For someone who blogs a lot about memory, a post on the DSM-5-TR was inevitable. For the uninitiated, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) is a 1050-page guide published by the American Psychiatric Association outlining the criteria for around 300 psychiatric diagnoses.
Part of the PA school curriculum in my final semester of didactic year is to memorize the criteria for each disorder, little by little, week by week.
Here’s an example of one:
Now, we don’t technically need to memorize it word for word, but anything there is fair game to test on. We’ve been responsible for anywhere from 3-10 of these a week for the past three months.
With a healthy mix of distinguishing features, time frames, age-ranges, and number of criteria needed, the DSM-5 is the purest test of raw memory that I’ve encountered so far in PA School. And without a solid memory strategy, it can become a grueling slog of time-consuming repetition.
And this challenge is largely because it involves the memorization of a lot of numbers. It’s tough to keep each disorder separate. “Oh, did this one need three criteria or two criteria, and was it 3 months, 6 months, twice weekly, or no time frame at all?”
And I firmly believe that numbers are the most abstract and arguably the most difficult thing to remember, ever. There are countless posts and tricks online to help memorize numbers. I talked about this problem back in January when I trialed the Major System (which didn’t end up working out because that’s better suited for long strings of numbers). Think about how hard it is to remember a simple phone number. Before smart phones and when you were without a pen it was always: “Okay you memorize the first three digits, I’ll take the middle three, you take the last four.”
Try to remember these three words:
Adam Sandler
Billiard Ball
Cat
Now try to remember these three numbers:
3
8
9
Words are much easier to remember, yea? You can picture them. You can come up with similarities or make up a story: “Adam Sandler playing pool with a cat.”
But what does the number 3 look like? What does it sound like? What does 3 make you think of? Well if you’re normal, probably nothing… it’s just a number. Unless it’s your favorite number or if you have it tattooed on your hand, it’s just not memorable. And what do 3, 8, and 9 have in common? I have no idea. Numbers are pretty arbitrary and it’s difficult to make connections amongst them.
But what if numbers… weren’t numbers?
If numbers are objectively hard to memorize, and the DSM-5 requires the memorization of a lot of numbers, I’m making the argument that you should… stop memorizing numbers.
Let me explain.
In one of my very first blogs I came across this post on a forum called “The Art of Memory” where a user said they had converted every number from 1-100 to an object or a person. I laughed a bit at that idea… until I tried it for the numbers 1-10. I stopped laughing. It works insanely well.
So here’s the trick: You should convert the numbers 1-10 (and beyond) to literally anything else: people, shapes, objects, foods, family members, celebrities, whatever. The more ridiculous, the better.
The number 1 for me is anything Pixar related (My #1 favorite movie studio): the Pixar Luxo Lamp, Woody, Steve Jobs (he was a founder), etc. Two is any set of twins: Olsen, Lindsay Lohan from The Parent Trap, real sets of twins that I’ve encountered in life, etc. Three at first for me was just Adam Sandler (I don’t have a clear reason for that one; it just stuck) but the number 3 comes up so often in the DSM, that I expanded to Drew Barrymore (his co-star in 50 First Dates), Happy Gilmore, etc. Eight is a billiard ball or a pool table. And 9 is a cat, Cat Woman, Anne Hathaway (played Cat Woman), just to name a few.
The absurd picture of a horse (my number 5 because 5 kind of looks like a seahorse) riding a cat (9) helped me remember that the age peak for Specific Phobia was 5-9.
The slight learning curve of remembering who or what signifies what numbers takes a fraction of time compared to how much time I’ve saved by using this strategy. The incidence of interference with the DSM is insane. Was it two criteria or three criteria? I would never confuse the Olsen Twins for Happy Gilmore.
The other thing you can do is convert time periods. For me, 1 year is Santa or a Christmas Tree. So Happy Gilmore (3) attacking Santa (12 months) with a hockey stick (a physical act of explosive anger) is 3 criteria in 12 months, part of the criteria for Intermittent Explosive Disorder.
Six months is Fifty Cent (half of a year) or any rapper. So suddenly Snoop Dogg (6 months) underneath the Pixar Lamp (1), is 1 criteria in 6 months, for Specific Learning Disorder.
One week for me is a margarita (like at a happy hour at the end of a long week), so suddenly two twins (2) making a toast with margs (1 week) while a limo pulls up with a small rapper like Little Bow Wow (3 months) is: 2 events, weekly, in 3 months, the exact criteria for the other part of Intermittent Explosive Disorder.
Yes, I actually study like this. No, it did not take long to memorize who or what represents each number or time frame. If it took longer than 2 hours to memorize the entirety of 12 DSM-5 criteria, I’d be lying. I run through it once (combining this strategy with a memory palace), once again an hour later, and then once more the following morning, and I know I have it committed to memory. There’s little reason for me to have to review the information again before the quiz. It’s impossible to forget an image of Snoop Dogg under a Luxo Lamp, or Adam Sandler fighting Santa. Scenes like this that you can combine in any way you want are infinitely more memorable than just abstract numbers and has made tackling the DSM a breeze.
The magic of this is that you can scale this as high as you want. 18 for me is Ulysses S. Grant or the Civil War (he was the 18th president). So suddenly a Civil War battle with each side throwing eggs (my code for 6) at each other are the ages of 6-18 for Disruptive Mood Dysregulation Disorder.
As a side note, converting numbers to their respective presidents was extremely valuable for me for Women’s Health. I always have trouble remembering milestones for the weeks of pregnancy. Suddenly a cannon (15 for James Buchanan) being operated by Cleveland from Family Guy (in Grover Cleveland’s first presidency he was the 22nd) was the time-frame for a Quad Screen. A landslide (for Landslide Lyndon B. Johnson) for 36 helped me remember when to test for Group B Strep.
I know it sounds insane, but it’s been the most effective way for me to remember numbers, which have been the bane of my existence since the start of PA School. Blood pressure thresholds especially… for strokes, pre-eclampsia, grades of hypertension, etc. Those are tough to remember. But suddenly Abe Lincoln’s hat (16) with polka dots (James K. Polk = 11) gives me the severe threshold for preeclampsia of 160/110.
Obviously some knowledge of the presidents was necessary here (I only knew a handful), but I just looked up who went with which number and it stuck.
The biggest barrier to strategies like these that I’ve heard is “I don’t have time to come up with stories or convert numbers.” I’d argue this strategy affords you extra time. Ask yourself how many times you have to repeat a flashcard, or look over a DSM Criteria for it to stick and even with that, just to stick long enough to survive through the quiz until your forget it entirely. How much time are you actually spending when you really add it all up? And then how often do you have to revisit that same information again before the exam?
Behavioral Health in PA School deserves to be an event at the USA Memory Championship. And I treated it as such the entire summer and it’s been one of my strongest (and most enjoyable) classes all year.
And I believe this class has become this big reason the summer semester can appear so brutal because memorization takes time. But it doesn’t have to. If you spend your time hammering in nails with a rock, it’s always worth it to take a day to put down the rock and build a hammer out of steel. Do you lose an entire day’s worth of progress? Sure, but you’ll save weeks to months of time in the long run. It’s about memorizing information in a way that makes it stick so you don’t have to keep returning to it.
And maybe I was the only one who had issues memorizing numbers. But after 11 months, I’ve finally found my solution.
Three weeks and I’ll be a P2. I’ll see you then.