Categories: Generelt

ADHD: Why Don’t You ‘Recall’ anything?

That ADHD causes massive impairment of Executive Functioning particular in Working Memory is not news ... But did you know that many people with ADHD are also impaired on ‘recall’ (re-experiences of past events) and therefore cannot make ‘predictions’ of future consequences of their immediate behavior? In this article we dive deep into the complex world of how memory works ...

That ADHD causes massive impairment of Executive Functioning particular in Working Memory is not news … But did you know that many people with ADHD are also impaired on ‘recall’ (re-experiences of past events) and therefore cannot make ‘predictions’ of future consequences of their immediate behavior? In this article we dive deep into the complex world of how memory works …

Summary

In this article you can get an idea of how the normal memory functions, in rather in-depth detail, as well as how it relates to the deficits that is experienced when a person is suffering from ADHD.

Key Points

  • There are 5 distinct types of memories: Short-Term Memory, Long-Term Episodic Memory, Long-Term Procedural Memory, Long-Term Semantic Memory and Sensory Memory.
  • A memory is not stored ‘as-is’ but is recalled from memory by reconstructing the past event, piecing together all the sensory information (images, sounds, tastes, smells, feelings, emotions etc.).
  • The recalled memory is then used to simulate potential future outcomes of imagined possible solutions to the problem at hand, and these are in turn evaluated and a RESPONSE is chosen for being the instruction which is send from the MIND to the BRAIN and from there on to the BODY which acts out the RESPONSE (verbal and/or non-verbal) which the MIND have chosen. This is also known as BEHAVIOR.
  • All memories are subject to change over time. This is due to the recall process, that uses a ‘filter’ or ‘dictionary’ of our subjective values and beliefs, which is constantly updated based on our previous experiences. Since our ‘interpretation’ of past experiences is filtered every time we access them, our memories are not ‘hard-coded’ into our brain, but actually ‘soft-coded’ instead. This is why Cognitive Behavioural Therapy (CBT) can be so effective in changing our habits, values and beliefs, since it ‘re-encodes’ our past experiences anew along with an updated understanding of the past event, including feelings and emotions.
  • ADHD creates vast impairments in memory utilisation, both in the function of Working Memory, as well as in the ability to predict future consequences of current behaviour. It also impair our Time Management, our Social Skills and ability to store, retrieve and reuse stored knowledge.
  • And a lot of other things that you have to read the whole lot to get stored in your own MEMORY.

Introduction

One of my absolute heroes, Steve Jobs, was known for being a visionary par non and although he didn’t create all his products alone, he had an amazing ability to not only envision novel products, but also to predict what people would need in the future, so he could instruct his engineers to create products that met these future needs, before the rest of us even knew that an iPad would revolutionise not only how we access knowledge, but also how we educate and entertain ourselves today.

He was interviewed back in the days when he and Bill Gates where still jousting for World Domination and where Gates made statements like “A computer on every desktop”, “The Information Super Highway” and my favourite “We’ll never need more than 64Kb of RAM …”, Jobs was already talking about how people in the future would be able to access all of their data, right from the palm of their hand, without any wires attached and at speeds that made it feel like a natural part of your daily experience … I can’t remember exactly where or when I heard this interview, but it stuck in my MIND and I have always marvelled over his ‘foresight’.

“You can’t connect the dots looking forward; you can only connect them looking backwards; so you have to trust that the dots will somehow connect in your future”

– Steve Jobs (2015)

The human species is the only one which is able to make predictions of potential consequences of future outcomes, based on simulating various scenarios.

This ability is possible only, due to our neurobiological computer, the BRAIN, our identity/self, the MIND, and our anatomical physiology, the BODY.

The 3 parts are connected through our Nervous System and the information that passes through the system is called STIMULI, while the actions that is controlling our verbal and non-verbal behavior is called the RESPONSE.

All these working in unison I will refer to as the YOU (meaning that it is what the integration of MIND, BRAIN, BODY, STIMULI and RESPONSE ends up as, namely YOU).

