Rebuilding identity after brain injury: Standard cognitive and music-evoked autobiographical memory training

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Journal name, number (year), pp.:

International Journal of Therapy and Rehabilitation, June 2014, Vol 21, No 6

Authors:

Authors:Gurr, Birgit; Foxhall, Mia
Clinical Neuropsychologist, Dorset Healthcare University Foundation Trust and Poole Stroke Unit, Poole, UK
Assistant Psychologist, Dorset Healthcare University Foundation Trust, Poole, UK

Abstract:

This paper presents a report involving a male patient who had experienced a subarachnoid haemorrhage. He presented with profound anterograde and retrograde amnesia, which caused him to be severely confused about his social contacts and his environment. Aim: To describe the complexity of amnesia and identity loss and examine how the combination of cognitive and music-evoked autobiographical training affected a person with anterograde and retrograde amnesia following subarachnoid haemorrhages (acquired brain injury [ABI]). Method: The 47-year-old male patient, who had worked as a DJ for some parts of his life previously had a good memory of musical events and facts about musical artists. This patient received an applied cognitive training programme (part I), which was based on spaced retrieval and errorless learning methods. The patient also received therapy involving the administration of music-evoked emotional responses (part II). The cognitive training programme consisted of 13 hourly sessions spread over four weeks. The music-based intervention included 5 hourly sessions, which took part place over two weeks. Results: Part I optimised the patient’s name recall and local orientation. The resulting recovery of day-to- day memory and the awareness of the dependence on learning strategies led to the patient having a realisation of his severe loss of autobiographical memory. The patient became frustrated, angry and depressed and was at risk of disengaging from most areas of his neuro-rehabilitation programme. Part II enabled the patient to link the music or the artist with autobiographical events and to elicit emotional responses to such events. These were stringed into an autobiographical narrative with the result that the patient gained insight into the person he used to be and connected with past emotional experiences. The regained autobiographical memories were maintained beyond the training context. Conclusion: The patient’s mood and motivation to continue his neuro-rehabilitation programme improved. This enabled him to make further progress regarding his functional independence.