Psychology and word association

Marian Perera · Oct 30, 2017

Hey everyone,

I have a scene in the WIP where the MC has to help someone who's lost his memory. This will be a very brief scene, but I was a bit stumped in terms of what psychological techniques to use, because all I could come up with was word association. And from a Google search, I get the impression that this isn't exactly a widely used or reputable technique.

A few points to clarify :

1. The story is set in this world (link to previous thread in Research form). So there are no professional psychologists or psychiatrists at all.

2. The MC is a doctor, so his knowledge of psychology is pretty limited.

3. That said, I need him to learn a little information which is used to foreshadow the twist at the end, and the patient is anxious to discover why he lost his memory. This is one reason I thought of word association - it could bring up some hints as to who's behind the memory loss, and why they did it.

4. The doctor is aware that ideally, you wouldn't press such a patient to remember anything. But he doesn't have a choice, because the patient holds a lot of power over him and demands that he do something immediately.

So assuming there are no better techniques for a doctor to use under these circumstances (though if anyone can suggest any, that would be great), how to start the session? When I Googled this, I kept getting sites that looked...inauthentic, for lack of a better word.

Also, would it also be a good idea to have the doctor hang a lampshade on this by acknowledging the limitations/problems with word association - and if so, what would you consider those to be?

Thank you all.

rhdnor · Oct 30, 2017

Try hypnosis, I read somewhere that it's easy to learn.

bombergirl69 · Oct 30, 2017

"Memory" is a complex phenomenon, which is why there are several batteries (and subtests) to assess various components of memory--encoding, storage and retrieval. There is short term memory (various components to that) and long term memory ((different facets to that). The WMS (Wechsler Memory Scale) is one testing battery, as is the DKEFs (an instrument that assess executive functioning but includes a memory component.) The CVLT is another. Your doc would not be likely to use these (requires some training) Psychologists who use these (and others) are trained in assessments and can integrate information appropriately. Paired word associates is one subtest, which gets at various aspects of recall (one aspect of memory) The CVLT uses word lists, as you can test aspects of recall, look at interference, see if recognition helps and so on.

That said, if your person needs to remember some autobiographical memory, you might google olfactory sense and memory (cinnamon evokes memories of grandma's kitchcen, clove cigarettes evoke a rapist, etc.) I think there is some stuff out there on that, which might be helpful.

Marian Perera · Oct 31, 2017

bombergirl69 said:
There is short term memory (various components to that) and long term memory ((different facets to that).

I'll make sure the MC identifies the distinction here. The patient's problem is that he disappeared for fifteen years, and he doesn't remember anything about that time period - what happened to him, who's responsible for it, etc. He has no problems with short-term memory.

Paired word associates is one subtest, which gets at various aspects of recall (one aspect of memory) The CVLT uses word lists, as you can test aspects of recall, look at interference, see if recognition helps and so on.

Thanks! I'll look this up. I also like the phrase "paired word associates", which sounds better to me than "word association".

That said, if your person needs to remember some autobiographical memory, you might google olfactory sense and memory (cinnamon evokes memories of grandma's kitchcen, clove cigarettes evoke a rapist, etc.) I think there is some stuff out there on that, which might be helpful.

I'll consider working something like this into the course of the story (e.g. he sees or hears something which evokes a subconscious response). It's not something the MC can consciously set out to do, because in the story, the patient puts him on the spot regarding the treatment. Imagine someone shoving a pencil and paper into your hands and telling you, "Okay, figure out how I lost my memory. Now." He needs a fast basic technique that can be applied with a minimum of supporting material.

bombergirl69 · Nov 1, 2017

sounds like you're talking about a fugue state. And the evaluation depends on a good history -- > head injury? Tumor? Drinking? Trauma? Yeah, he could hear something, but the olfactory sense is stronger! We don't cure memory like that (here! Cure it now!) Buuuuuuuuuut we explore when people have strong emotional reaction to things (when is the last time you felt like this?) Hypnosis is unreliable (really controversial, actually) I could see someone remembering a tiny bit when they smell something -- > feeling fear, not goodness, need to get away-- and maybe something that would lead to another clue.

