Feb. 24, 2023

Why We Forget and How to Remember Better with Drs. Andrew Budson and Elizabeth Kensinger

Andrew Budson, MD and Elizabeth Kensinger, PhD are the Authors of the newly published book "Why We Forget and How To Remember: The Science Behind Memory". In easy-to-understand layman's terms, the doctors discuss how we create and store memories and why we forget things. We discuss normal age-related forgetfulness and how to distinguish between that and forgetfulness associated with diseases like Alzheimer's and that associatd with various medications. They offer simple suggestions on how to improve our memories, remember names and the importance of sleep.

This podcast and their book are essential listens/reads as we age.

Sponsorship and advertising opportunities are available on Specifically for Seniors. To inquire about details, please contact us at https://www.specificallyforseniors.com/contact/ . 


Disclaimer: Unedited AI transcription


Larry (00:01):

I just wanna remember to turn on recording. I forgot to do that once, <laugh>, that was before I looked through your book, <laugh>.

Dr. Budson (00:12):


Larry (00:13):

Okay. Today on specifically for seniors, it's my pleasure to introduce Dr. Andrew Butson, professor of neurology at Boston University, lecturer in neurology at Harvard Medical School, and Chief of Cognitive and Behavioral Neurology at the Veterans Affairs Boston Healthcare System. And Dr. Elizabeth Kenzer, professor and chairperson of the Department of Psychology and Neuroscience at Boston College. Dr. Kenzer directs a research laboratory that investigates many aspects of human memory. Together, they are the authors of the newly published book, why We Forget and How to Remember Better. And if all listeners would stay tuned to the end of the podcast, their publisher has graciously been willing to supply a couple of copies of the book to some lucky winners. Welcome to specifically for Seniors, doctor, it's an honor to have you both on the podcast.

Dr. Budson (01:29):

Yeah, thanks for having us. Absolutely.

Dr. Kensinger (01:31):


Larry (01:34):

Okay. What, what inspired the both of you to get together and write a book?

Dr. Budson (01:41):

Yeah, so I'll, I'll start and then then Elizabeth can, can jump in. So I had begun my writing books for the public to work on a, a problem that a lot of people were talking with me about is they, they knew I was a, a memory doctor and a, a memory researcher. And as people were getting a little bit older, they had been asking me like, you know, Andrew is my, is my memory normal? Is it not normal? Should I see my doctor? Do I not need to see my doctor? And I'm like, yeah, that's really good. And after I explained that, like for the hundredth time, I said, I should write a book about this cuz everybody wants to know the answer to that question. So I wrote that book in, in 2017, and then I began to get inquiries from people who were younger than older adults and they wanted to know, well, well what can I do to maximize my memory?

Dr. Budson (02:40):

And, and then some of my older adult friends, they were asking me, well, what can I do to maximize my memory? And I, I realized that we needed to write a book that could explain to people in clear terms, what are all the things that you can do to improve your memory? And the way to set it up, I thought the way to set it up is really to help people understand how memory works. Because once you understand how memory works, it's sort of a natural logical follow through to see, oh, of course this is what I need to do to make it better, cuz this is how the system works. And I knew that although I'm an expert in what happens when the memory system breaks down, I am not the world's expert on how does normal memory work. So I reached out to my colleague Elizabeth to say, Hey, you wanna, you wanna do this book with me? And I, and I think Elizabeth, you had been wanting to write a book like this too. Is that right?

Dr. Kensinger (03:46):

That's right, yeah. And I had approached this from a little different angle where, you know, I'm a professor, I'm dealing every day with college students who are in the business of trying to learn and remember information. And I was constantly finding that because they didn't understand the science of memory, it often wasn't intuitive to them what they should do. And many of the most important things that they should be doing, like getting enough sleep, getting exercises we'll talk about were things that they just genuinely didn't know were crucially important to them, being able to optimize their memory systems. And so I had been really excited when Andrew approached me about kind of combining our, our knowledge and just as Andrew said, I think presenting the science behind why these tips that we're talking about work so that people really understand the mechanisms behind it. And, and it just makes more intuitive sense as to why these are important things to do.

Larry (04:45):

Bef before we start to address memory concerns, we probably should get a better understanding as you brought up of how memory works. I guess we all have misconceptions that it's a, a one thing, that memory just is memory that's not correct, is it?

Dr. Budson (05:09):

No. And, and, you know, I think it, it seems only right that Elizabeth tell a little story with the individual who really broke open the memory field and taught us that memory is not one thing.

