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in: Behavior, Character, Podcast

• Last updated: November 1, 2021

Podcast #750: The Surprising Benefits of Forgetting

Whenever Dr. Scott Small is at a social event and tells people what he does for a living — that he’s a memory scientist — they inevitably tell him how much they bemoan their own lapses in memory and frequent forgetfulness.

But in his new book, Forgetting: The Benefits of Not Remembering, Scott makes the case that what we think is a problem is actually an advantage, and that if memory wasn’t balanced with forgetfulness, life would be a nightmare. Scott is the director of the Alzheimer’s Disease Research Center at Columbia University, and he begins our conversation by making the distinction between pathological forgetting like dementia, and normal, garden variety forgetting which we all experience, and which is the beneficial type. We then talk about how memories are made, and what happens when they fail to solidify and we forget things. From there we discuss the surprising benefits of forgetting, from giving us the ability to generalize, to allowing us to move on from traumatic events, to enabling us to be more magnanimous in relationships. We also talk about the role of sleep in forgetting, and forgetting in creativity, and how being forgetful might actually make you a better decision maker. We end our conversation with how to know if your forgetting is normal, or something you should be concerned about.

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Read the Transcript!

Brett McKay: Brett McKay here, and welcome to another edition of The Art of Manliness podcast. Now, whenever Dr. Scott Small is at a social event and he tells people what he does for a living, that he’s a memory scientist, they inevitably tell him how much they bemoan their own lapses in memory and frequent forgetfulness. But in his new book, Forgetting: The Benefits of Not Remembering, Scott makes the case that what we think is a problem is actually an advantage, and that if memory wasn’t balanced with forgetfulness, life would be a nightmare. Scott is the director of the Alzheimer’s Disease Research Center at Columbia University, and he begins our conversation by making the distinction between pathological forgetting, like dementia, and normal, garden variety forgetting which we all experience, and which is the beneficial type.

We then talk about how memories are made and what happens when they fail to solidify and we forget things. From there we discuss the surprising benefits of forgetting, from giving us the ability to generalize, to allowing us to move on from traumatic events, to enabling us to be more magnanimous in relationships. We also talk about the role of sleep in forgetting, and forgetting in creativity, and how being forgetful might actually make you a better decision-maker. And we end our conversation with how to know if your forgetting is normal or something you should be concerned about. After the show’s over, check out our show notes at aom.is/forget.

Alright. Scott Small, welcome to the show.

Scott Small: Thank you. Thank you for inviting me.

Brett McKay: So you got a new book out called, Forgetting: The Benefits of Not Remembering. Now, for most of human history, forgetting has been seen as a problem, we’re always trying to remember stuff. And when it comes to conditions like dementia, which you treat, you’re a scientist, a neuroscientist who helps dementia patients, people with Alzheimer, it is a problem, forgetting it as a problem, but in this book, you make the case that sometimes forgetting is quite healthy and beneficial. When did neurologists like yourself start to get a hunch that forgetting is actually adaptive in humans and actually not a problem?

Scott Small: Yeah, you’re right, it’s actually a new insight that really emerged in the last 10 years that could be called The New Science of Forgetting, and since you start by emphasizing that I do treat patients as a neurologist with Alzheimer’s and other forms of pathological forgetting, I think it’s good at the get-go to emphasize that what we’re talking about here is something different than that, this is normal forgetting, the forgetting that we’re all born with, that occurs naturally. Yet, as you point out, everyone complains about it. I trained in basic science of memory and forgetting, and it’s always been the case that more memory is better and forgetting should be fought tooth and nail, even normal forgetting. And that’s what’s been corrected by The New Science of Forgetting that really emerged mainly in the last 10 years or so.

Brett McKay: So it’s fairly recent then?

Scott Small: Yeah.

Brett McKay: Okay. So before we get into the benefits of forgetting, I think it would be useful to get a big picture overview of how memory works, because that will help people understand the role of forgetting a memory. I think a lot of times people think that memories are just… They’re just things in your brain, like in a specific spot in your brain, and it’s kind of like that, but kind of not.

Scott Small: Yes, it is kind of like that, and not exactly. So, memories are distributed across our cortex, our brains, but there are central regions of the brains that can be considered hubs, where most of the mechanics and action of memory happen.

