The brain is actually a supple, malleable organ, as ready to unlearn as it is to learn, capable of transforming vicious circles into virtuous circles, of resetting & repairing its internal communications. Far more than once dreamed possible, the brain can—if not always cure—heal itself.
Doidge wrote about the brain’s remarkable ability to recalibrate itself—what doctors call neuroplasticity—in his 2007 bestseller The Brain That Changes Itself. His new book recounts an astounding array of radical improvements in brain problems long thought irreversible. There are newly effective therapies, leading to improvement in, & sometimes even complete cures, for conditions ranging from stroke to traumatic brain injuries, learning disorders & missing brain parts. Even Parkinson’s & MS symptoms can be improved in new ways. “Like Marshall McLuhan said, the future is already here,” says Doidge in an interview. “The early neuroplasticians had to battle to get their findings accepted but now the field is not remotely controversial. I’m no longer talking about ‘promising’ developments down the road, but therapies that are here now. Patients & their caregivers just have to know who is doing things they thought impossible.”
Consider Dr. Michael Moskowitz, who knows pain both professionally & intimately. The co-operator of Bay Area Medical Associates in Sausalito, Calif., Moskowitz is a star in the treatment of pain, the man who sets the exams in pain medicine for aspiring American doctors. ... “We are where people come to die with their pain,” he told Doidge. By 2007, 13 years after a waterskiing accident, it looked like Moskowitz would be one of them. The acute pain from his neck injury had morphed into permanent, & growing, chronic pain.
It did so via the same mechanisms that create that transformation in anyone. “Chronic pain is plasticity gone wild,” Doidge says. The injury to Moskowitz’s neck had also affected his body’s pain system, specifically the neurons in the brain associated with the neck area, causing them to fire repeated false alarms long after the neck had healed. What happened next illustrates core laws of neuroplasticity. Neurons that fire together, wire together: the more Moskowitz’s pain signals flared, the better & quicker they became at it. Use it or lose it: the fight for brain territory is competitive. The more Moskowitz favoured his neck because of the pain, the less the neurons involved with it had to do, & the more vulnerable they become to hijacking by nearby areas, including the pain sensors now working overtime. Moskowitz was caught in a vicious circle. His pain, 3/10 on the standard scale at the best of times, & spiking frequently to 8/10, was only getting worse. “Plasticity is a blessing when you’re listening to classical music & developing an appreciation for it,” Doidge wryly notes, “but it’s a curse when you are reinforcing pain.”
As his quality of life inexorably eroded, Moskowitz sat down to read 15,000 pages of cutting-edge neurological research, seeking a way to make plasticity work for him. Moskowitz concentrated on 2 areas of the brain among the dozen that do at least some pain processing, the posterior cingulate & the posterior parietal lobe, areas whose primary purpose is to deal with visual information.
He knew already that when a brain area is processing pain it uses about 5% of the neurons in the area, but the reinforcement involved in chronic pain means about 15% - 20% of the neurons become involved. By concentrating on an image of his brain—an image in which it changed from being lit up by pain activity to being calm & pain-free—Moskowitz thought he could quiet the original pain receptors & force the hijacked neurons back to their day jobs as visual processors.
It required relentless dedication at first, a conscious response to every twinge. In 3 weeks, Moskowitz thought he detected slight improvement, enough to spur him on; by 6 weeks the pain that had spread to his back was gone; within a year he was almost always pain-free everywhere. He had turned the vicious circle virtuous. “Relentlessness was the most important factor, absolutely,” Doidge agrees. “As a psychiatrist, I know that if you reframe a symptom attack as an opportunity, if instead of becoming crestfallen & pulling back, you treat every pain, anxiety or inhibition—reframe it as your moment—that’s the route to altering that circuitry. That’s what Moskowitz did. He didn’t let a single twinge of pain go by.”
Intense dedication is a hallmark of those who, all on their own, accomplish large-scale change in their brains. John Pepper, a South African now in his late seventies, was diagnosed in his thirties with the incurable, chronic, progressive neurodegenerative disease known as Parkinson’s. By all odds he should be immobile, if not dead, by now, but Pepper has fought his symptoms to a standstill by vigorous exercise carried out with ferocious determination & conscientious attention to detail. “Even as his unconscious ability to walk unravelled,” Doidge explains, “Pepper realized that if he analyzed how he walked & used his conscious mind to guide him, he could still do it. So he used a different part of his brain, the frontal lobes, &—like a child learning to walk—thought himself into efficient walking.”
