Amnesia in elderly and music therapy

Smrithy (Memory ) and Smrithinaasa :-

In second chapter of Geetha Smrithinaasa and as a result of it Budhinaasa(loss of intellect) are mentioned by Bhagavan Sri Krishna.Samsara leads to this Aamaya (disease)and to be Niraamaya,bondage to samsara has to be lost .

When my mother’s sister Poet Balamani Amma lost her memory in old age ,my son wrote a poem (Which appeared in Keralasahitya Academy journal Malayalam Literary survey Oct –Dec 1996 No :4 page 96).He wrote :-

For me,
She was art
Which as they say
Is impersonal ;.
And that day
Her croaked voice
Faltering,
Breathless in spurts
Recited through the recorder
Some rare moments
Reduced
To a Laser-magnified page.

I longed for life;
The real
Just as she too
Would have longed for it.
Only the spools
Of the tape worked
That of the memory
Didn’t.












It was a sad sight to see her like that.The pain which we suffered was intolerable .She could not recognize her own daughters and sons and used to call them Ammini,which is my mother’s name.The only memories that remained were that of her ancestral house with Ammaman(her uncle and Guru Poet Narayanamenon),her mother and sister Ammini.No one else existed in her memory.Sometimes she spoke of a temple and a Devi inside and also that her husband is taking a bath and requires dress when he comes back (and kept dress ready for him.He was dead several years back and she did not remember it).
I tried some old poems and when I sang Kannuneerthulli she recognized it as Ammaman’s poetry.When I recited four lines from her own poetry she said that must be by Vallathol.Only Vallathol can write such beautiful verse.She remembered her aesthetic sense but not her own creation.When my brother Asokan visited her and said “I am Asokan”she didn’t recognize him but recited a verse from Kalidasa’s Kumarasambhava starting with the word Asoka.And when I tried Lalithasahasranaama her favourite which I remembered her reciting every day morning (while I was a child) she was able to recollect some of the verses and recited them along with me.That was in the middle stage of her illness in 1998-99. Then after sometime she became totally forgetful and continued like that till her end.

I had seen such incidences of amnesia in my family and in others .
1My father’s elder sister ( mother –in-law of KamalaDas)
2.Younger sister Leelavathy Amma .
3.Another sister Kamalakshi Amma
4.A brother of him .
And I had heard of such incidences in the great intellectuals like Kuttikrishna marar ,a great friend of Ammaman and the greatest literary critic Malayalam literature has ever seen.So this can occur to common man as well as intellectuals alike.But it is not mandatory that all in the family should have it.My mother,my grandmother’s mother,my father etc lived upto 92-93 and even more ,with excellent memory till the day of death.I had taken histories of 9 elderly people in a carehome and found different results with music and related activities in them.And in my book Music therapy in management ,Education and administration (Readworthy publications New Delhi )I had given a project for such institutional documentation and a case history of music being useful in a person with Alzheimers dementia.Here I discuss the amnesia ,its pathways ,its uses as well as disadvantages to individual and society .There are some clues given to keep a good memory at the end which may be of help both to students and professionals,for housewives and for every one.

Amnesia or loss of memory :-

Normal human beings have a memory that is selective,vague and we forget certain things and if not so we would not have survived so long.Remembering every wound inflicted by every one and trying to pay back an eye for an eye would have wiped out the races .So forgetting and forgiving is inherent in human organism for survival of the races.The races which perpetuate violence and bloodshed is doing this only.The sages of India practiced this and Christ asked his disciples to forget and forgive but modern scholars are perpetuating illfeelings against remote crimes which they think had been committed by ancestors of one race to another thereby perpetuating violence and separatisms.So forgetfulness of certain things are essential for human race for survival.
Why are the past happenings and experiences recorded as history? Just to learn from it and shape a better future,a better world.Not for perpetuating feelings of enmity and perpetuate misery.The recording of past experiences as history is just to make us remember from that narrative that we have to learn to live as aco-operative unit of human race to survive on earth.
Here amnesia of a separate type is discussed.For daily routine life each one of us need to remember certain things.The words(language of communication,)names of people,places,dates for doing certain important actions,to carry out certain plans and locations and time for that etc.A driver has to remember the technique of driving a car and the traffic rules.A doctor or an engineer has to know his profession and remember it .Similarly every professional has a special memory of what is his/her day to day activity so that it is carried out efficiently .We have to remember the places where we have kept our things at home and office ,and methods of keeping our body and premises clean.The foods which have to be eaten and the methods of its preparation and so on.In onld age we find several people loosing this common day to day memory and this amnesia is called dementia .This is a major problem that we encounter in modern world.
Another problem of memory that we encounter is the perpetual remembrance of the painful traumatic incidents of individual as well as social and national life.The pain as a recurring memory is made perpetual by annual celebrations of painful memories .This replay after the injury has healed is like re-opening a wound after it has repaired well .This also is a problem which is leading different types of terrorisms and upheavals and violence in the world today.
How to reduce such painful memories?How to bring back memories that are needed for a day to day existence in the old age ?How to increase memory in a child who is learning in any educational institution? Can we use music for this purposes?Raagachikitsa has been addressing these questions .

Memory ,learning and Recall of learning:-
Memory is not a database of information storing but is a dynamic process.Storage is only one aspect of it.Thoughts,emotions,perceptions and actions (all cognitive functions intertwined)are functioning as memory and therefore it is a dynamic process.There are minimum three stages in the process.
1.Selection:-Only a very tiny fraction of our daily experience is selected by our brain to be stored.Vast majority are not selected by brain and they are therefore as good as never experienced by us and forgotten soon.
2.Lay-down:- The selected ones are encoded (stored)for just a split second for a lifetime.Only those that go through an elaborate process of consolidation for at least a period of two years do stay back.
3 Recollection:- The memories thus stored may be inaccessible for re-collection.That is re-collection is faulty.Recollection is not a simple matter of reactivating stored information.It involves changing memories to incorporate new information.The fluidity of thought which help us to act intelligently come by this change.Sometimes forgetting of bad experiences in life is thus a good change for a human being.Forgetting the good things is a bad things to happen to any individual or society or culture.

