Metacognitive Training for Depression

© Jelinek, Hauschildt, Moritz & Schneider, 06|22

 Metacognitive Training for Depression (D-MCT) 2

D-MCT: Satellite Position

 Metacognitive Training for Depression (D-MCT) 3

Today‘s Topic

Depression
Perception Memory
Behaviors of Emotions Thinking
and Self-Worth and
Strategies Reasoning
 Metacognitive Training for Depression (D-MCT) 4

Previous session

 What did you do for follow-up?

 Do you have any questions or success stories?

Training session

D-MCT 2 – Memory
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How is memory related to depression?

 Many individuals with depression complain of having problems

with concentration and memory.
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How is memory related to depression?

 Many individuals with depression complain of having problems

with concentration and memory.

 Decreased concentration may even be a symptom of

depression.
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How is memory related to depression?

 Many individuals with depression complain of having problems

with concentration and memory.

 Decreased concentration may even be a symptom of

depression.

Have you experienced this?

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Is it theoretically possible to remember everything?

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Is it theoretically possible to remember everything?

 No, the storage capacity of our memory is limited.

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Is it theoretically possible to remember everything?

 No, the storage capacity of our memory is limited.

 Imagine that I tell you a story. How much would you be able to remember half an hour
later?
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Is it theoretically possible to remember everything?

 No, the storage capacity of our memory is limited.

 Imagine that I tell you a story. How much would you be able to remember half an hour
later?

On average, only about 60% of the information from a story can be recalled (40% cannot!).
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Forgetting is normal.
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Forgetting is normal.

 Advantage: ...
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Forgetting is normal.

 Advantage: Our brains are not overloaded with irrelevant information, but ...
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Forgetting is normal.

 Advantage: Our brains are not overloaded with irrelevant information, but ...

 Disadvantage: ...
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Forgetting is normal.

 Advantage: Our brains are not overloaded with irrelevant information, but ...

 Disadvantage: A lot of important information is also lost (appointments, vacation

memories, information learned in school).
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Forgetting is normal.

 Advantage: Our brains are not overloaded with irrelevant information, but ...

 Disadvantage: A lot of important information is also lost (appointments, vacation

memories, information learned in school).

A memory exercise ...

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Exercise

 Complex scenes will be shown to you.

 Then, you will be asked what was depicted in the picture.

During this exercise, you should try to correctly remember as many details as possible.
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Camping Trip
What was shown?
 Mobile home
 Awning
 Table with place settings
 Bicycles
 Tablecloth
 Chairs
 Blue sky
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Camping Trip
What was shown?
 Mobile home
 Awning
 Table with place settings
 Bicycles
 Tablecloth
 Chairs
 Blue sky

= not depicted
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What was shown?

 Horse
 Fire
 Crown
 Wing
 Sword
 Armor
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What was shown?

 Horse
 Fire
 Crown
 Wing
 Sword
 Armor

= not depicted
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False Memories!

 Not everything we remember really happened the way we remember it

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False Memories!

 Not everything we remember really happened the way we remember it

 Our memory does not work like a “video camera” that records everything in detail
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False Memories!

 Not everything we remember really happened the way we remember it

 Our memory does not work like a “video camera” that records everything in detail

 Our brain fills in and mixes current impressions with past similar events (such as with the
camping scene), and we also supplement our memories through “logic” (for example, the
awning)
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False Memories!

 Not everything we remember really happened the way we remember it

 Our memory does not work like a “video camera” that records everything in detail

 Our brain fills in and mixes current impressions with past similar events (such as with the
camping scene), and we also supplement our memories through “logic” (for example, the
awning)

This phenomenon is also evident in everyday life:

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False Memories in Everyday Life

Example: Childhood  Sometimes we think that we clearly remember experiences

memories that, in reality, we know only through photographs or stories
from our parents.
 Classmates often remember the same event completely
differently.
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False Memories in Everyday Life

Example: Childhood  Sometimes we think that we clearly remember experiences

memories that, in reality, we know only through photographs or stories
from our parents.
 Classmates often remember the same event completely
differently.

Example: When  A woman is certain that she has her wallet and remembers
situations are very putting it in her red jacket. Instead, the woman put the wallet
similar in her blue jacket the day before.
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Does this mean I can no longer trust my memories?

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Does this mean I can no longer trust my memories?

 No! False memories are normal and affect everyone.

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Does this mean I can no longer trust my memories?

 No! False memories are normal and affect everyone.

 Keep in mind that (like everyone else) you will make errors because memory is not like a
video camera.
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Concentration & Memory

 How well we are able to remember things depends on how well we

concentrate in the moment and what we focus on.
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Concentration & Memory

 How well we are able to remember things depends on how well we

concentrate in the moment and what we focus on.

How good is your attention? Here's a little math problem ...

