Conserving a sense of self despite significantly impaired short-term memory through songwriting and formative events

This case study reflects on the use of improvisation and songwriting to support a patient with significantly impaired short-term memory and long-term memory interference as a result of acquired brain injury. Memory has long been associated with personal identity, linking the past with the present, and enabling us to project into the future. This continuity of consciousness helps us to learn from, and make sense of our experiences, strengthening our internal representation of self. Disruption to short-term memory can significantly impact decision making, planning and initiation, all of which are key components of personal identity and self-expression. Supporting patient autonomy and self-expression through improvisation, and crafting lyrical content around personal preferences and events, sessions were designed to bolster his internalised sense of self through both revisiting old memories and facilitating new memory formation within the present. While short-term memory has been considered a conduit to long-term memory consolidation, and integral to the individual’s self-expression, this case study implies short-term memory was neither the gatekeeper to formation of long-term memories, nor critical to maintaining a sense of self, and reflects on how music helped the client create and access new learning beyond procedural memories, anchoring the self in newly internalised self-expression.