Something random could happen in the doc's office--a helicopter lands nearby and there's the smell of JP-4 fuel, the next client enters the waiting room with strong after shave,--and your MC ducks, covers his head, is fearful. Why? And that would lead to another clue.

veinglory · Nov 2, 2017

I also immediately thought that this sounds more like fugue state. In which case the main goal is more to make them want to remember and feel safe remembering. Long term but recoverable amnesia generally relates to a motivation to escape a life that was more stressful than the person could deal with.

Marian Perera · Nov 6, 2017

bombergirl69 said:
We don't cure memory like that (here! Cure it now!)

I know, but the circumstances in the story are quite different from what we'd normally expect - it's a fantasy world where an earth elemental sits a human doctor down and demands a quick cure for his memory loss. The doctor isn't in a position to say that this isn't how amnesia is normally treated, because the earth elemental is so powerful and overbearing that he expects things to happen when he wants them to happen.

There also aren't any olfactory triggers I can use, because what causes the memory loss doesn't have any smells associated with it. But yesterday I wrote the scene, using Jung's associated-word list as inspiration, and alternating a stretch of bland words like "water" and "window" with the ones the doctor expects to get a more meaningful response, like "hate". The whole purpose of the scene was to foreshadow what caused the memory loss, even if I could only do so via a couple of words, so it doesn't have to be 100% accurate in terms of modern psychotherapy.

Buuuuuuuuuut we explore when people have strong emotional reaction to things (when is the last time you felt like this?)

There's one point in the story where the elemental does have a strong emotional reaction to something that's associated with the memory loss (see below), so I'll add a line reflecting on this. Thanks!

Hypnosis is unreliable (really controversial, actually) I could see someone remembering a tiny bit when they smell something -- > feeling fear, not goodness, need to get away-- and maybe something that would lead to another clue.

Something random could happen in the doc's office--a helicopter lands nearby and there's the smell of JP-4 fuel, the next client enters the waiting room with strong after shave,--and your MC ducks, covers his head, is fearful. Why? And that would lead to another clue.

The real problem is that what causes the memory loss is so very different and completely removed from their "normal" circumstances (think something Lovecraftian bizarroworld) that the only such obvious trigger is sleep. And the elemental doesn't usually sleep - though he almost dozes off at one point and I'll have that upset him a bit. It's not easy to explain without going into details of the setting. But the scene is complete and I think it works OK, especially since I had the doctor state at the beginning that he is not a psychologist. "That's fine," says the elemental, wishing he knows what a psychologist is.

Marian Perera · Nov 6, 2017

veinglory said:
I also immediately thought that this sounds more like fugue state. In which case the main goal is more to make them want to remember and feel safe remembering.

True, under normal circumstances, but here the doctor's main goal is to do whatever it takes to make his patient leave him alone. Which means if the patient is ordering him to do something immediately, he'll try any technique that stands even a remote possibility of getting quick results.

Long term but recoverable amnesia generally relates to a motivation to escape a life that was more stressful than the person could deal with.

In this case, it means someone else was possessing your body for a long time, and during that time, your conscious mind was essentially switched off, so you don't have any memories of what happened. You want to remember, but it's not happening.

veinglory · Nov 6, 2017

In that case it might be more like coming out of a long term coma. So things that are familiar and have positive meaning would probably help.

Marian Perera · Nov 6, 2017

veinglory said:
In that case it might be more like coming out of a long term coma. So things that are familiar and have positive meaning would probably help.

Yes, after coming out of the coma (the story was inspired by Sleeping Beauty) the elemental returns to the town he rules, so that helps. His real problem is that, as you said, he was in a coma, and his memory of even what he did immediately before the coma is shot. The most he recalls of this is that sleeping is dangerous, but he thinks "well, sleep is dangerous because you can't defend yourself when you're asleep", rather than realizing that sleep is dangerous because that allows an alien presence to take over your body.

DrDoc · Nov 6, 2017

You said: "There also aren't any olfactory triggers I can use, because what causes the memory loss doesn't have any smells associated with it."

This is an assumption. Any olfactory memory can trigger a memory response, not just those associated with the cause of the memory loss. An elemental should be more attune to odors than humans. Perhaps the elemental is seeing the sunrise and gains a whiff of the sea, which is miles away...

