"The Brain's Way of Healing" - A Book Review
Posted May 13, 2022 by Matthew Romans
Norman Doidge, M.D., is a psychiatrist and psychoanalyst at the Toronto Institute of Psychoanalysis. He has written over 170 articles, many of which are academic papers on neuroplasticity, so he has extensive knowledge and experience on the subject. Dr. Doidge first wrote "The Brain That Changes Itself" in 2007 (which, in the interest of full disclosure, I have not read), and he followed that up with "The Brain's Way of Healing" in 2015. This book takes up the mantle where the previous book left off, and the central concept is that of the aforementioned neuroplasticity, which is "the ability of neural networks in the brain to change through growth and reorganization." Neuroplasticity is a relatively new theory in the study of how the brain works, and for many years scientists believed that the brain's abilities were static, particularly in the case of traumatic brain injury and genetic disorders. While this field is still evolving, there is a significant amount of scientific and anecdotal evidence presented in this book that supports Dr. Doidge's (and many other scientists') theories, and gives hope to people suffering from numerous brain difficulties.
I think it is important to briefly discuss what Dr. Doidge calls "the stages of neuroplastic healing." The first stage is neurostimulation. In this stage dormant circuits in the injured brain are revived, so that homeostasis can be achieved. Next is neuromodulation. This is where the balance between neural excitation and inhibition is restored, and the noisy brain is quieted. The brain cannot heal if it is stuck in a hyper-anxious state. The third stage is neurorelaxation, and here is where toxic buildups and waste products can be discharged from the brain through the cerebral spinal fluid. It also leads to more restful sleep. Finally, neurodifferentiation and learning occur. The brain is now rested and the circuits can regulate themselves.
The first chapter of the book discusses the nature of chronic pain and contrasts it with acute pain. Dr. Doidge talks with Michael Moskowitz, M.D., who is a psychiatrist-turned-pain-specialist who has had his own experiences dealing with chronic pain (he once suffered a broken femur). The author sums up the difference between acute and chronic pain by saying, "Acute pain is a sensation we feel, an 'input' that comes into the brain from the bottom up, from our sense receptors. But chronic pain is more complex and more a top-down process." Dr. Moskowitz believes that a person suffers from chronic pain because the cause of the acute pain has never truly been remedied, which causes damage to the central nervous system. He is convinced that, "The body's alarm system is stuck in the 'on' position." Our brain has "maps" for pain that get damaged and continuously send false alarms; we think that the problem is in our body, when it's really in our brain. Dr. Moskowitz has his patients work to rewire and repair those maps by simply performing those activities that are painful, as a way of counter stimulating the brain and weakening the pain circuits. He also uses visualization techniques in order to stimulate neurons and activate portions of the brain that have been underutilized. Slowly but surely, the majority of his patients have seen their chronic pain decrease and even disappear. This is a far more effective and safer strategy than using opioid drugs to simply treat the symptoms. As Dr. Moskowitz says, "I don't believe in pain management anymore. I believe in trying to cure persistent pain."
Dr. Doidge profiles a South African man named John Pepper, who was diagnosed with Parkinson's disease in the mid 1990's, although he had first started showing symptoms in the late 1960s. Medications that he was given to treat the symptoms of the disease had started to wear off after about five years, and his abilities had slowly started to diminish. The cognitive and physical decline in Parkinson's patients is often self-fulfilling. As their abilities recede, there can be less incentive to try and use what they have, which often sends them spiraling further downhill. As the author says, "...Our brains are more likely to waste away from underuse than to wear away from overuse." The same is likely true for our physical capabilities. Pepper decided to start a regular walking program, beginning slowly and covering short distances (with days in between for recovery) before working his way up to greater intensity and mileage. Because the effects of Parkinson's had done damage to his basal ganglia (the brain's subcortical nuclei that control motor learning and executive functions), Pepper had to do this very consciously and deliberately, in order to avoid injury and maximize the benefit. This regimen has worked wonders for him, arresting his Parkinson's symptoms and giving him a freedom of life that many sufferers of the disease could only hope to attain. In order to stimulate his brain, he also does crossword puzzles, plays chess, and learns French. He finds that when he decreases his activity his symptoms increase, so he stays as consistent as possible. Movement has been shown to be an effective treatment for other degenerative diseases, such as Huntington's and Alzheimer's. As Dr. Doidge puts it, "Perhaps the worst thing a patient can do, on getting the diagnosis, is to decrease their activity."
Light therapy and music therapy are emerging treatments that are discussed in detail. Low-level lasers help the body to harness its own energy, improve circulation, trigger the development of collagen tissue (which makes bone, tendons, ligaments, and even skin), and promote healing in a variety of conditions, such as fibromyalgia, joint injuries, traumatic brain injury, and some psychiatric disorders. Better still, there are no side effects. The positive effects of low-intensity lasers have been known to scientists since 1965, yet sadly, the FDA did not approve its use in the United States until 2002. Just think of how many lives could have been improved in that time frame! Music therapy has also been shown to be an effective treatment for children with dyslexia and autism. Dr. Doidge details the work of Alfred Tomatis and Paul Madaule, who have made great strides in the arena of music therapy. According to the author, this therapy works because, "The music in sound therapy turns on and enhances the connection between brain areas that process positive reward (which gives us a feeling of pleasure when we accomplish something) and the insula, a cortical area of the brain that is involved in paying attention." He adds that, "Since neurons fire in unison to music, music is a way to change the rhythms of the brain." Music therapy has been shown to improve the cognitive and social abilities of children with Down's Syndrome as well.
Exercise and lifestyle are also mentioned in the book, which was refreshing to see. Dr. Doidge lists five factors that will promote the general health of neurons. These include exercise (which is, "...the most powerful contributor to decreased risk of both general cognitive decline and dementia."), a healthy diet, normal body weight (defined as a BMI of between 18 and 25), low alcohol intake, and no smoking. These are the things that we should be doing every day. Dr. Doidge appropriately quotes late author Norman Mailer, "Every moment of one's existence one is growing into more or retreating into less. One is always living a little more or dying a little bit." If we don't use it, we lose it.
This book is pretty heavy reading at times. It took me a while to finish, and even now I'm not sure that I absorbed all the information, but "The Brain's Way of Healing" solidifies my belief in exploring ideas outside of the traditional viewpoint of the medical establishment. Dr. Doidge writes very well; he takes a complex subject and makes it interesting by relating stories of real people and their astonishing recoveries that traditional medicine did not think were possible. I see some distinct parallels between the growth mindset (the viewpoint that intelligence and achievement are not simply fixed by genetics) and neuroplasticity (where the brain can improve and heal itself in spite of injury or genetic defect). The information contained in this book can change the way we think about what the brain can do and how it can recover from physical and emotional trauma, and it shows that great things can be achieved with a combination of technology and grit. It is worth reading and just may provide you with some inspiration.