Preface

THIS BOOK IS about the discovery that the human brain has its own unique way of healing, and that when it is understood, many brain problems thought to be incurable or irreversible can be improved, often radically, and in a number of cases, as we shall see, cured. I will show how this process of healing grows out of the highly specialized attributes of the brain—attributes once thought to be so sophisticated that they came at a cost: that the brain, unlike other organs, could not repair itself or restore lost functions. This book will show that the reverse is true: the brain’s sophistication provides a way for it to repair itself and to improve its functioning generally.

This book begins where my first book, The Brain That Changes Itself, ended. That book described the most important breakthrough in under- standing the brain and its relationship to the mind since the beginning of modern science: the discovery that the brain is neuroplastic. Neuro- plasticity is the property of the brain that enables it to change its own structure and functioning in response to activity and mental experience. That book also described many of the first scientists, doctors, and patients to make use of this discovery to bring about astonishing transformations in the brain. Until then, these transformations had been almost inconceivable, because for four hundred years, the mainstream view of the brain was that it could not change; scientists thought the brain was like a glorious machine, with parts, each of which performed a single mental function, in a single location in the brain. If a location was damaged—by a stroke or an injury or a disease—it could not be fixed because machines cannot repair themselves or grow new parts. Scientists also believed the circuits of the brain were unchangeable or “hardwired,” meaning that people born with mental limitations or learning disorders were in all cases des- tined to remain so. As the machine metaphor evolved, scientists took to describing the brain as a computer and its structure as “hardware” and believed the only change that aging hardware undergoes is that it de- generates with use. A machine wears out: use it, and lose it. Thus, at- tempts by older people to preserve their brains from decline by using mental activity and exercise were seen as a waste of time.

The neuroplasticians, as I called the scientists who demonstrated that the brain is plastic, refuted the doctrine of the unchanging brain. equipped, for the first time, with the tools to observe the living brain’s microscopic activities, they showed that it changes as it works. In 2000 the Nobel Prize in Physiology or Medicine was awarded for demonstrating that as learning occurs, the connections among nerve cells increase. The scientist behind that discovery, Eric Kandel, also showed that learning can “switch on” genes that change neural structure. Hundreds of studies went on to demonstrate that mental activity is not only the product of the brain but also a shaper of it. Neuroplasticity restored the mind to its rightful place in modern medicine and human life.

THE INTELLECTUAL REVOLUTION DESCRIBED IN The Brain That Changes Itself was the beginning. Now, in this book, I tell of the astounding advances of a second generation of neuroplasticians who, be- cause they did not have the burden of proving the existence of plasticity, have been liberated to devote themselves to understanding and using plasticity’s extraordinary power. I have traveled to five continents to meet with them—the scientists, clinicians, and their patients—in order to learn their stories. Some of these scientists work in the cutting-edge neuroscience labs of the Western world; others are clinicians who have applied that science; and still others are clinicians and patients who together stumbled upon neuroplasticity and perfected effective treatment techniques, even before plasticity had been demonstrated in the lab.

One patient after another in this book had been told they would never get better. For decades, the term healing was seldom used in connection with the brain, as it was with other organ systems, such as the skin or the bones or the digestive tract. While organs such as the skin, liver, and blood could repair themselves by replenishing their lost cells using stem cells to function as “replacement parts,” no such cells were found in the brain, despite decades of searching. Once neurons were lost, no evidence could be found that they were ever replaced. Scientists tried to find ways to explain this in evolutionary terms: in the course of evolving into an organ with millions of highly specialized circuits, the brain simply lost the ability to supply those circuits with replacement parts. even if neuronal stem cells—baby neurons—were to be found, how, it was wondered, would they be of any help? How would they ever integrate into the sophisticated but dizzyingly complex circuits of the brain? Because it wasn’t thought possible to heal the brain, most treatments used medication to “prop up the failing system” and decrease symptoms by temporarily changing the chemical balance in the brain. But stop the medication, and the symptoms would return.

