Reminiscence therapy is an intervention technique used with people who have a memory disorder, by asking about their life history. For example, if an older person sees an old photo or a vintage car, then they may be asked if they remember when the photo was taken, or if they knew anyone who had a car like that. The technique is used to counsel and support people with brain-injured patients and people with Alzheimer's and similar cognitive problems.
The American Psychological Association (APA) defines "the use of life histories – written, oral, or both – to improve psychological well-being. The therapy is often used with older people." This form of therapeutic intervention respects the life and experiences of the individual with the aim to help the patient maintain good mental health.
The majority of research on reminiscence therapy has been done with the elderly community, especially those suffering from depression, although a few studies have looked at other elderly samples. Research and implementation has been tried in several areas with diverse cultures such as Japan, United Kingdom, USA.
Overall, reminiscence therapy is an inexpensive and potentially beneficial approach to helping the elderly age successfully and happily. It appears to provide them with a sense of overall life satisfaction and coping skills, and may also help to ameliorate the symptoms of depression and dementia.
Reminiscence
Reminiscence has been described as "the volitional or non-volitional act or process of recollecting memories of oneself in the past". In other words, it involves the recalling and re-experiencing of one's life events. This involves having an intact autobiographical memory in order to be able to recall certain life events.The meaningfulness of the reminiscence process depends on how meaningful the memories being recalled are. Different ways to make these memories more meaningful are to ask questions which suggest the importance of the event as well as using historical materials from ones past.
Reminiscence serves different psychological functions, including the taxonomy presented by Webster. Webster's Reminiscence Functions Scale (RFS) includes eight reasons why people reminisce: boredom reduction, bitterness revival, prepare for death, conversation, identity, intimacy maintenance, problem solving, and teach/inform. Psychologists have looked at using reminiscence therapeutically to improve affect and coping skills, although the effectiveness of this therapy has been debated. From more recent data, as outlined below, the therapy appears to have positive and even lasting results within the elderly community.
There are different types of reminiscence which can take place. The two main subtypes are intrapersonal and interpersonal reminiscence. Intrapersonal takes a cognitive stance and occurs individually. Interpersonal takes more of a conversational side and is a group-based therapy. Reminiscence can then be further broken down into three specific types which are: information, evaluation, and obsessive. Information reminiscence is done to be able to enjoy the retelling of stories from one's past. This type can also be used to help someone who may be lacking interest in his or her life and relationships. The ability to recall good memories can help them remember what they do have to be happy about. Evaluative reminiscence is the main type of reminiscence therapy as it is based on Dr. Robert Butler's life review. This process involves recalling memories throughout one's entire life and sharing these stories with other people. Often this is done within group therapy. Obsessive reminiscence occurs when somebody needs to be able to let go of any stress of guilt that may be lingering. By working through these issues it allows them to be at peace with themselves. Reminiscence has also been used to help people deal with the death of a loved one. By sharing stories about the loved one's life they can remember fond memories and gain a sense of peace with the death.
Method Reminiscence therapy is often used in a nursing home or "geriatric health facility." The structure of reminiscence therapy can vary greatly. In one documented session, a therapist played different songs from the 1920s-1960s and asked the patients which songs resonate or have a special meaning. In another session from the same therapist, the participants shared photographs and had a show-and-tell about why the pictures were important to them.
Psychological research has identified two types of reminiscence therapies that are particularly effective: integrative and instrumental. Integrative reminiscence therapy is a process in which individuals attempt to accept negative events in the past, resolve past conflicts, reconcile the discrepancy between ideals and reality, identify continuity between past and present, and find meaning and worth in life. An integrative life review provides individuals with the opportunity to examine events in their lives that may disconfirm negative self-evaluations associated with depression. Many depressed people ignore positive information and focus on memories that support their dysfunctional views, so this therapy helps lead clients to seek fuller, more detailed accounts of their life story and more balanced interpretations of past events. Participants review both good and bad experiences within the context of the entire life, which shows them that negative experiences in one life domain can be mediated with positive events in another. Individuals may disconfirm global, negative evaluations of the self that are associated with depression and begin to develop a more realistic, adaptive view of the self that incorporates both positive and negative attributes. Instrumental reminiscence therapy helps the elderly recollect past coping activities and strategies, including memories of plans developed to solve difficult situations, goal-directed activities, and the achievement of one's own goals or goals one helped others meet. Instrumental reminiscence therapy may exert a positive effect on individuals' self-esteem and efficacy by recollection of successful experiences in which individuals acted effectively to control their environment. This approach to reminiscence therapy puts roles and commitments that are no longer rewarding or attainable to the periphery and helps these patients invest in other goals that are more in tune with current conditions of living. This can be especially helpful for the elderly who may not be able to do what they were once capable of doing.
