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When Never Let Me Go was published in 2005, Ishiguro indicated that he ‘remain[ed] fascinated by memory’, and that his next challenge was to examine the themes of national memory and forgetting. The Buried Giant, published in 2015, represents Ishiguro’s unique meditations on collective memory, understanding, and the complexities of forgetting. Utilizing a third-person narrative voice, Ishiguro orchestrates a post-Arthurian landscape of buried slaughter and collective amnesia, whilst engaging in a critical enquiry into the nature of shared memories in relationships. This chapter will begin by considering Ishiguro’s memory work in his earlier novels, before an investigation into the fallibility of memory and understanding precipitated by the enigmatic mist. This is followed by an exploration of the question of culpability and the complexities of collective memory. The chapter concludes by reflecting on the figure of the boatman, the island of forgetting, and the implications of an enforced forgetting.
There are several examples from human neuropsychology of the intact preservation of processes and capacities in the absence of conscious awareness by the patients. These include loss of visual awareness (blindsight), episodic memory (amnesic syndrome), attention (unilateral neglect) and language (aphasia). The implication of these and other clinical phenomena is that descriptions of ongoing behaviour are necessary but quite insufficient for making inferences about conscious awareness, because even quite ‘high level’ behaviour can be run off in the absence of awareness. A commentary, or independent off-line response, is a prerequisite for determining whether the subject is consciously aware. Whether or not the commentary allows an inference about awareness in animals rests ultimately on an argument from analogy, just as is the case when we make judgements about fellow humans. But when parallel disjunctions between on-line behaviour and off-line classifications are found for both human and infrahuman subjects, as is demonstrable for blindsight and amnesia, not only do they bolster inferences about common neural mechanisms, but they strengthen inferences for analogous processing and hence for conscious experience.
In the year when France commemorated the sixtieth anniversary of the liberation of its territory from Nazi rule by the Allied Forces, President Abdoulaye Wade of Senegal initiated a commemoration of the contribution that the Tirailleurs sénégalais made to this military victory. Inviting the heads of different African states whose colonial subjects had joined the colonial army of Tirailleurs, the Day of the Tirailleur was celebrated on 23 August 2004 to commemorate the day of the landing at Toulon. In the Senegalese media, the ‘blood debt’ of France to its African liberators was widely debated, and the discrimination in pensions that African veterans have experienced since political independence was widely condemned. During the day, a statue of the soldiers Demba and Dupont was unveiled at its new location to recognize the contribution Africans have made to France’s military history. This colonial statue was first inaugurated in 1923 to recognize the role played by Tirailleurs in the First World War; it is now recycled to remind France of its colonial debt. The Day of the Tirailleur reminded France of its obligations towards the Senegalese migrants in France whose legal status was very much debated at the time. By reinstating a colonial statue and recycling the social capital made by sacrifice, the Senegalese government appropriated and reinterpreted African history, recycling its colonial legacy as a technique of repair.
Alcohol amnesia and palimpsests belong to understudied areas in addictology concerning the pathogenesis, risk factors, and development of effective integrated, targeted modalities of therapy, prevention, and after-treatment care.
Development of a new integrated, pathogenetically grounded approach to the emergency and routine therapy for immediate and long-term consequences of amnestic alcohol intoxication.
Modern complex clinical-psychopathological, pathopsychological, laboratory, electrophysiological, biochemical examination; method of analogues and prototype analytical examination.
Integrated anti-amnestic pharmacotherapeutic triad: Noobut IC (Phenibut) orally, before meals, for 6 days, twice a day: 250 mg in the morning, 500 mg at night, within days 7-14 250 mg twice: in the morning and at night; Vitaxon 2.0 ml daily, intramuscularly, No10 totally; ozone therapy for 10 days (ozone dissolved in olive oil, 6 mg/100 ml concentration), 5 ml orally 3 times a day. Complex therapy is concurrent with synergistic psychotherapeutic potentiation. Supportive anti-relapse prevention of alcohol-induced amnesia, palimpsests with Noobut IC: 1 tablet (250 mg) orally in the morning for 2 months. The pathogenetic support of the pharmacotherapeutic triad in treatment for alcohol addiction, comorbid with amnestic disorders, is pathogenetically focused on pharmacological properties of each component of the triad and their potentiating effects, involving most pathogenetic mechanisms of this disease.