Dr. Kensinger (05:27):

So in the 1950s, there was a man who was a young man at the time for a long time he was known in the scientific literature by his initials, h m we now know his, his full name is Henry Molay liaison. And he suffered from really severe epilepsy that was interfering with his ability to function in his daily life. And so as a result, surgeons tried an experimental brain surgery to see if it would cure him of his epilepsy. And they removed a portion, portion of the brain on, on both sides of the brain, a region called the hippocampus. And the surgery was effective in so far as it did greatly reduce the frequency of his seizures. But it had a really surprising consequence, which was that from that moment in time, Henry actually was never able to form a new memory that lasted over any type of duration to which he had conscious access.

Dr. Kensinger (06:26):

So he could not tell you anything that happened between his late twenties and, you know, for the rest of his life into his seventies. For all of those years, there was nothing that left that kind of conscious mark that he could remember. So I had the opportunity to work with Henry when I was a graduate student at M I t and experienced something that really emphasized this point, that memory is not all one thing. So by that point, Henry had been to m i t many times, and he would stay overnight in one part of campus being watched by the nursing staff in the university health services, and then he would be brought to the testing area. And so he would be brought through these underground corridors because often it's a, it's a Boston winter where you don't wanna be walking outside.

Dr. Kensinger (07:14):

And at one point in these corridors, you get to a set of doors that has a pretty tricky mechanism that you need to unlatch in order to be able to open the door and to pass through. And so I was fumbling around with this lock trying to get the door to open, and Henry just moved forward, performed this very complicated motion, and the door opened and we were able to move through. And so here's a person who has no conscious recognition that he's been on the m i t campus before, let alone ever encountered this door and this lock. And yet something has clearly left this memory impression in his brain such that he's able to perform this fairly complicated motion and to know that this is the right context in which to perform it. And it really is such a nice demonstration of exactly what heralded in so much of modern understanding of memory was this recognition that although Henry and other severely amnesic individuals like him don't have conscious access to what's happened in their past, they have many, many ways in which their behavior is able to reveal evidence of everything that they've been through in their life.

Dr. Kensinger (08:23):

And so that's that distinction between consciously accessible memories and memories that we don't have conscious access to, but that are guiding our behavior.

Larry (08:33):

So how do we remember, how do we create these sec sections of our brain, I guess that stores memory?

Dr. Budson (08:47):

Well, I'll, I'll take the first crack at this and, and explain a a little bit. So what happens when we have an event of our lives? And this could be, you know, your listeners, you know, listening to the podcast or, or watching us on the, on the video, and there will be sites and sounds. And if they happen to be, for example sipping a cup of coffee, there will also be smells and tastes. And perhaps there's thoughts and feelings that are all related to this episode of one's life. And the different sensory experiences are actually going on in the brain where the sensory information is processed. But what happens is, I, if you think about these different sensations, like little balloons that are forming in different parts of the brain, the strings of all these helium balloons are tied together in this structure called the hippocampus.

Dr. Budson (09:59):

That's the structure that Henry had removed by the surgeons. But in the healthy individual, they're all tied together by the hippocampus. And once they're tied together, that's actually what allows the memory to form. And so if you're trying to retrieve that information, that memory, so the next day your listener wants to think back when they were listening to the podcast, what happens is essentially there's a little tug on that collection of balloons and it reactivates all those little balloons begin to vibrate again. And then the memory can be retrieved. And so that's a little of the, the basics of, of how the memory is, is formed bound together by the hippocampus. And then the memory gets sort of replayed when it's being retrieved. But I, I think the next thing we should say is it's the, the construction and replay of the memory. It's not quite as simple as pulling a book out of a library. And, and maybe Elizabeth can, can tell us a better metaphor.

Dr. Kensinger (11:23):

Yeah. So I think this is one of those common misconceptions that we have is that once we have that memory that it just sits somewhere and it waits for us to retrieve it from storage and to replay it. But it turns out that actually at every stage of memory, there's a really active and effortful process that has to take place. And we're really rebuilding a memory every time that we think about it. And so in the book, we really do do analogize this to thinking about these different parts of an experience as being building blocks. The hippocampus is holding onto the blueprints for which building blocks go where, but then when we're retrieving the memory, we actually have to rebuild the memory. We have to put the building blocks back together. And I think that that analogy is really helpful because it hopefully helps to make more intuitive sense as to why we don't always recall exactly the same details about an event every time that we remember it.