Brett McKay: So what are those hubs? So let’s talk about… Let’s walk through like, how whenever a memory is formed, what goes on, like what parts of the brain are involved in that?

Scott Small: Right. And here I could use an analogy, which is really not a coincidence, ’cause after all, computer scientists needed to solve the same problems with how to store, retrieve and encode memories in our computers as we do in our natural computers, otherwise called our brains. And so, one way to simplify and understand these hubs, and this is exactly the simplification I use when I teach trainees, medical students, neuroscientists in training, is if you think about typing something onto your screen, you then… Onto your computer screen, you then need to save that information, you do that by click “Save” right, on your app. That shifts that information from your short-term memory, your screen, to your long-term memory, your hard drive. And then if you come back tomorrow and wanna edit that document, you need to then click “Open” and retrieve that information. And so, fundamentally, the management of memory requires an ability to save information into a hard drive and to retrieve it. And in essence, our brains have three regions, hubs, that are really dedicated to that function, and I can list them if you thought that would be interesting.

Brett McKay: Yeah. It would be interesting. So what are the three hubs? What hubs do they go through?

Scott Small: So, the save function in our brain is generally localized to a structure that I think many people are starting to hear about, it’s called the hippocampus, we have two of them, they’re nestled deep in our brains, right deep in our temples, if people wanna know spacialy where it’s located. The retrieve function is more or less in the prefrontal cortex, which is right behind our foreheads. And then the hard drive, as a hub, is mainly towards the back of the brain, right at the top of the skull, below it, there are a series of regions that store most of the memories that we think about when we think about memory. Obviously memory does a lot of things, learning to write a bicycle and things, but when we talk about thinking of a name and a face and where we were yesterday, that’s the hard drive where these memories are generally stored.

Brett McKay: Gotcha. And so, kinda walk through like, say, you wanna memorize… So you’re a student and you’re memorizing dates for a test. So what’s going on there is, first you’re using your prefrontal cortex, maybe it’s in your short-term memory, and then your hippocampus ideally would take that information, save it to the posterior area.

Scott Small: That’s right.

Brett McKay: Okay.

Scott Small: That’s right. That’s exactly right. And that’s why you need… Mainly when you’re learning new information, the most important part of this blueprint, the simplified blueprint, is you need your hippocampus to be firing on all cylinders, so you could save that information. And just think what would happen if you would type out all the days on your computer screen, and then God forbid, the lights go out, the electricity goes out, you turn off your computer before you hit click save, that information is gone, there is no way to retrieve it in the future.

Brett McKay: We do that all the time though, like we memorize things so that we just need to know it for three minutes, and so that’s… I guess, that’s called working memory, it’s like, in your pre-frontal cortex. It’s like typing something out in a Google Doc, but not hitting… And you just leave it on the screen, but you don’t hit save, and as soon as you’re done with it you just forget it, ’cause you no longer need it.

Scott Small: Yeah, that’s a great, great way to describe it, and it is called the working memory, and I’m not sure if this is too much information, but that’s why actually when people say short-term versus long-term memory, it’s generally true just because of the real life, but in principle, if I type something on a screen and I walk around with that screen on for days, that memory is still there. But if you wanted to turn off your computer and equivalently divert our attention to something else and then come back to that document, you need to be able to save that information in your hard drive.

Brett McKay: And then when memories are stored, whether time is short-term or long-term in that posterior area, is there something going on with our neurons, where they’re wiring together to form that memory?

Scott Small: Yeah, and that’s a great way to sort of zoom in a little bit deeper, if we just describe the sort of blueprint of how a computer shifts information around for memory, ultimately that information is stored in bits, right? And so the brain has its own equivalent of bits of information, and that is the tips of our neurons, and the tips of our neurons, basically neurons communicate with each other, they can communicate more strongly or more weakly, and the way they strengthen connections is by growing their tips, much like a good metaphor is the way trees can grow leaves or grass, blades of grass grow, that’s very similar and actually visually similar to what happens when we remember something, the tips of our neurons in the posterior area grow, and therefore the connections have strengthened.

Brett McKay: Okay, alright, so now we know how memory works, it goes through this process, starts in the short-term memory, your prefrontal cortex, if our brain decides this is… We need to remember this for a long time, the hippocampus will kind of transfer that to the posterior area. If the brain decides, “No, you don’t need to know this stuff for a long time, you just forget it.” So that’s the process. Where in this process can forgetting occur?