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Math Problem

A bus driver leaves the bus station in the morning with an empty bus.
At the first bus stop, 5 people get on. At the next stop, 4 more people
get on, and 2 people get off. At the next stop, 1 passenger gets on. At
the next stop, 6 more people get on. At the following stop 8
passengers get out and 3 people get on. Then, at the next stop, 2 more
people get out.
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Math Problem

Question: How many times did the bus stop?!?

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Math Problem

Question: How many times did the bus stop?!?

Correct answer: 6 times.

At the end, 7 passengers remain on the bus, but that was not the question.
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Concentration
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Concentration

 Our attention works like a spotlight; only one

object on the stage at a time can be illuminated.
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Concentration

 Our attention works like a spotlight; only one

object on the stage at a time can be illuminated.

 We can only correctly remember things that we

have previously focused our attention on (for
example, either the number of passengers getting
on and off the bus or the number of bus stops)!
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Concentration

 Our attention works like a spotlight; only one

object on the stage at a time can be illuminated.

 We can only correctly remember things that we

have previously focused our attention on (for
example, either the number of passengers getting
on and off the bus or the number of bus stops)!

 It is impossible to focus our attention on all the

information in our environment at the same time.
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How do problems with concentration &

memory occur?
 During strong ruminations, circling thoughts often claim all of our
attention.
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How do problems with concentration &

memory occur?
 During strong ruminations, circling thoughts often claim all of our
attention.

 There is hardly any attentional capacity left that can be focused on

other (more important) things in the environment. The spotlight is
focused “virtually inward.”
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How do problems with concentration &

memory occur?
 During strong ruminations, circling thoughts often claim all of our
attention.

 There is hardly any attentional capacity left that can be focused on

other (more important) things in the environment. The spotlight is
focused “virtually inward.”

 As a result, we can later barely remember some of the details in our

environment.
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A Frequent Concern: Am I Getting Alzheimer's?

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A Frequent Concern: Am I Getting Alzheimer's?

No! Memory problems in the context of depression are explainable.

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A Frequent Concern: Am I Getting Alzheimer's?

No! Memory problems in the context of depression are explainable.

 In depression, memory problems are more closely related to decreased information
intake than to “forgetting.” Also, they are severe than in Alzheimer's.
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A Frequent Concern: Am I Getting Alzheimer's?

No! Memory problems in the context of depression are explainable.

 In depression, memory problems are more closely related to decreased information
intake than to “forgetting.” Also, they are severe than in Alzheimer's.
 The loss of motivation, apathy, and lack of energy that often occur during depression can
also explain reduced information intake.
 D-MCT 2 – Memory 51

A Frequent Concern: Am I Getting Alzheimer's?

No! Memory problems in the context of depression are explainable.

 In depression, memory problems are more closely related to decreased information
intake than to “forgetting.” Also, they are severe than in Alzheimer's.
 The loss of motivation, apathy, and lack of energy that often occur during depression can
also explain reduced information intake.
 Often, memory problems in depression are subjective, a result of self-imposed
perfectionism, and cannot always be detected in tests.
 D-MCT 2 – Memory 52

A Frequent Concern: Am I Getting Alzheimer's?

No! Memory problems in the context of depression are explainable.

 In depression, memory problems are more closely related to decreased information
intake than to “forgetting.” Also, they are severe than in Alzheimer's.
 The loss of motivation, apathy, and lack of energy that often occur during depression can
also explain reduced information intake.
 Often, memory problems in depression are subjective, a result of self-imposed
perfectionism, and cannot always be detected in tests.
 When ruminations/depression are reduced, individuals can attend to other things again
and remember them.
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Do we all see and remember the same things?

Example: 3 artists painting the same Catalan countryside…

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Pay attention to the differences in the colors and the sizes in

the three paintings!
Are there things that each artist depicted or omitted differently?

Are there things that each

artist depicted or omitted
differently?

Andreas Weißgerber Bernd Hampel Helmut Schack

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Pay attention to the differences in the colors and the sizes in

the three paintings!
Are there things that each artist depicted or omitted differently?

Andreas Weißgerber: The hills in this picture are flatter Bernd Hampel: The colors in this landscape are much Helmut Schack: In this picture, a different field
than those in the other two paintings. earthier than in the other paintings. The tree on the appears to extend to the horizon. The landscape
right side of the street is missing (red circle). is almost colorful. In comparison to the other
pictures, the cluster of trees is more visible on
the horizon.
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Do we all see and remember the same things?

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Do we all see and remember the same things?

 No, every person perceives things differently! As in the three paintings—the same
landscape is visible but with different accents!
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Do we all see and remember the same things?

 No, every person perceives things differently! As in the three paintings—the same
landscape is visible but with different accents!

 In general, we focus our attention on information that is personally meaningful,

sometimes because it fits our mood.
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Do we all see and remember the same things?

 No, every person perceives things differently! As in the three paintings—the same
landscape is visible but with different accents!

