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Restoring Cognitive Function

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One step at a time

Diamond Member
I'm having more than my usual amount of trouble with remembering things like:
- what I was planning to do with the can of beans in my hand
- the noun for that thing
- what I did this week
- what I need to do this week
- what I have or haven't explained to someone yet, whether a person has what they need to complete a task

Today's examples:
(1) I misread a fairly straight forward instruction. It dawned on me after half an hour that these were obviously not the carrots that she meant!
(2) I skipped one step in a sequence of steps I've done hundreds - maybe thousands of times. I didn't notice until someone asked if it had been done. (This isn't like me. I am often the leader, organizer, holder of the tasks, chief cook and bottle-washer, etc).

I guess my first question is: does anybody have useful language for the different parts of our cognition that can go awry? Or ways of categorizing? I'd like to be able to name what's going on, so that I can search for solutions by name. I'd also like to be able to identify what /isn't/ a problem right now.

I know a few things that help:
- journaling
- talking aloud to myself, narrating what I'm doing
- playing rhyming games
- learning and reciting poems
- writing to do lists
- dealing with the underlying dissociation by eating, sleeping, and grounding well

Second question: Other strategies?
 
Whenever I get like this it is because I am distracted somewhere in my thinking, so I have to get more mindful of what I am actually doing. In a way I pause, reflect that I am missing things and remind myself to slow it down, pay attention, check my work. Once I start doing that I improve, because I start actively paying attention rather than mindlessly doing something.
 
suggestion: that sickening favourite of cbt and therapists of all stripes: 'mindfulness.' (i still gag a little saying or typing the word)

'mindfulness' turns what you're trying to accomplish into something you know.

also, check if meds might be exacerbating cognitive difficulties. some can.

** i use written lists too.
** i narrate when preparing meals. you wouldn't believe how many loaves of bread i mauled before i started reminding myself to slice the bread.
 
I suffer from memory loss too. One thing that I learned way long ago is that my hearing memory is far better than my thought memory. So, for instance, when I go to a check-out in a store, I always speak aloud what I am giving the cashier to pay for my order. I'll say, "Here's a twenty." Then, if she stuffs it into the drawer or places it where I cannot see it while she counts out change, I can still hear clearly in my mind what I just said to her.

I write to do lists, but sometimes I get sidetracked before I get to my list to add something to it. So I try to carry them around with me, along with a pen, so that I don't lose track of what I write there before I write it.

I do word puzzles, not crosswords, but word finds. I actually do them upside down, because a friend of mine and I do them together. She always marvels at how I can find a word when I am looking for it up-side-down! I'm dyslexic, and was tutored as a kid to read up-side-down, backwards, etc. This was the only way I could finally learn to read, but it did not happen til I was in the 3rd grade, my second time around.

One thing I do, also, is ask folks to remember things for me. I'll say, "We have to go to the pharmacy, can you help me remember?" You would be surprised at how many folks don't think they can remember! Then I don't feel so alone.
 
Memory devices and strategies is a favorite topic as I am always looking for good advice on the subject to keep my memory working at it's best-yes, I sometimes fail....trauma and TBI. The rate and quality of my ability to recall information is directly related to higher stress levels and cognitive load or demands, whether I'm grounded and present in the moment of recall, my sugar level (eating regularly) is appropriate, making sure my vitamin B12 levels are good (low B12 can cause horrible memory issues (people who have poor eating habits are prone to this as are the elderly ), my protein intake (50 grams per day) because protein is the building blocks for creating a working neural network, and getting a good night's sleep essential to brain functioning and memory. If any one of these things is out of whack.....well, it is likely that my memory will be, too.

Organization and Memory: I think being more structured at home/work and organized on a daily basis is one of the key things that has helped lower my cognitive load (being structured about the every day stuff makes life more predictable and less stressful), reduce unnecessary worry, and take control of the things that I can change that can negatively impact my brain/memory function. When I get up in the morning, I take my meds, and assess my sleep (in total hours), assess my vision (is it clear?) and if it isn't, then it's an orange flag morning as opposed to a green flag. I know immediately if my vision isn't crystal clear, I didn't sleep well, had bad dreams/restlessness, or am suffering from yesterday's stressors, or failed to take my medication which also can impact my memory if I don't. Next, I read my schedule on the whiteboard which includes the date and time I have meetings, appointments, classes, vacations, exercise class, etc. on that day, and anything important that would have a consequence if not attended to (I have 3 months of whiteboard calendars on my wall) and update them each night before bed. Making sure I accomplish the minimum things I have to do to keep from causing more stress is a positive action I can do....and when I get things done, this creates a positive can-do attitude. I have found that when I'm more positive, remembering is easier. Above my bed, I have an atomic clock in digital format, and it also gives me the inside/outside temperature so I can plan what to put on and don't stress over getting dressed (yes, I used to spend 30 minutes trying to get dressing "right" wasting time changing clothes-now I don't). I write down in Notes on my phone, any appts I see on the daily wall calendar and add any last minute things to my list, in priority. I check each one off as it gets done. After getting dressed...I get my protein shake (40 grams) after adding milk. If I drink a protein shake first thing, it helps my brain process information and recall things more readily than if not. I can feel the difference in my energy level too when I stop getting lots of morning protein (So if I'm depressed, and not connected with my body and feeling hunger pains, I at a minimum have 1 protein shake during the day-and I just get that done in the morning).

Keeping My Surroundings Picked Up: There is nothing more frustrating than trying to find something in a mess. When I'm depressed or looping about something, I naturally tend to let things go. But now, I've gotten to the point, after lots of practice with being in a new place, by myself for the first time in my life, that there is a part of me that struggles with disorganization, and I believe a messy living space.....doesn't help memory. Pills fall on the floor (Where'd my pills go?), the TV remotes are under the clothes on the floor (and I looked forward to the show that is starting without me), I used my credit card online and didn't put it back (it's somewhere in the mess.....I don't have enough gas in the car and no cash), the food spilled off the plate, onto the floor and now I have a stain I can't get out. A mess for me ultimately creates a lot of stress and more problems, and getting severely behind in laundry, cleaning, makes it harder......to get going again, because I'm now behind......causing more stress and internal conflict because it will take days of my time (which I could be spending doing more fun things) to clean because I let stuff go sooooo. badly and now I'm irritated (not the kind of chemistry I want in my brain).

Organizing during the day: I go about my day at school using a written planner, keeping daily notes, have a spiral notebook for passwords and all password changes, back up book for contacts, emails, and phone. I keep track of daily information and also used my Outlook/phone planner and email. Writing is a research-based method which helps general informational recall so I write things down.....even if I lost the paper, writing it down aids memory retention (that's a research based fact). I come home and have a routine of eating, bathing, reading or journaling, and meds again, and something fun or relaxing (my daily "me" reward). I try to stay away from TV/phone for at least an hour before bed, and if I started off on an orange day, I just avoid the TV-to avoid potential triggering stress/PTSD symptoms, the monitor can keep me from sleeping, and too many video games can ramp me up at night. I also don't exercise before bedtime. While routine sounds boring, it is, but I feel better with a routine than without. My phone is set not to receive calls between 9pm and 6am. It does receive emergency weather warnings and phone calls from one specific individual. My sleep time is secured which helps reduce unwanted disruptions to my me time.

Memory Strategies: I use lots of memory strategies, some that are already mentioned like lists and talking my way through a process like making a meal. I'm quite visual/tactile and both of these help my memory. Also visual in the picture sense is helpful. Numbers also can help with my memory.

Finding My Car in a Parking Lot: After roaming the parking lot for 20 minutes in a fog, in the rain, I now park in the same 2 rows (1 & 2), and always go out the same door I came in. When there is no row number, I park in the row/space that is closest to the door and I walk to the end if I have to. So I have certain established places to park or a fall back (like the row nearest the exit door). It is mortifying to me to walk the parking lot like I lost my dog. It is even worse when the old lady passes me, looks at my wandering face gazing all over the parking lot for my automobile, and says, "You can't find your car either, eh?" (Me turning purple and keep searching- a glorious moment in the rain-to see my car).