Dr. Kensinger (12:26):

It might be that one time you forgot that someone was with you during this event, and then another time it comes back to you that that person was there and maybe you don't think about some other aspect of the experience. And that's because each time you might be grabbing slightly different building blocks. I also think it makes a lot of intuitive sense then why we often can have distortions and errors in memory because it can actually be quite easy that we grab the wrong building block. Maybe we grab a similar building block, a nearby one, but not the proper one for that memory. And that's why we end up thinking we ate at one restaurant with our friends, when really we ate at a different restaurant, or we get confused about the order in which different experiences happen. Those sorts of errors don't make a lot of sense if you're thinking about a memory as a book that you're just pulling out and, and, and rereading it or replaying it. But they make a lot of sense if you understand that you're actually having to rebuild and reconstruct a memory every time that you're retrieving it.

Larry (13:23):

So forgetting is not as simple as just cutting the strings.

Dr. Kensinger (13:30):

No. So, so forgetting can happen for any number of reasons, and we really wanna emphasize that it's, it's normal, right? Forgetting is within, you know, within bounds is quite a normal effect of the way that our memory systems work. It can happen because you don't notice something as you're forming a memory. You don't pay enough attention to it. That building block never gets written into the blueprints. It can be that something happens as the blueprints are being stored that they, you know, get smudged, they don't have the resolution anymore. And so it's difficult to bring back the, the right building blocks later on. But often forgetting is just something that happens momentarily at retrieval. You know, we all have that experience where we know someone's name, but just in that particular moment, we can't come up with a name. And that's, you know, the building block is there, the blueprints for that building block as being part of this person's representation are there. But for whatever reason, right at that moment, we can't grab that building block until we don't have access to that content.

Larry (14:32):

Now this podcast is directed at those of us, as I like to say, in the remember when generations. So a very obvious question is how does memory change with age? What's normal aging forgetfulness?

Dr. Budson (14:51):

Yeah. So there are three basic changes in memory that I'd like to think about. And they're all related to the fact that the frontal LOEs are actually very important for our memory. And if we continue our sort of building construction analogy, it's sort of like the, the frontal lobes are, are sort of like the builder or sort of the contractor or organizer that's sort of organizing the whole building operation. And as we all get older, this builder gets a little bit older too. And so I, I'm gonna sort of stretch our analogy almost to the breaking point to help everybody be able to remember what are the three common changes that happen in normal aging. So one way I like to think about is our, our frontal low builder, you know, is getting a little hard of hearing as they're getting older.

Dr. Budson (15:56):

And because of that, as part of normal aging information may need to be repeated a couple of times in order for us to be able to remember it. Another thing that happens to our older builder is they don't move quite as quickly as they used to. And because of that, you can imagine that as the builder is sort of reaching into the box and pulling out those building blocks, it may take them a little bit more time to assemble them back together. So memory retrieval can take a little bit of more time. And the third thing that happens to our older builder is that their vision, their eyesight is not quite as good as it used to be. And because of that, as they're sort of squinting at the, the building blocks and trying to pick out the right one, they may need a hint or a cue in order to grab the right block for this memory. And so, in a nutshell, those are sort of three of the common changes that all happen as part of normal aging information may need to be repeated. It may take a little bit longer to get the information out, and sometimes one needs a hint or a cue in order to retrieve it.

Larry (17:31):

So, progressing from that, how do we determine the difference between normal aging and forgetfulness associated with disease or medication diseases like Alzheimer's? Well, that's not probably a good example in our discussion, but

Dr. Budson (17:54):

Yeah. Well, well, let me, let me talk for just a, continue this sort of little analogy to, to talk about what happens in Alzheimer's disease. And then maybe Elizabeth, you know, can maybe mention what happens in like medication side effects or, or something like that. So in Alzheimer's, instead of it being the frontal lobe builder the first thing that tends to happen in Alzheimer's is the, the hippocampus is having problems. And the hippocampus is where those blueprints are stored for the memory. And so you can imagine that, you know, an individual's trying to retrieve a memory of, you know, what they had for dinner last night, or they're trying to remember, you know, this podcast the following day. And so our builder is sort of looking to the hippocampus to pull out those blueprints to find out what blocks to pull for.

Dr. Budson (19:05):

And they can't, you know, they can't get the blueprint or the blueprint is torn and distorted, so they start to pull blocks out, but they're not, they don't quite all fit together and they have to sort of guess what are the intervening pieces. And because of that, the memory loss that occurs in Alzheimer's is qualitatively very different from the memory loss that occurs in normal aging. And this is one of the reasons that, you know, as a, as a memory doctor, it is often straightforward for me to figure out whether the memory problem someone is experiencing are from normal aging or from a disorder like Alzheimer's, because they really look qualitatively different

Larry (19:58):

Mm-Hmm. <Affirmative> and in medication related memory loss or other disease covid memory loss. That's, that's different.

