Attention and Memory

You may find that since your traumatic brain injury you have difficulty focusing or managing our attention. This often goes hand-in-hand with feeling like you can’t remember or memory loss. Let’s talk about both of those things - attention and memory. 

Attention 

Sometimes people think their trouble remembering things is because they have a bad memory - but sometimes we can’t remember things because of our attention. If we are not focused, our brains cannot absorb the information it needs to remember things. 

For that reason - let’s talk about attention before memory. Attention plays a BIG part in how memory is stored. 

What is attention? Attention allows us to be present and focus on something. This can be while we read, participate in a conversation, or work on a project. There are different types of attention. 

  • Sustained attention - Focusing on a single thing over a period of time in a quiet space 
  • Selective attention - Focusing on something and filtering out external distractions like noises and people 
  • Alternating attention - Switching your focus between two or more things 
  • Divided attention - Focusing on two or more things at the same time

It is not good to divide your attention because you’re more likely to make mistakes. The best attention happens when you focus on one thing at a time in a quiet space. 

Attention breakdowns  

The brain is not designed to focus on something forever. Attention breakdowns can happen to anyone. When they happen, we are unable to concentrate and find our minds drifting to other thoughts, people and/or tasks. Sometimes we are aware this is happening and sometimes we are not aware that it’s happening. 

The best way to deal with attention breakdowns is to become aware of what impacts your attention. Here are some things that can cause internal and external attention breakdowns.

Internal attention breakdowns and/or distractions - When something inside of us causes us to lose focus 

  • Fatigue (mental and physical) 
  • Pain 
  • Anxiety 
  • Hunger or thirst 
  • Depression 
  • Stress 
  • Sensitivity to light or sound 
  • Our thoughts 

External attention breakdowns and/or distractions - When something outside of us causes us to lose focus 

  • Noise 
  • People interrupting us 
  • Competing projects or tasks 
  • Objects in our visual space 

Strategies for managing attention breakdowns and distractions

Internal attention distractors 

Often internal attention distractors happen when we’re trying to focus on something, and other thoughts are popping into our heads to distract us from the task at hand. 

Strategies to help with internal attention distractors 

  • Consciously attend to small details, closely analyze what you are doing
  • Intentionally work slower than you might usually work, take your time
  • When reading, allow for time to re-read sections
  • Check your work for errors
  • Self-talk and walk yourself through tasks 
    • Repeat the steps of the activity to yourself as you complete them
    • Talk to yourself about your progress 
  • Make sure you are not hungry, thirsty, or have to use the bathroom 
  • Take all your medications that you are prescribed. For example, if pain or discomfort is distracting you, have you taken your medication to help with that? 
  • Get enough rest at night
  • If you are fatigued do some jumping jacks, stretch, or go for a vigorous walk 
  • Take frequent breaks 
  • If you find yourself repeatedly distracted by other tasks you need to do - jot those nagging tasks down on a piece of paper with the idea that you will do them at a later time. Commit to finishing the task you’re working on first (or set a timer to get a set amount of it done). 

Strategies to help with external attention distractors

  • Turn off unnecessary noises like television or radio 
  • Use a fan or white noise machine to drown out street noise or nearby conversations 
  • Wear earplugs, if it’s safe to do so
  • Remove visually distracting items like interesting magazines or pictures
  • Find a quiet room and close the door 
  • Think about creating a “quiet space” in your house or work setting that you can use regularly 
  • Try to be alone or ask others to be quiet 
  • Ask others not to interrupt 
  • Use a DO NOT DISTURB SIGN when you need a break with no interruptions

MEMORY 

Let’s talk about memory. Remember, attention strategies remain critical! You need to actively attend to information to move it into memory. Once it’s moved into memory, there are different strategies to help us store information and to help us retrieve it.  

Better attention → Better Memory → Less worry and more energy
Memory has the ability to ENCODE, STORE and RECALL information. 

Memory Encoding 

Memory encoding is what happens when we initially learn information. It is how the information comes through sensory input and is changed into a form where it can be stored in the brain (storage) and retrieved later (retrieval). 

  • Short-term memory holds information you need to remember in the following minutes, hours or days. 
  • Long-term memory is information that can be recalled days, months or years later. This is someone’s general fund of knowledge, much of it gathered before the injury. 

External Memory Strategies 

Forgetting to do things is a very common memory problem - especially for those who have had a traumatic brain injury. For example, forgetting to go to an appointment or forgetting to send a birthday card to a family member. There are strategies you can use in your environment to help you remember things. 

  • Use a calendar and take notes - The number one way to remember something is to write it down. Use a calendar or notebook to keep track of your appointments or tasks. Instead of having to remember each piece of information - write it down and remember to file the information appropriately each day 
  • Writing something down helps encode information in multiple ways, multiple times - Hear it, write it, read it out-loud 
  • Keep information visible, accessible - Keep your calendar out and available, leave a note on the wall or have a list displayed on the fridge. Out of sight, out of mind - so make sure it is visible and easy to access and update. 
  • Use a timer or reminders on your watch, tablet, or smartphone to remind you to check your lists or to remind you of a task. 