Fig 1 Cortical areas of memory .(Canadian surgeon:- Wilder Penfield)
Table 1.
The world we experience does not really exist.Grass,sunshine,rivers,a melody,a fragrance does not exist as such green,warm,pleasant or beautiful but our brain makes them so.Everything outside and inside is energy only and the external energy in these things is converted by our bioenrgy into such experiences .So the signals from outside is constructed by brain into pleasant and painful .The sights,sounds and smells etc are thus felt by us.When a lightray touch a eyeball nerve cells transform it to electrical and later to neurochemical energy . The same energy touching the ears is also converted in the same way but felt as a sound wave.The brain has a specialized function in each part of the sensory area corresponding to the sense organ of receipt of external cosmic energy.

Figure 2 Pathway of brain in constructing a visual image :-
This is the forgetting curve devised by German psychologist Herman Ebbinghaus which shows rapidity of loss of nonsignificant memory.Forgetting takes place soon after learning.If it sticks for three days at least,it is set for a long future.Meaningful information has a far less steep forgetting curve.How to keep memory ?By repetition.
The repetition or practice(Abhyaasa)and japa (repeating names)and gunakoshta(multiplication tables )every day was for this purpose.A short term memory remains onlytill the time it is repeated.If we continue to repeat it even after we need it,it becomes a long term memory .If we do it with your brain you will never forget it.If you do it with your calculator your brain will never store it and without a calculator you cant do anything.So mental arithemetic is more useful for human race than a calculator .Eric Kandel of Columbia university(2000 Nobel prize winner)showed that short term memory involves changes in already existing synapses.He did experiments with mollusk Aplysia which ahs relatively few and large neurons.
Molecular changes that underlie memory are not directly observed in human brain.Researchers of Uty of California,Santiago found that when a neuron is stimulated once a molecule called Actin moves towards neighbouring neurons.Actin is present in many cells throughout body and is associated with growth and cellular restructuring.The activity of the first cell stimulate the stimulate the neighbouring neurons.The changes are temporary and last for 3 – 5 minutes and disappear within 5-10 minutes.If the neuron is stimulated four or more times within an hour the cells creates new docking points or synapses with the neighbours creating an irreversible alteration in the cells wiring.The links between individual cells are formed by a process called long-term potentiation.Figure show cell 1 as initially stimulatd activating cell 2 in a alert state of stimulation from cell 1 for hours or even days.Each time the 2 cells fire together their mutual sensitivity or link is re-inforced.Eventually they are bound together so firmly that they may fire together for the rest of the lifetime in brain.When their combined activity is enough to trigger a cell to which both are attached,even if the links are weak with it and if this happens repeatedly the 3rd cell is also bound with the link of the first 2 cells.Memories are formed in firing of networks of neighbouring cells linked in this way.

Figure 3 of LTP The hippocampus is a formation whichlies in the brain and records conscious experiences and then files some of them in other parts of the brain.Damage to hippocampus can cause profound memory disorders.The hippocampus does lot of Lay-down work when we sleep.During jagrad(wakened state)it is busy with selecting,processing and storing current information.In sleep this bombardment stops.The hippocampus starts to trawl over what it has recently dealt with.The neural pattern replay spontaneously and some of them appear as dreams.So in REM sleep if I have been dealing with astronomy an astronomy pattern is replayed.If I am dealing with chopping vegetables,a chopping vegetable neural pattern only will replay.The patterns of music and astronomy are jyxtaposed in dreams of me when I deal with both .And if I deal with medicine as well that pattern also is juxtaposed and integrated.In the REM of a person who chops carrots chopped carrots are juxtaposed in dream with images of other vegetables and other day to day activities.The hippocampus thus acts consolidating experience into memory even when we are in sleep ,in a stage when we think we are unconscious of anything .It is in this state that it links the new experiences to the old experiences ,filling in the web .So for a person who integrates knowledge this sleep stage is as important as the jagrad state when he/she learns .The storing of memories in different parts of the brain as a huge cobweb has to be thus understood.Each element of a memory –the sight,sound,word or emotion that it consists of-is encoded in the part of the brain that originally created it.Each one is the same as current perception,except that the information that created it comes now from within the brain ,instead of externally via the sense organs.
If we want to remember a dravya .The colour is in the visual cortex.The name of the dravya is in the language storage part of Broca.The sound of the dravya is in the acoustic area.To get a memory of the entire dravya each has to be linked and integrated.Think of a swara as a dravya.Its varna or colour ,its dwani or acoustic part,and its form with length,breadth,area,height etc and its specific name and designation has to be correlated.All are one .But being stored in different areas by different sense organs these have to be integrated for perfect understanding.So with different disciplines in a sarvagna brain.The astronomy and musicology,the literature and philosophy,medical knowledge etc are stored and integrated in the same way.If you have only one sense developed and one area of brain associated with it developed , the knowledge remain imperfect.One thing reminds on eof another if we have learned both or heard or seen or experienced both .The memory system allows new events and experiences to be integrated to old ones.The present with the past .A map of memory is made so that every time we need it we can recall it .A mother’s image in a child is a combination of her sound,form,colour and moods and love and care and her softness or harshness integrated by all such sense organs and sensory areas.Even if the mother is no more the memory of the mother lives in every adult.Similarly with other loved persons/people/places/subjects etc.The use of this is that long term memories are made indestructible by storing them at different places in the brain.If in a single area of brain,and if that area is damaged,entire memory will be eradicated with one stroke.
According to Diana Deutsch experiment (California uty Santiago)when neutral sound tracks were presented to volunteers repeatedly the listeners started to hear voices that were not on the track.She thought it is subjective reflecting the listeners current state of mind.She likened this to Rorschhach inkblot test in which people see meaningful images in a randomely splashed blob of ink.Women hear words of a romantic nature whereas men do not and people hear the words in their native language more than an alien language .But this is not true.People can hear words which they have never heard before in another language and also before they have learned anything at all,in infancy itself.From where does the sounds come form a chaos of sounds to create a balance ?Why listeners hear only words which are meaningful to them?Deutsch played listeners two different pitched test tones that are separated by a time interval during which other tones are heard.Under these test conditions the listeners found it difficult to tell whether the two test tones are the same or different in pitch ,even though they can ignore the other tones.But when spoken words are presented during this interval instead of other tones ,most listeners had no trouble recalling the pitch of earlier tones.This experiment showed a striking dissociation between musical tones and spoken words in memory and indicated that separate memory stores are responsible for retaining different aspects of sound.