History of reminiscence
Before the late 1950s reminiscence was seen as a negative symptom which often lead to mental deterioration. Erik Erikson introduced his concept of the eight stages of psychosocial development which involved the progression of one's life and development from birth until death. The last stage known as late adulthood, brought up the idea of integrity vs. despair. At this stage it becomes important for one to look back on one's life with satisfaction before they die. In 1963, Dr. Robert Butler published a paper on the critical points surrounding the importance of life review and reminiscence. Butler is credited with starting the movement of reminiscence therapy.Woods, B., Spector, A.E., Jones, C.A., Orell, M., Davies, S.P.2009. "Reminiscence therapy for dementia (Review)." The Cochrane Library. 1: 1-34. The next advancement in this area was done by Charles Lewis in 1971. Lewis was able to create the first experimental study of reminiscence. Lewis wanted to look at any cognitive changes that may occur from reminiscence as well as how people perceive themselves. This experiment proved to be worthwhile as in the following years this area became very popular to research. In the following years, research on reminiscence was focused on the functions and benefits of reminiscence. In 1978 The Department of Health and Social Security started a project called "The Reminiscence Aids Project". This project was done in order to start reminiscence as a therapy process. Finally in the 1980s, reminiscence therapy was recognized by institutions and has begun to be used as group therapy. During this time period, there was an increase in the number of professionals trained in this therapeutic process. Reminiscence therapy has continued to be an area of research to this day. While there have been many studies done on reminiscence therapy lately, Butler and Erikson remain the two researchers most associated with this field of work.
Theories of reminiscence
Disengagement theory
Disengagement theory in reminiscence is used by some therapists and researchers and focuses on the patient withdrawing from social responsibilities. This movement away from social life is encouraged so that the patient (in many cases an elderly person) can brace themselves for the rapid changes associated with the end of life. In withdrawing from interaction with others, disengagement theory aims to prepare the person for the most powerful and taxing separation of death. The hope in using this therapy is that when death comes, it will not be as painful or upsetting an experience as typically thought. The notion can be a comforting one that instead of being fearful patients that participate in the disengagement aspect of reminiscence theory will no longer be afraid but empowered when meeting their end.
Ego integrity theory
Ego Integrity Theory is based on the individual having a sense of fulfillment and success when looking back on their life and accomplishments. A person who has achieved ego integrity does not fear the uncertainty that comes with meeting their death. In a successful case of ego integrity theory the patient is at peace with the eventuality of death. This theory was developed from Eric Erikson's stages of development in which Integrity vs Despair is a crucial stage for later life psychological development.
Continuity theory
Disengagement and ego-integrity may offer tools helping the elderly or ill deal with the prospect of death but it is thought that Continuity Theory offers more profound insights when trying to fully understand the true meaning of reminiscence theory. A passage from Lin illustrates the concept of continuity the best "As individuals move from one stage to the next and encounter changes in their lives, they attempt to order and interpret changes by recalling their pasts. This provides an important sense of continuity and facilitates adaptation. Change is linked to the person's perceived past, producing continuity in inner psychological characteristics and in social behavior and social circumstances." Reminiscence can provide a mechanism by which individuals adapt to changes that occur throughout life Continuity Theory requires the effective use of remote memory. Reminiscence processes occur in this type of memory which is usually the last memory system to deteriorate. Research has found that frequent exercise of this system improves general cognitive function.
Therapy