Good Luck with your story!

DrDoc

Marian Perera · Nov 6, 2017

DrDoc said:
This is an assumption. Any olfactory memory can trigger a memory response, not just those associated with the cause of the memory loss.

But for story purposes, shouldn't there be some connection? For instance, it seems odd to go from "I smell chicken stew" to "I remember a crypt". It would feel a bit arbitrary to me. Now if whoever was responsible for his memory loss often cooked chicken stew while he was in a coma (though this doesn't happen), and he smelled chicken stew after he woke up and was therefore triggered, that seems more reasonable.

An elemental should be more attune to odors than humans.

Is that something readers would normally expect of earth elementals? It's not part of my worldbuilding. I'm also reluctant to make the elemental any more powerful than he already is, and part of the story establishes that his hearing is far more sensitive than that of humans.

bombergirl69 · Nov 6, 2017

DrDoc is right about olfactory triggers--not necessarily related. And plenty of people (trauma victims, for example) do not like sleeping as a) they feel vulnerable and b) they have nightmares. That's not really a "trigger." And not uncommon at all to not remember events prior to an injury (retrograde amnesia) And Veinglory is right that people do need to feel safe (which is actually a treatment approach for trauma--safety first!)

Memory is complex,which is why we can't just "fix it" when people can't remember stuff. Variations in memory and forgetting are really interesting, though, and not completely understood, interesting enough that I'd spend some time reading about the hippocampus/the limbic system and long term memory, at least if you want to describe anything that remotely actual memory. people who do understand how encoding, storage and retrieval work might read your book. If you have created your own world with its own rules about memory, then you'd be good to go, obviously!

) )

Marian Perera · Nov 6, 2017

bombergirl69 said:
DrDoc is right about olfactory triggers--not necessarily related.

But it would still come off as odd to me if I read a book where the olfactory trigger had no relation at all to the memory.

I'm not saying this can't happen in real life. I'm just wondering how to make it plausible in a fantasy romance.

And plenty of people (trauma victims, for example) do not like sleeping as a) they feel vulnerable and b) they have nightmares. That's not really a "trigger."

I'll be sure not to use that word in the story. The thought of sleeping makes him irrationally afraid and upset, because sleep is directly related to what happened to him (the immediate cause).

Memory is complex,which is why we can't just "fix it" when people can't remember stuff. Variations in memory and forgetting are really interesting, though, and not completely understood, interesting enough that I'd spend some time reading about the hippocampus/the limbic system and long term memory, at least if you want to describe anything that remotely actual memory. people who do understand how encoding, storage and retrieval work might read your book. If you have created your own world with its own rules about memory, then you'd be good to go, obviously! ) )

It's not so much that the world has its own rules about memory, as that the elemental wants results now. Explaining to him that memory is complex and that it can't be fixed fast won't make him happy. Part of the worldbuilding is that elementals can heal physical injuries almost instantly, so he finds it very difficult to accept that mental problems take longer to deal with. And because the elemental is in a position of extreme power, the doctor has to at least attempt to placate him by doing something now.

I understand what you're saying, in other words. But my character doesn't. And he's driving the story.

That said, the word-association test session doesn't have to do a great deal in terms of memory retrieval. Actually, it needs to accomplish very little. It's not like after the session, he gets memories back. It just drops a couple of foreshadowing hints. After that, other parts of the plot kick in and the elemental doesn't have time for any more psychotherapy.

bombergirl69 · Nov 6, 2017

Hmmm. You know, the sleep thing is complicated. People tend to avoid it, get anxious thinking about it and so on. Not really a trigger I don' t think you'd be wrong to consider it one! What would be is feeling out of control, perhaps the feeling just before sleep--definitely anxiety provoking! Perhaps for your guy!

Paired word associates is actually all about retrieval (and the impact of time and interference) There are a variety of conditions (delay, cued recall, etc.)

Like I said, probably more detailed than you need!

Marian Perera · Nov 6, 2017

bombergirl69 said:
Hmmm. You know, the sleep thing is complicated. People tend to avoid it, get anxious thinking about it and so on. Not really a trigger I don' t think you'd be wrong to consider it one! What would be is feeling out of control, perhaps the feeling just before sleep--definitely anxiety provoking! Perhaps for your guy!

