>> doctor small is the director of the alzheimer's disease research center at columbia where he is professor of virology published more

than 140 studies on memory function earning him the scholar word of research american federation on aging most recently his research into alzheimer's disease led him to cofound a new biotech company. joining him in conversation tonight's best-selling writer and journalist, the author most recently of the novel summer hours at the roberts library. scholar and resident at middleberry college whose writing has appeared in the new yorker, new york review of books, rolling stone and more. this evening discussing doctor smalls first book forgetting talks about walter isaacson's sue rice forgetting is the work of an accomplished

neuroscientist who follows in the tradition of oliver sack illuminating the mysteries of the brain with personal stories and lively acceptable writing. we are so pleased to be hosting so now the digital podium assures. >> great. hi scott.

alzheimer's and in many ways i never thought that this book is now completely a third category which is normal forgetting that occurs in all of us normal unto itself not part of the aging process. >> i think that's really confusing because what do you

mean by normal forgetting? how is that normal? what does that mean? >> of course that is a complicated question. to answer that conclusively but in the spirit of the book more most would say is what we all born with it occurs naturally in that includes forgetting may be pathological forgetting it's important that nobody things i have written a book that politicizes pathology. there is pathological treatment and by definition it means it is worsening from your baseline whether that's caused by alzheimer's or normal wear and tear of aging that is pathological i would never expose my patients to say there is a silver lining this is in contrast. something we all born with that occurs naturally but yet we all complain about it.

>> you say in the book forgetting is that cognitive gift. how is that a gift? >> it is a gift only because most people who turn it on its head is occurs and most people i speak to and as i memory doctor whatever age they are at any stage they will start complaining about forgetting as if it's not a curse but a problem or a failure. so what emerged from writing this book i wouldn't necessarily describe anything is a gift, certainly mother nature's gift but is writing the book, it's only by balancing memory with normal forgetting it is a gift because allows us to be better in smarter and happier people.

>> one of the things they want people to know about this book besides it is beautifully written is that you are really a master of the metaphor. that's really important when you write about science because as you know, science can be complicated and difficult to understand. some of my favorite metaphors in this book other than you call yourself a brain mechanic. [laughter] talk about the different regions of the brain the prefrontal cortex the school library and in the hippocampus as a schoolteacher. one of the things that is remarkable and wonderful is how literary it is i know this about you. you are a reader who care deeply about literature. that's also how we met because

i am a scientist and word is this turn into that transitional work - - transactional work that you do? period that's an interesting question i will get to the more important question in the second but on metaphors i begin the book in a way that spoofs that use for memory in my first patient uses the only one that i detest is the bear trap the steel trap analogy. there are many metaphors the challenge was not to trip on too many but i use them sparingly about what is most helpful in trying to read the stories. this is a book about stories to impart the science so now on the influence of literature and science, i start the book with a quote.

i have a chapter on the book that talks about how in his short story about argentinian cowboy who is thrown from his horse wakes up with the inflamed brain and cannot forget anything that true photographic memory that we fantasize about it in the forties and fifties intuitive in a literary sense it is occurs not a gift we think it is and it was very interesting to me he was writing at the same time that the father of american psychiatry in the pursue introduce the term autism started to wonder of autism and to much memory there is an interesting link that clearly in a particular case he completely foreshadowed our understanding or appreciation of the detriments of having your mind that can't forget.

>> let's talk about autism for a minute. i have never thought of this this way in one of the things you are talking about is that with autism often there is a fixation like a metaphor the trees instead of the forest. tell me if you can talk more and how that works with autism and why forgetting becomes so important in this concept is normal and the benefits. >> it was very interesting so every chapter have a guide for

one of the leading autism researchers and directors from ucla. and in many ways and i talked to people about the book, the punchline is harder to get to it. most people intuitively understand you have to forget to forgive and but why word forgetting something that takes away from our brain make us smarter and more astute? >> you will forgive me by saying if we are talking about autism it isn't all autism and there is a legitimate debate in the field if it is a real disease or biodiversity and i'm respectful of that position but it was amazing to read the original transcripts

are he introduces the term autism and then the second he basically says autism is a disorder for the kids because mostly children were presented at johns hopkins who can't associate the parts from the whole that is such an interesting observation because in this case foreshadowing the psychology is something that is so fundamental so the example i used in the book is you and i are both dog lovers so in the morning and in the evening, after all the visual areas of our brain see very different information. that is a very simplistic