Scott Small: Right. So forgetting, the normal kind of forgetting occurs mainly in the posterior area as we described. If a memory can be defined in a very simple sense, caused by the strengthening of neurons, the tips grow. Forgetting is just the opposite; the tips wilt back down and that memory is therefore forgotten or weakened.

Brett McKay: Gotcha. So, this is a problem of the hippocampus, like… So the hippocampus… Is there something going on with the hippocampus that causes stuff to not get strengthened in that posterior area? Is it like a transfer problem?

Scott Small: There could be a transfer problem, and what we’re talking about now is exactly what we do in our clinics when someone presents to me and says I have worsening forgetting, that if… You can just intuitively understand now, that could be because the hippocampus didn’t allow the posterior cortex to strengthen the connections across neurons, it could be because the cortex itself in the posterior area is somehow… The neurons there are sick, malfunctioning, or it could be because the retrieval process is dysfunctional. So right, so basically, that’s… When a person presents to us, they’re not expected to know the anatomy and to say, “My hippocampus is malfunctioning,” they say, “I’m experiencing forgetting.” It’s on us to then try to localize the problem to what part of this diagram, this memory diagram, and forgetting diagram is malfunctioning. Typically, when we talk about normal forgetting, we assume that the hippocampus is generally okay, and it’s just that the cortical areas are wilting back down, and that’s what results in the ultimate ability and the benefit of forgetting, the ability not to remember everything, ’cause that turns out to be a nightmare.

Brett McKay: Okay, let’s talk about that. So, let’s dig into the benefits of forgetting. I think we often think it would be great to have a photographic memory where you can remember everything that ever happened to you, dates, names, you’ll never miss a name and a face, you’ll always be able to put them together. But you talk about how the writer Jorge Luis Borges, the Argentinian short fiction writer, he actually speculated that having a photographic memory would create a whole host of problems. And what’s interesting, his speculation, he wasn’t a neuroscientist, but his speculation is now being confirmed by neuroscience. So, what are the problems of not forgetting that Borges speculated would exist?

Scott Small: One of the interesting things to me, which is perhaps not completely surprising, that great literary writers are actually neuroscientists, because after all, they’re trying to capture the human condition, and the brain is of course central to the human condition. And it’s often the case, not only Borges, but many of the great writers sort of intuited how the brain actually works and then science needed to come sweep… Come in later and try to understand the precise mechanisms for what was described by a poet or a writer or any artist for that matter. And so, what Borges intuited is, you’re absolutely right, we all sometimes secretly hope to have this superpower of photographic memory, I think many of us fantasize about that power, and Borges wrote his short story called Funes the Memorious by sort of setting that up, by describing this Argentinian cowboy who falls off a horse and wakes up with perfect memory, he can remember everything, he can learn Latin in a few days, he can remember all of Shakespeare in a few days.

And while you’re reading it, you’re thinking, “Wow, wouldn’t that be wonderful?” Right? And that’s the setup, because then he shows that like any superpower, there is a hidden curse to that, and the curse is, as he described, is actually something similar that some people with autism experience, and that’s the inability to generalize, to abstract, and he says, “To think is to forget.” And so, there are some parts of the book that I think are intuitive emotional forgetting, I think maybe we’ll get to that. But when it comes to our cognitive abilities, the ability to generalize information and to sort information is so fundamental to what we do, we don’t even realize it, that ability requires forgetting, and I can elaborate on that if you’d like.

Brett McKay: Yeah. So, do. So, sort of, if you remember everything in detail, you get so focused on the trees that you forget the forest, basically is what’s going on?

Scott Small: Right. And so the trees from the forest is a great analogy, but if you just expand on that to our daily lives, right? You saw someone this morning, that person was seen in a particular light shading, that person might have worn different hats or makeup or facial hair. In the evening, that same person appears very different, your visual cortex factually see something very different just on lighting alone, but maybe different attire, glasses or not, and yet your brain says, “That’s not different, that’s the same person,” and that is the ability to generalize. And that ability, computer science has taught us, requires forgetting. And so, what… Back to Borges, he talks about how Funes was confronted, even seeing himself in the mirror, in the morning and in the evening, seemed novel and different, and it created such cognitive chaos, such anxiety, that he basically banished himself to a dim, quiet bedroom for the rest of his life.