It turns out that the brain is not too sophisticated for its own good after all. This book will show that this very sophistication, which involves brain cells being able to constantly communicate electrically with one another, and to form and reform new connections, moment by moment, is the source of a unique kind of healing. True, in the course of specializing, important reparative abilities, available to other organs, were lost. But some were gained, and they are mostly expressions of the brain’s plasticity.

EACH OF THE STORIES IN this book will illustrate a different facet of these neuroplastic ways of healing. The more I immersed myself in these different kinds of healing, the more I began to make distinctions among them and to see that some of the approaches targeted different stages of the healing process. I have proposed (in Chapter 3) a first model of the stages of neuroplastic healing, to help the reader see how they all fit together.

Just as the discoveries of medication and surgery led to therapies to relieve a staggering number of conditions, so does the discovery of neuroplasticity. The reader will find cases, many very detailed, that may be relevant to someone who has, or cares for someone who has experienced, chronic pain, stroke, traumatic brain injury, brain damage, Parkinson’s disease, multiple sclerosis, autism, attention deficit disorder, a learning disorder (including dyslexia), a sensory processing disorder, a developmental delay, a part of the brain missing, Down syndrome, or certain kinds of blindness, among others. In some of these conditions, complete cures occur in a majority of patients. In other cases, illnesses that are moderate to severe can sometimes become milder. I shall de- scribe parents who were told that their autistic or brain-damaged children would never complete a normal education, but who saw them do so, graduate, even go to university, become independent, and develop deep friendships. In other situations, an underlying serious illness re- mains, but its most troubling symptoms are radically reduced. In still others, the risk of getting an illness such as Alzheimer’s (in which the brain’s plasticity decreases) is significantly reduced (discussed in Chapters 2 and 4), and ways of increasing plasticity are introduced.

MOST OF THE INTERVENTIONS IN this book make use of energy— including light, sound, vibration, electricity, and motion. These forms of energy provide natural, noninvasive avenues into the brain that pass through our senses and our bodies to awaken the brain’s own healing capacities. each of the senses translates one of the many forms of energy around us into the electrical signals that the brain uses to operate. I will show how it is possible to use these different forms of energy to modify the patterns of the brain’s electrical signals and then its structure.

In my travels, I saw examples of sounds played into the ear, to treat autism successfully; vibration on the back of the head, to cure attention deficit disorder; gentle electrical stimulators tingling on the tongue, to reverse symptoms of multiple sclerosis and heal stroke; light shone onto the back of the neck to treat brain injury, into the nose to help sleep, or administered intravenously to save a life; and the slow, soft movements of the human hand over the body to cure a girl, born missing a huge section of her brain, of cognitive problems and near paralysis. I will show how all these techniques stimulate and reawaken dormant brain circuits. Among the most effective ways to do so is by using thought itself to stimulate brain circuits, which is why most of the interventions I witnessed paired mental awareness and activity with the use of energy.

The use of energy and the mind together to heal, while novel in the West, has of course been central to traditional eastern medicine. Only now are scientists beginning to glimpse how these traditional practices may work in terms of Western models, and it is remarkable the extent to which almost all the neuroplasticians I visited were deepening their understanding of how to use neuroplasticity by linking insights from Western neuroscience to insights from eastern health practices, including traditional Chinese medicine, ancient Buddhist meditation and visualization, martial arts such as tai chi and judo, yoga, and energy medicine. Western medicine has long dismissed eastern medicine—practiced by billions of people for millennia—and its claims, often because it seemed too far-fetched to accept that the mind can alter the brain. This book will show how neuroplasticity provides a bridge between humanity’s two great but hitherto estranged medical traditions.

IT MAY SEEM ODD THAT the ways of healing described in this book so frequently use the body and the senses as primary avenues to pass energy and information into the brain. But these are the avenues the brain uses to connect with the world, and so they provide the most natural and least invasive way to engage it.

One reason clinicians have overlooked using the body to treat the brain is the recent tendency to see the brain as more complex than the body and as the essence of who we are. In this common view, “We are our brains,” the brain is the master controller, and the body is its sub- ject, there to follow the master’s orders.

