Memory and Psychosis

People who experience psychosis have somewhat lower tested intelligence, with a higher proportion of psychotic individuals scoring below the mean score of 100 on IQ tests. But I think that psychosis may impact tested intelligence by lowering it in a spurious way.

Essentially, psychosis interferes with cognitive processes, compromising the mental activity of psychotic individuals. This is seen most prominently in individuals who experience auditory hallucinations.

Psychosis is implicated in the processes of learning and memory. This impacts cognitive ability and the ability to formulate a sense of time passing, due to the lack of reminiscing about events, and a tendency to live in the present moment as a result of dealing with ongoing auditory hallucinations. Clearly memory relies on rehearsal of material that is the foundation of memory and remembering. As indicated, it is postulated that psychotic individuals and those who have auditory hallucinations, in particular, have deficits in memory due to their experience of perhaps ongoing hallucinated dialogue in their mental arena.

Living in the present moment is an aspect of psychotic involvement with auditory hallucinations. In terms of this, there exists a lack of assimilation of ordinary memories. This is based upon many factors, such as the abilities to think productively, abstractly and creatively about non-normative experience. It is evident that a lack of comparison of the present, the past and the future, as seen in the psychotic individual and as affecting the structuring of time-related memories, can detract from normal cognitive processes. Without an orientation regarding the passing of time by means of remembering and rumination, there is a deficit that is seen in the psychotic individual’s over-involvement in the mental realm, and there is little basis for enhanced memory related processes.

In terms of memory related deficits, psychosis can interfere with cognitive processing that is represented by the three-box model of memory. This model is based on how a computer might work, reflected in the terms “encoding”, “storing” and “retrieval” of memories. There exist three stages of memory processes in the three-box model of memory, including the following:

  1. Sensory memory
  2. Short-term memory
  3. Long-term memory

It is obvious that hallucinated “sensation” and delusional “perception”, both of which can be considered somewhat arbitrary in presentation in the psychotic individual, will interfere with the processes of encoding, storing and retrieving. The three-box model relies on rehearsal of memories, and when the processes of encoding, storing and retrieving are affected by psychosis, the abilities reflected in memory are compromised. The focus of the mental experience of the psychotic individual emerges in the “here and now”. Quite simply, memory and legitimate cognitive epiphanies are strengthened by recall and rumination.

I think that creativity relies on divergent thought as an accumulation of myriad details derived from the mental and physical realms, and convergent thought implicates analytical reasoning and derivation of narrowed possibilities regarding the products of thought or the solutions to ordinary problems. This has bearing on the connectionist model of memory.

This model represents “a group of theories that hypothesize insight as being encoded by links over symbolizations retained in the mind instead of in the symbolizations themselves. Connectionist designs imply that insights are dispersed instead of being centralized and that they are recalled via spreading activation over such links”, as stated by Clearly, if a person has abilities related to both divergent and convergent thinking, even if that individual is psychotic, he may be able produce or deduce information related to connections of unconscious semantic material.

It should be noted that the pseudo-sensations or auditory hallucinations that are manifested by the psychotic individual may allow for little but the most primitive thought, even if this individual demonstrates abilities related to the connectionist model of memory. It is possible to experience cognitive epiphanies whether one is psychotic or not so, and these epiphanies may be legitimate as opposed to delusional. The intellectual strengths regarding cognitive ability implicate divergent and convergent thinking, in addition to memory. However, the three-box model of memory may not provide an accurate representation of how the products of thought and memory are achieved by psychotic individuals.

Image via agsandrew / Shutterstock.

Ann Reitan, PsyD

Ann Reitan, PsyD, is a clinical psychologist and well published essayist of fiction and creative nonfiction. She holds a Bachelor of Arts in Psychology from University of Washington, Master of Arts in Psychology from Pepperdine University, and Doctorate of Clinical Psychology from Alliant International University. Her post-doctoral research at Washington University in St. Louis, MO, involved personality theory, idiodynamics and creativity in literature. She recently published Illuminating Schizophrenia: Insights into the Uncommon Mind.
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