Brett McKay: Well, and you talk about that, one of the ways that people with varying degrees of autism do to cope with, ’cause they see the trees and not the forest, is that they’ll create a routine for themselves so that things are the same, and they don’t get… They don’t have… What happens to that cowboy won’t to happen to them.

Scott Small: Yes, and that’s so interesting. First, I’d like to emphasize, Brett, if we’re talking about autism, one needs to insert a qualifier.

Brett McKay: Sure.

Scott Small: There’s a whole debate about autism. Is it biodiversity” Is it a disease? Is it one disorder or many? I, in that chapter, relied on an expert in autism to really make sure that I was getting this right, and I am certainly sensitive to those views. But it is interesting that Leo Kanner, who was the physician who first coined the phrase “autism” in the 1950s, writing 10 years after Borges, and I’d love to know if they met, because Borges actually travelled through the United States, I doubt it, but Kanner, Leo Kanner’s first paper was basically autism is a problem of seeing the whole from the parts. And that is the trees from the forest issue.

And so if you think about the inability to… If you have no forgetting and everything is novel, that could be exciting, and I describe my own experience going to New Year’s Eve one night here in New York, full of cacophony and chaos, and it was exciting, but after a few hours, [chuckle] it became a little bit anxiety-provoking. It was nice to come back to my quiet apartment. And imagine what life would be if everything was novel, even people you know, even apartments you know, every little change provokes novelty, which would then result in an anxious state. And that’s one of the reasons why some people with autism like to insist on sameness.

Brett McKay: We’re gonna take a quick break for a word from our sponsors. And now back to the show. Alright, so the first benefit or forgetting, it allows us to generalize, which reduces anxiety about seeing novelty all the time. Alright, so that’s one benefit. Another benefit you talk about is with maybe emotional memories, and you use your own experience as a starting off point to talk about this, particularly with PTSD. So, you’re from Israel and like all Israeli citizens, you served in the military, ’cause you’re required to, and you actually took part in a pretty heavy gruesome battle, and you used that experience that you had as a jumping off point to discuss how PTSD can be seen as a problem of too much memory. Walk us through that idea.

Scott Small: Yeah. So, until now we’ve really been talking about factual memories, so faces and names, those are… That’s facts, right? We wanna be able to associate a face and the name. But now to get into PTSD and the emotions, we need to then insert a third domain here, or another domain, and that’s emotions. So imagine walking down on the street and seeing a bully that you’ve confronted before, you’ll not only remember that person’s face and name, but you’ll also remember the previous emotionally charged experiences. And that relies on this exact same mechanisms, generally the same regions of the brain we discussed in laying down that information, face and the name and the emotional association. And so, that is a part of the forgetting mechanisms and the benefit of forgetting mechanisms that I think people intuitively understand, people know that it’s not good to perseverate over emotional memories too much, ’cause that could be disabling.

And you’re right, in that chapter, I start with, if we said before that autism could be debated whether it’s a disorder or not, there’s no question that PTSD is a disorder, and there’s no question that PTSD is fundamentally a disorder that is characterized by an inability to emotionally forget normally. It’s a disorder of too much emotional memories, emotional memories that burn too hot. And I use my own experience… And I’ll quickly add, if you don’t mind some contextualizing, that I had some resistance because it was such an intense battle, and because I tend not to think about it that much. I didn’t want this book to be too much about me, but as I was talking to the PTSD expert at Columbia, who was my guide through that book, he said he knew about my experience. He says, “Well why don’t you write about your experience?” So I resisted. I got permission from my military friends and I did. And basically it allowed me to present the interesting question. We clearly, all of us in that battle, clearly were exposed to emotional trauma. There’s just no question about it, ’cause as you point out, that particular battle was particularly gruesome and bloody. And yet, the three of us, I interviewed my friends, really didn’t suffer PTSD as defined by the clinicians.

And so the question is, well, why not? And why did maybe someone else in the same battle experience PTSD? And then that allowed me to not only describe the mechanisms of emotional memory, how that gets laid down in our brains and how we forget emotional memories normally, but also talk about some mechanisms that accelerate emotional forgetting.

