For
years she had tried to be the perfect wife and mother but now,
divorced, with two sons, having gone through another break-up and in
despair about her future, she felt as if she’d failed at it all, and she
was tired of it. On 6 June 2007. Debbie Hampton, of Greensboro, North
Carolina, took an overdose. That afternoon, she’d written a note on her
computer: “I’ve screwed up this life so bad that there is no place here
for me and nothing I can contribute.” Then, in tears, she went upstairs,
sat on her bed, swallowed her pills with some cheap Shiraz and put on a
Dido CD to listen to as she died. As she lay down, she felt triumphant.
But
then she woke up again. She’d been found, rushed to hospital, and
saved. “I was mad,” she says. “I’d messed it up. And, on top of that,
I’d brain-damaged myself.” After Debbie emerged from her one-week coma,
her doctors gave her their diagnosis: encephalopathy. “That’s just a
general term which means the brain’s not operating right,” she says. She
couldn’t swallow or control her bladder, and her hands constantly
shook. Much of the time, she couldn’t understand what she was seeing.
She could barely even speak. “All I could do was make sounds,” she says.
“It was like my mouth was full of marbles. It was shocking, because
what I heard from my mouth didn’t match what I heard in my head.” After a
stay in a rehabilitation centre, she began recovering slowly. But, a
year in, she plateaued. “My speech was very slow and slurred. My memory
and thinking was unreliable. I didn’t have the energy to live a normal
life. A good day for me was emptying the dishwasher.”
Scientists used to think the way our brain was wired could not be changed (Credit: Getty Images)
It
was around this time that she tried a new treatment called
neurofeedback. She was required to have her brain monitored while
playing a simple Pac-Man-like game, controlling movements by
manipulating her brain waves. “Within 10 sessions, my speech improved.”
But Debbie’s real turnaround happened when her neurofeedback counsellor
recommended a book: the international bestseller The Brain that Changes
Itself by Canadian psychotherapist Norman Doidge. “Oh my God,” she says.
“For the first time it really showed me it was possible to heal my
brain. Not only that it was possible, that it was up to me.”
You’re not stuck with the brain you’re born with – Debbie Hampton
After
reading Doidge’s book, Debbie began living what she calls a
“brain-healthy” life. That includes yoga, meditation, visualisation,
diet and the maintenance of a positive mental attitude. Today, she
co-owns a yoga studio, has written an autobiography and a guide to
“brain-healthy living” and runs the website thebestbrainpossible.com.
The science of neuroplasticity, she says, has taught her that, “You’re
not stuck with the brain you’re born with. You may be given certain
genes but what you do in your life changes your brain. And that’s the
magic wand.” Neuroplasticity, she says, “allows you to change your life
and make happiness a reality. You can go from being a victim to a
victor. It’s like a superpower. It’s like having X-ray vision.”
‘Series of miracles’
Debbie’s
not alone in her enthusiasm for neuroplasticity, which is what we call
the brain’s ability to change itself in response to things that happen
in our environment. Claims for its benefits are widespread and
startling. Half an hour on Google informs the curious browser that
neuroplasticity is a “magical” scientific discovery that shows that our
brains are not hard-wired like computers, as was once thought, but like
“Play-Doh” or a “gooey butter cake”. This means that “our thoughts can
change the structure and function of our brains” and that by doing
certain exercises we can actually, physically increase our brain’s
“strength, size and density”.
Neuroplasticity is a “series of
miracles happening in your own cranium” that means we can be better
salespeople and better athletes, and learn to love the taste of
broccoli. It can treat eating disorders, prevent cancer, lower our risk
of dementia by 60% and help us discover our “true essence of joy and
peace”. We can teach ourselves the “skill” of happiness and train our
brains to be “awesome”. And age is no limitation: neuroplasticity shows
that “our minds are designed to improve as we get older”. It doesn’t
even have to be difficult. “Simply by changing your route to work,
shopping at a different grocery store, or using your non-dominant hand
to comb your hair will increase your brain power.” As the celebrity
alternative-medicine guru Deepak Chopra has said, “most people think
that their brain is in charge of them. We say we are in charge of our
brain.”
Is the brain really as malleable as Play-Doh? Some advocates think so (Credit: Getty Images)
Debbie’s
story is a mystery. The techniques promising to change her brain via an
understanding of the principles of neuroplasticity have clearly had
tremendous positive effects for her. But is it true that neuroplasticity
is a superpower, like X-ray vision? Can we really increase the weight
of our brain just by thinking? Can we lower our risk of dementia by 60%?
