Seahorses in the blob

Many of the more probing questions about memory are actually questions about forgetting. Why, for instance, do we have such a poor memory for the history of faces? Try to remember what your parents looked like when they were around forty, or your children at the age of ten. What appears before your mind’s eye will probably come from photographs; it is very difficult to summon up their former faces from memory. Or, to take another example, why does it happen that a colleague might remember a helpful idea from last week’s meeting, but forget whose idea it was?

This complex relation between memory and forgetting is a central theme of Veronica O’Keane’s The Rag and Bone Shop. O’Keane, a professor of psychiatry at Trinity College Dublin, specializes in mental illnesses during or shortly after pregnancy, such as postpartum depression. Like every depression, it is characterized by a debilitating forgetfulness. Depression provides a window on changes that take place in the hardware of the brain (“a gelatinous blob of uncooked-shrimp colour, with squiggly indentations”). Deep down in this blob are two hippocampi, one left, one right, named for their resemblance to a seahorse. They are essential for receiving information from the outer and inner senses and relaying it to long-term storage in the cortex. Imaging techniques have shown that in patients with severe and prolonged depressions the left hippocampus is reduced in size. As the brain ages, both hippocampi tend to get smaller, which may also be related to forgetfulness as one gets older. These relations are, of course, correlations, and leave the matter of cause and effect undetermined. O’Keane supposes that the shrinking hippocampi fail to support the storage of memories, which leads to forgetfulness during depression and old age. But one could also suppose that sensitive cerebral structures such as the hippocampi lose volume as a result of disuse – after all, severely depressed patients become apathic and withdrawn, hardly the circumstances in which to gather salient memories.

The Rag and Bone Shop – a welcome, realistic metaphor for the memory, in comparison to the ubiquitous palaces, libraries and archives – deals with the full spectrum of what makes memory central to one’s personal life. It follows the trajectory of what enters our minds through the senses, the absorption of sensations into perceptions, and storage in short-term and eventually in long-term memory. Forgetting, not remembering, is the default setting of our memory, and most information will get lost again, sooner or later, but some will stick with us for the rest of our lives. Vocabulary, for instance, once committed to memory, will hardly erode with age; it is kept in the aptly named “permastore”.

O’Keane also looks at how memory develops throughout our lives. She writes on the lack of memories before the age of two or three (childhood amnesia), the early development of a self that becomes the “owner” of memories, and age-related changes in memory, such as the difficulties in finding names, even those of family and friends. In excellent prose, O’Keane takes us from first memories to the reminiscences of the elderly, bringing in ideas from writers, poets, philosophers and scientists from fields other than psychiatry and brain science. The philosopher Henri Bergson, for instance, captured much of O’Keane’s perspective when he wrote that “in truth, all sensation is already memory”. This was written in 1896, more than a century before it was established that for every neural connection transmitting information from the eyes to the primary visual cortex in the back of our brain, there are ten connections in the reverse direction. What we see is, in a large part, what earlier experience leads us to expect.

The book’s opening chapters are, in comparison, somewhat meaningdering. O’Keane’s discussions of past theories of sensation, perception and memory are less than convincing, as she fails to avoid some of the more obvious historiographic pitfalls. Accomplishments that match the present scientific insights she hails as heroic, while those that don’t she discards as “pseudo-scientific”. The great minds of the past are too easily sorted into dilettante dichotomies, where John Locke is luckily in the first category and poor René Descartes in the second.

What O’Keane does superbly, though, is to make her point by providing case descriptions taken from her own wards and consultations. She is an admirer of Oliver Sacks, and shares his view that studies of disorders and diseases should include the suffering individuals. Sacks, moreover, said that he was not a man of grand theories: he argued that his experiments and case descriptions should supply the material for others to devise theories. And so, too, O’Keane writes: “In this book I have turned my back on intellectual explanations and eschewed theory.” But there is no such thing as a theory-free experiment or description; Sacks was wrong about that, and so is O’Keane. There is – fortunately – quite a bit of theory in her book. Professors shouldn’t apologize for intellectual explanations.

One of the cases helps O’Keane to detail the relation between memory and the subjective speed of time. “Nora” suffered from bipolar disorder. She was admitted to an inpatient unit in a manic state: euphoric, talking uninterruptably and hyperactive. She had the delusional idea that people were plotting against her. It was decided that involuntary treatment would be in her best interest. Nora had been in this same hospital years earlier. At the time of her discharge, the medical staff assumed that she was in remission (an apparent absence of symptoms in the course of a disease). It turned out that she had actually entered a depressive “shut down” state. During these years she had withdrawn from public life, not leaving home, not following the news, not watching television. When she suddenly “woke up” in a manic state of mind, she found herself living in a world that seemed to have changed overnight. She had hardly any memories of the missing years.

The shut down also affected her sense of time. For those suffering from depression, time seems to crawl, if it moves at all. Those long days, months and years spent in the family home went by slowly. But to Nora, as she looked back on the period, it seemed as if time had ceased to exist. And so she experienced a gap in time narrower than the calendar would indicate. O’Keane cites the physicist James Clerk Maxwell: “The idea of ​​Time in its most primitive form is probably the recognition of an order of sequence in our consciousness.” The tick-tock of psychological time is a series of memories.

The charm of many of O’Keane’s case descriptions is that they point to familiar experiences. Nora’s shut down was pathological, but some of her experience is recognizable to many of us from the pandemics. Without travel, visits, holidays or holidays, it became difficult to position past events in the time scheme of our autobiographical memories. We have been guinea pigs in a psychological experiment of nature. William James is reported to have said that “to study the abnormal is the best way to understand the normal”, and O’Keane drives this home in a personal and at times intimate way.

Douwe Draaisma is professor of the history of psychology at the University of Groningen in the Netherlands. He is the author of several books on autobiographical memory, among them The Nostalgia Factory2013, and Forgetting: Myths, perils and compensations2015

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