absurd ability to generalize something in her brain knows how to risk - - extract adjust and generalize and that extraction as computer science has taught us requires forgetting in areas that are brain that process information don't get too sticky with memory. it allows information to flow and to the people i know if they have autism but just this idea of intellectual flexibility that it is dependent on forgetting it is dependent on our brains to make connections and associations if you can't and

it is out of order but if you have that rigid understanding of what something should be and it is changed, it is disturbing. >> it's exactly disturbing and that's what i quote from tanner because again he basically says these kids are suffering from any change in their environment. any change and to use an example what would it be like? i use the example of going even in times square so if everything is novel if you can't say no then that is old

and i recognize that. it squelches so i think that's interesting with some thought-provoking. >> and then the other part of that is the flipside that your discussion about savant and so can you talk about that? there is a way in which we look at savants and think oh my goodness that is amazing. it is. but from what i get so the flipside is the inability to generalize. >> i have said this a few times. i don't want to simplify too much. but generally it is true, this

idea of having a pocket of incredible ability to store list of information savant is a means you have a pocket pocket of in this case is not the creative memories we talk about but for those that are able to store the information and it might come at the cost, or it probably does come i would have to infer that but it comes at the cost of being able to generalize and not get stuck on the details. >> but here you are one of the great neuroscientist and translational and you know a lot. you have a lot in your big

brain. you don't have to agree with me. [laughter] so how does a person like you who is supersmart but also have to keep a lot of stuff in their head? to do that, there is a mere level on —- mirrored level for people that have this ability as you do to know so much. and not forget. >> i gather i am allowed to disagree. i will do that in a way is at least another chapter on creativity that people who know a lot so if you remember

every detail to store a lot of information across multiple domains. like a robot lifting things by the ability so that requires extracting a just and that ability is some forgetting and i will tell you if there is any ask medical training, was never the one who couldn't list to a differential diagnosis my memory was not excellent. it was good enough that wrote to memory but synthetic thinking i think forgetting could be helpful. >> it's interesting. that's good to know for all of us. [laughter]

part of the book is personal there is a lot of stories. and it has to do with your work or people you know or your patience. but there is one chapter which is incredibly moving and also a little upsetting not in real terms but to know that i think may be because i know you but the chapter is very personal so if you can just talk a little that about to write that chapter but that story is interesting in terms of the experience that you have to read that chapter. >> you are absolutely right the easiest chapter to

understand to talk about generalization abstract everyone knows ptsd is too many emotional memories that cannot be shaken so that is easy to explain so there was an idea for every chapter in the person i was talking to at columbia he knew a girl up in israel and he knew that my unit had this event that led to emotional trauma to write about your own personal experience. >> ultimately i did.

comrades in arms he was behind the gallows humor. and want to violate confidences. but it ended up to be interesting because it adds up to the interesting question because here are people exposed to the same trauma and what is up with that? so you know i am hard-core in cells and molecules. and talking way too much about love but the strongest risk

pastor factor and not exposed to the social fabric those people that will develop with a lot of complicated things for all of these drugs was fascinating to say for something like ptsd to accelerate emotional forgetting is behavioral and social and i say something with love and friends it still makes me cringe a little bit.

in terms of treatment with exposure therapy and how that and with forgetting because the whole point of exposure therapy is to say the same thing over and over to relive this memory again and again. so why is that useful? why is that there politically beneficial what about the paradigm to repeat the experience? >> because basically if one would reduce the memory to an association the face in the name that's what i use over and over again but that associated at his word is stable of ptsd so what exposure therapy does is

loosens that association by exposing to a phobia over and over that now not associated with the painful associations of that is what has happened to the science of forgetting and how forgetting actually happens so in a very simplistic way with pieces of information represented by two neurons to strengthen their connections. if i show you over and over that now without the associated painful memory naïve have mechanisms to disassociate that memory. >> and one of the things you write about is the use of drugs like ecstasy for the treatment of ptsd.