And learn to love broccoli?
It’s hard, for the non-scientist to
understand what exactly neuroplasticity is and what its potential truly
is. “I’ve seen tremendous exaggeration,” says Greg Downey, an
anthropologist at Macquarie University and co-author of the popular blog
Neuroanthropology. “People are so excited about neuroplasticity they
talk themselves into believing anything.”
Gloomy prognosis
For
many years, the consensus was that the human brain couldn’t generate
new cells once it reached adulthood. Once you were grown, you entered a
state of neural decline. This was a view perhaps most famously expressed
by the so-called founder of modern neuroscience Santiago Ramon y Cajal.
After an early interest in plasticity, he became sceptical, writing in
1928, “In adult centres the nerve paths are something fixed, ended,
immutable. Everything may die, nothing may be regenerated. It is for the
science of the future to change, if possible, this harsh decree.”
Cajal’s gloomy prognosis was to rumble through the 20th Century.
Although
the notion that the adult brain could undergo significant positive
changes received sporadic attention, throughout the 20th Century, it was
generally overlooked, as a young psychologist called Ian Robertson was
to discover in 1980. He’d just begun working with people who had had
strokes at the Astley Ainslie Hospital in Edinburgh, and found himself
puzzled by what he was seeing. “I’d moved into what was a new field for
me, neuro-rehabilitation,” he says. At the hospital, he witnessed adults
receiving occupational therapy and physiotherapy. Which made him think…
if they’d had a stroke, that meant a part of their brain had been
destroyed. And if a part of their brain had been destroyed, everyone
knew it was gone forever. So how come these repetitive physical
therapies so often helped? It didn’t make sense. “I was trying to get my
head around, what was the model?” he says. “What was the theoretical
basis for all this activity here?” The people who answered him were, by
today’s standards, pessimistic.
Brains had rewired themselves in a radical and useful way that had long been thought impossible
“Their
whole philosophy was compensatory,” Robertson says. “They thought the
external therapies were just preventing further negative things
happening.” At one point, still baffled, he asked for a textbook that
explained how it all was supposed to work. “There was a chapter on
wheelchairs and a chapter on walking sticks,” he says. “But there was
nothing, absolutely nothing, on this notion that the therapy might
actually be influencing the physical reconnection of the brain. That
attitude really went back to Cajal. He really influenced the whole
mindset which said that the adult brain is hardwired, all you can do is
lose neurons, and that if you have brain damage all you can do is help
the surviving parts of the brain work around it.”
But Cajal’s
prognosis also contained a challenge. And it wasn’t until the 1960s that
the “science of the future” first began to rise to it. Two stubborn
pioneers, whose tales are recounted so effectively in Doidge’s
bestseller, were Paul Bach-y-Rita and Michael Merzenich.
Bach-y-Rita is perhaps best known for his work helping blind people
‘see’ in a new and radically different way. Rather than receiving
information about the world from the eyes, he wondered if they could
take it in in the form of vibrations on their skin. They’d sit on a
chair and lean back on a metal sheet. Pressing up against the back side
of that metal sheet were 400 plates that would vibrate in accord with
the way an object was moving. As Bach-y-Rita’s devices became more
sophisticated (the most recent version sits on the tongue), congenitally
blind people began to report having the experience of ‘seeing’ in three
dimensions. It wasn’t until the advent of brain-scanning technology
that scientists began to see evidence for this incredible hypothesis:
that information seemed to be being processed in the visual cortex.
Although this hypothesis is yet to be firmly established, it seems as if
their brains had rewired themselves in a radical and useful way that
had long been thought impossible.
Santiago
Ramon y Cajal believed an adult's nerve centres were fixed; they could
not regenerate but were doomed to die (Credit: Alamy)
Merzenich,
meanwhile, helped to confirm in the late 1960s that the brain contains
‘maps’ of the body and the outside world, and that these maps have the
ability to change. Next, he co-developed the cochlear implant, which
helped deaf people hear. This relies on the principle of plasticity, as
the brain needs to adapt to receive auditory information from the
artificial implant instead of the cochlea (which, in the deaf person,
isn’t working). In 1996 he helped establish a commercial company that
produces educational software products called Fast ForWord for
“enhancing the cognitive skills of children using repetitive exercises
that rely on plasticity to improve brain function,” according to their
website. As Doidge writes, “In some cases, people who have had a
lifetime of cognitive difficulties get better after only 30 to 60 hours
of treatment.”