Relieving and prophylactic efficacy of the proposed pharmacological triad (Noobut, Vitaxon, ozone and concurrent psychotherapeutic potentiation) is proven by the statistical reliability method and illustrated by clinical examples of patient-specific research.
Wearable cameras have been shown to improve memory in people with hippocampal amnesia and Alzheimer's disease. It is not known whether this benefit extends to people with amnesia of complex or uncertain origin.
This case study examined the effect of wearable camera use on memory and occupational performance in a patient with memory loss and complex mental health problems following a severe neurological incident. With the help of his occupational therapist (OT), Mr A used a wearable camera to record a series of eight personally significant events over a 6-week period. During visits from his OT, Mr A was asked to report what he could remember about the events, both before (baseline) and during the review of time-lapsed photographs captured automatically by the camera.
The results showed striking improvements in recall while reviewing the photographs, relative to baseline recall, but the additional details recalled during review did not appear to be maintained at later tests, after several days. Across the study period, there were moderate increases in occupational performance, measured using the Canadian Occupational Performance Measure. However, after the study period ended, Mr A ceased to use the wearable camera due to technological difficulty.
There was a clear benefit of wearable camera use, but the real-world impact of the technology was limited by the complexity of the system. The results of the study are discussed alongside novel clinical insights and suggestions for developing wearable camera support systems that can be used independently by people with memory problems.
This chapter examines the concept of the self. It begins by looking at the work of Hume, and the distinction between ego and bundle theories of the self. We consider the distinction between the knower and the known, and the idea of the homunculus. The chapter examines Damasio’s model of three levels of self, and other ‘types’ of self. It looks at how the self is related to psychological models of control and executive processing. It then looks at our perception of our continuity of existence, and how it can be disrupted by age, sleep and amnesia. The chapter examines the neuroscience of the self, and which neurological structures give rise to our sense of self. We look in detail at split-brain studies and what we can learn from them. It then looks at dissociative states and dissociative identity disorders (multiple personalities). It also looks at the boundaries of the self, and phantom limbs and the rubber hand illusion. The chapter concludes by asking whether the self is just another illusion.
To allow identification of stimuli, sensory input is initially held briefly in sensory memory. It is then held in a short-term store (STS), where it can receive the additional processing required to form a permanent memory. The existence of separate short- and long-term stores is supported by research on amnesia, demonstrating that brain damage can affect one but not the other. Forgetting in STS may be caused by decay, and by interference from other memories. STS can hold information retrieved from long-term memory when required for activities such as reading; to reflect this, it is now called working memory. Baddeley proposed that working memory has 3 components: the phonological loop, visuo-spatial sketch pad, and central executive. Consolidation theory suggests that the formation of a permanent memory requires time for the strengthening of synaptic connections; there also appears to be a consolidation process that can occur over years. We cannot attend to all the stimuli that seek entry into working memory; change blindness provides a striking example. Some theories suggest that selection occurs early in processing, others that attention can be allocated flexibly after stimuli have been identified. With practice, processing can become automatic, so that stimuli no longer require attention.
Physical evaluation and ancillary testing need to be interpreted in a context. Here, we focus on the relevance of history taking and how missing or misinterpreting clues in the history can affect diagnosis.
China's emergence as a great power has been accompanied by the official rhetoric of the China Dream of Great Rejuvenation (weida fuxing 伟大复兴). Although there are conflicting views among academics and political elites about the exact content of the China Dream, one of its features is the nostalgia for China's past and its five-thousand-year-old civilization. Xi Jinping's current rhetoric of a China Dream of Great Rejuvenation uses a reinvented history as an asset for the future, linking China's natural progress as a global power with a selective re-reading of its millennial history. While much existing literature already discusses China's Great Rejuvenation, this article looks more specifically at the role of historical memory and deconstructs the key interconnected components that support Xi's rhetoric, namely, the chosen trauma, glory, and amnesia. The conclusion offers some general remarks about the effect of this rhetoric on China's domestic and foreign policy and some of the risks that accompany it. This article contributes to the debates on the influence of memory in International Relations (IR), showing how constructed memories of history can significantly impact both national identity and foreign policy.
There have been reports of long-term subjective memory worsening after electroconvulsive therapy (ECT).
To study the prevalence and risk factors of long-term subjective memory worsening among patients receiving ECT in routine clinical practice.