In this article I’ll use these 6 terms to describe how we as humans operate, by referring to MIND, BRAIN, BODY, STIMULI, RESPONSE and YOU so as to better explain how YOU function as a whole, as well as how the different systems within YOU, operates, both integrated and individually.

What is ‘a’ memory?

Memories are stored events of past experiences. These include visual, auditory, touch, taste, smell and spatial STIMULI. Memory is the process by which we encode, store, and retrieve information.

The Big Five of Memory

Encoding a new memory

Sensory memory, corresponding to each of the sensory systems, is the first place where information is saved. Sensory memories are very brief, but they are precise, storing a nearly exact replica of a stimulus.

Roughly seven (plus or minus two) chunks of information can be transferred and held in short-term memory. Information in short-term memory is held from 15 to 25 seconds and, if not transferred to long-term memory, is lost.

Memories are transferred into long-term storage through rehearsal. If memories are transferred into long-term memory, they become relatively permanent.

Long-term memory can be viewed in terms of memory modules, each of which is related to separate memory systems in the brain. For instance, we can distinguish between declarative memory and procedural memory. Declarative memory is further divided into episodic memory and semantic memory.

Some theorists view short-term memory as a working memory in which information is retrieved and manipulated and held through rehearsal. In this view, it is a central executive processor involved in reasoning and decision making; it coordinates a visual store, a verbal store, and an episodic buffer.

Storing memories

Semantic networks suggest that knowledge is stored in long-term memory as mental representations of clusters of interconnected information.

Memories are distributed across the brain, relating to the different sensory information-processing systems involved during the initial exposure to a stimulus.

The hippocampus, a part of the brain’s limbic system, plays a central role in the consolidation of memories. Located within the brain’s medial temporal lobes just behind the eyes, the hippocampus aids in the initial encoding of information, acting as a kind of neurological e-mail system. That information is subsequently passed along to the cerebral cortex of the brain, where it is actually stored.

The amygdala, another part of the limbic system, also plays an important role in memory. The amygdala is especially involved with memories involving emotion.

Understanding what makes YOU … YOU

The MIND is where you make sense of the world around you and the BRAIN is the engine under the hood that makes the BODY operate the way your MIND decides. But since your outside world has great influence on your basic survival, the BODY can also direct the BRAIN to warn the MIND of potential dangers (and opportunities), which has consequences for your current and future survival.

The MIND is locked up inside a dark, silent skull dome and do not have any direct connections to the world outside itself, it relies on the BRAIN to tell it what’s going on out there. The BRAIN on the other hand haven’t got a clue either so it relies on the STIMULI that it receives from the BODY.

Before we proceed, we need to get our knowledge aligned, so that you can get the full effect of the information which is to come. If you know this already, skip ahead …

 

The Basics …

STIMULI is a nerve signal containing information about something which have triggered your senses. It travels from the point of impact up through the Central Nervous System (CNS) where it is relayed to the BRAIN. The nerve signals travels through the Neuronal Network.

Neural networks are groups of neurons or structures that are connected together. The structures that create the pain matrix are, together, an example of a neural network.

NEURONS are physical entities within the BRAIN that communicates with each other and the CNS, by neurochemical and electrical signalling, that causes the neuron to ‘fire‘ (creating a RESPONSE to the STIMULI it has received) which then instructs the BRAIN on how to instruct the MIND and the BODY to react.

The BRAIN then either creates either; (1) an autonomic RESPONSE (verbal or non-verbal) by activating the MOTOR SYSTEMS or (2) refer the STIMULI to the MIND for further analysis.

Ivan Pavlov, and later on, B.F. Skinner both demonstrated how all species can be ‘conditioned’ to respond to a stimulus with a pre-learned behavior – the so-called stimulus/response encoding of past experiences.

Today it is known that memories that are past events, activate unique neural networks, and imagines future experiences activates other neural networks.

This is the cause to why dreams can “feel” so real, why we are able to visualise and predict the future, as well as find (neurochemical) motivation to realise our visions (by rewarding our BRAIN with an increase in Dopamin, the BRAIN reward neurotransmitter).