Calendar management

As mentioned above, a calendar is one of the best ways for you to keep track of the things you need to remember. Let’s talk about some strategies you can use when it comes to your calendar. 

  • Weekly planning session (or brain dump). Set aside some time at the end of each week (perhaps on the weekend) and sit down with your calendar (and maybe even your family/friends that support you) and plan out the upcoming week. As you sketch out your week, add important appointments to your calendar, including items on your to-do list that you want to accomplish. Overestimate the time you might need, and include travel time to/from appointments, so you aren’t crunched for time (and stress). Write everything down on to your calendar 
  • Each morning, check your calendar. Set up your morning routine to have a set time to check your calendar (so you don’t forget). For example, you always check the calendar while you eat your breakfast. If you’re particularly busy - check your calendar throughout the day. 
  • Be sure to carry your calendar with you always. If you’re going to count on your calendar for important appointments and tasks - it’s important that it be with you at all times. Bring it to appointments so you can schedule follow-up appointments. 
  • Store your calendar in the same spot always. Just like your keys or reading glasses - put your calendar in the same spot so it’s easier to find when you need it. 

These strategies, such as a calendar, can be implemented in your environment to help you remember things - but you can also try these internal memory strategies for helping you memorize things without writing them down. 

Strategies for Internal Memory Strategies 

These are simple mental tricks to help organize the information you’re learning to make it easier to recall later. 

  • Association - You can use something called “association” and link new information with old information you already know. Focus on similarities and differences between new and old information. Association works well when meeting new people. For example, when you meet someone new, and her name is Jane - remember her by mentally comparing her to your other friend named Jane. You could note that this new Jane has blue eyes, but my other friend Jane has brown eyes. Both Janes are tall, though. By making a mental note you’ll be associating both Janes and it will be easier to recall her name. 
  • Categorizing or chunking information - Divide a large amount of information into smaller groups or chunks to be remembered. Chunking is typically used for remembering numbers. The most common example of chunking is a 10-digit phone number 6192993510 versus (619) 229-3510 - which number would be easier to remember? 
  • Acronyms - Acronyms are words made up of initials that stand for a series of words. Acronyms reduce the amount of information you have to recall because each letter is a cue for another word. You can make up acronyms to remember groupings of names or a list. For example, ROYGBIV is a common acronym for the colors of the rainbow - Red, Orange, Yellow, Green, Blue, Indigo, Violet. 
  • Visual Imagery - Turn the information you are trying to remember into a memorable picture. Draw or imagine a picture. The weirder or funnier, the better! This strategy works well to remember people’s names. For example, your new doctor is Dr. Burns - who has dark stubbly hair - as if there was a big brush fire (burn) on his head! Or you meet your new neighbor, Sandy Reese, you can picture her eating Reese’s Peanut Butter cups on a sandy beach. You can also do the same thing by imagining it as a movie or acting it out. 

Strategies to help you RETRIEVE information 

You’ve made sure to pay ATTENTION to new information, you’ve implemented strategies to ENCODE the new information. . .. now you have to RETRIEVE that information. 

Memory retrieval problems mean that a piece of information is in your brain somewhere, but you are having difficulty getting it out (for example, remembering a name that is on the ‘tip of your tongue’) 

  • Relax. Anxiety can often make it difficult to retrieve information or memories. If you are feeling anxious use relaxation/mindfulness techniques to help you relax and enhance your memory. 
  • Mental Retracing. This strategy is great for finding something you lost by remembering where you last put it. Mentally retrace your steps and reconstruct events leading up to when you lost an item. 
  • Alphabet searching. A great technique for remembering a word or name, go through the alphabet - starting with A and ask yourself, “Does it start with an A? Does it start with a B?” and so on. If you can identify the first letter, use the same process for the next letter. 
  • Recreate the context. This is a good strategy when you can remember where you were or what you were doing when you learned the information. For example, you remember that you were eating at a certain restaurant when your friend told you about a class that you wanted to take - but you can’t remember the class. Recreate the context - imagine the restaurant, the things you talked about - and it will be easier to retrace your mental steps to remember the class information. 

Organization to help with memory - encoding, storage and retrieval 

Organization in your environment and in your daily routines will help you remember things more easily. Having automatic places for things - like specific spots in your environment for things like your keys, your calendar, valuable papers, or important phone numbers. You can also organize your schedule so that it becomes a routine - which makes it easier to remember. 

Memory loss 

Even by practicing all these memory tricks and strategies you may still struggle with memory loss. Memory loss is one of the most common cognitive results of a traumatic brain injury - even with mild traumatic brain injuries. Your memory may not be as accurate or strong as it was before the injury. Memory loss may be more selective in that people may find it difficult to remember how to do simple, everyday tasks. Be patient with yourself and work with your healthcare provider to implement strategies, when possible, to help mitigate the memory loss. 

If experiencing any, or all, of these symptoms and would like additional resources and Get Support