Brett McKay: Can you hit briefly on that, like why do some people get PTSD and some people don’t? Do we have an idea?

Scott Small: Yes. And I’m smiling as you can probably hear, because I’m a kind of a what could be described as hardcore basic scientist. I think of, disorders should be treated by focusing on molecules and cells. And yet, in this chapter, in discussions with the expert and reviewing literature, the punchline is that, really one of the best ways to accelerate emotional forgetting after a trauma, is behavioral, by which I mean engaging in a socially active network right after the trauma. It turns out the greatest risk factor for why someone will develop PTSD is if they come back from a battle, let’s say, and we’ve all seen these scenarios, and they’re socially isolated, versus someone who is ensconced by a very active and loving and friendly social network. That socializing turns out to be the way to accelerate forgetting, and that is linked to some of the basic mechanisms; we now understand how that happens.

Brett McKay: When you talk about your own experience after the battle, there is a period where you and your unit were just kind of cordoned off from everybody. And you just had this period where you’re just with yourself where you could… I guess, it sounds like you kind of processed what you went through, not directly or… It wasn’t like you were sitting down in group therapy, but in your own way, you were able to process what happened to you during the battle?

Scott Small: Right, and that actually… The PTSD expert glommed right on to that to illustrate what I was just saying before because the battle happened, we were then sent back to our unit in northern Israel and we all lived together in this sort of social environment; it was very social. And frankly, we were 18, 19-year-olds, we engaged in macabre humor, we laughed. And so it wasn’t as if we were engaged in sort of psychodynamic therapy, but by necessity, given that context, we were engaged in all the socializing that the PTSD expert explained is a way to sort of bathe out the bloody use of our emotional memories. So, never forget the details, and that’s not what I’m arguing. And no one should ever forget bad things that happened on the facts, but it is beneficial to try to turn down and let go of the emotional component. And letting go is just another one of the many colloquial terms that turns out to be forgetting.

Brett McKay: We’ve had experts on PTSD before who’ve talked to veterans particularly, and one theory that I’ve heard, I haven’t seen it confirmed by any research, but it’s speculation, is that one of the reasons why we’re seeing more PTSD amongst modern veterans is that they can get from the battlefield to home a lot faster. You could be in Afghanistan one day and the next day you’re back home going to the grocery store. There’s no… Before, war was like, you’d have to march there, and it’d take a long time to get back after the battle, so you’d have that time to decompress. The way the nature of war today, you really don’t get that decompression time, you’re just like, well, you’re in the battlefield now, you’re civilian the next day.

Scott Small: Right. And I guess it can cut both ways. I think the more important part is when you come home, what happens? And particularly, I think during Vietnam, we sadly know what happened. Many of these veterans came back and they were not necessarily accepted because of the political climate. They maybe went shopping, as you describe, but they didn’t have the supportive social network of love, laughter and happiness, and that… Again, I smile ’cause these are sort of general terms. I talk way too much about love in a book for someone like me, but that turns out to be the case. And again, we know some of the underlying mechanisms for why that’s important.

Brett McKay: One treatment that we know works for PTSD but takes a long time to do and has to be done under strict supervision is exposure therapy. How does exposure… So exposing yourself to the thing that triggers your PTSD. So if you’re a veteran and you hear a loud noise that might trigger that emotional response of, there’s a gunshot going off or there’s an explosive going off, how does exposing yourself to that trigger over and over again dampen the emotional memory?

Scott Small: Yeah, and exposure therapy is of course useful for PTSD, for some obsessions, compulsions and phobias, and it very much links into the new science of forgetting. Because if we think back to the, sort of simple view, you have two neurons, imagine one neuron stores the emotional memory, this is of course, a simplification, another neuron stores the memory of the event. Now, every time you think of the event, there’s a strengthening of that connection, the emotional valence is activated and you’re disabled. What exposure therapy does is it overrides that by tapping into our forgetting mechanism, so you have a re-balancing of your memory, because now that event, let’s say, seeing a snake or thinking of the event during wartime is now being associated with something that’s benign. And that is a great example of why normal forgetting is required at the molecular level.

Brett McKay: That’ll take time, ’cause it sounds like what you’re doing is you’re laying a new track for a new connection, and as you do that, your brain slowly degrades the emotional connection.