Patients (n = 535, of whom 277 were included in the final analysis) were recruited from eight Swedish hospitals. Participants' subjective memory impairment was assessed before ECT and a median of 73 days after ECT using the memory item from the Comprehensive Psychopathological Rating Scale. Participants also rated their pre-ECT expectations and post-ECT evaluations of the effect of ECT on memory on a 7-point scale. We used ordinal regression to identify variables associated with subjective memory worsening and negative evaluations of the effect of ECT on memory.
Comparisons of pre- and post-ECT assessments showed that subjective memory worsened in 16.2% of participants, remained unchanged in 52.3% and improved in 31.4%. By contrast, when asked to evaluate the effect of ECT on memory after treatment 54.6% reported a negative effect. Subjective memory worsening was associated with negative expectations before ECT, younger age and shorter duration of follow-up.
Although subjective memory improved more often than it worsened when assessed before and after ECT, a majority of patients reported that ECT had negative effects on their memory when retrospectively asked how ECT had affected it. This might suggest that some patients attribute pre-existing subjective memory impairment to ECT. Clinicians should be aware that negative expectations are associated with subjective worsening of memory after ECT.
This chapter argues that one can have some memory loss over time but remain the same person and be held responsible for one’s earlier actions. Amnesia following an action does not entail that the agent had no cognitive or volitional control when he acted. Amnesia as such is not a mitigating or excusing condition. But an individual who had undergone a substantial identity change from extensive memory loss could not be held responsible or punished because he would have become a different person. The chapter also considers dissociative disorders such as somnambulism. The main question regarding these states is whether they impair a person’s capacity to form and translate an intention into a criminal act. Dissociation comes in degrees. A person in a dissociative state may have enough behavior control to be at least partly responsible for her actions. In addition, the chapter examines memory loss in omissions and whether it can be a mitigating factor in cases involving negligence causing death. The chapter also argues that a victim of an assault does not have an obligation to retain a memory of it to testify against the perpetrator. Her cognitive liberty gives her the right to erase the memory.
The past 30 years of research on human amnesia has yielded important changes in our understanding of the role of the medial temporal lobes (MTL) in memory. On the one hand, this body of evidence has highlighted that not all types of memory are impaired in patients with MTL lesions. On the other hand, this research has made apparent that the role of the MTL extends beyond the domain of long-term memory, to include working memory, perception, and future thinking. In this article, we review the discoveries and controversies that have characterized this literature and that set the stage for a new conceptualization of the role of the MTL in cognition. This shift toward a more nuanced understanding of MTL function has direct relevance for a range of clinical disorders in which the MTL is implicated, potentially shaping not only theoretical understanding but also clinical practice. (JINS, 2017, 23, 732–740)
Background: To a large extent, discussions about dissociative identity disorder (DID) revolve around the way in which identity states (alters) that are thought to be typical for this condition should be interpreted: are they metaphors or are they genuine actors? Recent literature offers some fine examples of studies demonstrating that alters differ in their physiological profile. On the basis of this type of evidence, some authors have concluded that alters are more than just metaphors.
Objective: Drawing upon an experimental example, we argue that such a line of reasoning is highly problematic.
Method & Results: Our example demonstrates that normal subjects are perfectly able to simulate alters such that these alters are accompanied by different physiological profiles.
This is especially true for subjects scoring high on fantasy proneness.
Conclusions: Psychobiological research on DID should include normal controls, preferably controls who are fantasy prone. Unless such a strategy is adopted, psychobiological research on alter activity will not be very informative.
The anterior cerebral artery (ACA) arises as the medial branch of the bifurcation of the internal carotid artery (ICA) at the level of the anterior clinoid process. The ACA supplies the whole of the medial surfaces of the frontal and parietal lobes, the anterior four-fifths of the corpus callosum, the frontobasal cerebral cortex, the anterior diencephalon, and other deep structures. Ischemic stroke in the ACA territory is most often the result of emboli from the heart or the ICA. Transient loss of consciousness has been described in patients with ACA territory infarctions, but it is uncommon; sustained unresponsiveness most often indicates abulia or akinetic mutism. Anterograde amnesia has been known to follow rupture and related surgery for an anterior communicating artery (ACoA) aneurysm. Distinct syndromes of callosal disconnection resulting from ACA territory infarctions include ideomotor apraxia, agraphia, and tactile anomia restricted to the left hand in right-handed patients.