Although it took several decades, Merzenich and
Bach-y-Rita were to help prove that Cajal and the scientific consensus
were wrong. The adult brain was plastic. It could rewire itself,
sometimes radically. This came as a surprise to experts like Robertson,
now a Director of Trinity College Dublin’s Institute of Neuroscience. “I
can look back on giving lectures at Edinburgh University to students
where I gave wrong information, based on the dogma which said that, once
dead, a brain cell cannot regenerate and plasticity happens in early
childhood but not later,” he says.
Rewired brains
It
wasn’t until the publication of a series of vivid studies involving
brain scans that this new truth began to be encoded into the synapses of
the masses. In 1995, neuropsychologist Thomas Elbert published his work
on string players that showed the ‘maps’ in their brain that
represented each finger of the left hand – which they used for fingering
– were enlarged compared to those of non-musicians (and compared to
their own right hands, not involved in fingering). This demonstrated
their brains had rewired themselves as a result of their many, many,
many hours of practice.
Three years later, a Swedish-American
team, led by Peter Eriksson of Sahlgrenska University Hospital,
published a study in Nature that showed, for the very first time, that
neurogenesis – the creation of new brain cells – was possible in adults.
In 2006, a team led by Eleanor Maguire at the Institute of Neurology at
University College London found that the city’s taxi drivers have more
grey matter in one hippocampal area than bus drivers, due to their
incredible spatial knowledge of London’s maze of streets. In 2007,
Doidge’s The Brain that Changes Itself was published. In its review of
the book, the New York Times proclaimed that “the power of positive
thinking has finally gained scientific credibility”. It went on to sell
more than one million copies in more than 100 countries. Suddenly,
neuroplasticity was everywhere.
I do think human beings have much more control over their brain function than has been appreciated – Ian Robertson
It’s
easy, and perhaps even fun, to be cynical about all this. But
neuroplasticity really is a remarkable thing. “What we do know is that
almost everything we do, all our behaviour, thoughts and emotions,
physically change our brains in a way that is underpinned by changes in
brain chemistry or function,” says Robertson. “Neuroplasticity is a
constant feature of the very essence of human behaviour.” This
understanding of the brain’s power, he says, opens up new techniques for
treating a potentially spectacular array of illnesses. “There’s
virtually no disease or injury, I believe, where the potential doesn’t
exist for very intelligent application of stimulation to the brain via
behaviour, possibly combined with other stimulation.”
Does he
agree that the power of positive thinking has now gained scientific
credibility? “My short answer is yes,” he says. “I do think human beings
have much more control over their brain function than has been
appreciated.” The long answer is: yes, but with caveats. First there’s
the influence of our genes. Surely, I ask Robertson, they still hold a
powerful influence over everything from our health to our character? “My
own crude rule of thumb is a 50–50 split in terms of the influence of
nature and that of nurture,” he says. “But we should be very positive
about that 50% that’s environmental.”
A
brain injury like a stroke will have a more pronounced effect on
someone older, research suggests (Credit: Science Photo Library)
Adding
extra tangle to the already confused public discussion of
neuroplasticity is the fact that the word itself can mean several
things. Broadly, says Sarah-Jayne Blakemore, Deputy Director of London’s
Institute of Cognitive Neuroscience, it refers to “the ability of the
brain to adapt to changing environmental stimuli”. But the brain can
adapt in many different ways. Neuroplasticity can refer to structural
changes, such as when neurons are created or die off or when synaptic
connections are created, strengthened or pruned. It can also refer to
functional reorganisations, such as those experienced by the blind
patients of Paul Bach-y-Rita, whose contraptions triggered their brains
to start using their visual cortices.
On the larger, developmental
scale, there are two categories of neuroplasticity. They are “really
different,” says Blakemore. “You need to differentiate between them.”
Throughout childhood our brains undergo a phase of
‘experience-expectant’ plasticity. They ‘expect’ to learn certain
important things from the environment, at certain stages, such as how to
speak. Our brains don’t finish developing in this way until around our
mid-20s. “That’s why car insurance premiums are so high for people under
25,” says Robertson. “Their frontal lobes aren’t fully wired up to the
rest of their brains until then. Their whole capacity for anticipating
risk and impulsivity isn’t there.” Then there’s ‘experience-dependent’
plasticity. “That’s what the brain does whenever we learn something, or
whenever something changes in the environment,” says Blakemore.
