Lately I’m coming across questions similar to this one:
“I see fellow students learning things very easily, but me, I seem to have to put a lot of effort into learning things. For example, any concept for me is hard to grasp lately, and I have to study for hours to make learning material clear. I have OCD and I’m wondering if this plays a part in the mental blocks and memory recall I’ve recently been experiencing.”
Okay, let’s figure this out by first considering memory. Psychology suggests that OCD may be seen as a result of an imbalance between long-term memory and short-term memory processes. Short-term memory relies on auditory and visual codes for storing information. Longer term memories are the result of shorter term memories which go through a process known as consolidation, which involves rehearsal and meaningful association. *
What is meant by these terms?
To start with, rehearsal is the re-assessment of information you have previously learned with an eye toward a later need to recall it. Meaningful association relates to the significance of what has been learned and correlates highly with other dimensions such as how well you form images in your mind and retaining them. Also, having a good command of the language used in delivering reading information is important. This would include your ability to tune into audible teaching and then recalling how this was expressed; for example, how a tutor conveys meaning by the tone of their voice, their choice of language, vocabulary, gestures… and so on. *
How does OCD affect my ability to retain information during study?
To start with, any student’s aim is to store the memory and then be able to retrieve the information they need at any time. To store the memory remember the process of consolidation would first take place – this is the merging of short-term memory with long-term memory. So let’s say you are studying for an exam. First, the ability to retain information happens with repeated revision over a long period of time. Now, if you were to revise for hours the night before the exam you would be less likely to retrieve information. This is because there hasn’t been sufficient time for the longer term memory to re-consolidate previously established learning material. *
So coming back to OCD, how does this play a part in my ability to retain information?
It could be that the natural process of consolidation is interrupted by obsessions or ruminations. For example, the brain’s thalamus acts as a kind of “relay station” whereby motor and sensory information (except smell) are received by it and projected to the cerebral cortex (responsible for the so-called “higher-mental processes” of language, thinking and problem solving – Arthur S. Reber). Given the nature of its role, it makes sense how the thalamus loops the same information to and from the cerebral cortex in those who have OCD. The striatum, another part of the brain affected by OCD, transmits information involved in thinking, automatic filtering and movement. Because automatic thinking and filtering as well as automatic movement become sticky in those with OCD, it means that forming new memories is a challenge, and since the consolidation process gets interrupted doubts about memory loss starts to nag at your mind. Then of course the worry about failing to absorb study material and making topic concepts clear in your mind can offset all kinds of threat-related thoughts in which ruminations further affect your study time, e.g., “What about my future prospects?” “Without being able to study and recall information what will my point in life be?”
I worry that I have memory loss and re-check my work. Is this OCD related then?
Well foremost, and from what research tells us, it seems that people who have OCD were once thought to have poor memories, but then it was realised that they are more likely to have poor confidence in their memories. So if you have checking OCD, you might check your work once for accuracy, and then double check due to the doubts associated with OCD. You might say: “I re-read and checked my assignment four times already, but just in case I cannot recall whether I missed a mistake or not, I’ll re-read and check again.” The more you check, the stronger the obsessional doubts and ruminations become.
So what are the solutions?
First of all, when you are challenged, remember to mentally take a step back, be mindful of your breathing, observe your present situation objectively because then you’ll see the bigger picture. Next generate some workable solutions (the tips below can be a start for you), and then from your list of solutions practice what works best for you.
(1) SLEEP – Studies have shown that information is transferred between the hippocampus and the cerebral cortex during deep sleep. In humans the hippocampal formation plays an important role in the formation of long-term memories and the cerebral cortex mediates language, thinking and problem-solving. Slow wave, or deep sleep, is thought to improve the consolidation of information in memory and activates patterns in the sleeping brain. This mirrors those recorded during study tasks from the previous day. Even daytime naps can help improve memory to some extent, and helps with memorising important facts. Good sleep hygiene therefore is worth noting.
(2) CHUNK INFORMATION – The network of interacting brain regions in a person who has OCD ceases to function in an efficient way and gets locked; as a result, they are less able to move to another thought/behaviour automatically (see striatum above). The striatum consists of two parts (1) the putamen and (2) the caudate nucleus. The second controls automatic thinking and filtering and the first controls automatic movement. Non-OCD students are able to move automatically from one study task to the other than and are usually able to problem-solve as they go along. The opposite seems to occur for people who have OCD because, and as noted before, they get stuck in the obsessional loop and have a need to re-read information and repeatedly check on accuracy. Problem-solving and perfectionism are difficult areas too, since living with uncertainty is part of the structure of OCD. One solution then for people who have OCD (including those in remission) would be to CHUNK information. This refers to organising or grouping separate pieces of information together, which makes remembering easier. For example, if you were asked to remember this number 07514656135 you can break the numbers into chunks, such as: 0-751-465-6135. When the numbers are set apart like this they will be easier to recall as a whole (Study Methods)
(3) TWO-DAY CHECKING EXPERIMENT. On the first day of this “checking experiment” you would force yourself to do your usual checking behaviour just once, whatever this might be. Later that day, on a scale of 0-10, you would rate how confident you are in your memory of what you did (0 being not at all confident and 10 being very confident). Only note this down once. The next day, repeat the same experiment and this time note down how confident you are in your memory of what you did every 2 hours instead of just once (do this over an 8 hour period). The point in the experiment is to spot that the urge to repeat the checking behaviour happens the more times you check your memory. This is because you become less sure about whether you did that last check or not; or whether you did it correctly. Because OCD is a paradoxical disorder this experiment can help you do the opposite of what it wants by helping you live with uncertainty, simply by forcing yourself to check once only.