Scott Small: That’s right, because that emotional… That connection is no longer being strengthened and you have the wilting back down of the original connection; that wilting is exactly the forgetting mechanisms we’re talking about.

Brett McKay: Well, let’s take this over to human relations. So there’s been philosophers, the one that comes to mind is Nietzsche, who praised the virtues of forgetting for human relations, ’cause it’s what allows you to be magnanimous, it allows you to let resentments go. Have you come across any research that suggests forgetting personal hurts can help us live flourishing lives?

Scott Small: Yes, and I actually thank you for quoting Nietzsche, I love the guy. Nietzsche emphasized resentment so much so, even though he wasn’t French, that he apparently used the French way of saying it, “ressentiment” as a thing unto itself, which is at the core of human suffering, and it’s very much linked into this idea that your emotional memories are just burning too hot, you’re looping on these memories. And a number of philosophers, again, have intuited this, in this case, philosophers have intuited before us neuroscientists had to slowly catch up. I think one immediate example is when I was talking to a couples therapist recently, who knows my work and now knows about this book, he said, “Look, Scott, if you develop… I know you’re trying to develop drugs for Alzheimer’s, that’s great, but if you ever develop a drug that will accelerate forgetting, please call me because my couples therapy practice will thrive.” And I think most people who’ve been in couples know that you need to forget to forgive, and the curse of not being able to forget.

Brett McKay: So how do you do that, though? Say you have someone that hurt you, you don’t wanna forget what they did, because then you… It’s like “fool me once, shame on you; fool me twice, shame on me” type of thing. Is it you’re just trying to forget the emotional part of it?

Scott Small: That’s exactly right. And I, again, would like to emphasize another example, in a different chapter I talk about communal memory and forgetting. If we need to forget to forgive an individual, we also need to forget to forgive an offending nation. So amnesty, whether it’s South Africa or Germany or anywhere else, amnesty from the Latin, means “to forget”. So you need a certain amount of forgetting to forgive communally or personally, but you’re absolutely right, never forget 9/11, never forget the Alamo, never forget the details. But what you’re trying to do is to turn down and let go of the resentments, of the emotional component of that memory, so it’s emotional forgetting that in this example is most critical.

Brett McKay: Alright. So forgetting emotions can be helpful to an extent. You also talk about the role forgetting plays in creativity. What role does forgetting play in creativity?

Scott Small: Yeah, thanks for that question, ’cause in some ways, that’s my favorite chapter. And in that case, I was lucky to have Jasper Johns as my guide. He’s a friend and we’ve had a lot of chats about the brain, he’s one of these… Again, we talked about this earlier, Brett, artists who really are interested in the brain, he clearly is and truly, truly a smart man. And so we talked a little bit about how pathological forgetting may or may not influence creativity, and we used Willem de Kooning, a great American artist who had dementia but still created art. But that quickly led into an observation that Jasper made, not to me because he’s very coy about talking about the creative process, but in the literature, where his most famous work, The Flags, that he painted in the 1950s, came to him in a dream.

And that leads into the really interesting question of sleep and dreaming, one of the great mysteries of our lives, something we engage in at least, or usually a third of our lives, being forced to be in a position where we’re very vulnerable to the world, yet we all have to do it, and when I say we all, I’m not just talking about us humans, but every mammal, almost every species down to flies, have this daily slumber-ness where they’re exposed to the environment. And so physiology can explain the need to drink water, the need to eat food for energy, but it’s always been a mystery about why we need to sleep, and it turns out… And I’m happy to elaborate on this, but I don’t wanna be too long-winded, one of the reasons we sleep is to forget.

Brett McKay: Well, yeah. So what happens when we sleep and we forget? How can that contribute to creativity?

Scott Small: Well, first, let me say a little bit about the evidence to support what I just said… And just as an aside, Brett, if I get too sort of academic or long-winded, please help me here.

Brett McKay: Okay.