Pictures of overtime memories encoded in outer cortical areas of brain(sound and words in temporal cortex in red) and working memory in frontal lobes pulling out and selecting long term memories to guide current actions (red colour )

Subsystems within the system of memory:-
All the subsystems work in close relation and are interactive and integrated.The declarative memories are those about which we can talk about and bring to mind consciously.But memory is more than that.We have a vast store of learned information that is not consciously learned and without which we would be lost forever.

1Episodic memory:- Are replays of personal experiences of events especially of sounds and sights .Therefore the individual is the center of these memories.Personal memories of sounds and sights of each individual is person centered.They are unique to each person.They may infold with time as if in a movie or may be like a sudden flashback.
In Music therapy when we assess the musical life panorama(MLP)of an individual we are starting with this type of memory.How episodic memory works?It though appearing as a mental act is reproducing a physical state that the person was in when the event occurred.That is ,when a old man remembers a music which he loved in his teens the physical state of that age is being recreated in his brain cells .The same type of firing of neurons happen and the cell returns to a younger state.Thus the person gets invigourated as if in youth and feels healthy.The experience of the youth is relived in brain .But it is not a hallucination but a remembering of a healthy past ,a re-living of most cherished days of life giving same state of happiness which takes one away from the stress of life.The two hemispheres of brain are connected by a thick band called corpus callossum.This allows information sharing between left and right hemispheres.Episodic memories are suffused with emotions.Semantic memories do not have that emotional content.The episodic memory therefore requires more inputs from right hemisphere.(Which specialize in emotional aspects of perception).The role of right hemisphere in episodic memory enhancement is demonstrated ,and people by hereditary reasons having more fibres in corpus callosum bring more right hemisphere information to bear on what they remembered.Since both hemispheres work together ,people with more communication fibres remember emotional events better than they remember facts .