Dr. Kensinger (20:14):

So I think there, it's important to recognize that just as we talked about kind of more normal forgetting being able to happen for a number of reasons, the types of more extreme memory loss that people experience can also be happening for lots of different reasons. So sometimes it might not actually be an impact directly on memory, it might be that something is affecting someone's ability to engage attention. And because someone isn't able to focus their attention on what's happening, they're not able to create a stable memory. It could be that a medication is affecting someone's sleep quality and is reducing that, and as a result, the person isn't getting the sleep that they need to store a memory. And sometimes what's happening is that a medication is altering the, maybe even intentionally, the purpose of the medication is that it's altering some aspect of the neurochemical environment of the brain.

Dr. Kensinger (21:04):

And so when we're talking about these blueprints that are being written in the building blocks that are being assembled, of course all of this is really happening by cells of the brain that are getting reconnected in different ways. And the way that they connect is through chemicals that they, that they use to communicate and to connect with one another. And so different medications can affect different types of chemicals, and the particular ones that they're affecting can really influence whether the problem is somewhat similar to what Andrew just described with Alzheimer's, a problem with the blueprints being written. Other times it might actually be a problem with some of the chemicals that help to give the brain prioritization signals and to say, okay, this is something that's important. Let's make sure we get the blueprints written for this memory. And that can really be thrown off. And so people can have a lot of difficulty getting into memory and storing the events that would otherwise be obvious as the important moments from the day to, to record a memory of.

Larry (22:03):

So what can we do as seniors to improve our memory excluding diseases and drugs?

Dr. Budson (22:12):

Yeah. So, you know, I'll, I'll begin by mentioning some of the lifestyle changes that one can do. And Elizabeth, as part of writing this book, came up with this wonderful acronym that helps us all remember including when we're getting a little older good ways to remember. So one of the most important things that we can do regardless of our age to help our brains be really ready to learn new information, is to engage in regular aerobic exercise. And it's recommended that everyone, including seniors, do at least 30 minutes a day, five days a week of aerobic exercise. And, you know, in part, this of course will help our, our heart and our general health of our body, but in fact, the exercise has direct effects on the brain. It actually helps to release growth factors in the brain that helps us grow new brain cells.

Dr. Budson (23:28):

And there was one study that looked at individuals age 55 to 80 and found that those who engaged in regular aerobic exercise had such a growth of brain cells in the hippocampus, that they could actually see the change on an MRI scan in as little as six months. And this was a one year study, and then it got even larger over a year. And there was a correlation between how much people improved their fitness, how much growth factor was released, how large their hippocampus got, and how good their memory was. So the first, second, and third things that I want to tell all your listeners out there is exercise. Exercise, exercise is as close as we have to a magic bullet to improve memory now. So other things, two other things I'll mention that have been shown are really important as well. One is to eat healthy foods.

Dr. Budson (24:37):

And one way to think about these would be the Mediterranean menu of foods that includes fish and olive oil and avocados and fruits and vegetables, nuts and beans, whole grains. And from sort of a sister diet that's also been studied, we can pull in poultry chicken and Turkey as other foods that have been shown to be healthy. But in fact, more recent research suggests one of the reasons the Mediterranean menu of foods is healthy is that portions are a reasonable size and it does not use processed foods. And I think the main message I'd like your listener to take away, it isn't that they can't have a little bit of red meat or a little bit of dessert once in a while, but that these things should be reasonably sized and when possible again, they shouldn't be highly processed.

Dr. Budson (25:41):

So one can have a delicious dessert that may be, you know, fruit. It doesn't have to all be sort of processed into a, a, a, a pie or a puree and add sugar and all sorts of other things. Just have it just the, the natural fruit and then it's perfect and perfectly healthy. And the last lifestyle change I wanna mention is sleep. And sleep is, is very important. We can get into more of the details of it if you wish, but it's important that people have a, a normal healthy amount of sleep. For some individuals that might be seven hours a night, others it might be eight hours a night or eight and a half hours a night, and that's all fine. Getting fewer than seven hours of sleep is a little questionable. Fewer than five hours of sleep, I would say is always too little. But people should also not go the other extreme. People who try and sleep nine or 10 hours a night are gonna find it's not gonna work, and that's not a good thing to try and do either.

Larry (26:52):

So what about brain games? We've all heard if you do sudoko, if you do crossword puzzles, does that help help?

Dr. Budson (27:03):

Well, well, I'll, I'll let Elizabeth take, take that one and, and maybe talk about her little acronym as well.