People with Parkinson’s have 6 times the dementia rate of those who do not, & Pepper is reaching what are the danger years for anyone, yet his mind is sharp. That, together with his mode of exercise & the first-the-right-heel-then-the-left-knee precision with which he pursues it, raise a question about Alzheimer’s, a disease where both exercise & conscientiousness are proven factors in delaying onset. Is Alzheimer’s a disease of plasticity, or rather of its absence? Doidge is cautious in response. “There are so many ways of looking at Alzheimer’s. Most researchers analyze it chemically, because of the proteins involved, in hopes of finding alleviating drugs, but to look at Alzheimer’s that way is to put it under the microscope at very high power—it is more holistic to think of an Alzheimer’s brain as one that is losing plasticity.”
Whether walking battles the onset of dementia through its link to plasticity or by its more general health benefits, it’s one of the most potent anti-dementia forces known. “Now we have the Cardiff study looking at the British men over 30 years & it shows that if you did 5 things, including walking at least 3 kilometres a day,” Doidge says, “the risk of dementia falls a staggering 60%. If any medication did that, it would be the most talked-about drug in history.”
Not that drugs have any role in the story Doidge tells. Moskowitz, who has switched the goal of his clinic from pain management to pain eradication, recognizes that he himself (& the likes of Pepper) is an outlier set apart by his iron determination. Not all his patients can follow him down his own relentless road. Even so, Moskowitz does not always seek to aid them with drug therapy—instead devoting considerable effort to weaning them from painkillers—but with touch, sound & vibration. It’s a pattern Doidge sees everywhere. “Almost all the success stories involve a combination of mind & energy.”
Much of The Brain’s Way of Healing is devoted to non-invasive energy therapies. The author is particularly enamoured with light therapy, once far more prominent in Western medicine than it is now. Doidge likes to quote Florence Nightingale, who said “Light is not only a painter but a sculptor,” after she took note that wounded soldiers in outdoor field hospitals in Crimea recovered better than those stuck indoors. “We are far more transparent than we think & more sensitive to light than we think. So I have an entire chapter on the use of light, including cold lasers, to heal the brain.”
Light and other energy therapies have fallen from favour, Doidge believes, because for 50 years scientists have focused on the brain’s material & chemical side. Chemicals do work in small regions for signalling, he says, but the true universal language of the brain lies in its pattern of electrical signals. “All our senses take energy from outside & translate it into another form of energy inside the brain. Clinicians can now use these natural forms of energy to ‘talk’ to the brain.” And nothing speaks more loudly and clearly than the electrical pulses of the PoNS.
Originally thought of by its inventors as an aid for brain-injured people with balance troubles, the Portable Neuromodulation Stimulator has astonished even them with its effectiveness over a range of conditions &, especially, the speed with which it helps. A small, pocket-sized device, part of which went into the mouth & rested on the tongue & part of which stayed outside—144 electrodes that fired off electric pulses to activate the tongue’s sensory neurons. After 2 weeks of sessions with it, a voiceless MS patient could sing; a woman immobilized by Parkinson’s could walk; a stroke victim who couldn’t understand a newspaper article could read whatever she wanted.
All this because the tongue, Doidge says, “is the royal road to the brain”—with no dead skin & a moist surface making it an excellent conductor, & rich in sensory preceptors for touch, taste & pain that lead directly to the brain stem. “The PoNS turned out to be a very good stimulator for the whole brain.” Doidge thinks it clears up “noise” in the brain caused by disease or injury. “People tend to think neurons are either dead or alive afterwards, but actually many are firing at an irregular or wrong rate. Incoming information is thus chaotic & noise-filled, with even the healthy cells unable to communicate.” The PoNs, via the tongue’s access to the brain stem & hence the entire brain, can reset the circuitry, allow effective electrical communication & return the brain to a state of equilibrium. That’s why the application is so wide-ranging: with the noise gone, the brain starts working with what it has, in whatever condition it finds itself.