This system is a basic function of the human species (and many others as well) and the core reason for Dopamine is to reward us for taking actions that improve the survival of our species (note not the individual) and is therefore the core motivator for sex – treating the next generation.

This is why sexual fantasies invoke your sexual responses both in the MIND, BRAIN and BODY, even though you are not in any likelihood of having sex with anyone – other than your self.

Anatomy (the science dealing with the structure of animals and plants) and Physiology (the scientific study of the functions and mechanisms which work within a living system) is what I have described using the term the BODY. Is is the totality of all which makes you YOU.

Neuroanatomy, Neurophysiology and Neuropsychology are the disciplines that goes into detail of human structure and functioning, and also plays a key role in what goes on, within the Nervous System.

The BODY

Within the BODY there is two distinct nervous systems, the Central Nervous System (CNS) and the Peripheral Nervous System (PNS). The PNS is then again separated into the Somatic Nervous System (SNS) and the Autonomic Nervous System (ANS).

 

The Nervous Systems in the BODY
The Autonomous Nervous System
The Sympathetic (fight-or-flight)) and Parasympathetic (rest-and-digest) Nervous System
How external STIMULI is sent to the BRAIN

The STIMULI and RESPONSE …

The STIMULI/RESPONSE system

The BRAIN …

Major areas in the BRAIN

The MIND …

Major Executive System in the BRAIN, which is what creates the MIND.

The NEURONAL NETWORKS and SYNAPSE

How connections consolidate events in our memory networks in the BRAIN.
Illustration of how our memories change over time. (Synaptic Plasticity)
Illustration of how our Neuronal Networks change over time. (Neuronal Plasticity)

The NEUROCHEMISTRY …

The main chemicals that synapses uses to interact with the BRAIN (Neurotransmitters)

This quick rundown of how YOU are built and function, will be key for your understanding of the rest of this article. Lets put some perspective on, as seen from another view, how it actually works …

FUNCTION: So how does it all work?

Anatomical Nervous System translated into Functional Nervous System.

To describe how memory works, I don’t imagine that you can grasp the complexity, merely based on the graphics above, but it is nonetheless essential that you realise that the MIND, BRAIN and BODY are different functions in my interpretation here and that STILMULI and RESPONSE are actions that are created by chemical and electrically signals in the NEURONS and in the SYNAPSE.

Let’s try with a metaphor …

Imagine that YOU are a computer. YOU have many functions (Word, Excel, Counterstrike etc.). The functions are stored in your BRAIN and to get them working, you need to activate the specific program (e.g. Word). A signal is sent to the BRAIN when it received the STIMULI (you clicked the Word icon), which then triggers another program, the retrieve-Word-from-LTM-program, which communicates using the internal electrical circuits on the motherboard of your computer, which in turn activates the SYNAPSES that store the Word program. Within the SYNAPSES the neurotransmitter, dopamine gets all excited and ‘fires’ a command that open Word, by sending signals back into the NEURON which then sends signals back into the BRAIN which then stores Word in the MIND, so that YOU are ready to write your document.

Another way to see how Neuronal Networks and Synapses are different would be to think of Neuronal Networks as Ethernet LAN and Synapses as WiFi, since Neurons needs to be physically connected to communicate, whereas Synapses can communicate, without touching, by sending packets of Neurotransmitters from one to another. Although this is not technically correct, it is useful for our purpose in this article.

OK, Wiseguy … could we get to the point already?

Apologies for the long introduction, but this is complicated stuff and I wish to ensure that you get the most out of spending your valuable time, here on our blog. So lets get down to business …

How does MEMORY RECALL work?

A STIMULI is received from somewhere, outside the BODY, which activates your sense of touch which then send a signal to your BRAIN that something is going on. Your BRAIN then quickly evaluates if this STIMULI should evoke the ‘fight-or-flight’, ‘rest-and-digest’ or the ‘whatever’ RESPONSE.

If the BRAIN thinks that this is dangerous, it will signal the BODY to prepare to run like crazy to get to safety (‘fight-or-flight’). If the BRAIN believes that the STIMULI is safe, the it will ask the Autonomic Nervous System to take care of it (‘rest-and-digest’), and if the BRAIN is sure that it is not dangerous, but not sure whether it is safe, it will ask the MIND to please handle this STIMULI (‘whatever’).