This view was accepted because 150 years ago neurologists and neuroscientists, in one of their greatest accomplishments, began to demonstrate the ways in which the brain can control the body. They learned that if a stroke patient couldn’t move his foot, the problem wasn’t in his foot, as he felt it to be, but in the brain area that controlled the foot. Through the nineteenth and twentieth centuries, neuroscientists mapped where the body was represented in the brain. But the occupational hazard of brain mapping was to begin to believe that the brain was “where all the action is”; some neuroscientists began to talk about the brain almost as though it were disembodied, or as though the body were a mere appendage to it, mere infrastructure to support the brain.

But that view of an imperial brain is not accurate. Brains evolved many millions of years after bodies did, to support bodies. Once bodies had brains, they changed, so body and brain could interact and adapt to each other. Not only does the brain send signals to the body to influence it; the body sends signals to the brain to affect it as well, and thus there is constant, two-way communication between them. The body abounds with neurons, the gut alone having 100 million. Only in anatomy textbooks is the brain isolated from the body and confined to the head. In terms of the way it functions, the brain is always linked to the body and, through the senses, to the world outside. Neuroplasticians have learned to use these avenues from the body to the brain to facilitate healing. Thus, while a person who has had a stroke may not be able to use his foot because the brain is damaged, moving the foot can, at times, awaken dormant circuits in the injured brain. The body and mind become partners in the healing of the brain, and because these approaches are so noninvasive, side effects are exceedingly rare.

IF THE IDEA OF POWERFUL and yet noninvasive treatments for brain problems seems too good to be true, it is for historical reasons. Modern medicine began with modern science, which was conceived as a technique for the conquest of nature, for—as one of its founders, Francis Bacon, put it—“the relief of man’s estate.” This idea of conquest gave rise to the many military metaphors that are used in everyday medical practice, as Abraham Fuks, a former dean of medicine at McGill University, shows. Medicine be- came a “battle” against disease. Drugs are “magic bullets”; medicine fights “the war against cancer” and “combats AIDS,” with “doctor’s orders,” from the “therapeutic armamentarium.” This “armamentarium,” as physicians call their bag of therapeutic tricks, honors invasive high-tech treatments as more scientifically serious than noninvasive ones. There is definitely a time for a martial attitude in medicine, especially in emergency medicine: if a blood vessel in the brain bursts, the patient needs invasive surgery and a neurosurgeon, with nerves of steel, to operate. But the metaphor creates problems too, and the very idea that it is possible to “conquer” nature is a fond, naïve hope.

In this metaphor, the patient’s body is less an ally than the battle- field, and the patient is rendered passive, a helpless bystander, as he watches the confrontation that will determine his fate between the two great antagonists, the doctor and the disease. The attitude has even come to influence the ways many physicians now talk to their patients, interrupting their story as they speak, because often the high-tech phy- sician is less interested in their narrative than in their lab test.

NEUROPLASTIC APPROACHES, ON THE OTHER hand, require the active involvement of the whole patient in his or her own care: mind, brain, and body. Such an approach recalls the heritage not only of the east but of Western medicine itself. The father of scientific medicine, Hippocrates, saw the body as the major healer, and the physician and patient working together with nature, to help the body activate its own healing capacities.

In this approach, the health professional not only focuses on the patient’s deficits, important as they may be, but also searches for healthy brain areas that may be dormant, and for existing capacities that may aid recovery. This focus doesn’t advocate naïvely replacing the neurological nihilism of the past with an equally extreme neurological utopianism— replacing false pessimism with false hope. To be valuable, discoveries of new ways of healing the brain do not have to guarantee that all patients can be helped all the time. And often, we simply don’t know what will happen, until the person, with the guidance of a knowledgeable health professional, gives the new approaches a try.

The word heal comes from the Old english haelan and means not simply “to cure” but “to make whole.” The concept is very far from the idea of “cure” in the military metaphor, with its associated ideas of di- vide and conquer.

What follow are stories of people who have transformed their brains, recovered lost parts of themselves, or discovered capacities within that they never knew they had. But the true marvel is less the techniques than the way that, through millions of years, the brain has evolved, with sophisticated neuroplastic abilities and a mind that can direct its own unique restorative process of growth.