Touch Memory/Verbal Rehearsal: If I leave the car, I write down 3 or more things that I need in the grocery store and take my list.
If I only need two things, I work hard to recall and use my brain. I'll use my right index finger and middle finger to tap #2 (2 fingers like you are holding up to tell the number 2) and tap twice on my left forearm, and then say the two items names aloud to myself. I do this twice, and on a bad day 3 times while I'm walking towards the store. If there is only one item, I do the same-1 tap with index finger (#1), do it a couple times, and say the item name a couple times. Adding touch when trying to remember for the short term really helps me get through the store -feeling successful coming out with what I intended. I get the items usually in the order that I recall them. If I forget one, I tap the number of times on my arm and think a moment. Always, I can remember if I stop and focus on the trip inside, the tapping and verbal rehearsal-and repeat the number of taps on my arm. If I know the other item name, I say it aloud. I get 100% recall for a couple of items, and 90% for 3 items. I usually walk back to the car for the list for 4 items, but have been known to be successful and recall 4 items with at least 75% accuracy doing it this way.

If I see something else in the store I want, I don't get derailed until everything is in the cart-because going down a candy or sweets isle can derail me quick-and then I forget-so I go into the store like it is a mission and do that first. Once I have what I came for, I can get other stuff-because I know I got what I really came for. This can also works with having to get things done in the yard, get something out of the car, getting ready to leave,
order of steps, etc.

I also know basic sign language-letters, and have used the letters of the alphabet in tapping. I recall the first letter of the object by signing the first letter of the object on my arm, and tapping a couple times, saying aloud the name. So part of how you do it is how you recall words and what method works the best for you.

Another way to recall unrelated words is to take the words and make up a silly story and repeat it a few times. If I need to buy napkins, hamburger, and pickles I might think a sentence like: I had a juicy hamburger with pickles and now I need a napkin. By connecting the words in a sentence, I make a visual picture of the scene in my head, and doing this I can remember the sentence and the things I need in the store. I use verbal rehearsal with the sentence a couple of times walking into the store, then I do it again as I enter the store to be sure I have the picture in my head of what I need to get. This memory method works pretty well, too.

Preparing to Leave the House: Before going to bed, I put everything by the door that I will need except (phone). I keep a list which has all the things I need to survive the day, on the back of the front door. (Keys, phone, meds, credit card, lunch). If I'm having a particularly bad day, I put the stuff in the car and get out the next days clothes to help modulate am stress. If there is something I have to bring from the fridge, I put a note in front of the door.... on the floor so I have to walk over it to get by.

Sticky Notes: I love sticky notes and keep them by my bedside table, in my car, my purse, and at work. I make notes to myself of things to do. Each time I finish a sticky note, I toss it.....and that is positively rewarding and I feel like I'm moving forward. For organizing ideas, I write them on sticky notes and put them in order on the wall, or desk, or wherever. This is a quick way to prioritize things too. Sticky notes have so many organizational and memory uses. They are also good for self-esteem. I will write myself a positive sticky note when I have accomplished something or really handled something well......and put it on my dashboard or bedside table. Increasing positive, I believe helps manage my stress.

Stress Reduction at Work: I recently retired as a teacher. During my lunch break, I locked my class door and took my full 25 minute lunch. If someone knocked, I was having my state mandated unencumbered lunch in which when I stopped answering e-mails at lunch, I didn't answer the door if someone knocked, and as a result having this me time I was much less stressed and more relaxed to better handle the remainder of the day.
-listened to music
-played video games
-ate lunch quietly and thoughtfully
-let the phone go to voicemail
-did my mindfulness, visualization when appropriate

Playing at Home:
Playing may sound weird as a way to aid memory, but by reducing stress through playing (clay, watercolors, hobbies, playing an instrument, scrap-booking, photography, etc.) other parts of me unwind.....more creative and expressive parts and I'm ultimately happier. This has been tremendously positive and helped overall stress reduction and recall.

