Specificity training

Aurélie Wagener explains that Filip Raes’s team at the Catholic University of Leuven, trained depressed patients to recall specific memories (5). This resulted not only in greater specificity with regard to the memories reported, but also to a significant reduction in mental brooding and cognitive avoidance as well as an improvement in the ability to resolve problems. If the patient could access a specific memory of the way he dealt with a similar situation in the past whenever he is faced with a problematic situation, he could then use the strategy previously deployed. The consistency that he will observe with regard to his way of acting, will then greatly reinforce his sense of self-continuity.

Furthermore, work carried out by Hamid Taher Neshat-Doost (6), at the University of Ispahan, in Iran, has demonstrated that ‘specificity training’ leads to an improvement in the depressed mood. “Certainly, this study focussed on ‘typical’ autobiographical memories, but the theory could also be posited that a similar effect might be produced from self-defining memories”, considers Aurélie Wagener. A priori, the specificity training approach represents a promising therapeutic option. As pointed out in the article published in Acta Psychiatrica Belgica, “We can also surmise that recollection of a specific self-defining memory could favour and reinforce a sense of self-continuity, because the individual concerned would not evoke an abstract and blurred characteristic associated with it. Specificity could therefore allow the individual concerned to have a clear and concrete image of who they are and the reasons why they became the person they are. Furthermore, because the overgeneralization bias is a factor of vulnerability with regard to depression relapse, recollection of specific self-defining memories could also serve as a strategy for relapse prevention”.

Towards a unified self

Apart from specificity, another dimension to be exploited is autobiographical reasoning. In fact, it would seem appropriate from a clinical point of view to encourage the depressed patient to attribute significance to his memories, to learn a life lesson from them. In other words, patients should develop their abilities of meaning making. Generating self-defining memories integrated with our history, those which allow us to say for example, “At that moment I understood that... “, or “From that moment on I became aware that...” are likely to reinforce the sentiment of self-continuity and, thus to favour the construction of a unified self, in accordance with the terminology used by certain authors.

The emotional dimension is another vein to be exploited, but, in reality, it is largely a continuation of the previous one. “According to our work, it is inseparable from training in autobiographical reasoning, says Aurélie Wagener. She adds: “our theory is that the capacity to think about a memory soothes the intensity of emotions and could modify the emotional valence associated with them”. In other words, the development of autobiographical reasoning abilities seems to be an essential condition for developing redemption capacities.

Furthermore, in 2013, Tim Dalgleish, at the University of Cambridge, suggested helping patients suffering from depression to build up a store of positive memories which they could instantly draw on when they felt their humour deteriorating(7). According to the British psychologist, these patients could even begin their days by systematically recalling a memory with a view to dispelling their morning brooding. “In addition, in the case of euthymic individuals, this store of positive memories could contribute to the prevention of depression relapse given that it has been shown that they derive benefit from recalling these kinds of memories”, comments Aurélie Wagener.

Patients suffering from depression show a deterioration in their sentiment of self-continuity. In psychotherapy, allowing them to reinforce this sentiment, to regain a more affirmed identity, is essential in order to equip them with the means to project themselves into the future and therefore to redefine objectives that need to be reached. Acting on the different dimensions of self-defining memories seems to be a promising approach, but, for the moment, apart from observing a decrease in short-term depression symptoms in the subjects treated, it is impossible to conclude that there is a lasting beneficial effect because this approach is very new and there is currently an absence of consistent studies on its long-term impact.

(5) Raes F., Williams J. & Hermans D., Reducing cognitive vulnerability to depression: A preliminary investigation of Memory Specificity Training (MEST) in inpatients with depressive symptomatology, J Behav Ther Exp Psychiatry, 40, 24-38, 2009.
(6) Neshat-Doost H., Dalgleish T., Yule W., Kalantari M., Ahmadi S., Dyregrov A. & Jobson L., Enhancing Autobiographical Memory Specific Through Cognitive Training: An Intervention for Depression Translated From Basic Science, Clinical Psychological Science, 1(1), 84-92, 2013.
(7) Dalgleish T., Navrady L., Bird E., Hill E., Dunn B. & Golden A., Method-of-Loci as a mnemonic device to facilitate access to self-affirming personal memories for individuals with depression, Clinical Psychological Science, 1, 156-162, 2013.