Scott Small: But the idea that we sleep in order to forget was proposed by one of our great luminaries in biology, and that’s Francis Crick. So this is Crick and Watson, the duo who solved one of the greatest mysteries in biology, and that’s the genetic code, that’s what they got their Nobel for in 1962, and I somewhat facetiously say… Well, I never met Francis Crick, but apparently he was a true genius, and he said, “Well, that was easy, let’s now focus on more complicated things, on consciousness and why we sleep.” And he published a thought-provoking paper in 1983, I believe, or ’84, where he basically said we sleep in order to forget, and he laid down some reasons for this, and it was simply impossible to test this empirically, this really shocking idea, but he spawned a whole group of students who only in the last 10 years have been endowed with the right kind of tools and technologies to investigate this question, and it turns out that when we sleep, all those mechanisms that result in memories in our posterior cortex wilt back down.

So if we use the leaves of grass as a metaphor, you have this sort of trimming or mowing down of most of your memories, so that has turned out to be generally true; sleep does other things, of course, but that has been shown to be true. And then, researchers in creativity has shown that most creative types seem to function best in the morning, most creative types across the spectrum, whether they’re artists, scientists, journalists, and you can define who’s creative or not, have this ability to create these unexpected associations between things, that ability to create unexpected associations requires forgetting. Because if your associations, your memories were stapled in steel, the kind of photographic memory we talked about earlier, there would be no looseness or play in those associations, and you would never have those eureka moments that define creativity.

Brett McKay: Well, I know the connection between sleep and creativity. There’s one artist, Salvador Dali, he actually… One of the things he did, he did this thing called slumber with a key, where he would take an afternoon nap, and then he would hold a key in his hand and place a pie pan beneath his hand. And he would doze off, and as soon as he slept, his hand would let go of the key, the key would drop in the pie pan and it would wake him up. And so, he’s in this in-between sleep and awake state, and he said he got his best ideas in that between awake and asleep state, then he would just like paint or draw whatever he was seeing in his head at the time when he woke up.

Scott Small: That’s fascinating. I vaguely recall that, there’s my forgetting, but one of the joys of having these interviews is, people are now coming to me with all these examples. I’ll look into that more deeply. If we talk, Brett, about how poets and artists really intuited things quickly… Quicker than we have, Emerson, the great American poet, has this great line, I’m not sure exactly what he meant, but the line is, “Imagination is the morning of our mind and memory is its evening.” This idea that memories moor our imaginations down with detail. In order to have flights of fancy, creativity, we are benefited by not having our creativity moored by memory.

Brett McKay: Another place or area where you talk about how forgetting can be useful, is decision-making, which, this is counter-intuitive, ’cause you’d think if you wanna make a good decision, you need to know and remember as much information as possible to make the best decision as possible, but you’ve actually come across research that says, no, people who might have a bad memory, what we call a bad memory, tend to make better decisions. What’s going on there?

Scott Small: Right. And in that case, again, I was lucky to have Danny Kahneman, who’s the Noble Prize winner for decision-making as my guide, and it actually… There was a lot of discussion over this, and in that case, one really needs to go back to the diagrams or the basic anatomy of memory we were talking about earlier. You talked about frontal cortex, working memory, that is certainly critical for good decision-making, because you need your working memory to act like a juggler, you have multiple things happening simultaneously, you need to decide what’s right or wrong. But on the hippocampal memory, what has turned out to be the case in some of the literature, is that if you just know, and we all vary in our hippocampal-dependent abilities, more or less, if someone knows just by experience, they don’t, maybe not know it’s the hippocampus, but by experience, they know that they don’t learn things very quickly, it takes them longer, right? In medical school, in anything.

They’re gonna be more what’s called intellectually humble, ’cause they’re not gonna trust their memory as much as someone who… And we all know that person who can remember baseball stats or cranial nerves or anything at the tip of their tongue, that person is more likely to slip on decision-making errors because they’ve learned to over-index their memories. And so, this idea of intellectual humility, which is not meant to be a sort of moral judgment, it’s just that a person whose hippocampus doesn’t function as well as others, just learns to take their time, and I use a line in the book, I think, where I say that the… In decision-making, the tortoise mind always beats the hare brain.

Brett McKay: And yeah, you used an example of a doctor that came to you who felt like, “I’m having a hard time with my memory, or I’ve always had a hard time with memory, but I seem to do… ” He actually brought this idea… I seem to make better decisions than my colleagues. And this is where, yeah, he confirmed like, yeah, maybe my knowing that I don’t have the best memory in the world has helped me have that intellectual humility to check and double check decision so I make the best one.