(4) LIVE WITH UNCERTAINTY – To keep this simple, people who have OCD tend to find living with uncertainty very difficult. However, if you are to come to an understanding in that no amount of re-reading or checking your work ever takes the grain of doubt away (see technique 3) you will then be better able to live with uncertainty knowing that mostly your work is fine – that is, whilst living with the uncertainty that it might not be fine. Re-reading study material “just in case” you missed something or didn’t quite grasp the comprehension wastes time, exhausts you and keeps you in a loop. Double-checking that you have your letters and symbols correct for your algebra paper for example will only keep you stuck in that paper, forever wondering if it is “correct”. So along with good sleep hygiene, chunking information, and checking once only is important, and then to live with uncertainty. With practice, and by managing associated anxiety until it reduces naturally, you can help your sticky thoughts and filtering processes become more automatic; or help a lapse turning into a full-blown OCD symptom relapse.
(5) GET BETTER AT DECISION MAKING: Let’s say you are in the process of providing answers to a topic, such as calculating in Math, and you know intuitively what the answer is yet have doubts about your answer. What you need to do is look at the facts instead of ruminating on “what-ifs” and trying to make decisions on an emotional level. Research suggests that in those with OCD there is diminished confidence, conviction, or certainty with regard to assimilating the information necessary to reach a decision (Nestadt et al). Yet, by tuning back in to making intuitive choices objectively you learn to separate the emotional value, and thus learn to tolerate the sensation that comes with ambiguity – e.g., “my mind says the answer is right, but emotionally it feels wrong”. Believe that you can go from subjective decision-making (based on emotions) to objective and rational decision-making. In other words you have in your capacity to make definite choices; that is, without too much hesitation. When you base your decisions on objective biases that are focused on facts coupled with instinctive knowledge/belief your studying will take off again and there’ll be no stopping you!
(6) LOOK AFTER YOURSELF: Giving yourself a time to stop studying gives room for eating properly, taking time out to do other pursuits, such as a favourite hobby; going out with friends etc. If you tend to study at night, then giving yourself a suitable time for retiring to bed is also wise because, as mentioned earlier, sleep helps the brain to process old information and clears the mind for new information the next day. Finally, listening to study music can be useful and sleep inducing music for relaxing at night can be helpful; or visualising relaxing your body from your head down to your feet can bring on a more restful sleep. Relaxed hands by your sides is most helpful as is a relaxed jaw.
(7) RULE OUT MEDICATION: If you are still finding that you are having problems with your memory, medication expert, Armon B. Neel, Jr, PharmD, CGP, FASCP gives some advice. He says there are a number of drugs that can cause memory loss, or concentration difficulties. He suggests you become an educated patient and understand exactly what you are taking, why you are taking it, and the risks involved. Talking to your doctor and your pharmacist about whether you believe your prescriptions are causing you memory loss can make all the difference to your mental health.
If you take one or more medications that you suspect is causing cognitive problems, here are the steps Armon B. Neel recommends you take:
- Write an inventory of what you are taking. Write down every medication, dosage, and when you started taking it.
- Talk to your doctor about what you are taking, how much you are taking, and why you are taking it. If you have more than one physician, have this conversation with each of them.
- Find out the consequences of stopping any medication, and if so if there are any non-drug approaches you can take instead.
- If there are any medications that can be eliminated, discuss a plan for getting off them and follow the plan.
- You should always get all your medications filled by the same pharmacy. Talk to your pharmacist about your regime to make sure there are no known interactions. For example, sometimes one medication can interact with another and cause cognitive problems, or other problems, so do discuss this with your prescribing physician.
Even if you have to stay on your medications, you can lessen the load on your brain by taking proactive steps such as eating a brain-healthy diet, getting the sleep and physical exercise your brain needs, managing stress, and taking the right brain supplements such as cod liver oil. The links below can help with this. In the meantime why not go to What Happened to my Memory? – 7 Tips to Help Students Who Have OCD
Armon B. Neel, Jr. received the 2009 Armon Neel Senior Care Pharmacist Award
* Source of reference: The Human Memory
Carol Edwards © 2016 Updated 2017
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