How To Fix A Damaged Brain


Norman Doidge looked exhausted. It must take it out of you, being one of the most popular drawcards at the Sydney Writers’ Festival. He had just given yet another lecture to yet another capacity crowd, and then spent an hour signing yet more copies of his book, The Brain That Changes Itself, for yet another throng of admirers.

Backstage at the Sydney Theatre he sank into an armchair and shut his eyes against the fluorescent lights of the dressing room. When he opened them, he looked so tired that a nice person, a considerate person, would tell him to forget the interview — just take a breather, settle back into that armchair with a nice herbal tea, far from the madding crowd.

Unfortunately for Doidge, I was only willing to let him take a breather for as long as it took to figure out the buttons on my mp3 recorder. Then I wanted to hear about neuroplasticity.

Norman Doidge is a psychiatrist and psychoanalyst, a member of the research faculty at Columbia University and the University of Toronto’s department of psychiatry. In The Brain That Changes Itself, he tells the stories of doctors, researchers and patients who are exploring the implications of neuroplasticity — a way of understanding the brain that opens possibilities for people with a wide range of medical conditions, and indeed people with no particular medical condition at all, other than age. As Doidge said when I commented on his packed lectures, neuroplasticity "has implications for everybody: it addresses issues of chronic pain, psychiatry, learning disorders, stroke treatment, brain injury, diffuse brain damage, the aging brain, our understanding of human nature."

Doidge and other writers on neuroplasticity reject what they call the "neurological nihilism" of seeing the brain as a machine that runs down over time, and may be damaged beyond repair by an accident or a stroke. Instead, they talk about the brain as an organ that restructures itself according to how it is used, and one that has the potential to "rewire" itself to adapt to damage.

Doidge’s book describes blind people learning to see through the use of a camera connected to a strip of electrodes slipped over the tongue; elderly people turning back their neurological clock to regain the sharp memories they had decades before; and survivors of trauma who have used neuroplasticity as a form of psychoanalysis. Doidge even describes how neuroplasticity provides researchers with a way of understanding and addressing the pain that amputees feel in their "phantom limbs".

They are intriguing stories, and after reading them, I wanted to hear more.

But I didn’t just want to hear Norman Doidge talk about neuroplasticity. I want neuroplasticity to work for me. More specifically, I wanted to be told that my brain’s amazing plasticity will enable it to adapt to the lesions that appear as a scattering of white dots on my MRIs — a sign of remitting-relapsing multiple sclerosis — not too much of a problem right now, although my balance is not always what it could be. (As I made my unsteady way around the Writers’ Festival, I found myself grabbing the shoulders of friends, festival staff, and passers-by, just to stop myself from tipping into the harbour, or onto Bob Ellis.)

I want to find a way to regain control of my brain, to reassert its mastery over my body, over my entire self. Doidge’s book seems to offer something that I want so badly that I don’t trust my own judgment. A few more stressful doctor’s appointments, and I’ll be seeking reassurance from astrologers, scientologists, and Appalachian snake-handlers

Norman Doidge seems a safer bet than any of those, but I am a dumb social scientist — what do I know about neurology? I have to admit that I am more scared of ending up as an object of ridicule than I am of ending up in a wheelchair, so even though I desperately want him to be right, I’m going to make sure I’ve got the story as straight as possible. If neuroplasticity turns out to be the next "magic water" story, well, I don’t want to be Paul Sheehan.

I was so concerned my hopes had blunted my analytical power that I compensated by adopting a skeptical tone that bordered on hostility. I asked Doidge how he deals with the fallout of having written a book that has raised the hopes of so many people, and how he negotiates transforming such hope into realistic expectations.

Doidge responded graciously: "By the way that I wrote the book. There is a noble tradition in medicine which says that when people dare not face the inevitability of death, or the power of disease, and when people are pursuing vain hopes, that the physician should take the side of reality. So that if someone is very ill, you tell them so, and you work towards helping them to find acceptance. If they are dying, you tell them to set their affairs in order, so they can say their goodbyes. But with neurological and psychiatric illnesses — where rehabilitation and all the effort involved may be of value — we had better be sure that we are right when we tell people there’s nothing we can do."

"I’ve described some very dramatic cases, because they illustrate just what neuroplasticity means for our understanding of the brain. They have a resonance that goes beyond individual clinical vignettes. But I would not claim that all strokes — and there are many different kinds of strokes — are anything but cerebral catastrophe. To get back some of what is lost in the stroke requires that the person can pay attention, has not lost the part of the brain that is helpful for motivation, and a number of other things must be in place. So many patients can’t be helped — but that said, it so happens that the commonest form of stroke that people survive, where a person is paralysed on one side, can be helped by constraint-induced therapy, a neuroplastically-based treatment."

"People have a right to protect themselves from false hope, and should ask questions. I would say to read the book carefully, and they will see that the treatments I described were all hard work and that the limits of plasticity were respected just as much as its potential."

Doidge is right when he says that the concept of neuroplasticity provides much food for thought for even healthy brains. If our brains can be so profoundly changed according to how we use them — that in a very real sense our brains are what they eat — then many of us are eating way too much junk brain-food. As Doidge says, "It’s no accident that TV has so much downmarket content, because as Marshall McLuhan wrote, ‘the medium is the message’."

Put simply, our brains respond differently not only to different information, but to the way in which the information is transmitted. "Brain scans show that when you read a book, as opposed to when you listen to it, different parts of the brain analyse the meaning for each. Absorbing information aurally rather than through print exercises the auditory cortex, and McLuhan wrote about how reading books teaches people to make linear arguments, and therefore emphasises the role of reason.

Aural and print media cultures have different impacts upon the mind and brain. Oral traditions, and traditions that value the written word — in contrast to those such as our own that value electronic media — wire up processors differently. We know that Orthodox Jewish children — who are very much in a literary culture — can memorise vast amounts of the Torah and Talmud, just as Muslim children memorise the Qur’an, and until the 1960s, children in our own culture would memorise classical poetry as part of their education. And Homer appears to have been transmitted orally as well by the ancient Greeks. These extraordinary memory skills seem almost beyond belief to those of us who have lost such skills."

Doidge is careful to place caveats on his claims for neuroplasticity, warning that "we should not go from a view of the brain that is overly rigid to seeing it as infinitely plastic. Human beings have a tendency to swing between improbable hopes and improbable fears."

It’s a tendency that I recognise in myself. After my discussion with Doidge, I’m swinging towards improbable hope, filled with an evangelical fervour to persuade everybody to learn a new language and acquire new skills — brain-exercise that Doidge says can help keep our brains fit as we age.

Next week, I’ll probably swing back towards improbable fear. If you want to contact me, I’ll be striding down the aisle of an Appalachian church, clutching a serpent in each hand.

Launched in 2004, New Matilda is one of Australia's oldest online independent publications. It's focus is on investigative journalism and analysis, with occasional smart arsery thrown in for reasons of sanity. New Matilda is owned and edited by Walkley Award and Human Rights Award winning journalist Chris Graham.