How things gets into your memory

If the BRAIN perceive the event as safe, it redirects the STIMULI to the Autonomic Nervous System (where all known, not-threatening events are handled) and a response is then sent back to the BODY which in turn create the appropriate behavior for this response.

If the BRAIN perceive the STIMULI to be unsafe, it sends an alarm to the Amygdala, which evokes ‘Presidential Executive Powers’ over both the BRAIN and the BODY, to ensure that YOU survive, without involving the MIND in the decision making process … Kinda like when POTUS Trump decrees something, without receiving counsel from the Senate or the House, by issuing yet another Executive Order …

If the BRAIN have no information on this STIMULI, it will refer the information to the MIND for further analysis.

Recall, recall, recaaaaaaallllllll …

If you are trying to solve a novel problem, you will have to rely on your stored past experiences, memories, in order for you to accurately predict the consequences of a given RESPONSE to the STIMULI.

If you do not have any exact past experience that is identical to this one, your MIND will try to ‘guesstimate’ what the best solution to the problem is. This process is called Generalisation, which means that the STIMULI is sorted into a given category of STIMULI, e.g. fruits, books, automobiles etc., and if the MIND and the BRAIN in cooperation cannot recall any exact STIMULI matching the new STIMULI, the MIND will then guesstimate what it is and means, by analysing the category of things that the STIMULI belongs to.

If you are able to match the new STIMULI to a stored past experience, then you are able to replay the past event with visual imagery, seeing it in your Mind’s Eye, with sounds, hearing in your Mind’s Ear, while the recalled feelings and emotions likewise are recreated and sent to your BRAIN which in turn instructs your BODY to reenact the past experiences by sending instructions out into your BODY so that you can enjoy the full richness of reliving your memory. You can even create a Narrator, the voice that instructs your Mind’s Voice, to ‘talk’ your memory by commenting on it, while you are reliving it.

Fake it … till you make it …

When the MIND receives this event, it will create an understanding of what’s going on, based on past experiences, feelings from the senses, emotions and try to simulate which response will best serve our survival, and yet giving the maximum reward, using the minimum required energy.

The predictions (or simulated possible future outcomes) requires that your MIND is able to recall your past experiences, which are stored in your BRAIN.

Since your memories are not stored in a single ‘memory snapshot’ but actually is stored in bits and pieces (imagery, sound, taste, touch, smell, emotions etc.) and stored in various locations in the BRAIN, all of your past experiences are reconstructed each time you recall this memory.

When you imagine possible future consequences, you activate your memory to recall relevant past events, and reconstruct them into new, virtual experiences that only is ‘real’ inside your MIND.

This is so that you can evaluate which of the imagines possible futures will bring you the maximum long-term outcome, by using minimum energy in the now.

LEFT: Memories – RIGHT: Imagination

All this might seem a bit strange to newcomers to neuropsychology, but I can assure you that it is all based on scientific evidence collected and confirmed by a multitude of scientists in many fields of research over the past 200 years. If you are intrigued by this, then I would refer you to the source material which can be found at the end of this article.

So how does ADHD makes this different?

In order to understand how ADHD creates a wide array of possible impairments on our memory systems, we have to ‘recall’ that ADHD is a specific neurodevelopmental disorder, which corrupts both the anatomy and physiology of the BRAIN and therefore also the functioning of the MIND.

Since ADHD creates a lag in the timespan it takes the BRAIN to fully develop, the MIND operates on a chronic 30% delay in Executive Functioning, compared to other persons of the same age, environment and social eco-system.

In practice this means that a child of chronological age of 10 years, have an Executive Age which is 30% delayed in its maturity, causing age-inappropriate behaviours, expressed through behavioural deficits on the Inhibitory Systems, both verbally and non-verbally, on emotional self-control and emotional self-regulation (easily angered, hard to calm down again), Attention Systems (easily distracted by task-irrelevant stimuli), Sensory Systems (hyper vigilant to sounds, light, smell, touch) and Memory Systems (to many STIMULI gets stored in the BRAIN, but without any prioritisation or categorisation, making recall of knowledge slow and energy taxing on the BRAIN).

