Tuesday, July 26, 2016

The Brain that Changes Itself, by Norman Doidge

Book cover The Brain that Changes Itself is a remarkable book for several reasons. M.D. Norman Doidge presents several cases of extraordinary events that constitute proof for the book's thesis: that the brain is plastic, easy to remold, to adapt to the data you feed it. What is astonishing is that, while these cases are not new and are by far not the only ones out there, the medical community is clinging to the old belief that the brain is made of clearly localized parts that have specific roles. Doidge is trying to change that.

The ramifications of brain plasticity are wide spread: the way we learn or unlearn things, how we fall in love, how we adapt to new things and we keep our minds active and young, the way we would educate our children, the minimal requirement for a computer brain interface and so much more. The book is structured in 11 chapters and some addendums that seem to be extra material that the author didn't know how to properly format. A huge part is acknowledgements and references, so the book is not that large.

These are the chapters, in order:
  • Chapter 1 - A Woman Perpetually Falling. Describes a woman that lost her sense of balance. She feels she is falling at all times and barely manages to walk using her sight. Put her in front of a weird patterned rug and she falls down. When sensors fed information to an electrode plate on her tongue she was able to have balance again. The wonder comes from the fact that a time after removing the device she would retain her sense. The hypothesis is that the receptors in her inner ear were not destroyed, by damaged, leaving some in working order and some sending incorrect information to the brain. Once a method to separate good and bad receptors, the brain immediately adapted itself to use only the good ones. The doctor that spearheaded her recovery learned the hard way that the brain is plastic, when his father was almost paralyzed by a stroke. He pushed his father to crawl on the ground and try to move the hand that wouldn't move, the leg that wouldn't hold him, the tongue that wouldn't speak. In the end, his father recovered. Later, after he died from another stroke while hiking on a mountain, the doctor had a chance to see the extent of damage done by the first stroke: 97% of the nerves that run from the cerebral cortex to the spine were destroyed.
  • Chapter 2 - Building Herself a Better Brain. Barbara was born in the '50s with an brain "asymmetry". While leaving a relatively normal life she had some mental disabilities that branded her as "retarded". It took two decades to stumble upon studies that showed that the brain was plastic and could adapt. She trained her weakest traits, the ones that doctors were sure to remain inadequate because the part in the brain "associated" with it was missing and found out that her mind adapted to compensate. She and her husband opened a school for children with disabilities, but her astonishing results come from when she was over 20 years old, after years of doctors telling her there was nothing to be done.
  • Chapter 3 - Redesigning the Brain. Michael Merzenich designs a program to train the brain against cognitive impairments or brain injuries. Just tens of hours help improve - and teach people how to keep improving on their own - from things like strokes, learning disabilities, even conditions like autism and schizophrenia. His work is based on scientific experiments that, when presented to the wider community, were ridiculed and actively attacked for the only reason that they went against the accepted dogma.
  • Chapter 4 - Acquiring Tastes and Loves. Very interesting article about how our experiences shape our sense of normalcy, the things we like or dislike, the people we fall for and the things we like to do with them. The chapter also talks about Freud, in a light that truly explains how ahead of his time he was, about pornography and its effects on the brain, about how our pleasure system affects both learning and unlearning and has a very interesting theory about oxytocin, seeing it not as a "commitment neuromodulator", but as a "demodulator", a way to replastify the part of the brain responsible for attachments, allowing us to let go of them and create new ones. It all culminates with the story of Bob Flanagan, a "supermasochist" who did horrible things to his body on stage because he had associated pain with pleasure.
  • Chapter 5 - Midnight Resurrection. A surgeon has a stroke that affects half of his body. Through brain training and physiotherapy, he manages to recover - and not gain magical powers. The rest of the chapter talks about experiments on monkeys that show how the feedback from sensors rewires the brain and how what is not used gets weaker and what is used gets stronger, finer and bigger in the brain.
  • Chapter 6 - Brain Lock Unlocked. This chapter discusses obsessions and bad habits and defective associations in the brain and how they can be broken.
  • Chapter 7 - Pain: The Dark Side of Plasticity. A plastic brain is also the reason why we strongly remember painful moments. A specific case is phantom limbs, where people continue to feel sensations - often the most traumatic ones - after limbs have been removed. The chapter discusses causes and solutions.
  • Chapter 8 - Imagination: How Thinking Makes It So. The brain maps for skills that we imagine we perform change almost as much as when we are actually doing them. This applies to mental activities, but also physical ones. Visualising doing sports prepared people for the moment when they actually did it. The chapter also discusses how easily the brain adapts to using external tools. Brain activity recorders were wired to various tools and monkeys quickly learned to use them without the need for direct electric feedback.
  • Chapter 9 - Turning Our Ghosts into Ancestors. Discussing the actual brain mechanisms behind psychotherapy, in the light of what the book teaches about brain plasticity, makes it more efficient as well as easier to use and understand. The case of Mr. L., Freud's patient, who couldn't keep a stable relationship as he was always looking for another and couldn't remember his childhood and adolescence, sheds light on how brain associates trauma with day to day life and how simply separating the two brain maps fixes problems.
  • Chapter 10 - Rejuvenation. A chapter talking about the neural stem cells and how they can be activated. Yes, they exist and they can be employed without surgical procedures.
  • Chapter 11 - More than the Sum of Her Parts. A girl born without her left hemisphere learns that her disabilities are just untrained parts of her brain. After decades of doctors telling her there is nothing to be done because the parts of her brain that were needed for this and that were not present, she learns that her brain can actually adapt and improve, with the right training. An even more extreme case than what we saw in Chapter 2.

There is much more in the book. I am afraid I am not making it justice with the meager descriptions there. It is not a self-help book and it is not popularising science, it is discussing actual cases, the experiments done to back what was done and emits theories about the amazing plasticity of the brain. Some things I took from it are that we can train our brain to do almost anything, but the training has to follow some rules. Also that we do not use gets discarded in time, while what is used gets reinforced albeit with diminishing efficiency. That is a great argument to do new things and train at things that we are bad at, rather than cement a single scenario brain. The book made me hungry for new senses, which in light of what I have read, are trivial to hook up to one's consciousness.

If you are not into reading, there is an one hour video on YouTube that covers about the same subjects: