Why do we sometimes feel like we've lost the keys or do words stay on the tip of our tongue? Why do we forget what we were going to do, when we just entered the kitchen? Is there a scientific reason that explains violent attitudes or ghost visions? Dr. Saul Martínez-Horta explains the behavior of the brain and clarifies what is normal and when we should worry. He does it in the book Where Are the Keys? (Geoplaneta), which he has just published.
Martínez-Horta, doctor of Medicine and specialist in clinical neuropsychology at the Sant Pau Hospital in Barcelona, directs the Department of Neuropsychology at CDINC and has extensive experience in clinical practice and research in neurodegenerative diseases, brain damage and neurodevelopmental disorders. On his Twitter profile, with more than 45,000 followers, he narrates clinical cases of his experience, cases that have sometimes gone viral.
This book talks about the neuropsychology of everyday life and if there is something common, it is the feeling of memory loss. In most cases is there a medical reason behind it?
It depends a lot on personal circumstances, age, and what these memory losses look like. Unfortunately, in my area, a significant proportion of the people who complain have a pathological process behind them. But it is important to note that, in a very significant part, you have the subjective or objective sensation that you forget things, and there is no pathological process behind it. If you detect that something is changing in your memory, it is a sign that it is worth someone looking at you, like if you have a toothache. Then we will find out if there is a disease behind it or if it is a completely benign circumstance. It is necessary to evaluate it.
When should you go to the doctor, then?
We must apply the same rule as with physical symptoms. When something happens to you that has never happened before, when a lump or irritation appears, you go to the doctor and consult. Exactly the same thing happens with cognitive issues: when you get the impression that something has changed compared to how you functioned before, you have a harder time finding words, you forget more things or you don't pay the same attention as before, you should go to the doctor. These symptoms are not necessarily a symptom, but they are worth checking without fear.
When there is no neurological disease behind it, what could be affecting us by having these forgetfulness?
The mechanisms that give rise to the cognitive processes that we continually deploy in life, that is, attention, memory, language, how we orient ourselves, etc., are complex and fragile in nature. Eventually, some processes fail, especially under certain circumstances: being exhausted, having anxiety, not having rested well, being very dazed with work... The attentional resources of human beings are very limited, and we are not aware of it. We are continually elaborating, processing information in a super chaotic way. This can cause interference in certain processes and, consequently, lead to errors such as not knowing where you left your keys, or not remembering someone's name. They are totally benign events, the product of a brain that is saturated.
Is it normal to lose memory due to age?
Aging inexorably involves changes and in the psychological field they are totally normal. We lose agility, we lose visual acuity, and obviously there is some cognitive loss, but it always happens within normal parameters. Memory impairment, when it involves an alteration, is never explained as a consequence of age. There is a terrible trivialization and normalization of cognitive deterioration associated with age that requires negligence in many cases in which there really is an underlying degenerative disease or other causes.
He says that senile dementia does not exist...
Aging is not a disease, but it is associated with the risk of developing age-related diseases, such as certain cognitive disorders. Senile dementia as such does not exist, there is a secondary dementia due to biological processes that could be Alzheimer's or an infinite number of other causes, but age is never the explanation. A memory disorder as such is not a consequence of age, if we age healthily, this should not happen.
We have things on the tip of our tongue, but we cannot verbalize them. When is it a problem?
When we speak we automatically access stores in which we have the words stored and these are organized in a certain way. It is a process of access and bringing to consciousness an item that we have stored somewhere. This process may occasionally fail, for example, because a similar word interferes. In certain pathological circumstances there is a progressive and persistent loss of the ability to find names in things: the person tries to speak spontaneously or tries to name objects and has great difficulty, even transforming the word or another word from the same family comes out. So it is worth seeing if there is something significant that is causing it.
And when is it normal not to find the word you are looking for?
The usual phenomenon of, “oh man, I can't get the idea” and after a while it ends up coming out on its own, that is a consequence derived from how we function and that has no pathological implications.
I can't find my car keys or my cell phone, to the point of tachycardia... and maybe I have it in my hand or in my pocket. But I can't find it and I can spend half an hour with significant anguish. What happens to us in the brain?
What has happened is that you have not learned where you left your cell phone. For something to be forgotten, you must have previously learned it, you must pay attention to it. If we do not dedicate enough attention to it, it will never become a learning experience, a memory. Since we do many things completely automatically and our attentional system is very under pressure because we are doing a thousand things at the same time, the minimum attentional requirement of having processed where I left my keys or cell phone has not occurred. Since there has been no attentional resource directed at what I just did, it has not been stored. The fact that it happens a lot to us when we are in a hurry or anxious is not a coincidence, because we are saturating these attentional systems even more and, therefore, the information is processed in a much less elaborate way.
Sleep paralysis can affect between 8 and 50% of the healthy population! How would you explain why it occurs and what it generates?
