2011 Holiday Newsletter Addendum

I ran out of room for my Holiday Newsletter...so here's some of the rest of what I wanted to include.

A little more information about how your brain works and changes. These are somewhat in a random order, but I think you will find the quotes very interesting. All are from Dr. Norman Doidge's "The Brain That Changes Itself" and are referenced by page. If you find the following factoids interesting, you should also check out the lectures from the latest Nobel Conference, which can be linked by clicking HERE (I personally recommend the lectures by Patel, Ramachandran, Young, and Donahue).

“When we wish to perfect our senses, neuroplasticity is a blessing; when it works in the service of pain, plasticity can be a curse.” (177)

V.S. Ramachandran “...shows us that we can rewire our brains through comparatively brief, painless treatments that use imagination and perception.” (178)

“Normal pain, “acute pain, “ alerts us to injury or disease by sending a signal to the brain, saying, “This is where you are hurt—attend to it”. But sometimes an injury can damage both our bodily tissues and the nerves in our pain systems, resulting in “neuropathic pain, “, for which there is no external cause. Our pain maps get damaged and fire incessant false alarms, making us believe the problem is in our body when it is in our brain. Long after the body has healed, the pain system is still firing and the acute pain has developed an afterlife.” (180)

“...skin, of course, conveys far more than touch; it has distinct receptors that detect temperature, vibration, and pain as well, each with its own nerve fibers that travel up to the brain, where they have their own maps, some of which are very near each other. Sometimes after an injury, because the nerves for touch, temperature, and pain are so close together, there can be cross-wiring errors.” (183)

“...brain maps are dynamic and changing: even under normal circumstances, as Merzenich showed, face maps tend to move around a bit in the brain.” (183)

“Pain and body image are closely related. We always experience pain as projected into the body. When you throw your back out, you say “My back is killing me!” and not, “My pain system is killing me.” But as phantom [limbs] show, we don’t need a body part or even pain receptors to feel pain. We need only a body image, produced by our brain maps. People with actual limbs don’t usually realize this, because the body images of our limbs are perfectly projected onto our actual limbs, making it impossible to distinguish our body image from our body.” (188)

“fMRI brain scans show that during the placebo effect the brain turns down its own pain-responsive regions.” (191)

“How much pain we feel is determined in significant part by our brains and minds—our current mood, our past experiences of pain, our psychology, and how serious we think our injury is.” (191)

“...important pain maps in the spinal cord can change following injury, and that a chronic injury can make the cells in the pain system fire more easily—a plastic alteration—making a person hypersensitive to pain. Maps can also enlarge their receptive field, coming to represent more of the body’s surface, increasing pain sensitivity.” (191)

“Sometimes a single pain signal reverberates throughout the brain, so that pain persists even after its original stimulus has stopped.” (191-192)

When the brain associates pain with movement, it will send signals to “guard” the movement, but with plasticity it also “learns” to associate pain with movement, so they can get cross-wired (and lead to a pain disorder called “reflex sympathetic dystrophy” or RSD.

For chronic pain and/or perceived paralysis (like after some types of stroke), studies are showing marked improvements with 4 to 12 weeks of daily “imagining” of the limbs moving; patients are using Ramachandran’s mirror boxes and/or visual images of the affected limbs.  G. L. Moseley asked his RSD patients to “...simply imagine moving their painful limbs, without executing the movements, in order to activate brain networks for movement. The patients also looked at pictures of hands, to determine whether they were the left or right, until they could identify them quickly and accurately—a task known to activate the motor cortex. ...with twelve weeks of therapy, pain had diminished in some and had disappeared in half.” (194)

“Think how remarkable this is—for a most excruciating, chronic pain, a whole new treatment that uses imagination and illusion to restructure brain maps plastically without medication, needles, or electricity.”(194)

“One reason we can change our brains simply by imagining is that, from a neuroscientific point of view, imagining an act and doing it are not as different as they sound… Brain scans show that in action and imagination many of the same parts of the brain are activated. This is why visualizing can improve performance.” (204)

A study by Drs. Guang Yue and Kelly Cole “...showed that imagining using one’s muscles actually strengthens them.” They had two groups, one that actually exercised a particular finger muscle, and one that only imagined moving the muscle. Both groups “exercised” the same amount of time over a four week period. “At the end of the study the subjects who had done physical exercise increased their muscular strength by 30 percent…[and] those who only imagined doing the exercise, for the same period, increase their muscle strength by 22 percent.”