Dr. Kensinger (27:09):

Yeah, yeah. Well, let me, let me say that, you know, I think that the conclusion that we came to from our reading of the literature is that if you enjoy doing brain games, great. If you enjoy doing Sudoku, great. But really it's about staying cognitively active in whatever way you find enjoyable and in a way that you'll continue to stay mentally active. So that might be learning a new language that might be learning how to golf, that might be any number of things. And as long as you're really, you know, having to engage different parts of the brain, different memory systems you know, it's, it's going to serve you very well. So it would be wonderful if there were a single thing that worked for everyone, but that just doesn't seem like, like there's strong data to suggest that that's the case.

Dr. Kensinger (28:00):

And I did wanna just circle back to say that we did realize in, in reading the literature that there are some simple strategies that people can use to help make sure that a memory is created. So this is really targeting that first stage. How do you make sure that whatever you're experiencing right now, if you want it to become a memory, whether that's remembering someone's name, remembering where you set down your car keys or remembering the password that you need to remember for an application, what are the steps that you can take to make sure that you actually get that content stored into a memory? And so the acronym that we developed is four F o u r, which conveniently is for the four things that you need to do. So the f stands for focus attention. And that I would say is the most important thing that really underlies memory.

Dr. Kensinger (28:52):

You cannot create a memory if you're not focusing enough attention on what it is that you're doing. And we all know that we are in a world where we're often trying to do more than one thing at a time, and that's just not what our brain is designed to do. So if you want to be forming a memory, you want to be in the moment, you want to be paying attention to where you're setting down your car keys, you wanna be thinking about the name that someone is telling you and how they're pronouncing it, if you want to get that pronunciation correct you know, it's really important that you're focusing attention. The o is that you want to organize information. And this can be particularly important for passwords, phone numbers, things like that. Because it turns out that the capacity of our memory system is really about organized pieces of information.

Dr. Kensinger (29:41):

We can get about three or four organized pieces of information into memory pretty easily. So if it's a password that is 12 characters long and you haven't given it any organization, that's gonna be really hard to get into memory, everyone is going to really struggle with that. But you might realize that you can actually organize the information differently. Maybe some of the letters cluster together in a way that form, you know, small words, or you could think of a sentence that makes sense using the first letter of the words. And now rather than having 12 individual pieces of information, you have a much smaller number of pieces of information. And so again, ideally you wanna be aiming for getting whatever you're trying to remember into no more than three or four organized pieces of information the you is for understand the information. And this can be something as simple as making sure that you've heard someone correctly.

Dr. Kensinger (30:37):

So if someone is telling you their name or their address, you need to actually understand and confirm that you've understood what they've said. But of course, it can also scale up, right? If you're learning that new language, you want to be sure that you're really understanding the rules behind the grammatical structure, right? You want to get to that level of understanding first before you just start to commit things to memory. And the r stands for relating information to something that you already know. So someone tells you their name and you realize that maybe they have the same name as your cousin or an author that you like. Make a note of that, right? Make a mental note of that relation. Oh, okay, I've noticed that there's this in common. Let me, let me record that as part of this representation of the information. Similarly, maybe you have a new app on your phone and you're trying to figure out how it works.

Dr. Kensinger (31:32):

You know, it can be really helpful to kind of take that step back and say, okay, what do these icons look like to me? And how can I relate what they look like to what their function is so that the next time that I open this app, I actually can figure out what I'm doing right. That was very important to me as I had to get used to, you know, all of these different ways to connect virtually is trying to make sure that the icons made sense to me in terms of, of what they meant so that I could easily find what I needed to do. So again, that F o u R focus, attention, organize, understand, and relate. And I think those are really basic strategies that can be applied to almost anything and can dramatically increase the likelihood that we create a memory

Larry (32:13):

That explains it. Thank you. Let's circle back again to the sleep issue. As a dentist who did some treatment of patients with snoring and sleep apnea and who couldn't sleep solidly through the night, let's get back and talk a little bit more about the importance of sleep.

Dr. Budson (32:39):

Sure, there, there's a lot of important things that happen when we're sleeping that can help us to remember things better. And I'll, I'll mention a a couple of them. So the first I would say is sort of the, the obvious thing, which is that if one doesn't get good sleep the night before, then you're often tired the next day. And if you're tired, it's hard to focus your attention. So of those four things we wanna do, we can't do the most important one, which is to focus attention. So that's the first way that sleep, poor sleep in particular can impact memory. The second thing is that it turns out that when we sleep, our memories change a little bit from being temporarily stored to being more permanently stored or at least much longer term stored. And this change occurs while we sleep.