My experience is that I can and have the ability to access all of the information when it is essential that I do so, as long as I am not stressed to do so. Using tactile combined with verbal rehearsal helps the memory code the information using an added sense. Also, when I initially can't recall, I counter that with "I can..... remember" or "I can figure this out", and that positive self-talk I believe reduces the stress, and for me leads to greater recall. So I don't beat myself up anymore and call myself stupid or other superlatives, I kindly encourage recall. Stress screws with our brains chemistry. Our lifestyle, which we control, can help change that chemistry which can positively impact memory. I have found that changing my lifestyle to avoid all drama (walk away/ignore) reduces stress. I'm working to create a lifestyle where I have structure that minimizes stress, low drama, and utilizes a variety memory techniques regularly to support my memory. This coupled with positive things that make me feel good/happy, then I physically/mentally feel good, good nutrition and sleep, is consistent with my ability to recall information. Not sure if this helped.....but my frontline attack for memory function are things in my control, personal home organization/ structure , a reduction in stress/drama/avoid self made stress, self-care, nutrition, and sleep.
 
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Reading books or Eliminating clutter are keeping psychologically active. Currently I am writing a blog on Beginning Surfing.

@KeepItSimple Today I cleaned the house after being gone a month on vacation. I put the task off, and the "relief" I feel is significant. I can find things more quickly in order, when I'm not paying attention and just set things down w/o thinking. I agree that decluttering is really helpful for an optimally functional memory.
 
I don't follow verbal instructions as well as written ones. I have no idea what that is called. My memory is usually fragmented and my thoughts scattered because I juggle too many thoughts in my head at one time. Being mindful of the present moment might help, I actually haven't tried that yet, but I am hopeful.
 
Going by what you posted and thinking these are work related, I will suggest what worked for me during my dissociation while I had a new job:
If they apply only
No alcohol
Minimize news intake (esp all Trump related even if you love him)
Take coffee breaks and lunch breaks
Listen to music you love
Be super compassion to self if you are going through some stress
make sure you are not oppressing anxiety or any other feelings that are zapping your awake energy
go for a walk in the sun during lunch

these were things that saved my life summer of 2018!
 
Memory devices and strategies is a favorite topic as I am always looking for good advice on the subject to keep my memory working at it's best-yes, I sometimes fail....trauma and TBI. The rate and quality of my ability to recall information is directly related to higher stress levels and cognitive load or demands, whether I'm grounded and present in the moment of recall, my sugar level (eating regularly) is appropriate, making sure my vitamin B12 levels are good (low B12 can cause horrible memory issues (people who have poor eating habits are prone to this as are the elderly ), my protein intake (50 grams per day) because protein is the building blocks for creating a working neural network, and getting a good night's sleep essential to brain functioning and memory. If any one of these things is out of whack.....well, it is likely that my memory will be, too.

Organization and Memory: I think being more structured at home/work and organized on a daily basis is one of the key things that has helped lower my cognitive load (being structured about the every day stuff makes life more predictable and less stressful), reduce unnecessary worry, and take control of the things that I can change that can negatively impact my brain/memory function. When I get up in the morning, I take my meds, and assess my sleep (in total hours), assess my vision (is it clear?) and if it isn't, then it's an orange flag morning as opposed to a green flag. I know immediately if my vision isn't crystal clear, I didn't sleep well, had bad dreams/restlessness, or am suffering from yesterday's stressors, or failed to take my medication which also can impact my memory if I don't. Next, I read my schedule on the whiteboard which includes the date and time I have meetings, appointments, classes, vacations, exercise class, etc. on that day, and anything important that would have a consequence if not attended to (I have 3 months of whiteboard calendars on my wall) and update them each night before bed. Making sure I accomplish the minimum things I have to do to keep from causing more stress is a positive action I can do....and when I get things done, this creates a positive can-do attitude. I have found that when I'm more positive, remembering is easier. Above my bed, I have an atomic clock in digital format, and it also gives me the inside/outside temperature so I can plan what to put on and don't stress over getting dressed (yes, I used to spend 30 minutes trying to get dressing "right" wasting time changing clothes-now I don't). I write down in Notes on my phone, any appts I see on the daily wall calendar and add any last minute things to my list, in priority. I check each one off as it gets done. After getting dressed...I get my protein shake (40 grams) after adding milk. If I drink a protein shake first thing, it helps my brain process information and recall things more readily than if not. I can feel the difference in my energy level too when I stop getting lots of morning protein (So if I'm depressed, and not connected with my body and feeling hunger pains, I at a minimum have 1 protein shake during the day-and I just get that done in the morning).

