Concentration & Memory
One way of thinking about memory problems is by thinking of a filing cabinet.
Information must be filed correctly and when the time comes we need to look in the right place to pull the file out. The sort of thinking and memory problems that people can experience after mild head injury are caused by problems with attention and concentration. These sorts of difficulties do not mean that there has been serious damage to your memory, and do not mean that you are at higher risk of developing dementia. They usually get better by themselves within a few months of the injury. However, here are a few tips for managing particular common problems.
‘I went upstairs / to the next room and couldn’t remember why I was there.’
This is a common experience that everyone has had at some time and many people experience frequently! What happens in this situation is a problem with concentration. If your mind is busy and you are not fully concentrating on your task, such as fetching your keys from another room, there is a good chance that ‘I am going to pick up my keys’ will get lost amongst the other thoughts. If this happens, try to retrace your steps, mentally or even physically. Think ‘What was I doing or thinking about before I left the other room?’ If you think back and remember that you were planning to go out later and so thinking about packing your bag, you might suddenly remember that you had come into the room to pick up your keys. Sometimes the reason might not come back to you at all. If that happens there is no need to worry – remember that these lapses are caused by poor concentration and not by a serious memory problem.
To reduce these kinds of lapses, try to be aware of distractions and to positively focus your mind when you set yourself a task. You could say out loud, or in to yourself, ‘I better go and get my keys.’ Hearing yourself say this will reinforce the plan you are setting in your mind and make it much less likely that you will forget.
‘I keep losing my wallet / keys.’
If you have recently had a head injury you might feel worried that losing things means that you have damaged your memory in some way. However, this experience is very common. It is easy to misplace items that we use all the time. We often misplace these things because we use them so often that we don’t really think about them, so our mind’s ‘spotlight’ isn’t paying attention when we put them down. If you are feeling unwell, anxious, distracted, or are ‘multi-tasking’, you are even less likely to fully focus your mind on where you are when you put your keys or wallet down.
One way of thinking about it is that when you put your wallet down, especially somewhere different from normal, you must ‘file’ this location in your mental filing cabinet. If your mind is busy elsewhere this information will never be filed. The best way to find them in this case is to think back to when you last had the wallet and retrace your steps – either physically, or in your ‘mind’s eye’ – in the hope that you will find them along the way.
You can try to avoid misplacing items like this with a few simple steps. Firstly, taking your time over routine tasks (getting home, taking off your coat and putting down your keys) will allow you more time to focus your mind on what you are doing. Secondly thinking out loud, or even talking inwardly to yourself quite firmly “I am leaving my keys in my pocket this evening.” will reinforce this information and make it much less likely that you will forget. Finally, some people find that simple practical steps towards building a routine and organising the space around you can really help: for example, a small hook or a particular shelf where you always keep your keys.
‘I lost track of the conversation.’
This can easily happen if you are distracted, worried, or perhaps do not feel fully involved in a conversation. For example, it is common for people attending medical appointments to afterwards find that they cannot remember all of what the doctor had said. This can be because they were feeling anxious or distracted by worries, but can also happen when professionals do not explain things using terms and language which are easy for non-experts to understand.
If you find that this happens to you, either when speaking to professionals or to friends or family, try hard to focus your mind on the person who is speaking and what they are saying. As soon as you miss something the person says or you find that they are talking about something that you do not understand, do not be embarrassed (this is a common experience!) but say something like “I’m sorry, I didn’t quite catch you – can you repeat what you were saying?”
‘I couldn’t recall the entire car journey home.’
It is possible for our minds to be so busy thinking about other things that when you think about very recent routine activities – travelling, eating, getting dressed – you might find that you can’t remember anything about them. This is also a very common and normal experience. If you are bothered by having experiences like this, it might be possible to prevent or reduce them by ‘slowing down’ during routine experiences and paying attention – focusing the mind – on what you are doing, and on your physical surroundings and physical sensations. In a sense, being more ‘mindful’ of what you are doing at any one time, rather than thinking about things that have happened, or planning or worrying about things to happen in the future.
Short gaps in memory during routine activities are different from ‘dissociative amnesia’, where a person might have quite a prolonged ‘gap’ in memory.
‘I pick up a book and can’t remember the bit I read before.’
It is easy to read the words and turn the pages of a book without fully
concentrating on the story or information contained in it. This can happen
if your mind is busy thinking about other things, worrying, ‘daydreaming’,
or sleepy. If you then come back another day and pick up reading where
you left off, you probably won’t remember the last bit. Although you were
reading it with your eyes, you did not really ‘take in’ the meaning of the
words. If you look back further in the book you will probably find that you
recognise the story up until the point that your concentration drifted off.
Try to avoid distractions when you are reading – start with a quiet room and a comfortable chair. Really try to focus on what you are reading and be aware of when you are becoming distracted.
‘I forgot my pin number / the name of a close friend.’
When you bump into a friend and can’t remember their name it can make you feel embarrassed and a bit worried, especially if in the background you are worried that there is a serious problem with your memory. The same goes if you need to get cash and can’t remember your pin number. But having problems accessing well-learned information is very common. Everyone has this experience sometimes!
Usually, the information is still there in your memory ‘filing cabinet’, but anxiety or even just trying too hard is getting in the way of you pulling the file out in the usual automatic way.
The best way to manage when this happens is not to worry. Worrying will make it feel worse without helping you remember. Accept that you can’t bring the name to mind just now but that it will probably come to you later. Once you feel a bit more relaxed about it, try to call to mind things you know about the person apart from their name: where you met, friends you have in common, names of other people in the person’s family. Thinking about these things is likely to help bring the name to mind by activating normal remembering procedures.
‘My boss asked me to talk about the accounts – my mind went blank!’
Sometimes feeling anxious about remembering something can make it feel even more difficult to remember. This is very much like when sportspeople get performance anxiety – think about how even top golfers and tennis players can make basic errors (‘choking’ or ‘the yips’) when they are feeling under a lot of pressure.
It can help to take a step back from the situation, and if possible move to a quiet environment for a few minutes. Simple breathing exercises can help – it is much easier to retrieve memories with a calm and clear mind. A bit of space and a clearer mind can allow you to focus your mind on the information that you are struggling to call to mind or put into words.
‘I need to get to an appointment at the other side of town and I feel like I can’t do it –
I can’t remember how to get there.’
If you are struggling to tackle a particular problem or plan a journey,
it is easy to feel overwhelmed. It can help to step back from the
problem and take a bit of time in a quiet place to think about the task.
Think about a time that you managed a similar problem before –
for example, if you have made a similar journey in the past, how did
you get there and how long did it take. Breaking the task into small
manageable steps and writing these steps down can help. For example,
you might look up the address and appointment time and write them
down, then check the bus map and timetable and write down the number and time of the bus you will need to take. You might also write down anything you need to bring to the appointment. Each of these
small tasks will feel more manageable than the task as a whole, and what you have written down will help to keep you right on the day. That does not mean that you will not still feel a bit anxious, especially if you haven’t done the journey before, but breaking tasks into steps and writing the steps down can help you to regain control when you feel overwhelmed.
‘I completely forgot to go to a meeting / send someone a birthday card.’
Using diaries, appointment cards and electronic reminders (for example, on your smartphone) can help with remembering appointments. However, the process of writing the appointment down or typing it into a phone – focusing your mind on the appointment for a short time – is probably as helpful as the reminder itself. Focusing on the thing you have to remember, thinking about arrangements you will need to make to get to the appointment and other activities on the same day, will link the appointment to other memories and so help to firmly embed the appointment in your memory.