If you don't like broccoli, you can't necessarily train your brain to find it delicious (Credit: Jeremy Keith/Flickr/CC_BY_2.0)
This,
then, is the truth about neuroplasticity: it does exist, and it does
work. But it’s not a miracle discovery that means that, with a little
effort, you can turn yourself into a broccoli-loving, marathon-running,
disease-immune, super-awesome genius. The “deep question”, says Chris
McManus, Professor of Psychology and Medical Education at University
College London, is this: “Why do people, even scientists, want to
believe all this?” Curious about the underlying causes of the
neuroplasticity craze, he believes it is just the latest version of the
personal-transformation myth that’s been haunting the culture of the
West for generations.
This myth – that we can be whoever we want to be, and achieve our dreams, as long as we have sufficient self-belief – emerges again and again
“People
have all sorts of dreams and fantasies and I don’t think we’re very
good at achieving them,” says McManus. “But we like to think that when
somebody is unsuccessful in life they can transform themselves and
become successful. It’s Samuel Smiles, isn’t it? That book he wrote,
Self-Help, was the positive thinking of Victorian times.”
Samuel
Smiles [Full disclosure: Samuel Smiles is my great-great-uncle] is
commonly cited as the inventor of the ’self-help’ movement and his book,
just like Doidge’s, spoke to something deep in the population and
became a surprise bestseller. The optimistic message Smiles delivered
spoke of both the new, modern world and the dreams of the men and women
living in it. “In the 18th Century, power had all been about the landed
gentry,” says historian Kate Williams. “Smiles was writing in the era of
the Industrial Revolution, widespread education and economic
opportunities offered by Empire. It was the first time a middle-class
man could work hard and do well. They needed a formidable work ethic to
succeed, and that’s what Smiles codified in Self-Help.”
The myth that we can be whatever we want to be is reinforced by the media (Credit: Getty Images)
In
the latter part of the 19th Century, US thinkers adapted this idea to
reflect their national belief that they were creating a new world.
Adherents of the New Thought, Christian Science and Metaphysical Healing
movements stripped away much of the talk of hard work, insisted upon by
the Brits, to create the ‘positive thinking movement’ to which some
believe neuroplasticity has given scientific credence. Psychologist
William James called it “the mind-cure movement”, the “intuitive belief
in the all-saving power of healthy-minded attitudes as such, in the
conquering efficacy of courage, hope, and trust, and a correlative
contempt for doubt, fear, worry, and all nervously precautionary states
of mind”. Here was the inherently American notion that self-confidence
and optimism – thoughts themselves – could offer personal salvation.
This
myth – that we can be whoever we want to be, and achieve our dreams, as
long as we have sufficient self-belief – emerges again and again, in
our novels, films and news, and TV singing competitions featuring Simon
Cowell, as well as unexpected crazes like that for neuroplasticity. One
previous, and remarkably similar, incarnation was Neuro-Linguistic
Programming, which had it that psychological conditions such as
depression were nothing more than patterns learned by the brain and that
success and happiness were just a matter of reprogramming it. The idea
appeared in a more academic costume, according to McManus, in the form
of what’s known as the Standard Social Science Model. “This is the idea from the 1990s where, in effect, all human behaviour is infinitely malleable and genes play no role at all.”
It’s a really exciting science, but to say these things are going to totally rewire your whole brain and gene functioning is taking it far too far – Jonathan Mill
But
the plasticity boosters have an answer to the tricky question of genes,
and their heavy influence over all matters of health, life and
wellbeing. Their answer is epigenetics. This is the relatively new
understanding of the ways in which the environment can change how genes
express themselves. Deepak Chopra has said that epigenetics has shown us
that “regardless of the nature of the genes we inherit from our
parents, dynamic change at this level allows us almost unlimited
influence on our fate”.
Jonathan Mill, Professor of Epigenetics at
the University of Exeter, dismisses this kind of claim as “babble”.
“It’s a really exciting science,” he says, “but to say these things are
going to totally rewire your whole brain and gene functioning is taking
it far too far.” And it’s not just Chopra, he adds. Broadsheet
newspapers and academic journals have also been guilty, at times, of
falling for the myth. “There have been all sorts of amazingly overhyped
headlines. People who have been doing epigenetics for a while are almost
in despair, at the moment, partly because it’s being used as an
explanation for all sorts of things without any real direct evidence.”