Dr. Budson (33:58):

What we think is happening is all the different sight and sounds and thoughts and smells and feelings of the different memory, instead of only being linked together through the hippocampal blueprint, these different parts get linked directly together. And so essentially you have a blueprint for the memory that can be reconstructed without needing the hippocampus. And that's why Henry Lazin was able to retrieve these previously consolidated memories of when he was, say, a teenager before he underwent his his surgery. And it is sleep. When this is going on, and we know it takes multiple stages of sleep, it appears, and I use that word because this has not been definitively proven yet, but it appears that during non rem sleep, so not dr not the rapid eye movement sleep, but other stages of sleep is when the memory gets sort of replayed and that basic consolidation is laid down and there is dreaming that can occur even during this non REM sleep.

Dr. Budson (35:22):

But then during the REM sleep is when the autobiographical memory of say, what happened to you yesterday is connected to all your other stores of memory within the brain and also your other store of factual information. So when and, and we think that this process is actually what dreaming is, so when people wake up and they remember dreams, it's actually us being transiently aware of this consolidation process. So sleep is important. So we're not tired and we can pay attention. Sleep is also important because this is when our memories change from short-term temporary memories to long-term, much more permanent memories. And then the last thing I'll just mention about sleep is that you and your, your listeners may know very well that one of the abnormal proteins deposited in Alzheimer's disease is called beta amyloid, and it forms these amyloid plaques in the brain that we think start the inevitable cascade that leads to Alzheimer's disease dementia. Well, it turns out we all make a little bit of this amyloid protein during the day, but we normally have it flushed out of our brains while we're sleeping. And because of that, it's important that we get enough sleep to give ourself time to flush away this amyloid protein. So it's at least a little bit less likely to form plaques.

Larry (37:14):

And you recommend reading your book in small sections and sleeping in between.

Dr. Kensinger (37:23):

Exactly. So, you know, we really did try to write the book with the science of memory in mind, and I think that was another really, you know, fun challenge for us, right? To really think about what does the science of memory say about how you want to construct a book, how much you want to be repeating key ideas. And absolutely one of the important takeaways is, you know, if you read something all in one sitting, you don't have the opportunity to reflect on it, you're probably reading it in the same chair, you know, with no changes in the environment. And to remember things well, you actually want to be learning that information across some different contexts, different times of day, ideally, different rooms, different spaces, and you wanna be sleeping in between. And so we really do advise the reader to, to take advantage of all of those strategies if they want to remember the content in the book as best as possible.

Larry (38:14):

One, one of the most embarrassing things as a senior adult is forgetting names. Can we go back over that? The process of trying to remember names once more?

Dr. Budson (38:32):

Sure. There's, there's a lot of different things that people can do to improve their memory for names. And, you know, probably one of the, the most important thing when you're, you're meeting someone new and then we'll talk about what is it, if you're trying to remember the name of someone you've known for 30 years, but let's start with when you're meeting someone new. So when you meet someone new and you say, you know, oh hello, you know, my name is Andrew, and they tell you their name, you wanna make sure you're paying attention to them. And it seems obvious, but so often when we're in a social setting, we're paying attention to all sorts of different things. We're sort of looking at the person's face and we're like, does this person like me? You know, are they happy to see me? Do they recognize me?

Dr. Budson (39:30):

You know, or we're thinking like, you know, I still have my coat on and I'm getting overheated. Or those o' dvs look really good over there and, and we're just not really paying attention. So the first thing is to pay attention. And then the next thing that will help us to remember that name better is to say the name back to repeat the name preferably out loud, but if not out loud, then say it to ourselves. And so we can say, oh you know, the it's nice to meet you Larry. And you might say, you know, I just did a podcast with somebody named Larry, you know, and try to relate that name to something that you know, and repeating the name, relating it to something that you know are really key. And then if you wanna take it to the next level, what you then wanna do is you want to try to connect something in the person's appearance that will help you to be able to remember their name.

Dr. Budson (40:45):

And so, for example, you know, looking at you Larry, you have a, a, a wonderful distinctive sort of a goatee beard, right? And so I might try to sort of form little Ls that are sort of mirror images of, of each other that are sort of making the form of your goatee. And so when I'm looking at you, I'm actually imagining these two Ls there, hoping that the next time I see you, it will help to trigger the Ls that will help me remember that your name is Larry. And then to help myself remember as I'm ending the conversation and going to get a cup of water, I might say, it's really nice to meet you Larry. And I'll say the name again. And then as I'm driving home from the cocktail party, I'll think to myself, let's see.