The cognitive symptoms that characterise the Wernicke-Korsakoff's syndrome include anterograde amnesia, confabulation, temporal–spatial disorientation, severe apathy, poor awareness of one's own mental state and changes in executive functions. Such deficits may persist even after the clinical profile stabilises. There are no studies that report an intervention after the acute phase, possibly due to the complexity of these cases. This study provides a descriptive analysis of neuropsychological rehabilitation concomitant to the neurological and psychiatric treatment of a woman who presented the symptoms described by Korsakoff. The intervention focused on reducing the impact caused by the cognitive and behavioural sequelae in the patient's daily life. It described a 25-week neuropsychological program, providing education and compensatory strategies for the patient, and also orientation and support from 2 professional caregivers and family members. Quantitative and qualitative measures were used to evaluate the effect of the intervention on memory efficacy, emotional state and social participation. Both caregivers reported a decrease in the frequency of memory lapses after treatment. Positive changes were also seen in self-care, activities at home, decision-making and participation in social activities. It is concluded that this case achieved results through the collaboration between members of an interdisciplinary team and caregivers providing daily support.
We describe an unusual cause of autobiographical memory loss in a 55 year old man who presented with prominent memory loss for significant events in his life over a period of five years with evidence of patchy memory loss for events prior to this. It was associated with emotional lability and was complicated by a number of tragic events in his life in the previous four years. In addition there were a number of brief episodes (< 30 mins) where he would transiently lose his memory for events including for hours, days or months prior to the event. Neuropsychological assessment confirmed prominent autobiographical memory loss with minimal deficits in other domains. An electroencephalogram (EEG) revealed a simple partial seizure arising from the right temporal lobe, pointing to a diagnosis of Transient Epileptic Amnesia. He was commenced on anti-epileptic medication and responded both subjectively and objectively. There are approximately 94 cases of TEA described in the literature and the diagnostic criteria and postulated aetiology of this illness is discussed here. Clinicians need to have high index of suspicion of epilepsy when assessing a patient with prominent autobiographical memory impairments.
Neuropsychological results are increasingly cited in cognitive theories although their methodology has been severely criticised. The book argues for an eclectic approach but particularly stresses the use of single-case studies. A range of potential artifacts exists when inferences are made from such studies to the organisation of normal function – for example, resource differences among tasks, premorbid individual differences, and reorganisation of function. The use of “strong” and “classical” dissociations minimises potential artifacts. The theoretical convergence between findings from fields where cognitive neuropsychology is well developed and those from the normal literature strongly suggests that the potential artifacts are not critical. The fields examined in detail in this respect are short-term memory, reading, writing, the organisation of input and output speech systems, and visual perception. Functional dissociation data suggest that not only are input systems organised modularly, but so are central systems. This conclusion is supported by findings on impairment of knowledge, visual attention, supervisory functions, memory, and consciousness.
This chapter talks about a 41-year-old man who was referred to memory clinic because of memory loss, poor verbal expression, loss of interest, and blunted response to environment. Cognitive status was evaluated by the mini-mental state examination (MMSE) and a detailed neuropsychological battery for assessment of memory, language and executive function, attention, and concentration. The examination documented moderate dementia with moderate amnesia and dysexecutive syndrome. Neuropsychological tests showed evidence of cognitive impairment of multiple domains, including memory, executive function, and attention and speed of information processing. He received 3-week penicillin therapy at an Infectious Diseases Hospital. During the follow-up check-up 3 months after penicillin therapy, the serum Rapid Plasma Reagin (RPR) was negative. Performance of verbal fluency and color trail making test was improved dramatically, suggesting executive function was restored after anti-syphilitic therapy. The follow-up magnetic resonance imaging (MRI) scan was unaltered compared with the initial visit.
The nature of residual cognitive deficits after out of hospital cardiac arrest (OHCA) is incompletely described and has never been defined against a cardiac control (CC) group. The objective of this study is to examine neuropsychological outcomes 3 months after OHCA in patients in a “middle range” of acute severity. Thirty prospective OHCA admissions with coma >1 day and responsive but confused at 1 week, and 30 non-OHCA coronary care admissions were administered standard tests in five cognitive domains. OHCA subjects fell into two deficit profiles. One group (N = 20) had mild memory deficits and borderline psychomotor deficits compared to the CC group; 40% had returned to work. The other group (N = 10) had severe impairments in all domains. Coma duration was associated with group. Neither group had a high prevalence of depression. For most patients within the “middle range” of acute severity of OHCA, cognitive and functional outcomes at 3 months were encouraging. (JINS, 2011, 17, 364–368)