i am wondering how that interrupts the memories. how does it enhance forgetting? what does it do? think if you use the right term, many people know just like a computer we divide memory into the formation of memory shifting from short-term to long-term to shifting and retrieval. and for the longest time emotional memories were thought to be distributed. of course they are but one of the good things that has come out that the emotional memories truly are stored fundamentally in one part of the brain called the amygdala. one of the things that ecstasy does do is turn down the amygdala. this is very simplistic but not far from the truth that

when you think of a child of an emotional memory your amygdala is activated and firing. people who have ptsd have too much memory activation in those storage areas one thing that oxytocin does is dial down that activity which is effectively another way of relaxing those fearful memories from leaping into our minds. >> why is that permanent? why does it only affect you while you are in that state to be receptive to the drug. >> so with temporary as long

as you are on the drug the fear has been diminished because it still stored in the amygdala and if you want to get rid of the storage you need more psychotherapy but it does illustrate how fear memories and forgetting of them just to turn them down temporarily so you mentioned ecstasy as a doctor i cannot advocate that that ecstasy was called ecstasy because of people take it they feel as static with prosocial feelings. even love. and ecstasy does a lot but another area of the brain so

think of your hard drive just cranking out too high and burning and feeding information on to your screen it turns it down which is a great personal way to experience the benefits of not completely eradicating fear and memories but at least squelching them momentarily. host: you talk about regions of the brain and neurons and so on and so forth but i'm wondering this because one of the things you and i did was talk a lot about genes and so thinking about this in relation to ptsd where genes come in you remember a couple of years ago there was a talk about the resilience gene so where do they fit it into forgetting in those paradigms? >> the easy answer is they fit into everything a lot of that i don't think has been replicated that no doubt to people exposed to the same

stress one develops ptsd and one doesn't is not a simple factor there are risk factors one way or the other that genes clearly matter and influence every disorder. what's interesting with ptsd there is no mono genic gene no single gene to call one —- cause alzheimer's or parkinson's it's part of many risks whether they are many genes interacting with environmental effects. genes matter but in this case the one thing to consider you cannot do you anything about your genes be you can do something about your social structure or trying to accelerate by tapping into the mechanisms. c might as well focus on things that you can modify. >> this did so well with your other work on alzheimer's just

on normal memory loss in which you do a lot of work talking about nutrition and exercise and how that helps with the normal process of memory loss in normal cognitive aging. we will have to turn it to questions soon but you say pretty early in the book that we know now forgetting is beneficial why do we know that now quick. >> it's a good question and it relates to my work of pathological forgetting if i say the new science of forgetting everybody says it's a failure of memory even doctors and scientist i was raised on that premise the new

science of forgetting has shown is a completely separate group of mechanisms in neurons that govern forgetting in other words not just memory failure you have two separate controls the braking system and accelerating systemwide by itself suggest is not just the resting of memory it implies that might be beneficial, but that is a slightly dangerous insurance to make that if nature endowed us with something there must be a purpose it has endowed us with an appendix and there are many examples where that logic can be slippery. but then i go chapter by chapter showing now that we know there are separate mechanisms working imbalance we can show what happens when normal forgetting goes awry and that allows me to conclude

is beneficial. now the distinction between pathological forgetting it turns out the molecular mechanisms that are pathological target the molecular components in neurons that regulate memory so pathological forgetting is a memory failure but they don't touch those mechanisms that regulate forgetting and that is a nice way to distinguish pathological forgetting from normal forgetting from your own experience and that is true aging and alzheimer's so now i

will pass it over that kate ask you the questions. >> we have been receiving some great questions anybody who is watching if you'd like to submit a question go to the q&a button at the bottom of your screen. let's see. so then to more general. >> so it's more of the absolute the issue of attention and forms memory the way neuropsychologist are slightly simplistic have attention and memory so it's

more about the question was asking. >> why does forgetting evil look such deep emotions and a sense of loss versus pathological forgetting? >> these are great venues because i get questions i never considered. speaking from a patient's they think pathological forgetting is upsetting to identify agree with the entire premise but normal forgetting under the older rubric of a memory failure in a world where we are so competitive information laden and be the person i think we beat ourselves up too much about normal forgetting one of the things i experience from writing the book is i

stopped at a moments of normalcy. but that's a really important point i'm not saying celebrate your foibles it can be frustrating but accepted as part of our makeup because with that we enjoy many benefits so the questioner is really feeling a lot of negativity maybe by reading this book you can relax on that a little bit. >> now that i'm over 80 and having more trouble memorizing poems or speeches for theater should i give up feeling disappointment or are there techniques they could do this better? he also has questions about techniques people can try.