Feelings derived from the Sensory System will activate the emotional RESPONSE in the BRAIN which signals the MIND to interpret the STIMULI as either good, bad or neutral, which then again interacts with how the RESPONSE the MIND sends to the BRAIN for the BODY to act out into behaviour.

Since ADHD causes major problems within the Inhibitory System (due to a lag in maturation (the 30%), persons with ADHD are unable to ‘stop, think, then act ..’, they just feel, emote and act … ADHD does not impair intelligence nor memory, but no matter what you KNOW will not be used, before you ACT, due to the missing Inhibitory functioning.

No matter how much your MIND may KNOW, your lack of Inhibitory Control causes you to be unable to use what you KNOW, before your BRAIN have already made a RESPONSE and ACTED, without any consideration of future benefits and/or consequences..

This is also why persons with ADHD often exhibit verbal and/or non-verbal hyperactive, impulsive and inattentive behaviour, not because of hyperactivity in the BRAIN nor in the MIND or the BODY.

These symptoms are in essence related to a defect in the BRAIN which causes the neurotransmitter, Dopamine, to be produced in much less quantity, than in a non-ADHD BRAIN, which in turn weakens the SYNAPSE to work as normal, which in turn decrease the activity in the Neuronal Networks overall.

So what makes a child with ADHD to be crawling around, talking excessively while shifting attention continuously while not finishing the task at hand, but rather roams around a novel things to experience, getting frustrated when bored and easily provoked when challenged, is all related to this simple fact: the MIND cannot control the BRAIN, since the BODY do not create enough Dopamine so that the MIND can control the BRAIN by rewarding it for behaviour that the MIND deems right.

This also explains why a child with untreated ADHD can play video games for hours on end, but not focus and concentrate for 5 minutes on their homework … Computer games requires focus and attention AND gives the BRAIN instant rewards, when the game is going good, homework gives you nothing in the now, and since time perception in ADHD is severely impaired and ability to ‘predict future consequences’ are shot to pieces due to the same Dopamine problem in the memory systems, it is not hard to understand why homework sucks, right?

Another major impairment is time perception. Time is based on an internal clock called the Circadian Rhythm. This regulates how your BRAIN works by adjusting which functions are needed, at which time of the day. It follows the sun and make you get tired and go to sleep, so that the BRAIN can regain some control, sort the new memories that is has encoded today, as well as give way for the ‘Night Shift’ that does the maintenance of the BRAIN, while YOU sleep.

The MIND however, is not always in agreement with the Circadian Rhythm, since it was created back when we lived on the African Savanna, where the day and night eas almost always equal in time.

The MIND have no ties to the Savanna anymore, the BRAIN and BODY have, and therefore the conflict of when to be active or inactive, is often causing people to experiences sleep related problems.

Persons with ADHD are especially vulnerable to this since our internal reward system is ‘out-of-whack’ (dopamine) and our MIND therefore insists on continuing with activities that gives an increase in dopamine in the BRAIN, like playing a computer game, having sex or reading a good book will do.

So however the BRAIN may wish for the MIND to go offline, the MIND is constantly bribing the BRAIN with dopamine, and like any other addict, the BRAIN cannot restrain itself from getting another fix.

Timing is also impaired in persons with ADHD, especially when it comes to ‘counting time in your head’ or ‘reacting to rapidly changing STIMULI’, and especially in your ability to guesstimate how long something will take to complete, which is why most people with ADHD are notoriously known as ‘Time Optimists” … and for being late as the standard.

Dr. Barkley have made a wonderful video on Time Blindness, where he illustrate what having untreated ADHD will do to your Time Management Skills and your general ability to meet the demands of society …

[embedyt] https://www.youtube.com/watch?v=fVqFElTrgLw[/embedyt]

Why don’t you ‘Recall’ anything?