Dr. Budson (41:48):

So this evening I met Elizabeth and I met Larry, and I met Jane, you know, and you go over the names and if you really wanna remember it, then the next morning or later in the week, say the names again. No. So that party last Saturday, you know, I met Elizabeth and Larry and Jane, and that will really help you remember the names for a long time. And I'll let Elizabeth talk about what do you do when you know the person's name? You've known them for 30 years, they're getting closer, they're walking up to you and you realize you're gonna have to introduce them to your friend standing next to you, and you can't remember their name.

Dr. Kensinger (42:32):

Yeah. So here, there are two things that we commonly do that make it harder for us to retrieve. And so really here the advice is to avoid doing two things. The first thing to avoid is getting really stressed and anxious, which is absolutely easier said than done. But you know, often we see that person coming toward us, their name doesn't immediately spring to mind, and at least, you know, I can feel my, my palms getting sweaty as I'm trying to come, you know, think of what their name might be. And instead we really wanna resist that temptation and instead just take some deep breaths, focus on how you're gonna engage the person without knowing their name, right? Most of the time it's actually okay. Someone doesn't expect to be called by their name every time someone sees them. You can give a very friendly greeting that makes it obvious that you know who this person is, even if the name isn't springing to mind.

Dr. Kensinger (43:25):

So you wanna kind of reframe your goals, not being about having to come up with their memory right then, but just being about relaxing and focusing on having a pleasant conversation with someone. The second thing to avoid doing is trying to come up with possibilities for their name. This feels like it should be helpful, right? Okay. And maybe you even have the first letter or the first sound of the name, or you think you do, or you think it's a short name, right? You might have some access to some content, maybe it's right. Don't keep thinking about possibilities. Again, it seems like that might be helpful, but actually the way that memory networks work, if you are bringing to mind this one sounding name, what you're actually doing is you're making it less likely that all the similar names come to mind. And so, when we're generating possibilities for what someone's name might be, if those possibilities are wrong, we've actually just made it really unlikely that we're going to generate the correct name.

Dr. Kensinger (44:25):

And I think it's those two things that we're stressed out and we're generating possibilities, which is why, why many of us have the experience that, you know, it's 15 minutes later, the person's gone, and suddenly their name comes back to mind. But what happened in that 15 minutes is we relaxed and we stopped coming up with all of the possibilities for their name. And so now that content kind of bubbled up to, to the surface, and we were able to access it. So, you know, again, instead relax, reframe the goals. If you want to try to help yourself, remember, think about other things you know about the person. When was the last time you saw the person? Maybe you remember that you enjoy some hobby with them, or that you discussed a book that you had both read or something like that, you know, that's fine content to bring to mind. And often bringing those other dimensions back to mind will help you generate their name, but don't actually keep trying to come up with possibilities for their name.

Dr. Budson (45:18):

Yeah. And I just want to say that I, I've had trouble coming up with people's names my entire life, and it really works to think of other things that you know about the person, think about their children, you know, just like Elizabeth was saying, like when you saw them last, think about those other things. It helps the name come to mind.

Larry (45:41):

So, Andrew, if we meet again in 30 years, which is fairly unlikely because I'm 86 and I have shaved <laugh>, you won't know who the hell I am.

Dr. Budson (45:53):

<Laugh>, right? Well, well you're, you're, you're, you're right that you know, it is important to try to pick a feature of the person that isn't likely to change dramatically from one time to the next. So don't, don't, for example, I mean, use an article of clothing. I mean, that might work when you see them later at the same cocktail party, but that's not gonna work when you see them six months later. But, you know, these things are, are very real. I remember vividly, so when I was in my neurology residency training, I had a long ponytail and and then I, I cut it sort of at the end at the couple years, a couple years later. And what I realized, like all these people like weren't recognizing me because I, my appearance had sort of changed dramatically. So these things really do make a difference whether you're using a mnemonic or not.

Larry (46:55):

And this comes and goes at Whim <laugh>. So your book again is Gimme the title,

Dr. Budson (47:06):

Oh, why We Forget and How to Remember Better. The Science Behind Memory,

Larry (47:14):

And it's available at,

Dr. Budson (47:17):

It is available at your local bookstore. It's available on, you know, amazon.com and, and other, you know, retail and online stores.

Larry (47:31):

Elizabeth Andrew, thanks for being on the podcast. You have really helped us to understand, not just remember, but understand the science of memory. It's been a pleasure having you on.

