Dementia, personhood and embodiment: What can we learn from the medieval history of memory?

Abstract

Memory and dementia are historical ideas that preceded the development of modern neuroscientific, psychogeriatric and medical approaches to aging and cognitive impairment. This article explores the value of such historical ideas in order to understand the discourses and metaphors by which Western thought has individualized memory as the guarantor of rational personhood, while at the same, treating memory decline as a threat to healthy and successful aging. Discussion focuses on the relationship between memory and the body in the classical and medieval ars memoria (the art of memory) and in the early modern philosophies of personhood, particularly the work of John Locke. Conclusions consider the significance of Western culture's history of embodied memory as it moved from cosmic to individual to neurocognitive sites for our wider views about the treatment of dementia.

Shifting dementia discourses from deficit to active citizenship

“…For example, the western socio‐political emphasis on early diagnosis means that the ‘taken for granted’ forgetfulness of older age is challenged; memory is repeatedly tested through standardised tests which one passes or fails, with implications for social status. Yet taxonomies of ‘acceptable’ memory are arbitrary, being historically and culturally defined (Harding and Palfrey , Katz ). A diagnosis of dementia does not change an individual's legal status, yet it is a pre‐cursor to significant change.…”

Narrative intelligence in nursing: Storying patient lives in dementia care

“…The cognitive status of older people is part of the cognitive status of people at all ages because memory is adaptable at all ages. ‘Reducing people to their brains and isolating them as sick and marginal in the name of cognitive care harms memory, which is continual even when forgetful’ (Katz, , p. 311). The pathologising of memory within a biomedical framework reduces memory problems to individual cognitive dysfunction rather than seeing the diverse context and form in which memory is transmitted and employed.…”

“…The Katz () description of a mediaeval perspective of embodiment may present a more helpful construction than post‐Cartesian mind/body split in supporting positive cultural framing for carers and people with dementia. If personhood is defined and located in the mind, biomedical narratives can exacerbate and perpetuate a reductionist interpretation of personhood that positions narrative foreclosure as an inevitable consequence of advancing dementia.…”

“…For this to occur, health professionals need to be attentive to metaphor, allegory and how patients with dementia and their supporters tell the stories of events and how they interpret this within their autobiography. An embodied understanding of dementia (Katz, ; Kontos, ) moves from personhood as an attribute bestowed on someone and acknowledges that stories are deeply embedded in our cultural frames, are tacit and predispose our interpretation of events. Therefore, even if someone with dementia loses the ability to articulate this through language, there is an intentionality grounded in narrative genres that generate stories and culturally frame our lives.…”

Challenging representations of dementia in contemporary Western fiction film. From epistemic injustice to social participation

“…We then accompany her back home at the end of the day where she introduces us to her own goats, Daisy and Nimble, taking evident pride in showing us around. In one particularly striking image, as we enter the stable where the goats live, Cath's hand goes out automatically to switch on the light, an example of what has been described as 'embodied (or procedural) memory' (Katz 2013).…”