“[Dr. Michael] Merzenic discovered that paying close attention is essential to long-term plastic change. In numerous experiments he found that last changes occurred only when his monkeys paid close attention. When the animals performed tasks automatically, without paying attention, they changed their brain maps, but the changes did not last.” (68)

Jeffrey M. Schwartz uses neuroplastic therapies to help his patients get past obsessive, habitual thoughts “...by paying constant, effortful attention and actively focusing on something besides the worry, such as a new, pleasurable activity. This approach makes plastic sense because it “grows” a new brain circuit that gives pleasure and triggers dopamine release which...rewards the new activity and consolidates and grows new neuronal connections. This new circuit can eventually compete with the older one, and according to “use it or lose it”, the pathological networks will weaken. With this treatment we don’t so much “break” bad habits as replace bad behaviors with better ones.” (170) He has his patients acknowledge their discomfort, and then refocus on a positive activity by doing something else. “It is essential to do something, to “shift” the gear manually.” (172)

“Each moment [a patient] spends thinking of the symptom—[such as] believing that germs are threatening them—they deepen the obsessive circuit. By bypassing it, they are on the road to losing it.” (173)

Alvaro Pascual-Leone explains habits with a metaphor. “The plastic brain is like a snowy hill in winter. Aspects of that hill—the slope, the rocks, the consistency of the snow—are like our genes, a given. When we slide down on a sled, we can steer it and will end up at the bottom of the hill by following a path determined both by how we steer and the characteristics of the hill. Where exactly we will end up is hard to predict because there are so many factors in play. “But, what will definitely happen the second time you take the slope down is that you will more likely than not find yourself somewhere or another that is related to the path you took the first time. It won’t be exactly that path, but it will be closer to that one than any other. And if you spend your entire afternoon sledding down, walking up, sldeeing down, at the end you will have some paths that have been used a lot, some that have been used very little...and there will be tracks that you have created, and it is very difficult now to get out of those tracks. And those tracks are not genetically determined anymore.”  The mental “tracks” that get laid down can lead to habits, good or bad… Is it possible, once “tracks” or neural pathways have been laid down, to get out of those paths and onto different ones? Yes, according to Pascual-Leone, but it is difficult because, once we have created these tracks, they become “really speedy” and very efficient at guiding the sled down the hill. To take a different path becomes increasingly difficult. A roadblock of some kind is necessary to help us change direction.” (209-210)

Some other online resources I visited:

http://en.wikipedia.org/wiki/Emotional_Freedom_Technique 

“EFT has the goal of desensitization, and utilizes the tapping of points while a client focuses on a specific issue. It was derived fromThought Field Therapy by Gary Craig, aneuro-linguistic programming practitioner who gave the technique away freely in an online manual. “

http://en.wikipedia.org/wiki/Eye_movement_desensitization_and_reprocessing 

“developed byFrancine Shapiro[1][2]resolve the development oftrauma-related disorders caused by exposure to distressing events such asmilitary. According to Shapiro's theory,[1]a traumatic or distressing experience occurs, it may overwhelm usual cognitive and neurologicalcoping mechanisms. The memory and associated stimuli of the event are inadequately processed, and are dysfunctionally stored in an isolated memory network. The goal of EMDR therapy is to process these distressing memories, reducing their lingering influence and allowing clients to develop more adaptive coping mechanisms. “  is thought that the distressing memory is transformed when new connections are forged with more positive and realistic information. This results in a transformation of the emotional, sensory, and cognitive components of the memory; when the memory is accessed, the individual is no longer distressed. Instead he/she recalls the incident with a new perspective, new insight, resolution of the cognitive distortions, elimination of emotional distress, and relief of relatedphysiological arousal. “

The challenge in acceptance of both of these techniques lies in anecdotal evidence.

Some anecdotal evidence does not qualify as scientific evidence because its nature prevents it from being investigated using the scientific method. 

http://en.wikipedia.org/wiki/Neuro-linguistic_programming 

“Fourth, assisting the client in achieving the desired outcomes by using certain tools and techniques to change internal representations and responses to stimuli in the world.[32][33]tools and techniques include indirect suggestion from the Milton model,, and. Finally, the changes are "future paced" by helping the client to mentally rehearse and integrate the changes into the his or her life.[30]example, the client may be asked to "step into the future" and represent (mentally see, hear and feel) what it is like having already achieved the outcome. “

http://en.wikipedia.org/wiki/Hypnosis 

Pain management

A number of studies show that hypnosis can reduce the pain experienced during burn-wound debridement, bone marrow aspirations, and childbirth. TheInternational Journal of Clinical and Experimental Hypnosisthat hypnosis relieved the pain of 75% of 933 subjects participating in 27 different experiments.[53]

In 1996, theNational Institutes of Health found hypnosis effective in reducing pain from cancer and other chronic conditions.[53]and other symptoms related to incurable diseases may also be managed with hypnosis.[62][63][64][65]example, research done at the Mount Sinai School of Medicine studying two patient groups facing breast cancer surgery. The group that received hypnosis reported less pain, nausea, and anxiety post-surgery. The average hypnosis patient reduced treatment costs by an average $772.00.[66][67]

TheAmerican Psychological Association conducted a study comparing the effects of hypnosis, ordinary suggestion and placebo in reducing pain. The study found that highly suggestible individuals experienced a greater reduction in pain from hypnosis compared with placebo, whereas less suggestible subjects experienced no pain reduction from hypnosis when compared with placebo. Ordinary non-hypnotic suggestion also caused reduction in pain compared to placebo, but was able to reduce pain in a wider range of subjects (both high and low suggestible) than hypnosis. The results showed that it is primarily the subject's responsiveness to suggestion, whether within the context of hypnosis or not, that is the main determinant of causing reduction in pain.[68]