How John Harrison creates space through cognitive science

Happyplaces Stories (video)

One of the things we know that is an early complaint of people with Alzheimer’s disease is the experience that their memory is not as good as it used to be. What we would normally do in clinical practice, is to evaluate people’s memory by asking them to remember maybe a list of words, or a sequence of pictures, something very visual and auditory. But one of the things that we know of early Alzheimer’s disease is that people have difficulty negotiating their way around space. They find it difficult to find their way around particularly new spaces. And one of the means by which we started to investigate the early problems in Alzheimer’s, is to put people in a very specific space. We have a room that we call the ‘blue velvet room’. It is essentially a darkened room where we show people a location that we’d like them to remember, and we show them clues to that location on the walls of the room. This is a very sensitive paradigm for detecting very early memory problems in patients with Alzheimer’s disease. We use that knowledge that there is a problem in getting to and from the supermarket, to finding your way to a new location. And these are the things that people often complain about. So we’re trying to take that experience and take that into a more controlled situation, the ‘blue velvet room’ that I described.

And Alzheimer’s is interesting also in this context because one of the things that patients and their caregivers would tell us is that the size of their world shrinks. So these people become less confident about finding their way to other locations, less confident about their social skills. They tend not to go out so much and they tend not to do things that perhaps they’ve been doing socially for a very long time. So, in percentage terms,the size of their world shrinks dramatically. So that idea that space is something that people experience, and it contracts as a function of their disease are things we learned from Alzheimer’s disease for a very long time.

Live sensibly

The challenge of Alzheimer’s is very much an issue for all of us. In popular media there is a lot of coverage, there is a lot of political activity, and I think there is a clear understanding that we are going to have a significant issue in the management and treatment of patients with Alzheimer’s disease. It is already a major concern, but the number of people that are going to be suffering from Alzheimer’s disease in twenty years time is close to two or three times the number of today. So we know that this problem is going to be even bigger. And in the absence of anything like a cure, perhaps we going to get a cure but not anytime soon, the trick is to try to prevent the onset of Alzheimer’s disease.

There are some things we know about Alzheimer’s disease that we can recommend to people as a way of trying to fend off the problems that Alzheimer’s will bring them. So we know that if you could manage your health if you can avoid hypertension if you can avoid type 2 diabetes — these are two very big risk factors for developing Alzheimer’s disease. So, healthy living, good exercise, a sensible diet — managing your health; these are very efficient ways of reducing your risk of ultimately, not just suffering from Alzheimer’s disease, but other disorders too. The trick really is to make sure that people understand that there are things that they can do for themselves which will help to prevent Alzheimer’s disease. And that’s of clear benefit for them, but given the very substantial costs of caring for people with Alzheimer’s disease, it is of a significant benefit for society more broadly. So, manage your health, try to exercise, manage what you eat and try to eat healthily — these are things that are going to almost certainly fend off Alzheimer’s disease for as long as possible.

There are other things that we know that are helpful. One of the curiosities of Alzheimer’s disease is that people can have the pathology, the problems that we see in the brains of people with Alzheimer’s disease; protein, amyloid protein clumps. You can have all that pathology, but if you are very well educated, you can seem to resist the ravages of the disease for a lot longer. And we don’t truly understand this. There are theories of cognitive reserve, but as a general principle, we know this as a fact. The idea that you keep your brain active, you might constantly challenge yourself mentally; learn your languages, study topics which are new topics to you, travel abroad, see places that you haven’t seen before. These are all going to facilitate richness of your memory and the accuracy of your thinking. So if you can do that kind of thing, that’s another obvious benefit of trying to manage the disease by engaging your brain. Keeping active, building your resilience.