The brain functions, among other things, at certain electrical frequencies, in certain phases of sleep. When we dream it is associated with a lot of brain activity, but, on the other hand, we are not moving, because there is a kind of disconnection. In sleep paralysis, it is assumed that this mechanism for regulating what the brain does and what the body does is dysfunctional. The awakened person is aware that he is awake, but has not regained mobility, he tries to move and cannot, he is paralyzed.
This is not the most surprising phenomenon, but in many cases paralysis is accompanied by experiences of terror...
It is accompanied by hallucinatory experiences and very terrifying sensations. For example, many people notice a presence in the room that is watching them, and in many cases they develop a very complex hallucination, which is having the sensation that an evil entity is placed on the person's chest and does not allow them to breathe, and does not allow him to move. It is such a generic, global and cross-cultural phenomenon that in practically every culture there is a word that defines this evil entity that blocks us while we sleep. For many people, there is a great fear of having to go to sleep so that the experience is not repeated.
Presences, hallucinations of presence, ghosts... Are many supposed paranormal phenomena explained by the functioning of our brain?
Exact. That's how it is. Yes Yes. And pathology should not be confused with normality in relation to these phenomena. That is to say, we very commonly see in the consultation setting people with neurological disorders where the symptoms of these conditions have exactly the same characteristics as many paranormal phenomena referred to throughout history. Just yesterday I saw a paradigmatic case.
What was happening to the patient?
It was a woman who began to see shadows on the ceiling that turned into people hanging from the ceiling of the dining room. After a while she began to hear voices coming from behind a wall in the dining room wall. Her voices told her that that house was not hers, that she had to leave. After a few days, while she was looking in the mirror, she saw that her reflection was another person, one of those who told her that she had to leave. She believed that these entities that lived behind the wall could access the house through the closet and so she decided to lock the closet, but while she was locking it she saw a hand appear from behind and take the closet key and lock it for her. hid And in fact they still have the closet locked because they have not yet found the key that locked the closet with.
Was all this the result of a pathology?!
It is dementia with Lewy bodies, a common neurodegenerative disease that associates very complex hallucinatory phenomena and experiences and in many cases creates the appearance of a paranormal phenomenon. However, just because a person has experienced an apparently paranormal event does not mean that he or she has an illness. That is to say, there are diseases that as symptoms give rise to these types of experiences, but there are errors in how the brain and the human mind work that can trigger these types of paranormal experiences, without there being an illness. A person who has had abnormal perception, or who has seen a ghost, does not necessarily have a neurological disease. A totally healthy, totally normal brain can give rise to this type of phenomena.
Talk about intuition, cognitive biases... How does the brain process work when we have to make an important decision?
It is an excellent question, we all ask it and it has a very complex answer, I must simplify the answer. There are many circumstances in which you must decide, in some there is risk, ambiguity. Simplifying, when we are deciding, we are using information related to previous similar events that in some way inform us of what is best for us. Which doesn't necessarily mean this is the right decision. But it is crucial to keep in mind that when we decide we are not aware that there are elements related to our own history that are conditioning the decision. This is part of a very elegant theory developed by Antonio Dámasio, which is called the theory of somatic markers and which has to do with how certain signals from our body, of an eminently emotional nature, shape the way we tend to make decisions. There is an emotional component inherent to the way we decide. We believe ourselves to be deeply rational beings, but if we were, we would not buy phones that are worth the same as a monthly rent for an apartment. Decisions are not strictly rational although they may seem that way to us.
What conditions them? What should we take into account when we decide?
Decisions are conditioned by our learning histories, by how we regulate our emotions. But for this to happen correctly, we need a series of brain systems dedicated to processing emotions, memory and integrating this information, of which the frontal lobe contributes a lot here. When these systems do not work correctly, we tend to make completely erroneous or wrong decisions because not all the information that we inadvertently use to make decisions is being used. In any case, if we are not immersed in a context of emotional pressure or stress, possibly guiding ourselves by this “intuition”, by what our heart tells us, by these sensations that we call somatic markers, is possibly one of the best ways to take decisions.
Regarding near-death experiences, he explains that the brain still functions for a while after clinical death. What is the most surprising thing that he has known or that he has seen in this regard?
When the brain begins to die, it does not die suddenly; When the neuroelectric activity begins to turn off, before it turns off, there are spectacular changes in brain activity, there is a very notable increase at certain frequencies, in certain areas of the brain... They are areas that have a lot to do with memory, with depth perception, with the location of our body in relation to space, and these electrical anomalies are reproduced in many of the people who are dying. When you look at what happens to the dying brain, it is biologically very plausible with the type of experience being explained, the feeling of tunnel vision, reliving life events, meeting people you have met, or even one's own. mystical experience, of contact with divinity, are phenomena that have a lot to do, if not everything to do, with what is happening in this brain. The near-death experience is just another consequence of the neurobiological change that the dying process imposes. We see these experiences when death is due to cardiorespiratory arrest, where the brain is intact.
This article was originally published on RAC1