2.Semantic memory:- Laying down and retrieving of facts .For example the fact that mangoes come from mango trees and coconut from coconut tree and New Delhi is India and Kennedy was US President etc are memories of all alike and it has no personal episodic nature.The memory of me and you are alike in such facts.
The personal built-in encyclopedia of knowledge differ in individuals.Yet a person remembering a scientific or geographic fact need not be emotioanally connected to it.You don’t know how you learned or knew it.Somehow you have learned it and now you can state it as a fact .The same event is thus described as a fact as well as an experience emotionally connected(the language of a scientist and that of a poet/artist) by the same person.The hook is usually in the languge area of the brain ,in the left hemisphere in majority of people .Language is the area where people hold factual information and semantic memory.
So the episodic and semantic memories ,though treated as separate categories are very closely related .Semantic memory as core piece of information is left,when the context in which it is learned(the emotional personal side or episodic memory )has faded away.Hippocampus is the area of semantic memory.Word storage is in the left hemisphere.Because it was first learned as an episodic memory ,complete and perfect with emotional ,sensory content and hippocampus is needed for firing up sensory areas in brain.While learning for the first time we are emotionally attached to the word Amma(mother) to all the sensations we associate with her but in adulthood it is extracted as a fact or a language term devoid of emotional relationships.(As a known or collection of letters).An emotion thus becomes a fact .When we ask the person to remember the MLP ,/or when we play a tune that the person liked in his/her childhood ,the hippocampus is springing back into action and recollecting all emotions that were associated with the first learning process.This helps in persons with severe memory loss to rewind the memory and recollect the language and motor skill associated with it too.
3.Working memory:-Capacity to hold information in ones mind long enough to work out what to do with it.For example keeping a telephone number long enough to dial it.Most of our day to day tasks are based on working memory which sorts out our thoughts ,guides our actions,organize cognitive processes so that we can do several motor as well as sensory functions at the same time.
The brain have short term and long term plans to be executed.The memories of what has to be done at each level,how to do them,have to be kept warm until the act is accomplished.If we forget what a cofffejar is and how to open it and what to do with it suddenly ,you will hold it and gaze at it without any action.Sometimes this happens with old people.In day to day working schedules they forget what they are doing and how to do it .Working memory is situated in front of the brain and has 3 main components .
One is a tiny spot that holds the main plan in mind ,the information needed for the rest of the brain to complete the task.We can call it the central executive.There are two neural loops that keep the main components of the plan conscious by repeating the pattern of activity that matches them.One of these holds verbal information and the other holds visual information.(Sruthy and darsana in Sanskrit).These are like scratchpads or black boards that can be wiped after doing the task ,so that next task is done.If the item is very very important it is relayed to hippocampus for processing into proper memory.But if it is an information like pick up the cofeecup,it is done and then it is simply thrown out and replaced by next command.
The scratchpads of working memory can hold between 5 to 7 items a time and in some experiments it was only 2 to 3.Very short term memory is related to intelligence.Like a computer with larger working memory solve problems more quickly,people with greater brain capacity to hold images in brain are expected to have better reasoning power and problem solving skills.
Working memory lasts for 30 seconds only.The emotionally significant things are sent to hippocampus for processing as long term memory while emotionally boring things are sent out within 30 seconds .
4.Procedural memory.The which allow us to carry out actions everyday without having to think about it much consciously.For example most of the motor functions like walking,swimming,bathing etc are procedural memories we do without much thoughts due to long term practice rather unconsciously.
The procedural memory is unconscious.The “how to “ knowledge that allows us to make physical movements,the acoustic knowledge of pitches and sounds are all learned in this way unconsciously .Learning to distinguish pitch and tone and sound starts in utero.And learnig to walk ,manipulate objects ,feed themselves etc are learned while we are infants unconsciously.What we do as adults are mostly learned by us ,as a race ,unconsciously .That is,they are in the genes of the human race.It is a species memory.But each person has to practice them to perfect them.
But physical skills like typing a letter,driving a car,playing a piano are not in our genes and have to be learned with deliberation and with conscious efforts.
Procedural memories are created and stored in a different way from declarative memories.The raw materials(conscious perceptions)constructed along an assembly line of declarative memory.But that assembly line is only one of the many.A different assembly line carry information through another part of the brain ,the parietal cortex where it is used unconsciously to guide our body to act appropriately.Seeing a cup,picking it up,making coffee,drinking it all are done by sensory and motor co-ordination of the procedural memories rather unconsciously .
There is a part called Putamen in brain which is connected by a complex bundle of nerves to pre-motor cortex, which instructs the body to move in a particular way.Procedural memories are in the putamen.When we undertake a new skill the conscious instructions ar essential.When you first learn to make coffe or to hold a cup ,when you learn to drive a car or pedal a tricycle these work .Learning a skill by repetition is happening .Then once it is learned it is left to the unconscious memories.So ,procedural memories are learned as any other skills or kinds of memory by repetition and later become part of the unconscious memory pool.But whereas event memories are stored and retrieved by hippocampal action,procedural memories are stored in putamen.
5.Implicit memory.This too is unconscious.They affect our actions in subtle ways.Sometimes with no discernible reason we feel uncomfortable in some situations,or in someones presense or we feel happy in someones presence.
Nostalgia,sudden anger,or sudden fear – a strong emotion that influence our behaviour yet cannot be brought consciously to mind –are in the realm of implicit memories.Some of these may be relics of past events.Some may be aspects of past experiences which the person did not realize when it first occurred.The surge of neurotransmitters that occurred at the first event/experience and all neuronal activity associated with it including processing is amplified suddenly.The original event is forgotten but this remnant of strong emotion that occurred at first sight or first hearing of a sound persists bringing about a implicit memory later on.Most of our likes and dislikes (love and hae)relationships with strangers are actually due to this.The deeply buried context-dependent memories are brought to surface as nostalgic love or fear or anger etc.
One example of implicit memory published by French physician Edourd Claparede (1911) was of a patient with amnesia.The patient never recollected his earlier visits.The doctor had a pin in his right hand when he visited the patient once and when they shook hands the pin might have hurt the patient .The next time the doctor visited,when they were trying to shake hands the patient did not wish to shake hands but he did not recognize the doctor since his amnesia was not cured.that shows the patient remembered the pinprick but not the doctor.
I will give another curious example of a case of trauma victim who lost consciousness and memory.He was a college student from Devagiri college.He was totally in amnesia and could not recognize his own father or sister .When the neurosurgeon visited the patient on the third day the boy started to speak of Shakespeare and his plays and his birthplace .Every body thought he was incoherently speaking .But the neurosurgeon said that he is regaining his power of memory and will be alright within a day.How did the neurosurgeon say that ? My husband Dr Udayabhanu explained it like this . This neurosurgeon was called Shakespeare Kumar during his college days due to his physical resemblance to the great poet. When the boy started to recite Shakespeare during his visit,the doctor recollected his college nickname and knew that the boy is able to memorise the picture of Shakespeare or image of Shakespeare form his memory and that had triggered his speech on Shakespeare so that the brain is on its right track of memory. Recognising a face from unconscious familiarity is known among experimental psychologists as the priming effect.The boy became normal within two days .
Implicit memories need not affect long term behaviour.
If a person can hear a familiar and loved and emotionally important music and then recall all the positive memories associated with it ,a string of such positive memories will by themselves start a self-healing process in music related activities of therapy.

How to build up a strong memory? Samuel Johnson said:-The true art of memory is the art of attention.
By attention or Sradha one enhance memory as well as learning .. But attention is an automatically captured rather than deliberately applied thing.Only if it is an interesting and catching attention thing we pay attention to it.Music is such a thing for entire human race .No other discipline can boast of such a universal attention from all alike.Music is emotionally related to our brain right from the time we are within the womb of our mother.
How can we correlate memories,emotions,and brain chemicals ?
Table 2
Thus different types of emotions and memories are linked with brain hormones.And a love or compassion generates oxytocin (the love hormone)while a stress hormone produced by negative emotions and memories.

Age-related memory loss:-
We can have a perfect replay of our life only if we can find the stored files when we need it ,in correct times.We forget a name on the tip of our toungue.The thing we want most from a supermarket shelf.The safe place we have kept a important document,or the car key or the salt bottle in the kitchen shelf.This sort of memory failures increase with age.
The younger people recall minute details of recent events,names etc .The older people are better in recalling external details which are having less details of recent event but general factual information which is extended knowledge about it .This is the wisdom of experience.In the history of human race the first hunter-gatherers and first cultivators had to remember and learn certain things.The youngsters had to learn how to thrust a spear,which tree to climb and how to pluck fruits ,and how to plough a field sow seeds etc.The youngsters of a seafaring tribe had to learn the spatial intelligence and vibration mechanics of the ocean quite early.The youngsters relied upon elders for knowing where the prey was most likely to be found,and in which season,and where certain fruits and leaves and trees are seen and in which part of year they grow best,the monsoon winds and its vibratory changes in ocean and the selection of seeds according to soil and climate and winds and seasons etc.That is on a wisdom based on previous years of experience,probably experience of generations of human races,which goes beyond the event of hunting,gathering fruits and making foodgrains itself.

