by listening to the voice of somebody who is trained to lead you into a deep state of relaxation. You can buy recordings of guided meditations usually on CD from health food shops or by downloading them. You don’t need to pay, though, as there are some good ones available free on YouTube.
Reading: I tried reading next. However, I have double vision and even though I have reading glasses to correct this, it was not something I found comfortable, and I never stuck to it. That was until I discovered audio books, and that was what worked for me.
Audiobooks: I started by downloading children’s books like Rudyard Kipling’s Jungle Book before eventually listening to books I had always wanted to read like Bram Stoker’s Dracula. Very often, I would listen to a chapter and my attention would drift off. I would just listen to it again because after all, the way to get better at concentrating is by practising concentrating. It’s not a problem, don’t get mad with yourself for losing concentration, just listen to it again! Eventually, it will stick!
As my concentration improved, I found myself being able to do various things again, like follow conversations better when I had previously forgotten the start of a sentence. I was able to watch a TV program again and eventually, an entire movie.