Scott Small: Yeah, and he came to me with that question, and he is a world-renowned infectious disease specialist, so you would think he needs to know a lot, and he does, [chuckle] but he decision-makes slowly. And in the book, I do talk about not every profession has the benefit of slow decision-making, right? An ER doc, a fireman, they need to make fast decisions, and there the frontal cortex will win. But if you are in a profession, or if you are in a debate or a discussion that allows you to slow down, then you will ultimately make the better decision, and he describes how when a case was presented to him and his fellow students in medical school, it was always that person who had the excellent memory who can just list all the causes of that potential disorder, but then you come back two days later, ’cause by necessity, you need to order some labs, and he would more typically get the final diagnosis right, because he was able to slowly think through the problem, and he felt he did it even more carefully, with greater fidelity, because he never trusted his memory.

Brett McKay: Okay, so I think by now, hopefully the listeners who are listening to the podcast right now can be relieved that some forgetting is useful and beneficial, shouldn’t freak out if they can’t remember, put a name with a face all the time. But you are a doctor who helps dementia patients. How do you know if your forgetting is drifting over to something pathological or maladaptive, like to dementia? Are there any signs that people should look for that might be a signal they might… They need to go visit a doctor to get it looked at?

Scott Small: Yeah, that’s… It’s a great, great question, also for me to emphasize that this is not a book where I’m sort of poeticizing pathology, you know, there’s a silver lining to a disease. I can’t say that because I, every day, confront the suffering of pathological forgetting, whether it’s Alzheimer’s or related disorders, or even normal aging. And so again, to re-emphasize, there is a simple distinction between pathological forgetting and normal forgetting, the book really emphasizes normal forgetting. Now, as a rule of thumb, how does someone know if they have pathological forgetting? A simple rule of thumb is whether you notice that your memory is worsening from your own baseline, so you… If you’re in your 20s, 30s and 40s, you know what your memory is; it might not be as good as you want, but that’s your normal balanced memory, forgetting equilibrium. If you then, as you enter your 50s, 60s and older, notice that your memory is worsening from that baseline, that’s an indicator that something pathological is happening. It doesn’t mean it’s Alzheimer’s, it could just be normal aging, but both of those are categorized as pathological forgetting.

Brett McKay: Gotcha. And then you wanna go talk to a neurologist, and this is a process, like it… The way you describe it, I thought it was really useful how you just walked through the process. It’s not like someone just goes in once and then, yeah, you have Alzheimer’s. It’s, well, we gotta take a look at this over an extended period of time, and then we can confirm whether it’s Alzheimers or not.

Scott Small: Right. Although, one day soon, if you worry that you have diabetes, you can get a blood test. And now the blood test will be very informative, but it’s usually the case. This is not me defending a physician’s livelihood, this idea of a robo-doctor might happen, but it’s not quite there. You need a test, a test tells you something, you need a doctor usually to put it into context. With Alzheimer’s we’re not quite there yet, Brett, but actually there’s a lot of exciting development in our ability to very soon, if not even now, use some fluids, whether it’s spinal fluid or even blood to help a doctor know whether someone has Alzheimer’s versus normal aging, for example. But even then, it’s gonna be very important for a doctor to really sort of localize the problem in trying to sort through the different causes of pathological forgetting.

Brett McKay: Well, Scott, this has been a great conversation. Is there some place people can go to learn more about the book and your work?

Scott Small: Well, my work, again, to emphasize, is primarily on Alzheimer’s and aging. I direct the Alzheimer’s Center at Columbia. We have a website, I’m easily found on the internet. I respond to all emails, at least I try to, so please reach out to me. I’d like to emphasize, Brett, if you don’t mind, that a lot of the research that I focus on in this book was done by my colleagues. I don’t really work, necessarily, on normal forgetting. And in the book, I do have an index where I cite some of the most important papers.

Brett McKay: Fantastic. Well, Scott Small, thanks for your time. It’s been a pleasure.

Scott Small: Thank you. Great questions.

Brett McKay: My guest today was Scott Small, he’s the author of the book Forgetting. It’s available on Amazon.com and book stores everywhere. Make sure to check out our show notes at AOM.is/forget where you can find links to resources where you can delve deeper into this topic.

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