Are we putting too much faith in stories of miracle recoveries from life-changing injuries? (Credit: Getty Images)
Just
as epigenetics doesn’t fulfil our culture’s promise of personal
transformation, nor does neuroplasticity. Even some of the more
credible-sounding claims are, according to Ian Robertson, currently
unjustifiable. Take the one about reducing our risk of dementia by 60%.
“There is not a single scientific study that has ever shown that any
intervention of any kind can reduce the risk of dementia by 60%, or
indeed by any percentage,” he says. “No one has done the research using
appropriate control-group methodologies to show that there is any
cause-and-effect link.”
Indeed, the clinical record for many
famous treatments that use the principles of neuroplasticity is notably
mixed. In June 2015, the Food and Drug Administration in the US
permitted the marketing of the latest iteration of Bach-y-Rita’s
on-the-tongue ‘seeing’ devices for the blind, citing successful studies.
And yet a 2015 Cochrane Review of constrain-induced movement therapy – a
touchstone treatment for neuroplasticity evangelists that offers
improvements in motor impairment and motor function for people who have
had a stroke – found that “these benefits did not convincingly reduce
disability”. A 2011 meta-analysis of neuroplasticity Godfather Michael
Merzenich’s Fast ForWord learning techniques, described to such
thrilling effect by Doidge, found “no evidence” that they were
“effective as a treatment for children’s oral language or reading
difficulties”.
False hopes
This, according
to Sophie Scott, goes for other treatments too. “There’s been a lot of
excitement about brain-training packages and, actually, big studies of
those tend not to show very much effect,” she says. ”Or they show you’ve
got better at the thing you’ve practised at, but it doesn’t generalise
to something else.” In November 2015, a team lead by Clive Ballard at
King’s College London found some evidence that online brain-training
games might help reasoning, attention and memory in the over-50s.
It’s
perhaps understandable why crazy levels of hope are raised when people
read tales of apparently miraculous recovery from brain injury that
feature people seeing again, hearing again, walking again and so on.
These dramatic accounts can make it sound as if anything is
possible. But what’s usually being described, in these instances, is a
very specific form of neuroplasticity – functional reorganisation –
which can happen only in certain circumstances. “The limits are partly
architectural,” says Greg Downey. “Certain parts of the brain are better
at doing certain kinds of thing, and part of that comes simply from
where they are.”
A brain injury at 25 is a total different ballgame to a brain injury at seven – Greg Downey
Another
limitation, for the person hoping to develop a superpower, is the
simple fact that every part of a normal brain is already occupied. “The
reason you get reorganisation after an amputation, for example, is that
you’ve just put into unemployment a section of the somatosensory
cortex,” he says. A healthy brain just doesn’t have this available real
estate. “Because it keeps getting used for what it’s being used for, you
can’t train it to do something else. It’s already doing something.”
Age,
too, presents a problem. “Over time, plastic sets,” says Downey. “You
start off with more of it and space for movement slowly decreases.
That’s why a brain injury at 25 is a total different ballgame to a brain
injury at seven. Plasticity says you start off with a lot of potential
but you’re laying down a future that’s going to become increasingly
determined by what you’ve done before.”
If
you have lost the use of an arm, it will take tens of thousands of
attempts to remap the neural pathways to use it again (Credit: Getty
Images)
Robertson
speaks of treating a famous writer and historian who’d had a stroke.
“He completely lost the capacity for all expressive language,” he says.
“He couldn’t say a word, he couldn’t write. He had a huge amount of
therapy and no amount of stimulation could really recover that because
the brain had become hyper-specialised and a whole network had developed
for the highly refined production of language.” Despite what the
currents of our culture might insistently beckon us towards believing,
the brain is not Play-Doh. “You can’t open up new areas of it,” says
McManus. “You can’t extend it into different parts. The brain isn’t a
mass of grey gloop. You can’t do anything you like.”
Even the
people whose lives are being transformed by neuroplasticity are finding
that brain change is anything but easy. Take recovery from a stroke. “If
you’re going to recover the use of an arm, you may need to move that
arm tens of thousands of times before it begins to learn new neural
pathways to do that,” says Downey. “And, after that, there’s no
guarantee it’s going to work.” Scott says something similar about speech
and language therapy. “There were dark days say, 50 years ago, where if
you’d had a stroke you didn’t get that kind of treatment other than to
stop you choking because they’d decided it doesn’t work. But now it’s
becoming absolutely clear that it does, and that it’s a phenomenally
good thing. But none of it comes for free.”