Dr. Budson (47:50):

Thank you. A, a, a pleasure to be here. Absolutely.

Dr. Kensinger (47:54):

Thanks so much for having us.

Larry (47:56):

Oxford Press has graciously agreed to give away two copies of Dr. Butson and Kens digger's book. For a chance to win a copy, go to, specifically for seniors.com, there's a box on the homepage to sign up for our email list and be notified when new podcasts have dropped. I'll be choosing a couple of names at random and pick winners in about a week. So stay tuned. Thank you again for coming on the podcast.


Andrew Budson, MDProfile Photo

Andrew Budson, MD

Andrew E. Budson, MD majored in chemistry and philosophy at Haverford College before receiving his medical degree from Harvard Medical School. Dr. Budson is Professor of Neurology at Boston University, Lecturer in Neurology at Harvard Medical School, and Chief of Cognitive & Behavioral Neurology at the Veterans Affairs Boston Healthcare System. His career combines education, research, and clinical care to help those with memory disorders. Budson is also the author of Seven Steps to Managing Your Memory and Six Steps to Managing Alzheimer’s Disease and Dementia.

Elizabeth Kensinger, PhDProfile Photo

Elizabeth Kensinger, PhD

Elizabeth A. Kensinger, PhD majored in psychology and biology at Harvard University and received her PhD in neuroscience at the Massachusetts Institute of Technology. After a postdoctoral fellowship at Harvard University and the Massachusetts General Hospital, she joined the faculty of Boston College, where she is now Professor and Chairperson of the Department of Psychology and Neuroscience. She directs a research laboratory that investigates many aspects of human memory, including how emotion, stress, and sleep affect memory, and how memory strengths shift as adults age. She also teaches courses on these topics.

Why We Forget and How to Remember Better: The Science Behind MemoryProfile Photo

Why We Forget and How to Remember Better: The Science Behind Memory

What would you do with the power to remember everything? If you could, would you want to? Is forgetting a weakness or an important brain function? What can you do to make your memory sharper? From two scientists specializing in memory comes WHY WE FORGET AND HOW TO REMEMBER BETTER: The Science Behind Memory (Oxford University Press on February 1, 2023) by Andrew E. Budson, MD and Elizabeth A. Kensinger, PhD. Dr. Budson is Chief of Cognitive & Behavioral Neurology at the VA Boston Healthcare System and Associate Director of Boston University’s Alzheimer’s Disease Research Center, and Dr. Kensinger is Professor and Chairperson of the Department of Psychology and Neuroscience at Boston College. WHY WE FORGET AND HOW TO REMEMBER BETTER provides answers to many questions related to the neuroscience of memory—answers that may surprise you!

We all wonder how we can best overcome one of the human experience’s most frustrating phenomena: forgetting. Why do we forget things we want to remember, and remember things we’d rather forget? How can we be certain about something we remember—and be wrong about it? Why is it so difficult to remember people's names? How can we study hard for an exam but not be able to recall the material on the test? In WHY WE FORGET AND HOW TO REMEMBER BETTER, Dr. Andrew Budson and Dr. Elizabeth Kensinger address these questions and more, using their years of experience to guide readers toward retaining information better and understanding why memory failures arise—and what we can do to prevent them.

WHY WE FORGET AND HOW TO REMEMBER BETTER shows the reader how to use these answers to improve their memory. In its pages, readers will learn:

- How memory's most important function is not to help you remember details from your past.
- How memory is a collection of different abilities.
- How your brain creates, stores, and retrieves memories in daily life.
- Ways to control what you remember and what you forget.
- Ways to distinguish between a true and false memory.
- Effective ways to study for an exam.
- How exercise, nutrition, alcohol, cannabis, sleep, mindfulness, and music affect memory.
- How to remember people's names, 50 digits of Pi, and anything else you desire.
- How memory changes in normal aging, Alzheimer's disease, depression, anxiety, PTSD, ADHD, and other disorders—including COVID brain fog.

WHY WE FORGET AND HOW TO REMEMBER BETTER explains how our memory works, enabling us to better control what we forget and what we remember, identify false memories, understand why most of what we believe about our memory and how it works is likely wrong, and how everything from inattention such as ADHD to psychiatric problems such as PTSD can affect our memories. The book also discusses why certain individuals have a remarkable ability to retain information and what we can learn from them to improve our own memories.

WHY WE FORGET AND HOW TO REMEMBER BETTER empowers readers with the knowledge of how to remember better, whether they are a student looking to ace their next exam, a business professional preparing a presentation, or a healthcare worker needing to memorize the 600+ muscles in the human body.