>> you really have to say something that is obvious obviously if i am asked clinical questions it is self evident i cannot be giving clinical advice. i do get this question from a lot of friends and family who call me and complain about a worsening of forgetting, i do think it is worth to see a doctor for just because you want to make sure there isn't something that could be treated. so let's assume it is normal forgetting and pathological forgetting. age-related memory loss. and i say this because the

brain is plastic in the mechanisms. and to enhance memory in later life if not alzheimer's. but surprisingly is how difficult it is to find but what is remarkable is we cannot say anything more specific physical exercise that seems to meet the standards of something that i can say routinely will help your memory in later life. >> there's a great question here. >> because think about it if

you type something on your screen then you can say that you are shipping your information to your hard drive and come back tomorrow with many documents to click open. and with that information of the restored. what you are seeing is a return on —- a retrieval problem. if there is a worsening? and to access the one thing of limiting debate and then there

is that experience of ten minutes later that's the piece of information because it's not a storage problem memory is there. it is not a click / save problem because you have done that with words it is a retrieval problem. i'm not saying it is a good problem to have but normal aging the way the brain has decided to enhance our ability to navigate a complicated world that's blooming with information that stays. that's what you are experiencing and wiper got of that is satisfactory. >> . >> i am jumping around so thank you for the talk i know you said you don't want to

politicize pathological forgetting that in optimism so in terms of normal forgetting that is applicable and pathological forgetting. >> thank you for the question because my patients have taught me a lot i am not sure if this is the silver lining for them, but what they have taught me is that we over index information. we love memory so who could remember more? and my patients particularly in the early stages not the later stages they can last 210 or 15 years but in that stage having a difficult time retrieving information and storing new information, a little bit unfocused, they still have taught me they can live a full emotional life they love their family, art,

and the leslie have learned from my patients with cranial nerves they taught me is not all about memory. >> here's an interesting question from kathy so if storage is enhanced by emotion and redial storage back by lowering emotion that might be enhanced by mindfulness and lessening a reaction? >> where did it help with memory? i think so so one form of psychotherapy because psycho

is more detailed and then to disentangle a memory from its association. and if you are mindful of why something triggers negative feeling and how that accelerates the forgetting process. >> i do feel like a good night sleep helps with my memory i take on —- i wish i could do that more consistently is there any evidence to support

this? >> that so interesting because i do talk about sleep in the chapter on creativity. it turns out sleep does to thing to improve your mind talking about connections , here is a metaphor imagine there are millions of connections to the cortex not in the neurons so now the field of grass of connections basically that's what happens when you live your day there is so much information our brain is exposed to most of it is not important but yet our brain is sticky with a storing that information. what sleep does first and foremost allows us to smart forget now we know sleep induces forgetting for the information that is unnecessary but at the same time if it's just mowing down all of these connections to

topiary and accentuate. so in a certain sense, does help short aspects of memory but fundamentally if anyone has been forced to be away two or three days and they feel their mind is static and they can concentrate that is because they have too much extraneous information. it's a great way to experience the detriment of not having forgetting. that's the mechanisms for sleep. >> talking earlier about this reminds me is there a special role of music to help memory retrieval to think of our senses?

>> the way to help with memory or forgetting? >> i'm sorry yes. is the role of music. >> yes. absolutely and maybe i should have been coached not to offer too many opinions but i will say i love produced. that is like pop-up book and it is all they are not because one that shows memory is not a museum of natural history but of modern art. and i think if we go for literary references i need to speak memory. but with a point of music commit so interesting any fundamental unit of memory anything that would trigger that association would be effective and those are unto

themselves with their earlier years also observations but the musical abilities are maintained and gives him a lot of joy the distinction between forgetting and ignoring? have you had that question before quick. >> but i think i understand the essence. i begin the book saying i'm

tired of people complaining about forgetting because it is great. i quickly qualify by saying to offer advice but then to say i'm not really great so that might be true to that if you are focused and if you are focused on one thing that and often people have forgetting for certain things. it's not so much to be neglectful or not that i'm not sure that's at the anonymous questionnaire was asking. >> not a question but a memory experience while trying to remember the name of a high