Keeping My Surroundings Picked Up: There is nothing more frustrating than trying to find something in a mess. When I'm depressed or looping about something, I naturally tend to let things go. But now, I've gotten to the point, after lots of practice with being in a new place, by myself for the first time in my life, that there is a part of me that struggles with disorganization, and I believe a messy living space.....doesn't help memory. Pills fall on the floor (Where'd my pills go?), the TV remotes are under the clothes on the floor (and I looked forward to the show that is starting without me), I used my credit card online and didn't put it back (it's somewhere in the mess.....I don't have enough gas in the car and no cash), the food spilled off the plate, onto the floor and now I have a stain I can't get out. A mess for me ultimately creates a lot of stress and more problems, and getting severely behind in laundry, cleaning, makes it harder......to get going again, because I'm now behind......causing more stress and internal conflict because it will take days of my time (which I could be spending doing more fun things) to clean because I let stuff go sooooo. badly and now I'm irritated (not the kind of chemistry I want in my brain).

Organizing during the day: I go about my day at school using a written planner, keeping daily notes, have a spiral notebook for passwords and all password changes, back up book for contacts, emails, and phone. I keep track of daily information and also used my Outlook/phone planner and email. Writing is a research-based method which helps general informational recall so I write things down.....even if I lost the paper, writing it down aids memory retention (that's a research based fact). I come home and have a routine of eating, bathing, reading or journaling, and meds again, and something fun or relaxing (my daily "me" reward). I try to stay away from TV/phone for at least an hour before bed, and if I started off on an orange day, I just avoid the TV-to avoid potential triggering stress/PTSD symptoms, the monitor can keep me from sleeping, and too many video games can ramp me up at night. I also don't exercise before bedtime. While routine sounds boring, it is, but I feel better with a routine than without. My phone is set not to receive calls between 9pm and 6am. It does receive emergency weather warnings and phone calls from one specific individual. My sleep time is secured which helps reduce unwanted disruptions to my me time.

Memory Strategies: I use lots of memory strategies, some that are already mentioned like lists and talking my way through a process like making a meal. I'm quite visual/tactile and both of these help my memory. Also visual in the picture sense is helpful. Numbers also can help with my memory.

Finding My Car in a Parking Lot: After roaming the parking lot for 20 minutes in a fog, in the rain, I now park in the same 2 rows (1 & 2), and always go out the same door I came in. When there is no row number, I park in the row/space that is closest to the door and I walk to the end if I have to. So I have certain established places to park or a fall back (like the row nearest the exit door). It is mortifying to me to walk the parking lot like I lost my dog. It is even worse when the old lady passes me, looks at my wandering face gazing all over the parking lot for my automobile, and says, "You can't find your car either, eh?" (Me turning purple and keep searching- a glorious moment in the rain-to see my car).

Touch Memory/Verbal Rehearsal: If I leave the car, I write down 3 or more things that I need in the grocery store and take my list.
If I only need two things, I work hard to recall and use my brain. I'll use my right index finger and middle finger to tap #2 (2 fingers like you are holding up to tell the number 2) and tap twice on my left forearm, and then say the two items names aloud to myself. I do this twice, and on a bad day 3 times while I'm walking towards the store. If there is only one item, I do the same-1 tap with index finger (#1), do it a couple times, and say the item name a couple times. Adding touch when trying to remember for the short term really helps me get through the store -feeling successful coming out with what I intended. I get the items usually in the order that I recall them. If I forget one, I tap the number of times on my arm and think a moment. Always, I can remember if I stop and focus on the trip inside, the tapping and verbal rehearsal-and repeat the number of taps on my arm. If I know the other item name, I say it aloud. I get 100% recall for a couple of items, and 90% for 3 items. I usually walk back to the car for the list for 4 items, but have been known to be successful and recall 4 items with at least 75% accuracy doing it this way.

If I see something else in the store I want, I don't get derailed until everything is in the cart-because going down a candy or sweets isle can derail me quick-and then I forget-so I go into the store like it is a mission and do that first. Once I have what I came for, I can get other stuff-because I know I got what I really came for. This can also works with having to get things done in the yard, get something out of the car, getting ready to leave,
order of steps, etc.

