These days people tote their individualism around with the fervour of rifle bearers. The inalienable right to be me. Yet, oddly, when it comes to health there is a stampede to cede control, and responsibility for cure, to others. I am but a hapless hostage to illness awaiting deliverance from the storm troopers of medical science. The new science of neuroplasticity promises to tip that locus of control out of the hands of our preferred healers, the pill makers, back to us.
Expansive: Brain based learning. Photo: Georgia Willis
In his first book, The Brain that Changes Itself, Canadian psychiatrist Norman Doidge wooed millions with the tale of a plastic brain whose billions of cells crisscrossed the cranial vault like flight paths, but whose routes weren’t fixed and could divert around stormy weather. Orthodoxy had cast the brain as malleable in infancy but once the basics like sight and hearing were soldered in that was your wiring diagram for life. Having none of it, the neuroplastic brain is a work in progress, constantly learning and shaped by experience.
Doidge showcased the work of late neuroscientist Paul Bach-y-Rita, whose Copernican idea was that the brain’s outer layer, the cortex, was really a generic hard drive ripe for reprogramming. The bits of brain that wag a finger, keep you balanced across stepping-stones or fix your gaze on some bucolic scene are not indispensable. If taken out by stroke, tumour or similar catastrophe their function can, with a little hi-tech coaxing, be hosted at a different cortical address.
The Brain’s Way of Healing by Norman Doidge.
Bach-y-Rita sat blind people in a chair that traced images on their backs with a bank of tiny vibrators. These “pictures” were of objects in their foreground, such as a telephone, relayed by camera to the tremulous chair. The blind folk “saw” the objects with such refinement they could even duck from a ball thrown at the camera. Because these tactile images are processed in the brain’s vision area, Bach-y-Rita quipped, “We see with our brains not with our eyes”.
This versatile cortex could be repurposed to move limbs paralysed after stroke, halt antibiotic-induced vertigo and overcome obsessive-compulsive disorder and addictions. Doidge’s alchemy blended hope with solid science and compelling narrative to yield gold, no cinch when the competition includes heavy-hitting science writers such as Malcolm Gladwell, Antonio Damasio and the now discredited Jonah Lehrer.
But conjuring bestsellers is a fickle art so there are no guarantees for Doidge’s second outing. The Brain’s Way of Healing trumpets more “remarkable discoveries and recoveries from the frontiers of neuroplasticity” and offers up psychiatrist-turned-pain-specialist Michael Moskowitz as exhibit A. Boyishly impulsive, middle-aged Moskowitz broke his neck waterskiing then snapped his thighbone in an illicit leap from a tank turret. Pressing agony to advantage, he guzzled 15,000 pages of neuroscience in a year to emerge, literally, as the physician who heals himself.
Moskowitz used visualisation to imagine the pain “hot spots” on his brain scans shrinking. Six weeks later he was pain-free and hawking the method to patients. Doidge’s scientific rationale is solid in this vignette but in later pages the epithet “miraculous” came frequently to mind and doubts intruded like a gathering storm.
Next under the lens is John Pepper, a South African businessman with Parkinson’s disease. He reversed his tremor, rigidity and slowness with exercise and a mental strategy that breaks down walking into its composite parts then rejoins them with conscious effort. Doidge reports Pepper’s symptoms in perplexing detail before revealing several doctors claimed he had a less severe variant of Parkinson’s, not the real deal.
Diagnostic quibbles aside, I was baffled that Doidge would devote nearly 70 pages to this single controversial case. Pepper’s dedication is inspiring but his is an atypical sample that hardly extrapolates to the wider Parkinson’s community. Then again, science may vindicate Pepper’s dogged self-belief.
Australia’s Professor Anthony Hannan, who gets a good rap in the book, has shown that exercise can delay onset of the devastating symptoms of Huntington’s disease in rats. Exercise and an enriched environment of interconnected burrows have also improved Parkinson’s symptoms in rats. And a recent study of people with brain injury found social connection, puzzles, reading and exercise fostered cell growth in the hippocampus, the brain’s memory powerhouse.
Moving on to a mind-shifting chapter on the healing power of light I was reminded why Doidge is such a bright star in the firmament of scientific storytelling. The Romans embraced “heliotherapy” when they built their villas around light-filled atria and enshrined access to solar rays with “right-to-light” laws. Many body cells are light-sensitive – lights have been used to treat jaundiced neonates for decades – and the new discipline of photomedicine suggests certain wavelengths can promote healing. Even so, after sourcing a number of reviews I couldn’t match Doidge’s enthusiasm for low-level laser therapy as a cure for everything from stroke to insomnia.
The second half of the book is almost entirely given over to the work of two men. Moshe Feldenkrais was an Israeli physicist and judo black belt whose eponymous method blames learned patterns of movement for back, shoulder and neck pain, and even the spastic paralysis of cerebral palsy. Feldenkrais practitioners claim cure through cultivating awareness of movement and retraining habitual actions.
Alfred Tomatis was a French ear, nose and throat specialist who linked dyslexia, depression and autism to developmental problems with hearing. He claimed some children can’t hear higher frequency sounds including their mother’s voice and are overwhelmed by low tones the body links to primal predators. This leaves them on edge and unable to form social relationships. Tomatis prescribed recordings of the mother’s voice, Mozart and Gregorian chants.
Despite Doidge’s painstaking explanation of both methods my baloney detectors whined incessantly through this section, especially when the theory was backed by recovery after stellar recovery. Contorted by spasticity, Sydney couldn’t roll over at five months but after Feldenkrais walked at 27 months and now, aged nine, speaks three languages. Profoundly brain-damaged at 18 months, Will underwent the Tomatis method and by four was reading at the level of a six year old.
These stories are moving and undoubtedly authentic but a detailed elaboration of theory doesn’t cement either method as the author of cure. These are fringe treatments upon which Doidge almost retrofits neuroplasticity while his usual armamentarium of brain data goes missing in action. For me this was a departure from Doidge’s first book whose lead players, Bach-y-Rita and fellow neuroscientists Michael Merzenich and Edward Taub, had their radical ideas accepted through hard-won publication in top-tier journals.
The deep wonder of neuroplasticity is that damaged brains can repair by co-opting healthy cells to take over lost functions. Doidge, more than any other writer, has shown us how we can seize control of our brain’s destiny with focused attention on tailored tasks while primed with sleep, exercise and a healthy diet.
The less self-possessed might turbo-charge neuroplasticity with a mini incarnation of Bach-y-Rita’s chair that stimulates the tongue with electrodes. And one day we may use “enviromimetic” drugs that distil an enriched environment into a single pill.
But the best counsel for people with injured brains is cautious optimism because, as Doidge acknowledges, “false hope and false despair are worthy rivals in doing inadvertent harm”. Meanwhile let’s hope the ebullience of Norman Doidge is soon justified by the dictates of hard evidence.
Paul Biegler is a physician, philosopher and adjunct research fellow in Bioethics at Monash University