The difference in memory is a general shift in the style of cognition.As the brain ages it shifts workload to distribute it evenly across both hemispheres of brain .It is just like using both hands to lift a heavy object rather than lift it with just one hand.This is a compensatory or balancing act for muscles of hands.Like that the use of both hemispheres is a balancing act .
The tasks that older people find difficult:-
Attending to a specific thing for example ;learning a new list of things without being distracted
Learning a new thing
Retrieving names and words on demand
Recalling details of past events clearly

By way of compensation they are better than younger people in :-
Making sense of new information by placing it in a meaningful context
Finding alternative words or phrases for a forgotten word
Using memories of a specific situation to draw general conclusions.
The elderly draw on both hemispheres to solve a problem while the young ones use only that specific area of brain suited for that task.Left hemisphere is best in perceiving and thus recalling details.Right hemisphere is best for looking at the whole situation .
When a person look at the figure below


One person concentrates on the L shape and another on the D or the details.The first is confined to right and the second to left hemisphere.The combined view of both hemispheres will make a complete perfect picture.The young and old people represent the two aspects and a combination of both makes up a perfect view of a nation and therefore both aged and younger individuals are both needed for any nation for problem solving.

Can you remember any event before age of three?Majority do not remember anything before three years .So lack of memory is there even in younger people.The toddlers learn hundreds of new exciting things and words a day and all these have been forgotten by them in teenage ,though it remains as a nostalgic emotion and surfaces again in old age .So old age is a second infancy.Autobiography is a memory which places an abstract version of ourselves within events that are recalled.Our past self is part of that memory and the feeling it gives of being there makes the autobiography distinct from a narrative of a story from a cinema or drama. Very young infants are good story tellers but they cannot create an autobiography because the brains have not matured sufficiently to form a necessary model of themselves.They do lay down events but they cannot recall it at will in an orderly way.
The older brains are becoming like that of an infant .The frontal lobes are susceptible to non –Alzheimer’s age-related degeneration and this makes the elderly less able to lay down new autobiographical memories.If proper mental exercise is there (just like muscular excercise0disuse atrophy does not happen to brain cells so that the loss of memory is not an inevitable thing.All people need not develop it.
The prefrontal cortex distinguish us from other mammals.It is the last part of brain to evolve in humans and last area to mature in an individual.It combines current perceptions with past memories to make judgements and decisions.In this process it creates a model of world in which it places oneself and thus guide our ations just like a road map for a journey.The right prefrontal cortex is more involved in producing an autobiographical smrithy which includes the sense of self.The left one contains memories that does not include the personal element.When we recognize an image of ourselves the right prefrontal cortex is activated.When we look at another rface this part is not activated usually.(A differentiation or the mine ,yours exists).And when the right hemisphere see the self in all as the Upanishads and Geetha says ,a integration and synthesis and a wisdom of oneness of entire creation happens.
When the hippocampus is injured by a stroke or any other reason the the navigation area of brain is lost and the ability to lay down new roués (of neuronal channels)is lost .But memories of places they knew years before,memories of music which they loved in their childhood etc may remain quite clear because they are in the cortex in the long term memory area.This fact is made use of when we get the MLP of a person from the relatives and we are trying to evoke such old memories and rewind the pools of memory.
ADHD or attention deficit hyperactivity disorder is a condition in which the brain’s natural impulse to scan the environment for information 9flitting attention from one thing to another in quick succession)cannot be controlled.We control the roaming by chithavrithinirodha (as in Yoga terminology) and by this we concentrate on a particular subject and learn it thouroughly and then shift to next in our younger ages .In adult stage once we have mastered the attention process and concentration,we can shift attention from one to another as and when necessity comes.Th ebest example I can give is a Pathologist’s day to day activity.
A experienced pathologist shifts attention from one diagnostic material to another with perfect control.The first slide may be a lesion of the liver and the second a lesion of kidney and a third that of lymph node and fourth that of skin and so on.With perfect ease one shifts from one to another after giving proper attention to each and solving each problem.
.People with ADHD cannot do this type of attention and concentration on a subject and then after solving a problem shift attention to the next with control.Their attention wanders from one to naothe rwithout concentration on anything. 2 to 6 % people have a difficulty in remembering numbers alone and this is called dyscalculia ,the numerical equivalent of dyslexia.
A small patch of cortical cells behind the ear,on fusiform gyrus of brain is called face area since this is activated by human faces.When this is lost the person fails to recognize even the dearest people (like daughter or son).
People who are tone deaf are not deaf to tones .They just cant tell them apart.People who are colourblind just cant tell colours apart .Similarly a person who has lost function of face area do see faces but cannot tell them apart .
Total amnesia occur when all memories are wiped out.
Retrograde amnesia:-One cannot recall memories that occurred before amnesia.
Anterograde amnesia:- cannot remember incidents that happened after onset of amnesia.


Table 3



Post-traumatic stress disorder (PTSD) is a disorder when a person cannot forget the appalling traumatic experience.The symptoms are
Nightmares
Flashbacks
Memory and concentration problems
Jitteriness and overreaction to ordinary events
Inappropriate fear and alertness constant anticipation of danger
Intrusive memoriesavoidance
Being startled at things that most people would ignore for example a rustle in the leaves
Extravagant reaction to mildly perilous event for example a funfair ride is treated as a lifethreatening event.
Which is the brains best witness of truth or lie –detector /Is it darsna or sruthy?Is it the visual cortex or the auditory regions?
Indian sages were very accurate when they said sruthy as best for any pramaana of doubtful cases.Harward university researchers of Massachussets found that auditory regions of brain are more accurate and active during accurate recognition than the visual cortex which sometimes gave mistaken or inaccurate results .Although a mind in conscious or jagrad state make mistakes about what is seen,the unconscious areas that actually sensed the original are not fooled.

