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Memory and Brain Injury

What is memory?

Without any memory our life each day would be impossible....You wake up in the morning, you remember where you are, remember what day it is. You can run through mentally the jobs do you have to do that day while still lying there. You go to the kitchen. Memory means you know where to find it. You know where things are. You remember what you have in the fridge to eat and how to prepare it. You remember how to dress yourself. You remember what you're doing that day before you choose what to wear (or else we'd all turn up to work in jeans...).

You remember what you need to take to work, how to get there, and know where you work. You remember how to drive a car.You remember where your office is. You meet people going in and remember who they are.

You remember how to switch your computer on, what meetings you have that day. You remember what you have to do today and suddenly you want to be on a beach somewhere (you know what the word beach means using memory). Thinking about one beach prompts memory of a lifetime of beach holidays from child to adult, perhaps a honeymoon, or the first trip with your new baby.

So far you have used many different types of memory and its only 9.30 am!

Without all these different memory systems life would be unimaginable. But people after brain injury rarely lose them all. Some areas of memory will be more affected than others.

Think of the pathways along which your memories are stored as a huge, complicated city with lots of roads. When roadworks are present certain roads are not open, so you can’t get to that place. That is what happens in memory loss. Either the pathways gets cut off because the road is blocked or gone or they are damaged. The remaining roads can become busy, so you find it hard to get places, it takes longer. Imagine you have storage blocks in the pathways. Either you can’t get to the memories in them or its too busy and you can’t get out exactly what you want or only more slowly. Also you can’t put new things properly away while the road is busy or slow. Imagine a three hour journey now takes five, you drive it every day. You get there or back tired, irritable, and feeling stupid at being slow. This is very like what people report after brain injury. Always having to think hard about your route, how you will navigate the day working around or hiding your memory problem is tiring. It affects self- esteem.

So in therapy we begin by identifying where the roadworks are, where the important roads are busy. We can then work out other ways of getting to where you want to go, which we call compensatory strategies, or help you use the pathways which are not affected or simply busy more effectively, so that memory works better. We will also tackle the tiredness and low self-esteem.

Different types of memory

  • Autobiographical memory is your vital store of information about you. Your name, address, job, age, where you were born, where you went to school, who you first kissed, your first holiday, what you like, what you don't.

    Born 1965, university, Aberdeen, hated Blackpool
  • Procedural memory is your memory of how to do things. Play a piano, drive a car, make your breakfast, how your computer works, how to swim.

    " I no longer have to remember how to ski or drive a car, it just comes back on doing it."
  • Visual memory or spatial memory enables you to remember routes. Switch the light off, you'll find your kitchen in the dark. Taxi drivers have been shown to have bigger areas of brain devoted to visual memory than the rest of us. They are not born with these bigger areas but develop through repeated use.
  • Semantic memory is your store cupboard of facts about the world and it includes words, so you know what a beach is, but you didn't always know that word. How exactly is a "beach" different from the "seaside"? Semantic memory knows.
    Holkham beach
  • Prospective memory is the memory of what you have to do or want to do at a certain point or when something happens in the future. So you remember when you get to work you are meeting a friend for lunch. Prospective memory is vulnerable in brain injury.
  • Short-term or working memory is a brief, temporary, very limited store of information you are using or remembering now. A telephone number long enough to dial it, the numbers in an arithmetic problem long enough to solve it. It decays very quickly and doesn't hold much information.

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  • Long-term memory is your ability to store information, produce it later, or just know it. Every memorable beach holiday, not all of them, people's names and information about them.

    Can you remember which beach you just saw?
  • Immediate memory is a bit longer than short-term memory but the two are often mixed up. You may remember what beach it was now, from having just checked it.
  • Facial memory is specific to faces. Babies can distinguish faces from a very young age. People who lose facial memory through brain damage have difficulty remembering different faces, their friends, wife, even a farmer who could no longer tell his cows apart.

Memory Detours

The red car needs to get to the silver house but the road is blocked where the red crosses are. So instead it can use the pathways with arrows, or use the white side-roads it would never use before.


The red car takes a different route. In memory this could be compared to remembering it in a different way, perhaps using a visual imagery strategy.


Another way to reduce the problem of the affected routes is to use more effective ways of learning. This is using neural pathways not normally used or those routes which are not broken or blocked but just slower or busy.

This might involve ways of better focusing attention on remembering or breaking the information into chunks. Chunking is what we do in remembering a telephone number but it has wider uses.

Click here for diagram which below is available in the library and explains the different stages involved in memory.

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