April 20, 2009

The Woman Who Can't Forget Is Awesome Because She Can Forget

Here's a question: when someone with OCD checks the stove twenty times, why wasn't fifteen times sufficient?

Wired runs a story about The Woman Who Can't Forget, Jill Price.  43 years old, unremarkable in most ways except that she can recall every (?) event in her lifetime, including events in the world.  For example, ask her when a certain plane crashed and she can tell you-- and also tell you what she was doing that day; as well as every other plane crash in the past forty years, as well as what she was doing those days, etc, etc.

It works also in reverse: give her a date and she can recall what happened to her, and what happened in the world.

She has a vivid, perfect autobiographical memory, and anything else that happened within the blast radius of her life experiences.

She's been the subject of newspaper articles, a 20/20 interview with Diane Sawyer, this Wired article.  She is amazing in her skill-- no one disputes that.

However, interestingly, she has trouble with recent memory.  She forgets an interview from a month ago.  She cannot recall a list of ten words read to her; and, she can be tricked into remembering a word that she never heard (thread, pin, thimble but she remembers also needle.)

She was a very average student.  She has not won Jeopardy.

But, she says that her memories are always running in the background of her mind, like a movie of sorts, that she can't turn off.  She is an obsessive journal taker, constantly jotting down the minutiae of her life-- however, she says she rarely rereads these journals. 

Wired also reports that she collects/hoards all the memorabilia of her life; her stuffed animals, old TV Guides, etc.

As I followed Price's story, I was fascinated but doubtful. I am a cognitive psychologist, and to me something didn't smell right.

The writer suspects that she doesn't have an impressive memory, per se, but rather OCD.

Price has spent her whole life ruminating on the past, constructing timelines and lists, and contemplating the connections between one February 19 and the next. Dates and memories are her constant companions, and as a result she's really good at remembering her past. End of story.
Slow down, James Randi.

It may indeed be true that she has OCD, but it is unlikely the cause of her impressive memory.


First, let's answer my opening question.  If someone with OCD has to check everything "seven" times or else something bad will happen, then it is the ritual that is the point, not actually getting any information from your checking.

But if someone is "neurotic" (vernacular) and has to check the stove twenty times in order to reassure himself that the stove is off, then something is not occurring between the eyeballs and the brain.  He sees the stove is off, but then when he diverts his attention to something else, he does not trust himself-- he has to go back and check again.  We've all had this experience to some degree-- tap into it, because there are three possibilities:

1a. you do not trust your memory of what you saw  ("Did I really see it off?")

1b. you do not trust your memory of the checking ("Did I really check it, or didn't I")

2. you do not trust your attention to it (I know I looked at the stove itself and the flame was off, but perhaps I didn't pay enough attention to the knob which was turned just enough to allow a gas leak)

A few minutes reflection on these two possibilities will strongly suggest that both or either might be the explanation for the initial two or three checks.  "I'm just not sure..."  But why more than that?  Is there a point when you feel totally satisfied?  No-- you force yourself away.

3. the more you check-- the process of checking itself-- causes you to distrust your how well you performed the previous check.

Number 3 is indeed so powerful that regular (non-OCD) people can come to doubt their checks by making them check multiple times.

So a downward spiral forms: lack of confidence in memory or attention makes you check again, which in turn reduces your confidence in your attention to the check, which causes you to check again, etc, etc.

Note that the actual content of the memory is intact, e.g. accurate.  If I make you check a word list,  and you check it thirty times ("are you sure those are the words?") your confidence in the check will be poor (did I really look at the top five closely enough?) but your actual recall of the words will be good.

Jill Price does not lack confidence in her memories.  She doesn't even need to check her journals.  Going over her memories repeatedly may be what helps her remember, but it isn't OCD that's making her go over them.


Lost in all the hype is an inconvenient fact: Price's brain was scanned more than two years ago, and the results--not yet published--apparently don't support the notion that she's some kind of memory goddess. Her hippocampus and prefrontal cortex are reportedly normal. The one significant aberration, according to Price--who was told about the scans by doctors who won't discuss them publicly--is that her brain resembles those of people with obsessive-compulsive disorder.

If by "resembles" he means "is as squishy as" then I'll concur.  If he means something else, say, "smaller grey matter in BA6" then I dissent: the brains of people with OCD don't even resemble the brains of other people with OCD.  First, anatomical differences are invisibly uninformative.  Second, functional differences (e.g. fMRI) are only visible when OCD is separated by subtype (e.g. checking, hoarding, etc) but these diffferences are useful only to distinguish between groups of people you already know have OCD, not as diagnostic tests.  For example, the pic below shows significant correlations to activity in (checking) OCD patients vs. controls:

ocd fmri.jpg

But if Jill Price's fMRI was any of the red circles, what would you deduce?  Anything?  In order for these scans to be useful, they have to be tied to the phenomenology, and even then, they aren't worth the money.


There are some mechanistic explanations for her abilities: notable is the way she uses emotional cues (such as songs) to call up the feelings; and an intuitvely backwards calendar system to remember dates.  That's for another post (someday, sigh.)

But let me leave you with a more general, social point, concerning her fame-- why we should care about her.

Oddly, the Wired writer does hit on the likely explanation for her memory:

Why were Price's abilities blown so far out of proportion? I wouldn't blame Price; she's as happy to tell what she doesn't remember as what she does. But her story has taken on a life of its own. It started with that 2006 journal article: Although the scientists knew about Price's diaries and compulsions, little in the paper speaks to the question of whether it might be personality, not memory, that makes her extraordinary.

Wrong: it is precisely her memory which makes her extraordinary, and not anything else.  the mistake the writer makes is the need to find a biological explanation for her extraordinariness, as opposed to simply the result itself.  Is her memory any less extraordinary because she doesn't have a gigantic hippocampus? 

Also, note the conflation of "personality" with OCD.  The writer is an academic psychologist, and he absolutely knows OCD isn't personality; but he uses the words interchangeably because they both mean "not related to specific memory modules in the brain."

This woman is 43, she lives with her parents, she is a school administrator, she looks like Janice from The Sopranos-- none of these things would make Wired want to write an article  about her.  But here's the point:  if she was born with a gigantic hippocampus, then Wired wouldn't care about her then, either.  And if she was born with a gigantic hoppocampus but she didn't have a superior memory-- then again, no article.

What's amazing about her is that she can do this for no good reason.

She is amazing by virtue of her personality-- i.e. adaptation to her environment.  If I was an amazing marathoner by genetics-- boring.  But if I was an amazing marathoner because for the first twenty years of my life I was relentlessly pursued by a puma, well, that's a story worth writing about.

She has caused to exist an amazing ability despite not having the biologic machinery one expects in these situations.

Let me put it another way: she's amazing because of what she has done, not of what she is

And that's supposed to be the way it is for everybody.