Jamais vu is a condition opposite to Déjà vu .Here instead of being familiar with a totally strange one,person feels unfamiliar in most familiar surrounding and fail to recognize own kith and kin.They ask who are you to a daughter ,son ,or husband or wife with whom they have spent entire life .
All these things a music therapist will come across when they start practicing with real life situations.It is not just singing for a elite group of rasikas alone.It is working with people who suffer from various conditions and help in a most efficient and possible way to reduce their suffering.
Age associated memory impairment (AAMI)and Alzheimer’s disease.
Table 4
Naama and roopa of a person /object /world and its linking for knowledge:-
The naama and roopa is the prapancha or world.And the linking of the two happens best when we are in sushupthy when the knowledge or gnaana is given as a darsana or internal perception akin to a Samadhi vision .This is the most ancient teaching of India.How does we compare this with modern scientific view?

1.During waking state (jagrad)the name Suvarna and a face of me is registered .This is fed to association area in your brain and to hippocampus.Acetylcholine is high during waking which prevents hippocampus from feeding signals back to cortex.So information is not merged or distorted with other incoming stimuli.Instead they link together and are locked or encoded in hippocampus.
2.During sushupthy(dreamless sleep)Acetyl choline falls and this allow the newly encoded memory to be fed to association cortex.There is no information coming frm outside to cortex.(due to a blockade of all sensory organs in sleep similar to chithavrithinirodha in yoga).The feedback from hippocampus therefore re-triggers neural patterns that were activated during previous waking .Including the sight of my face and its neural pattern corresponding to name suvarna.As these two cortical patterns fire in unison they become linked and the neuronal linkage forges a new connection between the concepts such that if one(the form or face)is triggered ,the other (the name)is likely to fire up too.Thus the name and form is consolidated.In the same way a word and its meaning become consolidated (Vaak and its artha)during sushupthy /Samadhi.Thus Naamaroopaathmaka prapancha is consolidated in sushupthy/Samadhi state by human brain .

Keys for a good memory:-
1.Interest,attention and emotional and personal involvement .
The wider the interests of a person,the more actively one engages with such interests,the denser and richer will be one’s memory network in brain.Thus new information is likely to find a place to lodge in your brain even in old age.
2.ordering our experiences
Experience is doubled by thinking about them.When we make a mental note of an (musical)experience we want to keep (in our brain network/or a notebook for later use)it will focus our attention,organize the information into a form that will make it easy to access later .This enhance memory
3.Repetition and rehearsal:-
Everytime we recall something ,we are fixing it more firmly in our memory.For this the best method is to think of what we want to remember always at the beginning of the day and end of day (The two sandhya ) .Japa is arepetition .In olden times students were doing along with sandhyavandhan,repetition of Gunakoshta(multiplication tables)and other things to be learned like seasons,etc.
4.Learn often,but little by little,step by step.
Give time for brain to assimilate and process new information.Several short sessions,punctuated by periods of review is best for this.By this we are not cramming the brain.
5.Keep socially,intellectually,mentally and physically in touch with likeminded ,good people (Sajjana samgha) called Sathsangha.Avoid contact with people who distract mind and intellect.
6.create memory games from every day experiences itself.
One can remember street names or district names or city names as we travel from one place to another.My father used to encourage this as we traveled by car from Punnayurkulam to Thiruvananthapuram or to Calicut.
Another game which children can do while traveling is to add the numbers on numberplates of vehicles that pass by and quickly decide which is odd and which is even .This will increase our number sense.I used to do this even after my marriage and my husband used to make fun of me for this pastime.
A jigsaw puzzle or a Gnan choupad(Leela)a chathuranga etc were used in ancient times to increase ones attention and problem solving ability.The scrabbles is for increasing vocabulary of children.

Some external aids:-
1 Reminder notes.
List of grocery items for shopping,organization and flow charts for office use,list of things to be done in a special date /week/month/year and so on .Look at them regularly.
Lecture notes and discussion notes of teachers
2.Visualise the colours,forms ,locations in mind when one visits a place or when one has a special musical experience etc .This will be more useful for making a memry connection and recall than a note prepared as a list.
3.An alarm clock or timer.Mobile phone alarms to remind something.
4.Wall planners and electronic organizers
5.Alarm device on keys,purse which you are likely to forget .
6.Labels on cupboards,drawers and on kitchen jars
7.A pill organizer for medication
8.Keep a journal.This is a hobby as well.This help you organize your entire life.
9.Pocket cassette recorder
10.A camere
11.Suppose you have found something very interesting in a new location and you want to measure it .You don’t have a measuring device .The best measuring device is your own hand and feet ,fingers etc.This is notan external aid but is a very valuable aid which you can carry anywhere you go.


When to use an external database?

When you don’t want to clog brain with lot of information which you can store somewhere else.A library is such a storehouse.
A telephone directory
An appointment list made long time in advance
Report of an event
To present a bulletin within a short prescribed time limit on radio or TV or in a speech
A lecture class .The points to make it more sensible
When no time for a rehearsal or repetition,when you are busy ,you can rely upon the note .
One important aspect for remembering things is by the puns which are abundant in all Indian languages as the literature and music suggests.the examples are voluminous and caanot be cited here.The modern use of Onamatopoeia and Mnemonics are used by such ancient authors.
Here I will consider Mnemonics.
When a medical student is taught the preliminaries of clinical medicine he/she is taught (for treatment of fainting):-

If face is red ,raise head
If face is pale ,raise tail.
(This depends upon the blood flow to head ).The rhythm and rhyme in this help student to remember the treatment .This technique was used in all sciences of India (Ayurveda,Jyothisha which show lot of rhyming verses and rhythmic poetry easy to memorise and keep in brain in a oral culture ).Rhythm and rhyme help storage in both hemispheres when combined with language.So music with a vocal literature has this property.When we recall rhythm or tune ,the words/sahitya /language also pop out of it and vice versa stimulating the two hemispheres simultaneously to function in unison.