I also know basic sign language-letters, and have used the letters of the alphabet in tapping. I recall the first letter of the object by signing the first letter of the object on my arm, and tapping a couple times, saying aloud the name. So part of how you do it is how you recall words and what method works the best for you.

Another way to recall unrelated words is to take the words and make up a silly story and repeat it a few times. If I need to buy napkins, hamburger, and pickles I might think a sentence like: I had a juicy hamburger with pickles and now I need a napkin. By connecting the words in a sentence, I make a visual picture of the scene in my head, and doing this I can remember the sentence and the things I need in the store. I use verbal rehearsal with the sentence a couple of times walking into the store, then I do it again as I enter the store to be sure I have the picture in my head of what I need to get. This memory method works pretty well, too.

Preparing to Leave the House: Before going to bed, I put everything by the door that I will need except (phone). I keep a list which has all the things I need to survive the day, on the back of the front door. (Keys, phone, meds, credit card, lunch). If I'm having a particularly bad day, I put the stuff in the car and get out the next days clothes to help modulate am stress. If there is something I have to bring from the fridge, I put a note in front of the door.... on the floor so I have to walk over it to get by.

Sticky Notes: I love sticky notes and keep them by my bedside table, in my car, my purse, and at work. I make notes to myself of things to do. Each time I finish a sticky note, I toss it.....and that is positively rewarding and I feel like I'm moving forward. For organizing ideas, I write them on sticky notes and put them in order on the wall, or desk, or wherever. This is a quick way to prioritize things too. Sticky notes have so many organizational and memory uses. They are also good for self-esteem. I will write myself a positive sticky note when I have accomplished something or really handled something well......and put it on my dashboard or bedside table. Increasing positive, I believe helps manage my stress.

Stress Reduction at Work: I recently retired as a teacher. During my lunch break, I locked my class door and took my full 25 minute lunch. If someone knocked, I was having my state mandated unencumbered lunch in which when I stopped answering e-mails at lunch, I didn't answer the door if someone knocked, and as a result having this me time I was much less stressed and more relaxed to better handle the remainder of the day.
-listened to music
-played video games
-ate lunch quietly and thoughtfully
-let the phone go to voicemail
-did my mindfulness, visualization when appropriate

Playing at Home:
Playing may sound weird as a way to aid memory, but by reducing stress through playing (clay, watercolors, hobbies, playing an instrument, scrap-booking, photography, etc.) other parts of me unwind.....more creative and expressive parts and I'm ultimately happier. This has been tremendously positive and helped overall stress reduction and recall.

My experience is that I can and have the ability to access all of the information when it is essential that I do so, as long as I am not stressed to do so. Using tactile combined with verbal rehearsal helps the memory code the information using an added sense. Also, when I initially can't recall, I counter that with "I can..... remember" or "I can figure this out", and that positive self-talk I believe reduces the stress, and for me leads to greater recall. So I don't beat myself up anymore and call myself stupid or other superlatives, I kindly encourage recall. Stress screws with our brains chemistry. Our lifestyle, which we control, can help change that chemistry which can positively impact memory. I have found that changing my lifestyle to avoid all drama (walk away/ignore) reduces stress. I'm working to create a lifestyle where I have structure that minimizes stress, low drama, and utilizes a variety memory techniques regularly to support my memory. This coupled with positive things that make me feel good/happy, then I physically/mentally feel good, good nutrition and sleep, is consistent with my ability to recall information. Not sure if this helped.....but my frontline attack for memory function are things in my control, personal home organization/ structure , a reduction in stress/drama/avoid self made stress, self-care, nutrition, and sleep.

Thank you so much for writing in depth about the different memories functions.
I have TBI also and wonder at times if it is PTSd, accumulated stressors from previous days....etc.

My pain doc told me to play or do something i like so i doodled before leaving the clinic.

At the DBT doc the other day i cried and disociated mega after she had me ice (T.I.P section of distress tolerance module). I was so fogged out cognitively her words didnt make sense and i tried hard to follow. it was like as if i was behind a plastic curtain.
I felt really dumb.
 
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