Wednesday, July 29

The Brain That Changes Itself - Norman Doidge

I can think of no better opening than Doidge's:

This book is about the revolutionary discovery that the human brain can can change itself, as told through the the stories of the scientists, doctors and patients who have together brought about these astonishing transformations.
Subtitled Stories of personal triumph from the frontiers of brain science, Doidge examines the work of a multitude of scientists who are, in separate areas of practice, overturning the long-held notion that the brain is hard wired and essentially immutable. Increasingly, says Doidge, we are discovering that the human brain is far more plastic, or mouldable, than we previously realised.
The copy I borrowed from a friend has tags sticking out from practically every page, and it's sadly beyond my ability to be able to convey all the aspects Doidge covers in this review. Instead I'll cite some of the sections that jumped out at or stuck with me, starting with senses we don't recognise we have until they're lost.
Doidge discusses the case of a woman who, as a result of treatment with gentamycin, an aminoglycoside antibiotic, lost her ability to maintain equilibrium - for five years she felt as though she was falling every waking moment, even if she was lying down. Related to proprioception (the awareness of how you're oriented in space and where your body parts are in relation to one another), equilibrioception is taken for granted by most of us. She reported thinking often of suicide, which is apparently not uncommon for sufferers of this condition. Doidge describes a revolutionary treatment that allowed her to recalibrate her spatial awareness using a complicated feedback system involving a helmet, tongue plate and oral sensations like fizzing champagne. The actual technique is too long to discuss here but fascinating, albeit considerably over my head. What's fascinating is that, with increased use of the treatment the woman had normal equilibrioception for increasing lengths of time when away from the treatment - despite permanent damage to her inner ear, and five years of altered function, she regained normal sensation.
I discovered the pioneering work of Paul Bach-y-Rita, a scientist and rehabilitation physician whose practice was informed by his father Pedro's recovery from what they later discovered was a significant stroke - contrary to most rehab practices Pedro taught himself how to walk again, beginning (as infants do) by crawling. Bach-y-Rita says "I can connect anything to anything" - new neurological pathways can be made via a multitude of circuits.
There are a number of other case studies and therapies discussed, from the Fast ForWord program that has had astonishing success with brain development conditions like autism to the way a shift from memorised or rote learning is linked with a variety of learning disabilities.
Doidge discusses new findings about the addictivity of internet pornography, which is apparently a real and significant phenomenon that causes significant changes in the way the brain is wired and operates. In an unrelated section I also learned that women are generally better than men at spatial recognition, which is why men can have trouble finding objects (like socks or things in the fridge) that are in plain sight.
At times controversial (there's a long section criticising animal rights association PETA), Doidge's message is clear throughout: the brain has far more potential than we believed; the impact of dementing illnesses can be reduced; and cross-fertilisation of ideas and disciplines is an essential component in advancing science - Doidge advocates unstructured early college courses for this reason. He revisits the well-trodden but still relevant issue of ideas that conflict with the dominant paradigm are ignored, ridiculed or doubted by the mainstream of scientists. In this case it's the revolutionary theory that challenged localisation theory, or the idea that neuro-specialisation is absolute, but he discusses other cases also.
Doidge also emphasises reality as culturally constructed - from the contemporary 'ew' factor of Elizabethan women keeping an unpeeled apple in their armpit for their lover, to cultural mores on when to interrupt someone speaking and how far away to stand - all of which is interesting to me as a social sciences student.
He looks at how the brain 'maps' activities, and how these maps can both limit normal function, and can be redrawn. Examples Doidge discusses include chronic pain and musicians losing the ability to move fingers independently - and be redrawn. Unlearning, he stresses, is harder than learning, but possible.
Neuroplasticity is far from a panacea for all neurological conditions, and research into it is still fledgling, but it's fascinating and inspiring, and I'm interested in seeing what happens next. I work in the neurosciences and am also interested in seeing how this will affect clinical practices, particularly as the work Doidge discusses takes place almost exclusively in the US. I do know that, if I sustain a severe neurological assault like a stroke I want to the centre Doidge recommends. - Alex

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