When we remember our Teacher /Guru ,and the voice of the Guru ,accompanied by the melody ,rhythm,rhyme and emotions that evoked within us,when we first heard him/her ,we are visualizing our first experience with the music and reliving it and recreating the same emotion in us after several years .The voice of mother,her lullaby,her love,care,face and even the smell of her dress come back to an adult when he/she visualizes such an emotional musical experience.It is the same with the musical experience with the Guru.The feeling of ecstacy,security and peace thus recreated from a sound and visualized and experienced again and again become fixed in our memory .That is how the musical life panorama works .
Creating a link:- Before the printing press and recording devices,only oral teaching/instructions were there.This could be achieved only with Mnemonics and visualization of musical lessons/rhyming sloka or sahitya.Brain retain and recall by creating links of language and for this Puns was used.Anotehr very interesting practice was to give a letter a number which was widely used in Astronomy and music of India.Now we use such a device for computer language .So the originator of the binary system as well as attributing number to letter ,both started in human computer brain millennia before the modern devices evolved.
Some methods of using mnemonics:- If you can remember SARCASM you can remember the list of mnemonics techniques .(The first letter of each )
1Sentences/Acrostics;-
To remember the order of the treble clef EGBDF a sentence
Every Good Boy Deserves Favour .
2.Rhymes and songs .
Rhymes,rhythms,melody and repetitions of it aid memory .Therefore music enhance memory.Word in left hemisphere9sahitya)and melody in right hemisphere (sangheetha)a combination is achieved with vocal music using both sangheetha and sahitya.Linking these two effectively so that information spreads equally throughout brain in a balanced way .This technique was a vinoda(leela or play/fun )for learned and creative people of India.But it was also a technique to keep cognition,intellect,memory and traditional knowledge intact through generations of mankind..The rhyme of the song draw auditary memory so that tunes,songs and poems are learned easily (Sruthy).Thus through that sciences and languages are interlinked .

Mnemonics of modern pilots to temperature and pressure drops at low and high altitude is comparable to that of medical students learning technique mentioned above.

High to low ; Look out below.
Low to high; Clear blue sky.

A weather tip:-
Rainbow in morning-Travellers warning
Rainbow at night-Travellers delight.
(Rainbow indicate humid air.In the west in morning a rainbow indicate storm which come from west .In the evening in east it indicate the storm is over and weather is good.)

3.Chunking is for remembering large numbers.One can remember upto 5-7 things at a time.Suppose there is a large number .

044 45500078
It is easy to remember this telephone number by splitting it into three chunks like



44455000 78 .This is my phone number and this is how I remember it .
Suppose it is 64831996
One can split it as 4 easy to remember chunks as
64 83 19 96
Or as three chunks
64 83 1996
Now adding and finding out even or odd is also easy .It is done as a mental exercise quickly.

4.Method of Loci:-
The way in which ancient bards and speakers/orators remembered their music/epics/speeches/commentaries etc.This combines use of organization ,visual memory or visualization and association and hence is a complex procedure achived by human brain.

I will give an exercise here for all readers.This is done in music therapy visualization procedures .
First ask your friend to sing two lines from a poem/song at a slow steady pace ,say one word per second.Concentrate on the words alone and remember.
How many words you can remember just by hearing once?
2.Think of a vast location.Or distance mapped in your memory.Visualise each river,mountain,greenery,each gurgling stream in the landscape.Then listen to the same lines again connecting each word with the landscape scenery one has visualized in order.( A krama or orderly arrangement of words ).Now the traveler know the visual imaginery landscape as well as the location of each on the song.This is how the epics of India are constructed.Almost similar process is used by Austalian aborigines in mapping the long and distant landscapes and geographical places.The Indian epics give landscapes of entire cosmos,of the globe earth and of Indian subcontinent in detail associating each with seasons,plant and animal varieties,fragrances,spices and human nature and customs etc .
The Indian music also has the same technique of relating each raaga with season,time of year and day,of a star,and a graham,to days of week and to human organs and panchabhootha,including living and nonliving objects like jewels etc.If one can know ones birthstar,the animal,plant and graham associated with it,the raaga associated with that star,and with each season,and with the organ of ones body affected by some illness etc ,one can use an assortment of Raaga suited for each for a perfect understanding of the problem and for solution of problem.Thus the method of loci is applied in Raagachikitsa.

5.Acronym :-I had left out the A which is used twice in SARCASM .This is the most common abbreviation that we now use.

Example :- RSPCA is Royal society for prevention of cruelty to animals.

In ancient India Panchadasi was called Lopamudrasuthra (after name of Agastya Rishi).This is a magical square (in which Srinivasa Ramanujan was expert) and this was called LOSu or Losoo.This was known to China from ancient period in this short or abbreviated form itself showing its origin.
Another rexample is Hora.People think that it is an adaptation of the Greek word Hour.But is not so.It is an abbreviation of the word Ahorathra. The first letter A and the last letter thra are removed and the middle word is used in order and in reverse order to create two words .One is Hora(or 15 degree) and the other is Raho or Rahu the node which creates the division of time which is indivisible.It is more likely that hour was derived from Hora because such an acronym practice was there in India.

The way of remembering parts of leg by a zoology student of modern times is :-

Cockroaches Travel Fast Towards Their Children

Coxa,Trochanter,Femur,Tibia,tarsus,claw .That make up an insects legs.
So both ancient and modern man alike use such techniques in learning and our brain has not changed much in the capacity of cognition and memory.And it is possible for one to learn by ancient methods and with music of ancient India which is riddeld with puns and praasa and rhymes,rhythms,repetition of sangheetha and saahitya alike to stimulate all parts of brain and nervous field of all living organisms.It is needed ofr balancing of our health and mind and body as well as intellect and spiritual development to be a perfect individual.

Feeding our brain adequately:- A nutritious food rich in cereals ,fruits,vegetables,nuts and if necessary and unavoidable a little bit of nonvegetarian food and milk,yoghurt etc and less of fats,oils is needed to keep memory acccordingto modern standards.But the use of butter and ghee in infancy and childhood is essential for brain formation and hence in infant diet,milk and milk products is a very important factor.