 In general, we focus our attention on information that is personally meaningful,

sometimes because it fits our mood.

 Studies show that our current mood influences the types of memories we have access to.
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What does this have to do with depression?

 Depressive moods often lead to remembering more negative

experiences—pleasant or neutral experiences are not so easily
remembered.
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What does this have to do with depression?

 Depressive moods often lead to remembering more negative

experiences—pleasant or neutral experiences are not so easily
remembered.

 Events are therefore experienced and remembered through gray-tinted

glasses much more often than through rose-colored glasses.
 D-MCT 2 – Memory 62

What does this have to do with depression?

 Depressive moods often lead to remembering more negative

experiences—pleasant or neutral experiences are not so easily
remembered.

 Events are therefore experienced and remembered through gray-tinted

glasses much more often than through rose-colored glasses.

 Example: During a concert, a man clears his throat frequently. In

hindsight, only the disturbance is remembered, not the beautiful music.
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What does this have to do with depression?

 Depressive moods often lead to remembering more negative

experiences—pleasant or neutral experiences are not so easily
remembered.

 Events are therefore experienced and remembered through gray-tinted

glasses much more often than through rose-colored glasses.

 Example: During a concert, a man clears his throat frequently. In

hindsight, only the disturbance is remembered, not the beautiful music.

Have you experienced this?

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Remembering through gray-tinted glasses

 The emotional coloring of memories also relates to false memories!

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Remembering through gray-tinted glasses

 The emotional coloring of memories also relates to false memories!

 This can impede a realistic view of the world and encourage depressive processing (thus
providing additional “evidence” through depressive processing).
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What can I do about it?

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What can I do about it?

Practice remembering positive events more frequently in your daily life. For example, keep a
joy diary in which you write down joyful events from your day every evening.
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What helps with memory problems in everyday life?

???
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What helps with memory problems in everyday life?

1. Try to incorporate as much structure into your daily schedule as possible. The more
routine your behavior is, the less risk there is of forgetting something.
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What helps with memory problems in everyday life?

1. Try to incorporate as much structure into your daily schedule as possible. The more
routine your behavior is, the less risk there is of forgetting something.

2. It is also helpful to maintain the best possible “external order”. You can find items more
quickly and remember better when everything has a specific place.
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What helps with memory problems in everyday life?

3. Post important notes in logical places (e.g., put your medication schedule on the
refridgerator or bathroom mirror; put a list of items to remember to take with you on the
front door).
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What helps with memory problems in everyday life?

3. Post important notes in logical places (e.g., put your medication schedule on the
refridgerator or bathroom mirror; put a list of items to remember to take with you on the
front door).

4. Use an appointment calendar or other types of memory aids, such as a Smartphone or

email program.
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What helps with memory problems in everyday life?

3. Post important notes in logical places (e.g., put your medication schedule on the
refridgerator or bathroom mirror; put a list of items to remember to take with you on the
front door).

4. Use an appointment calendar or other types of memory aids, such as a Smartphone or

email program.

5. Make it a habit to write things down (digitally or in a notebook).

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What helps with memory problems in everyday life?

6. When you are traveling and want to remember an idea but have no way to write it down,
try to anchor it by linking the idea to an object (e.g., “tie a knot in your hankerchief”).
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What helps with memory problems in everyday life?

6. When you are traveling and want to remember an idea but have no way to write it down,
try to anchor it by linking the idea to an object (e.g., “tie a knot in your hankerchief”).

7. The more senses and methods used while learning, the better the retention rate.
Therefore, try to use various “channels”, such as hearing, seeing, discussing, and
applying.
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Learning Points
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Learning Points

 Memory problems in depression can be explained and partly traced back to other
problems (for example, concentration problems, frequent rumination).
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Learning Points

 Memory problems in depression can be explained and partly traced back to other
problems (for example, concentration problems, frequent rumination).

 Unlike in dementia, the concentration and memory problems in depression are less
severe and can improve if the depression decreases.
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Learning Points

 Memory problems in depression can be explained and partly traced back to other
problems (for example, concentration problems, frequent rumination).

 Unlike in dementia, the concentration and memory problems in depression are less
severe and can improve if the depression decreases.

 In general, our memory is deceptive! Our memory is prone to bias. Memory is especially
dependent upon our current mood.
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Learning Points

 Use memory aids during periods of depression (calendars, sticky notes) and keep a joy
diary.
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Learning Points

 Use memory aids during periods of depression (calendars, sticky notes) and keep a joy
diary.

 Nobody's perfect; we all forget things. This is normal and sometimes even a good thing!
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Final round

 What was most important for you today?

 Which thought distortion would you like to do an exercise on as homework?

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For trainers

Please hand out the worksheets. Introduce our app COGITO (download free of charge).

[Link]/mct_app
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Thank you!

Memory