Walking into another room and forgetting why you’re there or missing a routine doctor’s appointment because you jotted down the wrong day are all part of life’s little hiccups. But when you can’t recall what you had for breakfast, struggle to find your way to the pharmacy you’ve visited for years or — as is often the case with cognitive decline — lose touch with familiar places and routines, it can lead to a deep sense of isolation and depression as you begin to disconnect from the world around you.
Finding ways to connect to your old self or to help a loved one do so can help reduce feelings of stress, anxiety and agitation for people with dementia. One effective approach to bridging that gap and reconnecting with the past is reminiscence therapy, a therapeutic method that encourages individuals to reflect on old memories.
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What Is Reminiscence Therapy?
Reminiscence therapy is a type of psychotherapy that uses techniques, such as visual cues, oral discussion, written stories or sensory engagement using taste or smell, to help individuals recall significant memories, feelings or thoughts from the past. This type of therapy is most commonly used with patients with dementia or depression.
“Dementia robs people of their short-term recall, but older memories tend to stay intact longer,” says Claire Law, a relational psychotherapist. “Tapping into those memories through reminiscence therapy can help clients maintain a sense of identity.”
“Instead of forcing them to remember what happened this morning, we tap into deeper, more ingrained memories that they still have a hold on,” Law says. “It’s not about perfection or getting every fact right; it’s about accessing a sense of self and familiarity they can still connect to.”
Dr. Naoko Muramatsu, a professor in the division of Community Health Sciences at the University of Illinois Chicago School of Public Health and co-director of the Center for Health Equity in Cognitive Aging, adds that patients with dementia often feel loneliness because it’s very difficult to connect with other people, and that isolation can be a real force for depression.
For those patients with dementia, reminiscence therapy can help connect them back to a stage of life that they cherish.
“The goal is to improve the well-being of the person,” Muramatsu says.
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How Reminiscence Therapy Works
Reminiscence therapy requires an individualized approach, so sessions can vary greatly in structure.
“There’s no strict blueprint for how to run a reminiscence therapy session because each person’s life story is unique,” Law says.
“Some sessions are almost like casual chats; others are more structured with photo albums or timelines. I might use a reminiscence ‘box’ filled with objects from a certain era, like old postcards, vinyl records or household items that spark a memory,” she says. “The common thread is that we focus on what the person still holds onto rather than what they’ve lost.”
Muramatsu likens the experience to seeing a friend from primary school as an adult. Although you may not have seen them for 20 to 30 years, you can naturally start a conversation and feel like almost no time has passed.
From personal experience, Muramatsu observed this in her mother, who was visited by a friend from childhood at a very different time and place in her life.
“They can just talk and talk,” she says. “My mother, who has difficulty remembering all the details of current (experiences), just remembers everything.”
Remembering these details can make people lively and may activate their cognitive function and mood, Muramatsu says. “Suddenly, the whole body is activated, just like exercise — if you move, then it’s not just that part that is activated, but (the) whole system of your body gets activated. So I think that is the power of reminiscent therapy if it is done in a right way.”
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Techniques Used in Reminiscence Therapy
Therapists may use a number of tools during a reminiscence therapy session, such as:
— Conversations with a familiar person, such as a family member or an old friend
— Storytelling, such as sharing stories from childhood, their first job or a home they lived in while newly married
— Using question prompts
— Viewing photographs or videos
— Using household objects
— Listening to music
— Reading books, newspapers or magazines
— Watching movies
— Eating or cooking favorite foods
— Smelling familiar flowers or perfumes
“Different clients respond to different prompts,” Law says. “Some love music from their teenage years. Others get a kick out of looking through old magazines from the decade they grew up in. A few respond best to cooking or baking something that triggers an old family recipe memory.”
“I once worked with a gentleman who had been a pilot, and just flipping through photos of airplanes led him to recount entire flight paths he used to take,” she adds. “The excitement in his voice was tangible, and for a moment, he was right back in that cockpit, feeling purposeful and proud.”
[READ: New Treatments for Alzheimer’s Disease.]
Benefits of Reminiscence Therapy for Dementia
Reminiscence therapy cannot reverse the effects of dementia or cognitive decline. However, it can significantly improve the quality of life for someone experiencing cognitive decline, including:
— Improved overall well-being and quality of life
— Improved self-esteem
— Improved mood
— Reduced stress, anxiety and agitation
— Reduced depressive symptoms
— Decreased feelings of isolation and enhanced connections to others and their surroundings
“That sense of accomplishment — of being able to remember something clearly and share it — is incredibly validating. It boosts mood, reduces stress and, decreases agitation because it’s a form of self-expression that doesn’t demand new learning or recall of recent facts,” Law says.
There aren’t any effective pharmacological treatments for dementia, Muramatsu says, so approaches like exercise and therapy continue to be very important for people with dementia and also those who are around them.
Challenges of reminiscence therapy
Not all memories are positive ones — reminiscence therapy can bring up old memories that might cause sadness or distress — particularly those tied to loss or trauma.
And not all reminiscence therapy is created equal, and definitions and practices aren’t universal, making it difficult to draw strong conclusions.
“For example, some approaches involve individual therapy facilitated by a clinical psychologist, while others were a small group listening to music from the past once a week,” says Laura O’Philbin, a researcher and policy manager with the Alzheimer Society of Ireland. She co-authored a 2018 Cochrane systematic review of studies on reminiscence therapy, which found that while its effects can vary, depending on how and where it’s administered, “reminiscence can benefit people with dementia in the domains of quality of life, communication, mood and cognition,” she says, even if the benefits are small.
However, not everyone may enjoy or be comfortable discussing the past.
“For some, reminiscence may trigger memories that cause distress or upset. Although we found no evidence of this in our Cochrane review, it does occur,” O’Philbin explains. Reminiscence facilitators must be prepared to manage negative responses sensitively, she says, and it can help to speak with a trusted relative or friend beforehand.
It’s so important not to start with assumptions because whatever may be favorable for one group could be a nightmare for another person, Muramatsu says.
Working with a therapist in tune with the patient’s feelings, emotions and even minor body language reactions and responses is key to navigating the conversation.
“With a sensitive approach, you can often guide conversations toward more positive or neutral recollections,” Laws says. “If a painful memory surfaces, acknowledging it rather than brushing it aside can actually help them process lingering feelings, provided it’s handled gently.”
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Importance of Family Psychoeducation
Having a family member with dementia takes a toll on loved ones and caregivers too. Reminiscence therapy can be a powerful tool for family members too, not just the patient.
“Families often find comfort in it,” Law says. “They see their loved one engaged and talking about things with a sense of clarity that might have been missing. It can lessen their own anxiety, reminding them there’s still a person with a rich personal history under the confusion.”
Additionally, family members can adopt reminiscent therapy techniques at home to encourage positive engagement with family members. This approach isn’t only used in a structured session with a therapist. For example, you could guide your loved one with questions or prompts, incorporating personalized details, such as:
— What was your favorite hobby as a teenager? Why did you enjoy it?
— Who was your best friend growing up? What did you like to do together?
— Tell me about the first concert you ever went to.
— Do you remember a special birthday celebration? What was it like?
You could also gather a box of photographs and mementos from their life and ask your loved one to tell you about each picture and item.
However, some memories can be painful for family members. It’s important that both parties feel comfortable and positive about engaging in conversations. Never push someone to say more about a topic they seem resistant to or unhappy about.
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What Is Reminiscence Therapy? originally appeared on usnews.com