Mnemonics

We know that there is one key technique in cognition, which is ‘mnemonics’. That’s a very old technology. Ancient Greek Horatius would use this to help them remember a presentation they were about to give. And it relies on some very simple imagery. One of the things that I always like to do when I go to talk about cognition, memory and schools, is to read the children a list of maybe seven words. And they might be something like: elephant, snowball, ukulele, scarf, socks; a whole bunch of things. And what I can get them to do, is to tell me those words a little bit later once they thought about it. But then, I can get them to build an image. An image might be an elephant, having a snowball thrown at him. Playing a ukulele wearing scarfs and socks. And when I get them to do that, they are much better in remembering the items in the list of words. So, that’s a simple mnemonic. A nice visual image that helps people remember a list of items. That’s the first step. So, if you can get people to do that, that is a really significant aid to your memory. But often people have to remember information in a useful order. And then there is another methodology that we can offer people. This is the so-called ‘method of loci’. And it would work like this: if you would pick a familiar building, maybe the house that you live in. What you would do is, you might put a mnemonic of the first thing you need to remember on the front door. And then you might put the second image that you need to remember, in the hallway to your house. And then you might put the third image in the kitchen, which could be off to the left. So what you are doing is: you’re placing a very rich image of something you need to remember in each of the rooms in your house. And then you need to remember them in the right order, you need to mentally walk through the house. And then the images will be in the right order for you to recall them. And therefor write your essay, write your book, remember a process. Whatever it is you have to do. And I think, this imaginative, but incredibly potent use of space as a methodology of remembering not just items, but also certain order is a very potent tool for memory. Almost all the studies that I can think of that cover the difference between just trying to remember things by repeating them versus trying to remember things through mnemonics, suggest that mnemonics is three times more efficient. And I say to my daughter, who is currently revising for exams: ‘So, you can either spend six weeks of your summer holiday learning things by road, or you can spend two weeks of your holiday learning it using mnemonics and then have the other four weeks off.’ As a technology, as a methodology for helping people employ sophisticated psychological theory to improve their memories, mnemonics would be absolutely the first thing I would teach every school child on their first day at school.

Attention

I think all of this applied psychology gets you thinking about how you could change the experience of learning. And one of the most interesting conversations I had recently, was with my son. He said: ‘Daddy, who is more clever, you or me?’ And I said: ‘Well, it depends what you mean with clever’, which is a very phychologist’s response to the question. And I said: ‘Let’s think about what it is to be clever. One the one hand, I might have more knowledge than you do. So maybe on that level, I’m a little bit more clever than you. Because I know more things. And I might know some techniques that help me learn information. maybe because I’ve got access to those tools, I can learn more efficiently or I can just learn more than you can. And I think the other bit to cleverness is how intelligent you are.’ And at that point, I said to him: ‘I think you are more intelligent than I am.’ I think intelligence, plus efficiency how you learn information plus knowledge is for me a pretty good working definition of clever. It is a very psychologist’s definition of clever, but I think one I could work with. And it makes me think about what you could do to enhance the learning experience. To follow up on the comments about mnemonics: it just is a much more efficient way of remembering information. But memory is just one facet to your cognition, you ability to think. Another important element is your ability to concentrate. Can you pay attention? And I think that it is probably the case that most people don’t pay much attention to what goes on around them. I think the idea that you might become a bit more mindful. Pay attention to things that you’re experiencing. Things you might see walking through Schiphol on your way home. Just paying more attention to your environment would probably mean that you process and retain much more information then you would do otherwise.

Analogy

When we talk about memory, we talk about ‘encoding’: how we get information in. We talk about ‘storage’: how you actually keep it. And we’re talking about ‘retrieval’: that is how you get information back out of memory. The key first stage is the encoding. And if you are paying attention, the encoding will be done much more efficiently. You might think about concentrating, paying attention. But there is another area where we can change the way we get people to think. And ‘problem solving by analogy’ has a very rich history in psychology, but I think that we don’t exploit it as much as we could and should. Some experimentation, like for example ‘Duncker’s radition problem’. This is an interesting thought experiment. You have a patient who has a tumor. And you will have a ray, which will destroy the tumor. But if you direct the ray at the tumor, you will also destroy the healthy tissue that is in the way between where you are and where the tumor sits. See, the problem is: how to destroy the tumor, but leave the healthy tissue intact? Just to get you quickly to the answer: you send lots of sub-threshold rays through the healthy tissue where they don’t damage the healthy tissue, but they will converge on the tumor. Where they will create a magnitude of force where they will destroy the tumor. So, the theory is: you take lots of different routes to the tumor and you get the rays to converge to destroy the tumor. And what’s that like? Another analogical situation to that would be: imagine you’re a general. And you’re trying to stom a fortress. But the fortress only has very small roads that lead there. So you have a very large army, and lots of very small roads. What is the most efficient way of capturing the fortress? Well probably send all of your troops down these little roads, but time it so they all converge on the fortress at the same time. So hopefully you can see the similarity between Duncker radiation problem and the fortress storming: sending small units that converge at the same time to either destroy a tumor, or to capture a fortress. So that’s analogical problem solving. Inducing people to say: ‘Let’s look at a problem and let’s ask ourselves: what is the problem like?’ And that seems to me a very efficient way in getting people to think about how to solve issues. So I think a combination, mnemonics, thinking about, paying attention, trying people to encode more information more efficiently and then trying to impact their problem solving approach, they seem to be very useful approaches that you can start to employ in the classroom. And get even very young children to be shaping their cognition, using these benefits from psychological theory.