Marie A. Mills - Narrative Identity and Dementia: A Study of Autobiographical Memories and Emotions

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A study of autobiographical memories and emotions

Marie A. Mills

First published 1998 by Ashgate Publishing

Reissued 2018 by Routledge
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Copyright Marie A. Mills 1998

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A Library of Congress record exists under LC control number: 98070989

ISBN 13: 978-1-138-32785-6 (hbk)
ISBN 13: 978-0-429-44902-4 (ebk)

To Ed Conroy, who organised and prepared this entire text for publication - 'a friend indeed'.

To Peter Coleman, the most encouraging and generous of mentors.

To my children Jem, Jon and Anne-Marie for their contributions and belief.

This is a book of many contrasts. It seeks to establish a firm theoretical base in order to sustain an argument that has frequently been anecdotal in nature. Consequently, the reader will move between the empirical world of evidence to the experiential world of the individual. It is hoped that the interplay between these two perspectives will strengthen the debate. The main discussion will focus on the characteristic features of emotional memories in a small group of older people with some form of dementia. However, the literature on the presence of emotions in dementia is relatively sparse, although several publications have appeared on the subject in recent years (Bromley, 1990; Hausman, 1992; Kitwood, 1990a; Mills and Coleman, 1994).

A small pilot study (Mills, 1991) suggested that some demented elderly people could recall past and current concerns. In this particular study, informants were seen on an individual basis over a period of three months. Counselling strategies were used during the research interviews in order to facilitate recall and disclosure. The findings implied that these informants displayed appropriate emotions associated with their memories and suggested that the relationship between memory, emotion and dementia were worthy of further exploration.

However, the questions to be asked of a future study were many. With the use of a similar approach, was it possible for older people with dementia to recall intact emotional memories associated with past and present events? Further, did these memories of a personal past contain pieces of information which formed part of their life histories or life stories? What type of emotional memories would be found amongst these older people? Would they be 'good' positive memories or might they be 'sad' and possibly negative? Finally, did the aided recall of these emotional memories, over time, allow these memories to remain, or would they gradually fade into oblivion due to the progression of the illness?

Thus, the investigation was interested in the concepts of dementia, memory and emotions, and their corresponding psychological, biological and social characteristics. It was concerned with an illness without certain aetiology or proven cure, the mysterious frameworks and processes of a mental phenomenon which is poorly understood, and the significance of the emotions for which there are over a hundred known theories.

Generated theries for this study, therefore, were cumulative in nature, but Baddeley (1992) suggests that his own preference is for breadth of application, as opposed to detailed prediction. The application of 'a broad sweep theory' has great bearing on this inquiry which investigated aspects of an illness that disrupts and destroys the lives of sufferers and their families alike. Certainly, Bond et al. (1990) argue that many new referrals for long term care are due to some type of dementing illness, an illness which Kitwood (1990a, 1993, 1997a) suggests can lead to the disintegration of personhood. Tobin (1991), too, maintains this process may cause the 'de-selfing' of the person.

I have long been interested in the preservation of 'uniqueness of being/personhood' among this client group, beginning with my involvement in the residential care of older people over many years. The last eleven years have been spent as an owner/manager of a residential home, now a specialist residential home, for twenty elderly people. My own practice suggested that the use of basic counselling skills in a discussion of their past life led to an immediate reduction in negative behaviour. Some years ago I began to notice that confused residents also enjoyed a discussion of their past lives. It tended to reduce high anxiety levels, providing it was handled with empathy and skill. It was also more effective when undertaken on an individual basis. Residents looked as if they were happy when discussing their past. They smiled and laughed during this activity. Reminiscence therapy gradually became a personal interest which widened into a desire to understand more about the process. I wondered if other older people with dementia would also enjoy this activity. Was it effective in the Home because I knew these people so well? Would it be as effective with strangers? This interest formed the basis for the pilot study.