school teacher i picture a clam when i finally remember the name i realized it was ronald donald i am associating the without well-known mcdonald's clown in my brain was showing me the way. >> that is spot on i don't know if anybody knows about memory magicians. and these memory athletes that can walk into a room and memorize all these names so they also tap into the hippocampus and the more you populate that stage with information and associations the more you can retrieve the memory that's a very interesting anecdote in the way i understand memory works. >> we have a question about sleep from anna. with those aspects of memory

is there a difference between natural sleep and sleep with assistance or sleeping aids? >> there is a real debate because there is a distinct difference. i'm not asleep doctor but i know enough to know that she's probably talking about pharmaceuticals are other ways that they are fraught and problematic. so to obsess under the industrialization of sleep. we need to go to sleep at 11 and wake up at seven and if i have less than that i will not function. what we do need is six or eight hours of sleep per day but not in a 24 hour period so

within one block. if you take a quick nap or go to sleep early and then sleep in a little bit as long as it is six or eight hours that seems to work. the reason i say that because so many people are so obsessed with the block idea they over medicate and as most people know that the press can get people into trouble it's not the same thing. >> were you saying just now that i keep reading things about how taking a nap longer than a certain amount of time is a bad thing. >> i will not argue on it because i am not asleep doctor. i don't think it is.

but yet it doesn't have to be in one block that a know for sure and so that great description of catherine the great. and then would go to sleep at a in wake up at 1:00 a.m. and then go back to sleep. and if i wake up in the middle of the night i try not to fight it and go right to my amb and maybe i will read chapter for half an hour than go back to sleep. that seems to help me know i'm getting too personal again. >> not to be clinical that are there techniques for forgetting things you want to forget quick. >> that such a great question

that's been asked a lot since i published the book. remember to sleep. i'm sure we talked about exposure therapy and ways to do it. and then to remind yourself to forget speaking to a clinician but one thing i can say that i find interesting that marriage counselors if i ever develop a drug that accelerates forgetting please contact them so that is interesting on the point of trying to let things go as they can. will talk about oxytocin

ecstasy does that temporarily and that there is research and ecstasy and lsd for ptsd. when that is a pharmacological way ultimately to eradicate fearful memory. but one thing i can say and i do say in the book and talk about socialization. so to experience that you should be lucky enough to have an animal at home. this is a little bit risky but if you do that closely the relaxation that is part of the

oxytocin oxytocin inducing fear forgetting so there is really good signs that have been shown i gazing with dogs them and us releases oxytocin into the brain. >> . >> artistic patients show in flexibility and repetitive behavior. >> that works this is just a loose interpretation and many other views of autism. but it works because and then if you really have no forgetting you will need your

memory to do that. then may be able have more memories but it turns out a lot more efficiently if you engage or forgetting. and then to demolish and build so then to be flexible in the face someone interpretation this week so that is why they are inflexible and to experiencing anxiety of change because they cannot modulate the memories in their mind.

>> so special like remodeling house if you cannot imagine will sake currently. >> and those that object to that chapter please write me. and those that found eliminating. >> we are almost at a time everybody that would want to read the book.

so talk about the drugs for sleep you mentioned nbn. but i wonder what about thc or cvd those chemicals which i don't know if they actually interfere or engage with sleep itself but they relax people and maybe even allow them the ability to what's going on. >> and with categories drugs like the ambien, but then you have the analytics of cvd and others. they are cutting away fear memories so i think that's the right way to go. so if you do read the book if you do get to the

acknowledgments you will see sue is someone i deeply they cannot was genuine. this was a new experience for me. i meant to be a science writer. without hubris i didn't realize writing in general science book is like using a new musical instrument. sue was with me throughout the whole two or three years i was writing it including one dark dark winter night when i thought i could not pull it off. thank you, sue. for those who have not read her, she is one of my favorite writers particularly about science and has been a great mentor for me. thank you in public and to be a little less fearful that is

a public service and then you learn so much. i spend a fair amount of time talking to over the years i have learned a ton i'm sure everyone well. but copies of forgetting are for sale and you can learn more about the harvard science book talk series. in the harvard library have a great evening

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