For decades, Doidge remarks, scientists wouldn’t use “healing” & “brain” in the same sentence, because they thought the brain was so sophisticated that it lacked self-healing powers. That turned out to be wrong—the brain is even more sophisticated than anyone realized.
Doidge wrote about the brain’s remarkable ability to recalibrate itself—what doctors call neuroplasticity—in his 2007 bestseller The Brain That Changes Itself. His new book recounts an astounding array of radical improvements in brain problems long thought irreversible. There are newly effective therapies, leading to improvement in, & sometimes even complete cures, for conditions ranging from stroke to traumatic brain injuries, learning disorders & missing brain parts. Even Parkinson’s & MS symptoms can be improved in new ways. “Like Marshall McLuhan said, the future is already here,” says Doidge in an interview. “The early neuroplasticians had to battle to get their findings accepted but now the field is not remotely controversial. I’m no longer talking about ‘promising’ developments down the road, but therapies that are here now. Patients & their caregivers just have to know who is doing things they thought impossible.”
Consider Dr. Michael Moskowitz, who knows pain both professionally & intimately. The co-operator of Bay Area Medical Associates in Sausalito, Calif., Moskowitz is a star in the treatment of pain, the man who sets the exams in pain medicine for aspiring American doctors. ... “We are where people come to die with their pain,” he told Doidge. By 2007, 13 years after a waterskiing accident, it looked like Moskowitz would be one of them. The acute pain from his neck injury had morphed into permanent, & growing, chronic pain.
It did so via the same mechanisms that create that transformation in anyone. “Chronic pain is plasticity gone wild,” Doidge says. The injury to Moskowitz’s neck had also affected his body’s pain system, specifically the neurons in the brain associated with the neck area, causing them to fire repeated false alarms long after the neck had healed. What happened next illustrates core laws of neuroplasticity. Neurons that fire together, wire together: the more Moskowitz’s pain signals flared, the better & quicker they became at it. Use it or lose it: the fight for brain territory is competitive. The more Moskowitz favoured his neck because of the pain, the less the neurons involved with it had to do, & the more vulnerable they become to hijacking by nearby areas, including the pain sensors now working overtime. Moskowitz was caught in a vicious circle. His pain, 3/10 on the standard scale at the best of times, & spiking frequently to 8/10, was only getting worse. “Plasticity is a blessing when you’re listening to classical music & developing an appreciation for it,” Doidge wryly notes, “but it’s a curse when you are reinforcing pain.”
As his quality of life inexorably eroded, Moskowitz sat down to read 15,000 pages of cutting-edge neurological research, seeking a way to make plasticity work for him. Moskowitz concentrated on 2 areas of the brain among the dozen that do at least some pain processing, the posterior cingulate & the posterior parietal lobe, areas whose primary purpose is to deal with visual information.
He knew already that when a brain area is processing pain it uses about 5% of the neurons in the area, but the reinforcement involved in chronic pain means about 15% - 20% of the neurons become involved. By concentrating on an image of his brain—an image in which it changed from being lit up by pain activity to being calm & pain-free—Moskowitz thought he could quiet the original pain receptors & force the hijacked neurons back to their day jobs as visual processors.
It required relentless dedication at first, a conscious response to every twinge. In 3 weeks, Moskowitz thought he detected slight improvement, enough to spur him on; by 6 weeks the pain that had spread to his back was gone; within a year he was almost always pain-free everywhere. He had turned the vicious circle virtuous. “Relentlessness was the most important factor, absolutely,” Doidge agrees. “As a psychiatrist, I know that if you reframe a symptom attack as an opportunity, if instead of becoming crestfallen & pulling back, you treat every pain, anxiety or inhibition—reframe it as your moment—that’s the route to altering that circuitry. That’s what Moskowitz did. He didn’t let a single twinge of pain go by.”
Intense dedication is a hallmark of those who, all on their own, accomplish large-scale change in their brains. John Pepper, a South African now in his late seventies, was diagnosed in his thirties with the incurable, chronic, progressive neurodegenerative disease known as Parkinson’s. By all odds he should be immobile, if not dead, by now, but Pepper has fought his symptoms to a standstill by vigorous exercise carried out with ferocious determination & conscientious attention to detail. “Even as his unconscious ability to walk unravelled,” Doidge explains, “Pepper realized that if he analyzed how he walked & used his conscious mind to guide him, he could still do it. So he used a different part of his brain, the frontal lobes, &—like a child learning to walk—thought himself into efficient walking.”