Thanks, I'll keep that in mind when I edit!

Paired word associates is actually all about retrieval (and the impact of time and interference) There are a variety of conditions (delay, cued recall, etc.)

One reason I picked paired word associates is that it made for a compact scene (fitting easily into a spare couple of hours that my characters had) that didn't require too much from the doctor in terms of resources. He was put on the spot and told to do something, anything, about memory loss. All he had in terms of equipment was a pen and paper, so this was all he could do. Even if he wanted to use olfactory triggers, and even if these are more accurate or more realistic than word association, it wouldn't be as easy to get his patient to smell different substances within the short period of time that they have.

The very rudimentary nature of the session is also affected by the fact that humans, in this world, have been completely cut off from our world for a hundred years, and this is a primitive world to begin with. So a lot of the finer points of psychotherapy have been lost over the years.

bombergirl69 · Nov 6, 2017

Well, it's pretty rudimentary, but your shrink, under the gun, could just ask your MC--what is your happiest memory? When were you the saddest? What about lonely? what about angry? When have you felt the most peaceful, contented, safest? And so on. Then--hey what are you doodling there? Obviously, for your story, your shrink may not have to ask twenty questions but could strike gold asking about...whatever your client was feeling before he went to sleep. People can doodle helpful clues as well. And you could toss in an olfactory trigger--cinnamon, cloves, lighter fluid, blood--that could happen randomly (as triggers can do in real life, which is what makes them so scary) and you're right, we don't toss out various odors (what about this one??) although it works in my favorite movie Harold and Maude! But they can happen...

Marian Perera · Nov 7, 2017

bombergirl69 said:
Well, it's pretty rudimentary, but your shrink, under the gun, could just ask your MC--what is your happiest memory? When were you the saddest? What about lonely? what about angry? When have you felt the most peaceful, contented, safest? And so on.

That's true, and I think that given more time (the characters' time, not mine), this could work. In fact, it's a great way for the characters to get to know each other better - since the book is primarily a romance, after all. I'll keep it in mind for the future.

For this romance, though, I think the word association does work better because it turned out to be so fast-paced. The words just snapped out one after another, and it was fun to see the elemental realize he'd said something strange or embarrassing, but he didn't have time to think what to do about that before he got the next word thrown at him.

Asking questions about someone's happiest memory or where they felt lonely is more realistic, but it's likely to have resulted in a longer, low-key scene with less tension, because the subject has enough time to think about the questions and answer them in detail. The other thing is, something like this actually happens through the course of the story, rather than in a single therapy session. Since it's a romance, the doctor and the elemental get to know each other and interact with each other outside of the therapy session, so certain details like "when have you felt the most peaceful" are things the doctor finds out just by spending time with the elemental, observing him and talking to him.

So for story purposes, I still think the word association works best, but thanks for the suggestions! These are great details that will come in very useful.

bombergirl69 · Nov 7, 2017

Is there a romance between the doctor and the elemental?

Marian Perera · Nov 7, 2017

bombergirl69 said:
Is there a romance between the doctor and the elemental?

Yes, that's right. Of course, a romance between a medical (or mental) health professional and someone who's a patient of theirs, albeit temporarily, wouldn't be ethical IRL. But it's a fantasy world and the circumstances are even more screwy than what the doctor's accustomed to - he doesn't get much choice about treating the elemental.

bombergirl69 · Nov 7, 2017

I was afraid of that. FWIW, "temporarily" doesn't have anything to do with it. A client is a client and no, mental health professionals do not treat family and do not have romances with patients. It's not wrong because it's a rule; it's a rule because it's wrong.

Marian Perera · Nov 7, 2017

bombergirl69 said:
I was afraid of that. FWIW, "temporarily" doesn't have anything to do with it. A client is a client and no, mental health professionals do not treat family and do not have romances with patients. It's not wrong because it's a rule; it's a rule because it's wrong.

And if I were writing a romance set on Earth, or even one where the circumstances are more "normal", for lack of a better word, I would be careful not to cross that line. However, given the setup of this story, I don't see any way around it here.

Psychology and word association

Marian Perera

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rhdnor

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veinglory

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