Can an adult brain grow and have new knowledge storage or memory ?Yes .How ?By synapse formation and synapse plasticity which cause structural and functional correlates of memory ,learning ability and intelligence is the answer of new neurobiology.(Sara Mariani conference report :The biology of memory and learning .Highlights from the annual meeting of the American society of Cell Biology Dec 13-17 ,2003 San Franscisco California .Medscape Molecular medicine 6(1 ) ,2004).By repeated stimuli (repetition )and by experience there is new protein and synaptic synthesis and the remodeling due to experience-dependent plasticity (EDP)leads to long term memory formation has been proved .So japa ,and repetition of the same learning for a period of time (practice)can lead to memory storage for longer periods.And the perpetuation of memory of tradition and culture is based on individual as well as archetypal memory of entire human race .Music and musical memory of India is here utilized for the purpose of improving memory in normal and compromised children for development and in people who have lost memory (amnesia) for retrieval of memory on such principles.

References.
1.Bhagavad Geetha second chapter
2.Keralasahitya Academy journal
3.Music therapy in management ,Education and administration (Readworthy publications New Delhi )
4.Papers of Dr Eric Kandell,Dr Karel Swaboda,Dr Yukiko Goda . Sara Mariani conference report :The biology of memory and learning .Highlights from the annual meeting of the American society of Cell Biology Dec 13-17 ,2003 San Franscisco California .Medscape Molecular medicine 6(1 ) ,2004).

Lec-Dem Music Academy

SYNOPSIS - MUSIC THERAPY

1.Music therapy is An interdisciplinary approach.and part of integrated medicine.When a new discipline is introduced there are some questions we should ask.


1.How does this discipline work ? What are the basic principles ? It works on principles

of ayurveda (thridosha balancing) and yoga.

Is it result oriented or not ? Are there any side effects ? Yes .It is result oriented and there

are no known side effects .

Is this a cost-effective procedure which can be implemented on a mass scale ? yes
2.The basic difference in the principle of Ayurveda and Allopathy medicine


The sound and swara as a dravya having the three guna and balancing of thridosha with it

build up immunity .

No killing of external life forms,only co-existence with them.

Increasing defence by balancing thriguna/thridosha according to the time

./season/day/night

Naada,laya,and yoga principles are incorporated.
Spirituality,physicality,aesthetics,mathematical cosmic order are integrated for physical,mental,intellectual,and spiritual health .But we have to combine the 21st century research methods of allopathy medicine also .

3.Research principles .

To the individual-centered family centered approach we have to include the hospital-based research protocols of Allopathy medicine
Statistics and proper documentation is a must .open approach .Discussions for growth of discipline


5.The physics of Raagachikitsa.
Our receptive sense organ being the ear ,we have to know the physics of hearing.What is good for ear and not.

ATH –Absolute threshold of hearing

S P L –Sound pressure level.

Comparison of dB SPL and distance and origin of sound –(Tables

Above 80-85 decibel is pollution level.So therapy cannot be done above this level.
60-80 is a lecel in a busy office and busy restaurant and most of the modern electronic instruments start from this level.(Can go up .In some traditional instruments can go down also)Usual vocal music is from 20-30 decibel level.30- mother and child in a silent house
20 – forest with rustle of leaves(below 16 and over 20000 are considered inaudible to normal human ear)
10-breath sounds(praanaayama)
0 the silence mouna.It is in silence the yogi hear and see sounds.



6.Four Examples -2 of them hospitalbased. Hospitalbased studies two case histories (personcentered familybased in two age groups ,and in two different situations).


On patients undergoing colonoscopy RCT 78 patients.Oct-2003 to Feb 2004
46 % vocal raagabased
10 % instrumental ragabased
56 %raagabased
Rest bioacoustics(natural sounds)and focal mappilappaattu
Mooladhararaaga majority .73. %
Pain,discomfort and anxiety was less in persons with music .The dose of Drug also less.

On autistic/CP children
Severe cerebral palsy ,brain damage with spasticity.24th Feb 1999(birthdate).Contacted me in 2006.Teacher was giving symphony orchestra.Mother ,a trained classical music singer noticed he responds to classical music and contacted me through a common friend.
In Oct 2009 the boy responds to sapthaswara of Mayamaalavagoula(15th mela).Shouts,make a stop when she stops,when she reach a higher octave he is most active.When she sustains thaarashadja and stress the nishada (sudhanishada)then again go to tharashadja he also makes these notes.
Seeing his improvement now the mother is asked by the teacher to come and help the other children in her school.
Interpretation:-trying to converse with mother musically
Turntaking is being learned.trying to interact with his sounds to the mother that he is recognizing what she communicates musically
First social skill he has learned
Cognition,sign of listening,so slowly brain function is improving .

On alzheimers patients..

On old and young approach is not same.We are trying to rewind memories.The other we are teaching to learn some basic skills.In both role of family is important.In the young the parents ,siblings help.
In the geriatric ,the children,spouse,siblings if they know the musical preferences ,they can help.

On anxiety,blood pressure as pilot projects
On volunteers and clients done.Subjective and objective parameters analysed .Pulse pressure ,difference between systolic and diastolic /Hamiltons anxiety score /significant.The high blood pressures brought down very effectively.Low blood pressures brought to normal,after an initial rise of pressure.

Importance :-for the risk factors of cardiovascular disease,for cerebrovascular strokes,for diabetic complications ,and for professional stress,and domestic stress and for stress related to hospital stay,and cancer chemotherapy etc we can use this.


4.Cosmic time and music .

Chakra ,seasons,ahorathra and raaga . North Indian Thaath and South Indian

Melakartha. Human anatomy according to this division of chakra. (Will show pictures

only .On powerpoint presentation). Bhava and rasa for total laya or layana (merging).


(The presentation done with power point .Demonstration of Subhapanthuvarali raaga ,a composition in Malayalam language was done)