People with Parkinson’s have 6 times the dementia rate of those who do not, & Pepper is reaching what are the danger years for anyone, yet his mind is sharp. That, together with his mode of exercise & the first-the-right-heel-then-the-left-knee precision with which he pursues it, raise a question about Alzheimer’s, a disease where both exercise & conscientiousness are proven factors in delaying onset. Is Alzheimer’s a disease of plasticity, or rather of its absence? Doidge is cautious in response. “There are so many ways of looking at Alzheimer’s. Most researchers analyze it chemically, because of the proteins involved, in hopes of finding alleviating drugs, but to look at Alzheimer’s that way is to put it under the microscope at very high power—it is more holistic to think of an Alzheimer’s brain as one that is losing plasticity.”
Whether walking battles the onset of dementia through its link to plasticity or by its more general health benefits, it’s one of the most potent anti-dementia forces known. “Now we have the Cardiff study looking at the British men over 30 years & it shows that if you did 5 things, including walking at least 3 kilometres a day,” Doidge says, “the risk of dementia falls a staggering 60%. If any medication did that, it would be the most talked-about drug in history.”
Not that drugs have any role in the story Doidge tells. Moskowitz, who has switched the goal of his clinic from pain management to pain eradication, recognizes that he himself (& the likes of Pepper) is an outlier set apart by his iron determination. Not all his patients can follow him down his own relentless road. Even so, Moskowitz does not always seek to aid them with drug therapy—instead devoting considerable effort to weaning them from painkillers—but with touch, sound & vibration. It’s a pattern Doidge sees everywhere. “Almost all the success stories involve a combination of mind & energy.”
Much of The Brain’s Way of Healing is devoted to non-invasive energy therapies. The author is particularly enamoured with light therapy, once far more prominent in Western medicine than it is now. Doidge likes to quote Florence Nightingale, who said “Light is not only a painter but a sculptor,” after she took note that wounded soldiers in outdoor field hospitals in Crimea recovered better than those stuck indoors. “We are far more transparent than we think & more sensitive to light than we think. So I have an entire chapter on the use of light, including cold lasers, to heal the brain.”
Light and other energy therapies have fallen from favour, Doidge believes, because for 50 years scientists have focused on the brain’s material & chemical side. Chemicals do work in small regions for signalling, he says, but the true universal language of the brain lies in its pattern of electrical signals. “All our senses take energy from outside & translate it into another form of energy inside the brain. Clinicians can now use these natural forms of energy to ‘talk’ to the brain.” And nothing speaks more loudly and clearly than the electrical pulses of the PoNS.
Originally thought of by its inventors as an aid for brain-injured people with balance troubles, the Portable Neuromodulation Stimulator has astonished even them with its effectiveness over a range of conditions &, especially, the speed with which it helps. A small, pocket-sized device, part of which went into the mouth & rested on the tongue & part of which stayed outside—144 electrodes that fired off electric pulses to activate the tongue’s sensory neurons. After 2 weeks of sessions with it, a voiceless MS patient could sing; a woman immobilized by Parkinson’s could walk; a stroke victim who couldn’t understand a newspaper article could read whatever she wanted.
All this because the tongue, Doidge says, “is the royal road to the brain”—with no dead skin & a moist surface making it an excellent conductor, & rich in sensory preceptors for touch, taste & pain that lead directly to the brain stem. “The PoNS turned out to be a very good stimulator for the whole brain.” Doidge thinks it clears up “noise” in the brain caused by disease or injury. “People tend to think neurons are either dead or alive afterwards, but actually many are firing at an irregular or wrong rate. Incoming information is thus chaotic & noise-filled, with even the healthy cells unable to communicate.” The PoNs, via the tongue’s access to the brain stem & hence the entire brain, can reset the circuitry, allow effective electrical communication & return the brain to a state of equilibrium. That’s why the application is so wide-ranging: with the noise gone, the brain starts working with what it has, in whatever condition it finds itself.
For decades, Doidge remarks, scientists wouldn’t use “healing” & “brain” in the same sentence, because they thought the brain was so sophisticated that it lacked self-healing powers. That turned out to be wrong—the brain is even more sophisticated than anyone realized.
