by Carolyn Thomas ♥ Heart Sisters (on Blue Sky)
If I asked you about the exact moment you were diagnosed with heart disease, would you be able to remember that moment? Research suggests that most of us (whatever our serious diagnosis) can clearly recall, often in surprisingly precise detail, the exact words used by the physician who broke the news to us – even decades later.
But what if I asked you what you had for breakfast last Tuesday?
The difference between those two questions about remembering seems obvious, because hearing a frightening new diagnosis is fraught with emotion. A bowl of oatmeal? Not so much.
Dr. Elizabeth Kensinger is a psychology professor at Boston College who studies memory – particularly how our memories are influenced by emotions.(1) As she explains:
“We remember some pieces of an event but forget others, and the event details we recall often are shaped not only by the emotions we experienced during that moment, but by our current emotional state while recalling that moment.”
She has found that after a strongly negative event, we are more likely to retain a memory of what happened than we are after a positive event.
Consider, for example, the tragic events of the terrorist attacks of September 11, 2001: People living in New York on 9/11 tended to remember more event details about that day (e.g. what time the second plane hit the World Trade Center) than autobiographical details (e.g. what they were doing when they first learned about the attacks).
In contrast, people who didn’t live anywhere near New York City on that tragic day retained more autobiographical details than event details.
What I vividly recall from that terrible morning, for example, was brushing my teeth while listening to the radio news (which had at first mistakenly reported that a small commuter plane had crashed into one of the towers).
But 15 minutes later, I arrived at the hospital where I worked and joined my stunned colleagues standing crammed around the TV in our Lounge – which kept broadcasting those horrific scenes of the huge planes crashing into the World Trade Center towers, over and over.
That vivid memory of unimportant details (like brushing my teeth) seems burned into my brain. It’s what Dr. Kensinger calls a “flashbulb memory” – which occurs when a highly emotional event – like a serious diagnosis – happens. She further explains this flashbulb memory as a kind of “special memory mechanism which takes over, causing the moment to be recorded in memory with picture-perfect accuracy.”
Memory, however, is not perfect – yet we’re not always aware of our memory’s imperfections. Even confident eye witnesses to criminal events are often notoriously wrong in their descriptions of the criminal. And many marital squabbles, Dr. Kensinger also reminds us, arise due to “inconsistencies in how a past event is remembered.”
We nevertheless share a kind of inborn intuition that there are strongly positive moments in our lives that have been indelibly preserved in our memory, too: perhaps our wedding day, or the day our first baby was born. Yet she also cites studies which have suggested that memories of those emotional moments may seem subjectively vivid, yet as the years go by, hold little accurate detail.
And a strong emotion enhances memory for some – but not all – details of any given experience. For example, Dr. Kensinger cites study findings that strong emotions linked with an experience may sometimes actually have a “narrowing effect” on memory:
“This can happen when emotional arousal restricts the focus of our attention, causing us to notice the information that may have caused the strong emotional response arousal in the first place, but then fails to process other information details nearby.”
This reminded me of a personal “narrowing effect” experience that illustrates the difference between what we notice and how we interpret what we notice – if it’s remembered at all. When the on-call cardiologist, for example, was called to the Emergency Department during my own heart attack, I remember very vividly that he sat down next to my gurney, took my right hand in both of his hands (a sweet gesture, as I recall thinking at the time). However, his next words were:
“Mrs. Thomas, I can tell from your T-waves and other diagnostic tests that you have significant heart disease!”
The weirdest part of this moment was that after hearing those memorably terrifying words, I do remember that his lips continued moving and sounds kept coming out of his mouth – so he must have been talking. But later, I described my reaction to what I’d seen and heard in that moment like this: he must have suddenly started speaking a foreign language. I simply was unable to understand or remember anything he said after those words “significant heart disease”. It was as if a speeding train was rushing loudly through my brain. That’s the “narrowing effect” that a strong emotional response can produce. (I may have also signed something before I was rushed to the cath lab. It could have been informed consent paperwork. Who knows?)
So while there is evidence that an event that’s strongly emotional is more likely to be remembered, there may also be what researchers call an “emotion-induced memory trade-off”, in which we remember the central emotional content of an experience, but often forget most other details. Dr. Kensinger compares that trade-off with a group of young adult participants in academic research who were asked to study photographs of a car accident on a street. These participants tended to have very good memory recalling the car accident (the central emotional content) but very poor memory about the street (the other details).
Dr. Kensinger also describes how people sometimes hold tight to emotional memories that are inaccurate, in what memory studies call an “accuracy-confidence-disconnect”.
Most freshly-diagnosed heart patients, for example, understandably expect their closest family members or friends to be their go-to listeners and on-call helpers as needed, especially when they’re back home in the vulnerable early days post-hospital discharge. While this expectation may be reasonable in most families, many of my readers over the years have felt openly disappointed by those who “didn’t show up when I needed them”. Their negative memories of what they felt as abandonment during a time of great need are examples of how that powerful “accuracy-confidence-disconnect” memory may feel worse over time. It’s as if they have already discounted any help that those disappointing visitors did provide. See also: Choose your listeners carefully
And conversely, some readers have also told me that they were often as surprised by who DOES show up to help as they were by those who don’t.
That experience of unexpected kindness from other people is a positive emotional response, which ironically – as Dr. Kensinger has found – may not be remembered over time as vividly as the negative memories of those who didn’t help.
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Kensinger EA. “Remembering the Details: Effects of Emotion.” Emot Rev. 2009;1(2):99-113.
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Q: Have you experienced that “flashbulb memory” experience of an event that’s burned into your brain?
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NOTE FROM CAROLYN: You’ll find more about how patients remember – or forget! – in my book, “A Woman’s Guide to Living with Heart Disease” (Johns Hopkins University Press). You can ask for it at your library or favourite bookshop (please support your local independent booksellers!) or order it online (paperback, hardcover or e-book) at Amazon – or order it directly from Johns Hopkins University Press (and use their code HTWN to save 30% off the list price when you order).

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