The power of nostalgia: what is Reminiscence Therapy?

What is reminiscence therapy?

Reminiscence therapy (RT) - sometimes called life review therapy - was introduced in 1963 by psychiatrist Robert Butler as a treatment for older adults experiencing dementia or cognitive decline. This process involves group therapy sessions led by a trained professional who uses prompts to draw out and encourage exchanges of positive memories.

It aims to use these thoughts, feelings and past remembrances to improve cognitive function and emotional wellbeing in the present.

How reminiscence therapy works

Some people with conditions such as Alzheimer's disease and dementia may find it difficult to remember experiences from their past. Using various techniques, RT aims to reconnect a person with these forgotten memories, to help reclaim their personal identity. These techniques can include art, music, video, audio clips, soundscapes, objects, smells, and group storytelling.

According to Dr Emer MacSweeney, CEO and Consultant Neuroradiologist at ReCognition Health, London, UK, RT engages long-term memory networks, which often remain intact in people with dementia - even as their short-term memory declines.

"The hippocampus - crucial for memory formation - and the prefrontal cortex - involved in retrieval of memories - are less affected in earlier stages of dementia compared to other brain regions involved in short-term recall," she says. "By activating these areas through sensory cues such as familiar sounds, sights, and smells, RT strengthens the brain’s capacity to access stored memories."

What are the techniques used in reminiscence therapy?

RT suggests that - with the right tools - dormant memories can be revived to help people reconnect with their personal histories, along with their sense of self.

Cross says that these tools are adapted according to different cognitive abilities. People with advanced dementia may benefit from simpler cues, while more complex objects or media are used for those in the early stages, to encourage engagement without frustration.

"It’s important that a personalised approach is taken for each person to get the most out of it," she advises.

She adds: "For some people - particularly those with sensitivities or who are in the later stages of dementia - breathing exercises paired with animal interactions have been effective ways in which to calm the mind and body. This multi-sensory approach - combining touch, sight and emotional connection - helps create a relaxed environment that encourages reminiscence.

Memory boxes are another effective tool used in RT to stimulate memories from past experiences. These boxes can include familiar objects and photos which act as talking points and help people recognise their personal living space."

Benefits of reminiscence therapy

While research on reminiscence therapy is limited, studies suggest it can have beneficial effects on the quality of life and psychological wellbeing of dementia patients. It can potentially reduce symptoms such as depression and anxiety, lift mood, enhance communication skills and improve cognitive function.

MacSweeney says this is because emotional brain centres - such as the amygdala - are stimulated during reminiscence, triggering feelings of happiness and nostalgia.

"Neuroplasticity - the brain’s ability to reorganise and form new neural connections - may be encouraged through this process," she says. "This could potentially slow the cognitive decline associated with dementia."

Cross adds that RT can also help family members, health professionals, and caregivers better understand people's behaviours and personalities. This could help further improve their overall standard of living.

She says: "Quality of life improvements are often measured using observational assessments of mood, behaviour and engagement levels, alongside their feedback and observations by carers and loved ones."

Reminiscence therapy for dementia

While RT shows promise in reducing some negative effects of dementia, it has its limitations. In advanced dementia - when a person loses the ability to access stored memories - the effects of RT can be weaker.

MacSweeney says: "As the neural circuits responsible for memory deteriorate, the brain's ability to retrieve long-term memories - which RT relies on - diminishes. In advanced dementia, this can make the therapy less effective, or even impossible, as the person loses the capacity to recall memories."

She also explains that while RT is designed to evoke positive memories, some may be distressing or traumatic, and lead to emotional discomfort or increased agitation.

Cross says that negative memories may surface, causing distress, which means some people might struggle to engage meaningfully with RT. To overcome this, she suggests RT should be tailored specifically to the person's life story - focusing on positive memories and using familiar, comfortable objects.

She adds: "A trained therapist can navigate these issues by guiding the sessions sensitively and adjusting techniques as the disease advances."

Reminiscence therapy may be a valuable tool for promoting wellbeing in older adults. However, it should only be conducted by a healthcare professional trained in RT. Because it is considered an alternative type of therapy, it may not be as readily available as more conventional forms. Ask your doctor for recommendations, or contact local care homes for advice on RT therapists organising activities in your area.