Monday, April 27, 2015

The Brain that Changes itself by Norman Doidge

Book cover image from Norman Doidge

As undergraduates at UBC in the late sixties, we used to joke about coffee killing brain cells. The science of the time told us that the brain had a finite number of cells, and neurons did not replicate. Now we know better.

In this amazing book, Toronto psychologist Norman Doidge shares case histories and research stories that demonstrate just how erroneous these ideas were.

Many of us know Hebb's concept (previously suggested by Freud, says Doidge). We create and strengthen neural pathways as we learn new things; "neurons that fire together wire together." The reverse is also true. Huge implications for those trying to break bad habits or forget old trauma.

Dr. Alvaro Pascual-Leone likens our brain tissue to a pile of snow that we sled on. We can create ruts as we use and re-use the same routes to slide down, or we can break new ground and create routes where none existed before. After either kind of use, the snow hill remains basically the same, but it never returns to its original condition.

Doidge presents some amazing case histories. With brain training, Cheryl regained her balance after five years of a falling sickness brought on by a drug side effect that virtually destroyed her vestibular apparatus. Michelle was born with half a brain but lives a full life on the other half, which has adapted to fill the void. Nicole survived a rare brain tumour only to become paralyzed. With neuroplasticity based treatment, she recovered enough to work as a physically able full-time producer for a television show. She still finds time for her volunteer work with sick children.

In addition to presenting case histories, the author takes the reader into the experimental laboratories of various groundbreaking neurologists, both historic and contemporary. VS Ramachandran has devised a simple mirror box that tricks the brain's perception in order to deal with the pain and trouble caused by painful or frozen phantom limbs, those that are still felt even though they have been amputated.

He and others have also demonstrated that like the learned aspects of phantom limb pain, the paralysis that follows strokes has learned components. Dr. Edward Taub has used this idea to develop CI, or constraint-induced stroke treatment that involves "massed practice." This breakthrough approach to paralysis addresses both the brain damage in the motor cortex and the learned behaviour of not trying to use "paralyzed" body parts. It has even helped patients whose strokes occurred years before.

Taub's therapy uses mitts and slings to restrain good arms and hands while patients practice intensive incremental physiotherapy to help retrieve "the motor programs that Taub believes are still in the nervous system, even after many strokes, illnesses or accidents." His pioneering approach has helped not only stroke victims, but people born with cerebral palsy, for whom such mobility gains as they have achieved were formerly assumed to be impossible.

This book is the most fascinating work of non-fiction I have read in quite some time. Who could resist such chapter titles as "Brain Lock Unlocked: Using Plasticity to Stop Worries, Obsessions, Compulsions and Bad Habits" and "Turning our Ghosts into Ancestors: Psycholanalysis as a Neuroplastic Therapy?"

Recently, Norman Doidge published a second book on neuroplasticity, reviewed here in The Guardian. It has already been made available in 20 languages, and has sold over a million copies in a hundred countries.

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