Can’t Remember What You Discussed in Therapy?

Source: Photo by SHVETS production from Pexels

Have you had the experience where you can’t remember what you discussed in your recent therapy session?

Blame it on sleep deprivation, increasing cases of depression and anxiety disorders, or the past social isolation forced on us by the COVID-19 pandemic. Blame it on attention deficit hyperactivity disorder (ADHD) or the general sameness of our lives and on what psychologists refer to as “Groundhog Day” syndrome.

Something seems to be affecting our memories—individually and collectively. We are a people increasingly struggling with problems of concentration, inattention, lack of focus, forgetfulness.

In the words of comedian Steven Wright: "Right now, I’m having amnesia and déjà vu at the same time. I think I’ve forgotten this before."

Psychologists and psychiatrists are finding that therapy sessions for both individuals and couples are becoming more and more like replays of the movie Groundhog Day, in which actor Bill Murray, as TV reporter Phil, laments, "Well what if there is no tomorrow? There wasn’t one today."

Is ADHD to Blame for Memory Lapses?

Is ADHD, a neurobiological condition affecting attention and concentration, behavior, and self-esteem, seemingly on the increase in this country? A study published in a 2018 issue of the Journal of the American Medical Association suggests “yes,” that the incidence of ADHD has been on an upward trend during the past two decades, with the number of diagnosed cases now impacting more than 10 percent of children between the ages of 4 and 17—up from just over 6 percent in the late 1990s.

Genetics and environmental issues, including low-weight and preterm birth, maternal smoking, and use of illicit substances are among factors suspected in promoting the development of ADHD. Symptoms of ADHD begin in childhood and frequently persist into the adult years. In fact, ADHD is considered among the most commonly occurring psychiatric disorders among adults.

Perhaps the deadening effects of routine, lack of inspirational creativity, and simply adherence to habit are prompting mental stagnation, with some patients considering a trip to the therapist’s office as a “new situation” and experiencing little, if any, memory of previous sessions? Have our lives simply become a string of recurring Mondays as in Groundhog Day or a succession of movies about which we remember the titles but have little recall of their story content? The American Psychological Association considers Groundhog Day Syndrome to be a state of mind, in which the individual believes himself or herself to be stuck in an unending time loop of sameness.

Yet can we put all the blame for this generalized inattention and lack of focus on ADHD or on a dearth of spontaneity in our lives? Perhaps, but the more likely answer is “no.” The complexities of the memory process argue against placing total blame for one’s forgetfulness on a single cause.

Effects of Sleep Deprivation

Scientists have recently uncovered new evidence about the role of brain structures like the hippocampus and the amygdalae, as well as specific brain neurons, in memory and recall during sleep and in response to anxiety, stress, depression, and other neurological issues. A raft of recent studies—one of the latest published in July 2021 in the journal Nature Communications—demonstrate the critical role of sleep in strengthening our ability to concentrate and remember.

In the 2021 study, researchers from the University of Geneva (Switzerland) show evidence of how the brain uses sleep to sort and evaluate our experiences of the previous day, retaining those that appear to be the most useful. And, in an article published online in May of 2019, experts report finding that loss of a mere 16 minutes of sleep can negatively affect a person’s cognitive performance. Their study determined that “a previous night’s sleep characteristics predicted next-day cognitive interference” and that “sleeping just 16 minutes less than usual was associated with one additional point on the cognitive interference scale the following day.”

Sleep Essential Reads

Are Night Owls, Drinkers, and Ex-Smokers Smarter?

6 Ways to Improve Your Sleep (without Medication)

Indeed, we are a sleep-deprived nation, with little understanding of how general fatigue and lack of sleep are impacting fundamental brain processes, including the ability to focus—was that a duck that just flew by?—experience, and remember.

Role of Anxiety and Depression

Meanwhile, complicating memory skills is the state of one’s mental health. Common mental disorders, including depression and anxiety, are considered significant causative agents for an underlying pattern of memory lapses. Depression, for example, is linked to multiple cognitive deficits, including an inability to sustain enough attention to even review and recall a set of written instructions or to read and comprehend a magazine article or chapter in a book.

Even more troubling is the high number of cases of depression in both the United States and globally. Data from the 2017 National Survey on Drug Use and Health indicate that as many as 17.3 million adults experienced at least one episode of depression during the prior year. Nearly 50 percent of depressed patients also are reportedly diagnosed with anxiety disorders. Anxiety is frequently linked to lack of focus, emotional problems, daydreaming, restlessness, and inappropriate behavioral responses to the surrounding environment.

Should We All Blame the Pandemic?

Of course, some experts blame the recent COVID-19 pandemic for much of the current mental health crisis, including the inability to concentrate and recall, and their claims are, in part, true. The Centers for Disease Control and Prevention reported “considerably elevated adverse mental health conditions” in 2020 at the height of the pandemic and indicated then that symptoms of anxiety and depressive disorders were on the increase. The problems were spurred, the CDC said, by the social isolation, endless cookie-cutter days, and “cabin fever” caused by cancellation of events, closing of restaurants and other public venues, and the admonitions of government and health care officials “to stay home and stop the virus’ spread.

Avoid Becoming Phil

Memories are built on our ability to “visualize” and “process” what we are seeing, feeling, smelling, touching, hearing, and thinking. As defined by the executive director for research at the Mind-Eye Institute in Northbrook, Ill., “visual processing is what enables us to respond appropriately to changes in the environment. We make decisions and predictions on the basis of our understanding, and understanding comes from the visualization process, using new experiences to compare and contrast with previous ones.”

So, what can we do to improve our own abilities to visually process—and remember?

First, get enough sleep—something not many of us do on a day-to-day basis. Secondly, exercise regularly. Research by the British Psychological Society that “physical arousal improves memory” and the ability to learn. Finally:

• Be inspired. Create for yourself those new experiences that aid understanding and memory. Prepare a list of goals or tasks you always wanted to do, pick one, and then start it—today, not tomorrow. Avoid the monotony of living life in the same way every day. As author Gary Ryan Blair has said, “By documenting your dreams, you must think about the process of achieving them.”
• Socialize. Contact friends and family members. COVID may not be over completely, but society is opening up. If you are vaccinated, get out of the house, participate, enjoy. And if you have not yet been vaccinated, do so now.
• Overlearn. When it comes to important matters, commit new information to memory by mentally repeating and rehearsing it.
• Contact an appropriate professional for help should you suspect that you might be suffering from persistent ADHD, depression or anxiety disorder or harbor suicidal thoughts.

Whatever you do, avoid becoming the Groundhog movie’s Phil, who quips while reporting about a town’s Groundhog Day celebration for the umpteenth time: "You want a prediction about the weather… I’ll give you a prediction about this winter. It’s going to be cold, it’s going to be dark, and it’s going to last you for the rest of your lives."