The title of this article is a reference to my own personal experiences of having major memory-related impairments caused by 40-years lived with untreated ADHD. Let me try to explain what “Episodic Dementia” as I’ve coined it is and how it influences my everyday life.

As you might recall … there are three types of Long-Term Memory, (1) Episodic, (2) Procedural and (3) Semantic.

Episodic LTM is where you store your experiences, based on all the STIMULI that you perceived at the time when the event was encoded in your memory. Let’s call this your EMOTIONAL MEMORY.

Procedural Memory is where you store the guidelines to how you brush your teeth, peel an orange, or drive your car. Let’s call this your HOW-TO-MEMORY.

Semantic Memory is where you store all the factual knowledge you have learned, like facts about where things are located, facts about which year you where born, in which city you where born, what you mother’s maiden name was, and all the knowledge which you have aquired from your education as well. Let’s call this the NERD-MEMORY.

Science tells us that these three types of memory are interacting in order to make you able to recall your past events, your memories, in as much detail as possible. But what if you lack the ability of one or more of these types of memory? Well that where I come in …

I’m blind … and I’m deaf and I’m dumb …

My MIND do not have the ability to recall any STIMULI of past events, other than the semantics, the facts.

So I know that I have been married twice, and I know to whom, and where we got married and also the dates. But I am unable to recall any images, sounds, tastes, tactile (touch) or emotional experiences from my wedding day(s) …

I am also unable to recall the face of my nearest family, even my girlfriend’s face is not popping up, as soon as she is out of sight. This do not mean that I am less able to recognise her or others, only that I am unable to ‘picture them in my Mind’s Eye’.

I am less able to ‘talk to myself’ since I have no Inner Voice, which makes my MIND connect to my lips, without any filtering or inhibition on the way, since I am unable to ‘reason with myself’ to predict the future consequence of saying what I think, feel and believe, right now.

I have no filter, but I have learned to say nothing at all, if I am in a situation that might trick me into ‘saying what’s on my mind’ without any consideration. I have, however, developed a cognitive inhibition ability through psychological techniques, but this only works when I am not emotional about the topic.

I am less able to ‘imagine how my life will be in 5 years’ as I am unable to predict my future feelings, since I am unable to recall my past feelings and use them as a guide, when simulating possible future outcomes.

I am, however, excellent at remembering facts, not in an Savant way, more in a contextual sense, I have vast knowledge on many topics and I am able to ‘bricolage’ them together and create novel ideas. Bricolage means something “to put things together which do not normally go together”.

When I am in my creative state of MIND, I have an ability to spot patterns and realign different knowledge into novel ideas. Its like having an epiphany on steroids, and I have made good work of this disability in my career in my previous 25 years in business.

I also have no worries about the future, since I have no ability to foresee any nasty things heading my way, so why worry?

And I don’t feel fear of anything, except from heights and certain creepy crawlies.

I am not afraid of getting into trouble or having an accident, but this do not make me a daredevil adrenaline junkie, since I have a factual way of living, which entails me having structure, planning (externally stored on my phone), notes on everything (also in my phone) and GB’s of PDF’s with all my references to what I KNOW, instead of keeping them stored in my BRAIN.

So when someone critique your for being late, again, or complain that you are ‘uninterested’ in planning a future event (like a party), baffled that you are less able to ‘realise by your self’ something in the household chores that everyone else with a heartbeat would recognise and automatically take care of, or even worse … when you do not remember what she said to you, 2 minutes ago, because your MIND was wandering, while she explained it to you, then you have to pull the emergency brake and explain that:

Even though I am unable to ‘recall’ you in my MIND’s Eye, you are always present in my HEART ….

I hope that you have enjoyed this article, if so please share it with your friends and love once, my pay is to know that others like me will feel a little less like a freak and more like ‘one-of-us’ instead 🙂

/ADDspeaker

References

1. Behave by Sapolsky, Robert M.

2. Fundamentals of Human Neuropsychology by Kolb & Whishaw

3. Cognitive Psychology by Goldstein, E. Bruce

4. ADHD and the Nature of Self-control by Barkley, Russel A.

5. Essentials of Understanding Psychology by Feldman, Robert S.

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